Retractor (medical)
Encyclopedia
A retractor is a surgical instrument by which a surgeon can either actively separate the edges of a surgical incision or wound, or can hold back underlying organs and tissues, so that body parts under the incision may be accessed. The two are each available in many shapes, sizes, and styles. The general term retractor usually describes a simple handheld steel tool possessing a curved, hooked, or angled blade fitted with a comfortable handle, that when in place maintains the desired position of a given region of tissue. These simple retractors may be handheld, clamped in situ, or suspended at the end of a robotic arm. Retractors can also be self retaining and not need to be held once inserted by having two or more opposing blades or hooks which are separated via spring, ratchet, worm gear or some other method and pull on opposite sides of a wound. The term retractor is also used to describe the distinct, hand-cranked devices such as rib spreaders (also known as thoracic retractors, or distractors) with which surgeons may forcefully drive tissues apart to obtain the exposure. For specialized situations such as spinal surgery retractors have been fitted both with suction and with fiberoptic lights to keep a surgical wound dry and illuminated.
. Branches or antlers of various shapes were used to dig and extract food from the ground. As the use of tools evolved, a variety of instruments came about to substitute for the use of hooked or grasping fingers in the butchering of meat or dissection of bodies. The use of metals in tool making was of great importance. A variety of Roman metal instruments of the hook and retractor family have been found by archeologists. These instruments would generally be called hooks if the end was as narrow as the handle of the instrument. If the end was broad, it would be called a retractor. Also arising from this group of tools were other related tools for displacing (elevators and spatulas) and scooping (spoons and curettes).
In a description of the procedure of tonsillectomy from the 7th century CE, Paul of Aegina
documents the use of a tongue spatula to keep the tongue out of the way while a form of tonsil hook is used to bring the tonsil forward for excision.
In 1000 CE Abu al-Qasim al-Zahrawi, also known as Albucasis or Abulcasis, described a variety of surgical instruments including retractors in his famous text Al-Tasrif
.
Vesalius
described a variety of hooks and retractors in the 16th century.
Jan Mikulicz-Radecki's invention of a hinged rib spreading retractor in 1904 prompted a flurry of development of distractors in the early 20th century, culminating in 1936 in our modern device based on the design of Enrique Finochietto
.
HAND HELD RETRACTORS
SELF RETAINING RETRACTORS
History
Surgical retractors probably originate with very basic tool use in the Stone AgeStone Age
The Stone Age is a broad prehistoric period, lasting about 2.5 million years , during which humans and their predecessor species in the genus Homo, as well as the earlier partly contemporary genera Australopithecus and Paranthropus, widely used exclusively stone as their hard material in the...
. Branches or antlers of various shapes were used to dig and extract food from the ground. As the use of tools evolved, a variety of instruments came about to substitute for the use of hooked or grasping fingers in the butchering of meat or dissection of bodies. The use of metals in tool making was of great importance. A variety of Roman metal instruments of the hook and retractor family have been found by archeologists. These instruments would generally be called hooks if the end was as narrow as the handle of the instrument. If the end was broad, it would be called a retractor. Also arising from this group of tools were other related tools for displacing (elevators and spatulas) and scooping (spoons and curettes).
In a description of the procedure of tonsillectomy from the 7th century CE, Paul of Aegina
Paul of Aegina
Paul of Aegina or Paulus Aegineta was a 7th-century Byzantine Greek physician best known for writing the medical encyclopedia Medical Compendium in Seven Books...
documents the use of a tongue spatula to keep the tongue out of the way while a form of tonsil hook is used to bring the tonsil forward for excision.
In 1000 CE Abu al-Qasim al-Zahrawi, also known as Albucasis or Abulcasis, described a variety of surgical instruments including retractors in his famous text Al-Tasrif
Al-Tasrif
The Kitab al-Tasrif was an Arabic encyclopedia on medicine and surgery, written near the year 1000 by Abu al-Qasim al-Zahrawi...
.
Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...
described a variety of hooks and retractors in the 16th century.
Jan Mikulicz-Radecki's invention of a hinged rib spreading retractor in 1904 prompted a flurry of development of distractors in the early 20th century, culminating in 1936 in our modern device based on the design of Enrique Finochietto
Enrique Finochietto
Enrique Finochietto was a distinguished Argentine academic, physician and inventor.-Life and work:...
.
Current
The following is an incomplete list of surgical retractors in use:HAND HELD RETRACTORS
- Lahey Retractor
- Senn Retractor
- Blair (Rollet) Retractor
- Rigid Rake
- Flexible Rake
- Ragnell Retractor
- Linde-Ragnell Retractor
- Davis Retractor
- Volkman Retractor
- Mathieu Retractor
- Jackson Tracheal Hook
- Crile Retractor
- Meyerding Finger Retractor
- Little Retractor
- Love Nerve Retractor
- Green Retractor
- Goelet Retractor
- Cushing Vein Retractor
- Langenbeck Retractor
- Richardson Retractor
- Richardson-Eastmann Retractor
- Kelly Retractor
- Deaver Retractor
- Parker Retractor
- Parker-Mott Retractor
- Roux Retractor
- Mayo-Collins Retractor
- U.S. Army Retractor
- Ribbon Retractor
SELF RETAINING RETRACTORS
- Alm Retractor
- Gelpi Retractor
- Gutow Retractor
- Weitlaner Retractor
- Beckman-Weitlaner Retractor
- Beckman-Eaton Retractor
- Beckman Retractor
- Adson Retractor
- Balfour Retractor
- Finochetto Retractor or Rib Spreader