Cylindrical channel retractor for intraventricular tumour surgery—a simple and inexpensive device

Singh, Lakhan; Agrawal, Nilesh

doi:10.1007/s00701-009-0256-y

Cited by 20 publications

(13 citation statements)

References 6 publications

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“…Some of the available tubular retractors have their own limitations. [1,6,7,10] Advantage of our retractor is that the cortisectomy required is small. Longitudinal cut reduces outer diameter of our retractor to half at the time of insertion.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] The low retracting pressure around a tubular retractor is not likely to be as disruptive as is the pressure in conventional retractor systems. [7] Although different types of tubular retractors are available, [1,[5][6][7][8][9][10] they have their own limitations. We describe a new tubular retractor which is easy to apply, inexpensive, requires small cortisectomy and is safe and effective.…”

Section: Introductionmentioning

confidence: 99%

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A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma

Yadav

Sherekar

et al. 2011

Neurol India

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Access to deep-seated brain lesions with traditional fixed and rigid brain retractors can be difficult without causing significant trauma to the surrounding brain. Tubular retractors offer an advantage of low retracting pressure. We developed a new inexpensive and simple tubular retractor which requires very small cortisectomy. The new tubular retractor was made up of silicone with inner diameter of 15, 18 and 23 mm and outer diameter of 17, 20 and 25 mm, respectively. This tube (1 mm thick) was cut in longitudinal direction. It was folded to make a small-diameter tube so that it could be introduced through a small cortisectomy. Margins of cortisectomy were gently and slowly retracted by Killian nasal speculum. Folded retractor, held by tissue forceps, was introduced inside the opened Killian nasal speculum. Tissue forceps and nasal speculum were removed leaving tubular retractor in place, which comes back to its normal tubular configuration after release. Surgery was performed using rigid Karl Storz 0° telescope (30 cm long and 4 mm in diameter) or microscope. Near-total removals of intracerebral hematomas, 37 hypertensive and 3 traumatic, was done using this retractor without any complication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma

Yadav

Sherekar

et al. 2011

Neurol India

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“…1 Complications like hemorrhagic infarct or contusions are reported with the use of such retractors. [2][3][4][5] Tubular retractors offer the advantage of low retracting pressure [1][2][3][4]6,7 that is unlikely to be disruptive. 8 Low retraction pressure in our retractor system is due to an even distribution of retraction force in all directions over the larger area.…”

Section: Introductionmentioning

confidence: 99%

“…Different types of tubular retractors are available including our own retractor. 1,[6][7][8][9][10][11] We report our experience in the excision of deep-seated tumors using a microendoscopic technique.…”

Section: Introductionmentioning

confidence: 99%

Microendoscopic Removal of Deep-Seated Brain Tumors Using Tubular Retraction System

Ratre

Yadav

Parihar

et al. 2016

J Neurol Surg A Cent Eur Neurosurg

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Background Retraction of the overlying brain can be difficult without causing significant trauma when using traditional brain retractors with blades. These retractors may produce focal pressure and may result in brain contusion or infarction. Tubular retractors offer the advantage of low retracting pressure that is less likely to be traumatic. Low retraction pressure in the tubular retractor is due to the distribution of retraction force in all directions in a larger area. Material and Methods We conducted a retrospective study of 100 patients with deepseated tumors operated on from January 2010 to December 2014. Tumor removal was accomplished with the help of a microscope and/or endoscope. Tubular brain retractors sizes 23, 18, and 15 mm were used. Folding of the tubular retractor after making a longitudinal cut allowed a small corticectomy. Larger retractor sizes were used in the earlier part of the study and in larger tumors. All the patients were evaluated postoperatively by computed tomography scan on the first postoperative day, and subsequent scans were done as and when needed. Any brain contusion or infarctions and the amount of tumor removal were recorded. Results A total of 74 patients had astrocytomas; 12, meningiomas; 4, colloid cyst of the third ventricle; 4, metastases; 4, primitive neuroectodermal tumor; 1, neurocytoma; and 1, ependymoma. Pure endoscopic excision without using a microscope was performed in 12 patients. Lesions were in the frontal (n ¼ 34), parietal (n ¼ 22), intraventricular (n ¼ 16), basal ganglion or thalamic (n ¼ 14), occipital (n ¼ 10), and cerebellar (n ¼ 4) areas. Total, near-total, and partial excision was achieved in 49, 29, and 22 patients, respectively. Use of a conventional retractor for excision of peripheral and superficial parts of a large tumor, small brain contusions, and technical failure were observed in 7, 4, and 1 patient, respectively. The low incidence of contusion may be partly due to the nonavailability of magnetic resonance imaging in the early postoperative period because of financial constraints. Conclusion Removal of deep-seated tumors was safe and effective using our simple tubular retractor. It also helped minimize bleeding during surgery. A tubular brain retractor and conventional retractor can be used to complement each other if required.

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“…Currently, different types of tubular retractor systems are available (8,10,15,24,27,31,33) but most of them have their own limitations. These limitations include; their need for frame-based or frameless stereotactic systems (not available in all neurosurgical centers), difficulties in combination with the navigation systems, their bulky and metallic or hard plastic nature (preventing visualization of surrounding tissue), difficulties in their surgical manipulations, and also their fixation problems.…”

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confidence: 99%

Fully endoscopic resection of intraaxial brain lesions using neuronavigated pediatric anoscope

Kutlay

Kural²,

Solmaz³

et al. 2015

Turkish Neurosurgery

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Endoscopic resection of deep-seated brain lesions with the neuronavigated tubular retractor is a safe and an effective technique and may be a feasible alternative to conventional microsurgical or endoscope-assisted methods in selected patients. The modified transparent plastic pediatric anoscope can be used as a tubular retractor and it is easy to apply, simple, lightweight, inexpensive and effective.

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Cylindrical channel retractor for intraventricular tumour surgery—a simple and inexpensive device

Cited by 20 publications

References 6 publications

A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma

A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma

Microendoscopic Removal of Deep-Seated Brain Tumors Using Tubular Retraction System

Fully endoscopic resection of intraaxial brain lesions using neuronavigated pediatric anoscope

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