Retractors; an Insight

What are Retractors? As the name suggest these devices are designed to hold tissue or the edges of the incision during surgical procedures. The human body is composed of variety of tissues and organs that overlap each other at various angles. Hence the main objective of the retractors is to clear the surgical field, so the surgeon has the proper view of the structure he/she is working on.

The retractors are usually used during all types of surgical procedures and are most useful when the surgeon is working in a close vicinity i.e. close cavity such as pelvis, or any organ that is placed deeply.

The retractors can be broadly classified in to two groups with respect to its making,

  1. Hand held Retractor
  2. Self retaining Retractor

Hand held Retractor:

Hand-held-Retractors

 

This type of retractor requires an extra hand to hold the instrument in place while the surgeon works in the operating field. The experience may lead the surgeon’s assistant to feel numb. Generally hand held retractors are composed of a blade that may be flat, curved or hook-like with a broad handle so as to be held by hands. They may be used in pair to retract the incised skin in opposite direction. The hand held retractors are designed to be non traumatic.

Caution: If excessive force is applied during retraction with the help of handheld retractor it may cause tissue damage.

Self-retaining Retractor:

Self-retaining-Retractor

This retractor is designed usually with a ratchet mechanism and no assistance is needed to hold it continuously. The retractor often has two blades which are opened manually but are held in place with the help of a lock. Therefore after incising the skin or tissue, the retractor is introduced in the wound and is opened by the surgeon or assistant. When the blades are apart the instrument is locked and held in place without any further aid.

Certain Considerations:

  1. Wet saline gauze should be used to pad the delicate structure or tissue which is being held with the help of the retractor. Since the surgical procedure may be prolonged leading to tissue desiccation and trauma due to friction.
  2. As mentioned above using hand-held retractor may be a tiring drill for the individuals, sponge pad may be used to ease up the numbness and fatigue.

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