The "Skubal Scope" Is Now Available in Los Angeles. Here's What You Need to Know.
If you follow baseball, you have heard about it. Detroit Tigers ace Tarik Skubal — two-time Cy Young Award winner — needed elbow surgery in May 2025 to remove a loose body. The typical recovery for that procedure is two to three months. Skubal was throwing bullpen sessions within weeks.
The reason: he was the first major league baseball player to undergo surgery using the Arthrex NanoNeedle™ Scope 2.0 — a revolutionary arthroscopic technology that is fundamentally changing what elbow surgery looks like and how quickly athletes recover from it. Within days, Blake Snell of the Los Angeles Dodgers underwent the same procedure on his pitching elbow.
The sports world is paying attention. Parents of young baseball players are searching for surgeons who offer this technology. Dr. Raffy Mirzayan is one of them — and he brings something that very few surgeons offering this technology can match: 25 years of elbow surgery experience, more than 1,000 elbow arthroscopies performed, and hundreds of Tommy John surgeries on baseball players at every level.
The NanoNeedle Scope 2.0 is a powerful tool. In the hands of an experienced elbow specialist, it is transformative.
Call to schedule a consultation.
What Is the NanoNeedle Scope 2.0?
Traditional elbow arthroscopy uses a scope approximately 4 millimeters in diameter — about the width of a pencil. The surgeon must make incisions large enough to accommodate that instrument, push through layers of tissue, and pump significant fluid into the joint to create visualization. The result is measurable tissue disruption: bleeding, swelling, scarring, and inflammation that extend recovery time significantly.
The Arthrex NanoNeedle™ Scope 2.0 changes all of that. It is just 1.9 millimeters in diameter — less than half the size of a traditional arthroscope. The entry point is described by surgeons as feeling more like an IV poke than a surgical incision. The scope glides to the target site with minimal tissue disruption, requires approximately 65% less fluid to insufflate the joint, and leaves incisions so small they are difficult to find days after surgery.
The technology at the tip of this needle-sized instrument is remarkable: a "chip-on-tip" high-resolution camera with 720×720 resolution — a 224% increase in pixel density over its predecessor — delivering visualization that rivals a traditional arthroscope at a fraction of the tissue cost. The result is less nerve damage, less pain, less swelling, less scarring, and a meaningfully faster recovery.
This is not experimental technology. The NanoNeedle Scope has been in clinical use since 2019 and has FDA clearance. The 2.0 version represents a significant upgrade in imaging quality and performance. Dr. Mirzayan is an Arthrex consultant and educator — the same company that manufactures and developed this technology.
Why the Surgeon Behind the Scope Matters
Dr. Mirzayan has been performing elbow arthroscopy for 25 years. He has completed more than 1,000 elbow arthroscopic procedures and hundreds of Tommy John surgeries on baseball players ranging from high school athletes to professionals. He has cared for overhead throwing athletes his entire career — understanding not just the anatomy of the elbow, but the biomechanical demands of pitching, the unique injury patterns of the throwing athlete, and what it takes to get a pitcher back on the mound performing at full capacity.
The elbow is one of the most technically demanding joints to operate on arthroscopically. Important neurovascular structures — including the ulnar nerve — lie in close proximity to the surgical field, and the smaller working space compared to the shoulder or knee means that surgical precision is not optional. It is essential. Published complication data show nerve injury rates ranging from 0.5% to over 10% in elbow arthroscopy series. Dr. Mirzayan co-authored one of the largest elbow arthroscopy complication studies in the medical literature, published in Arthroscopy: The Journal of Arthroscopic and Related Surgery, analyzing 560 consecutive elbow arthroscopies across 42 surgeons — and found an overall nerve injury rate of 3.5% across the broader surgeon group. In his own personal series of more than 1,000 elbow arthroscopies, Dr. Mirzayan has never had a single nerve or vascular injury. That record reflects not just technical skill, but a deep familiarity with elbow anatomy that only comes from a career dedicated to this joint.
When Dr. Mirzayan uses the NanoNeedle Scope 2.0, he is combining the most advanced visualization technology available with a depth of elbow-specific experience that is genuinely rare. That combination — technology plus expertise — is what produces outcomes like Tarik Skubal's.
What Conditions Can Be Treated with the NanoNeedle Scope?
Dr. Mirzayan uses the NanoNeedle Scope 2.0 for a range of elbow conditions, including:
Loose bodies in the elbow — exactly what Skubal and Snell had removed. Loose bodies are fragments of bone or cartilage that have broken free inside the joint, causing pain, catching, locking, and loss of full extension. They are common in throwing athletes and gymnasts. Traditionally, removing them required a standard arthroscopy with a weeks-long recovery. With the NanoNeedle Scope, the disruption is dramatically reduced.
Osteochondritis dissecans (OCD) of the capitellum — a cartilage condition seen in young baseball players and gymnasts. The NanoNeedle Scope is particularly well suited to the tight anatomy of the radiocapitellar joint, and its reduced fluid requirements help protect cartilage during the procedure.
Elbow synovitis and inflammation — chronic inflammation of the joint lining that causes pain and stiffness in throwing athletes.
Diagnostic arthroscopy — when imaging alone is inconclusive, the NanoNeedle Scope allows Dr. Mirzayan to directly visualize the interior of the elbow with minimal disruption, providing information that MRI cannot always capture.
Pediatric elbow conditions — the NanoNeedle Scope 2.0 has FDA clearance specifically for pediatric orthopedics and is the first arthroscopic camera designed to provide a sterile, minimally invasive option for young patients with small, immature joints. For teenage baseball players with OCD lesions or loose bodies, this is a meaningful advance.
The Recovery Difference
The numbers tell the story clearly.
Traditional elbow arthroscopy for loose body removal: two to three months before a pitcher can return to throwing at full intensity.
Tarik Skubal with the NanoNeedle Scope 2.0: throwing bullpen sessions within weeks of surgery, on pace to return well ahead of the standard timeline.
Connor Hellebuyck of the Winnipeg Jets underwent NanoNeedle Scope surgery to remove a Baker's cyst from his knee. Standard recovery: four to six weeks. Hellebuyck returned to full strength in three weeks.
The reason is straightforward: less tissue disruption means less inflammation, less swelling, and less healing time before rehabilitation can begin in earnest. When a pitcher does not have to rebuild arm strength from scratch after surgery — because the surrounding tissue was not significantly disturbed — the return-to-sport timeline compresses dramatically.
For a high school pitcher trying to protect a recruitment season, a college player on scholarship, or a professional athlete with contractual obligations, that difference is not academic. It is career-defining.
For Baseball Families Traveling to Los Angeles
Baseball is played year-round in Texas, Florida, Arizona, Georgia, and Nevada. The travel ball and showcase circuit — Perfect Game, USSSA, and similar events — means that families are already accustomed to traveling across the country for the sport. When a young pitcher needs elbow surgery, the question should not be "who is the closest surgeon?" It should be "who is the best surgeon for this specific procedure?"
Dr. Mirzayan regularly treats out-of-state patients from across the country. He is an out-of-network provider, but most patients with commercial insurance — Blue Cross Blue Shield PPO, Aetna, Cigna, United Healthcare, and similar plans — have strong out-of-network benefits that significantly reduce out-of-pocket costs. In many cases, the difference between seeing Dr. Mirzayan and seeing a local in-network surgeon is smaller than families expect. Dr. Mirzayan's office will gladly walk you though this process so you are at ease with your finances.
Virtual consultations are available so you can meet Dr. Mirzayan, review your imaging together, and determine the right path forward — before committing to travel.
Call or visit raffymirzayan.com to schedule a virtual or in-person consultation.
Frequently Asked Questions
Is the NanoNeedle Scope the Same Procedure Tarik Skubal had?
Yes. The Arthrex NanoNeedle™ Scope 2.0 — which Skubal's agent Scott Boras dubbed the "Skubal Scope" — is the same technology Dr. Mirzayan uses. Skubal's surgery was performed by Dr. Neal ElAttrache. Blake Snell of the Dodgers subsequently underwent the same procedure. Dr. Mirzayan is an Arthrex consultant and educator with access to and training on this technology.
Is This Experimental?
No. The NanoNeedle Scope has been in clinical use since 2019. The 2.0 version has FDA clearance including for pediatric orthopedics. Skubal's case brought national attention to the technology, but it is an established platform with a clinical track record.
How Does the Recovery Compare to Traditional Elbow Arthroscopy?
Significantly faster in most cases. Because the instrument is less than half the diameter of a traditional scope, requires far less fluid, and causes dramatically less tissue disruption, patients experience less swelling, less pain, and less post-operative inflammation — all of which compress the recovery timeline.
Is My Child a Candidate if They Are a Young Baseball Player?
Possibly. The NanoNeedle Scope 2.0 received FDA clearance specifically for pediatric orthopedics and is well suited to the smaller joint spaces of young athletes. Dr. Mirzayan will evaluate your child's imaging and clinical presentation to determine whether this approach is appropriate.
Do I Need to Come to Los Angeles for a Consultation First?
Not necessarily. Dr. Mirzayan offers virtual consultations for out-of-state patients. You can submit your imaging and records, meet with Dr. Mirzayan by video, and determine together whether surgery is indicated and what the next steps are — before booking travel.
Does Insurance Cover This Procedure?
Dr. Mirzayan is an out-of-network provider. Most patients with commercial insurance have great out-of-network benefits that cover a meaningful portion if not all of the surgical cost. Dr. Mirzayan's office will verify your benefits and walk you through expected costs before you make any decisions. Call (310) 746-5918 for more information.
What Makes Dr. Mirzayan Different From Other Surgeons offering This Technology?
The NanoNeedle Scope 2.0 is available to any surgeon who purchases the system. What is not transferable is 25 years of elbow-specific surgical experience, more than 1,000 elbow arthroscopies, hundreds of Tommy John surgeries, and a career dedicated to the overhead throwing athlete. The technology amplifies expertise — it does not replace it.
Dr. Raffy Mirzayan is a double-board certified orthopedic sports medicine surgeon at DOCS Health, 8436 W 3rd St #800, Los Angeles, CA 90048. He is a Clinical Professor of Orthopaedic Surgery at USC and an Arthrex consultant and educator. To schedule a consultation, call or visit raffymirzayan.com.
