Stitch retractor—simple and easy technique to retract brain

Singh, Lakhan; Agrawal, Nilesh

doi:10.1016/j.surneu.2009.01.031

Cited by 11 publications

(5 citation statements)

References 10 publications

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“…It is currently being used as a brain selfretraction system in various ways [22]. Various methods such as retraction using stitch and retraction using a pad with microbubbles have also been developed [23][24][25]. Recently, studies using a tubular retractor system to reduce collateral brain damage in deep seated tumor surgery have been actively performed [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Tumor retractor: a simple and novel instrument for brain tumor surgery

et al. 2020

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Background: It is important to secure a surgical space during brain tumor surgery. One of the commonly used methods is to retract the brain. We hypothesized that the tumor can be retracted and that the normal brain tissue retraction can be minimized during surgery, and thus, the degree of collateral damage caused by brain retraction would be reduced. Methods: The tumor retractor had a 90°, hard, and sharp tip for fixation of the tumor. The distal part of the retractor has a malleable and thin blade structure. By adjusting the angle of the distal malleable part of the tumor retractor, the operator can make the retracting angle additionally. Retractors with thin blade can be used in a conventional selfretraction system. To pull and hold the tumor constantly, the tumor retractor is held by a self-retraction system. The surgical technique using a tumor retractor is as follows: The first step is to fix the retractor to the tumor. The second step is to pull the retractor in the operator's desired direction by applying force. After the tumor is pulled by adjusting the degree of force and angle, the surgical arm should be held in place to maintain the tumor retracted state. Results: The tumor retractor was used to minimize the brain retraction, pulling the tumor in the opposite direction from the surrounding brain tissue. In clinical cases, we can apply the tumor retractor with good surgical outcomes. Conclusions: A tumor retractor can be used to pull a tumor and minimize the brain retraction.

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Section: Discussionmentioning

confidence: 99%

Tumor retractor: a simple and novel instrument for brain tumor surgery

et al. 2020

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“…The dentate ligament can be used to retract the spinal cord to reach anteriorly located lesions. Similarly, retracting the arachnoid over the Sylvian fissure and cerebellomedullary fissure with 4-0 silk sutures was described by Singh et al 16 The senior author (MKB) applied the principles of the above-mentioned techniques to cranial microneurosurgery with some refinements. After passing the 10-0 suture through the arachnoid of the sulcus to be retracted, the suture is secured to an adjacent dural edge.…”

Section: Discussionmentioning

confidence: 99%

Minimizing Retraction by Pia-Arachnoidal 10-0 Sutures in Intrasulcal Dissection

Uluç

Çıkla

Morkan

et al. 2017

ONSURG

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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%

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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Stitch retractor—simple and easy technique to retract brain

Cited by 11 publications

References 10 publications

Tumor retractor: a simple and novel instrument for brain tumor surgery

Tumor retractor: a simple and novel instrument for brain tumor surgery

Minimizing Retraction by Pia-Arachnoidal 10-0 Sutures in Intrasulcal Dissection

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

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