Retractor (surgery)

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Retractors ( lat. Retrahere "to withdraw") are a group of surgical instruments with the help of which access to the surgical field is kept open or even made possible in the first place.

Classification

The term describes a large group of sometimes very different instruments.

Retractors are used in various forms: blunt and rounded, in various shapes and sizes, they are used to hold sensitive tissues and organs such as intestines , liver , lungs and others aside . Typical representatives are the Roux hook, the Langenbeck hook or the Fritsch hook. Sharp and pointed, as “single-pronged” or multi-pronged “sharp hooks”, also “rake hooks”, they are used to precisely distinguish less sensitive connective tissue.

Specula , from Latin speculum - mirror (plur.), Are used to hold open natural body openings such as the vagina , anus , nose or ear canal . Specula can also be equipped with a spreading mechanism (e.g. Park's anal speculum) and / or a light source in order to ensure sufficient visibility in the depths of the body opening. Another important example is the laryngoscope .

With a snap-in system, retractors (e.g. the rib spreader ) allow the wound to be spread with varying degrees of force depending on the area of ​​application, and keep the access route passively open after it has snapped into place.

Lever and forceps are used in orthopedic and trauma surgery on the one hand, access to the bone to ensure, on the other hand also furnished fracture until the completion of fixation to keep in exact position. Typical representatives are the Hohmann lever and the Verbruegge pliers.

Clinical use

Use of a retractor system in a thyroid operation

Until recently, major operations were usually carried out by a surgeon and two assistants. The second assistant (usually a young professional, occasionally also an operating theater nurse or student) was then given the task of keeping the operating area open with the help of the respective retractors.

The increasing intensification of work in the health care system, however, barely allows such generous use of personnel, which is why more and more rigid brackets to which the required retractors can be attached in a freely selectable manner (so-called retractor systems ) are being used instead of the second assistant.

See also