Retractors in OB/GYN surgery are delicate instruments that facilitate a precise and gentle touch, opening up a world of possibilities for life-changing procedures. They gracefully hold back tissues, creating a clear and unobstructed view, while respectfully maintaining the integrity of the surgical field.
These beautiful tools are a testament to the power of human innovation and the art of medicine.
What is a Retractor
A retractor is a medical tool used in surgery to separate and hold back the edges of a wound or incision, allowing access to the underlying tissues and organs.
By holding back tissues and organs, a retractor helps maintain a clear view of the surgical field, facilitating precise and controlled surgical procedures.
There are various types of retractors, each designed for specific surgical procedures and anatomical locations.
Types of Retractor in Ob/Gyn
There are several types of retractors used in OB/GYN surgery, each designed to provide access to specific areas of the body and to accommodate the unique needs of these procedures.
Some of the common types of retractors used in OB/GYN include:
- Blade retractors
- Self-retaining retractors
- Fan retractors
- Tissue retractors
- Abdominal retractors
Blade retractors:
Blade retractors are surgical instruments that are used to hold back tissues and organs to give the surgeon access to the surgical site.
They are long, flat and narrow with a sharp or blunt end, and they come in different sizes and shapes to meet the needs of different surgeries.
Read also : The Basics of Surgical Instruments – Dilating and Probing Instruments.
Blade retractors are typically made of stainless steel and are used during a variety of surgical procedures, including orthopedic, gynecological, and neurosurgical procedures.
Self-retaining retractors:
Self-retaining retractors are surgical instruments that hold open the surgical site without the need for manual assistance. These retractors are designed with a mechanism that maintains their position and prevents them from sliding or moving during the procedure.
This allows the surgeon to have both hands free to perform the surgery without having to worry about holding the retractor. Self-retaining retractors are commonly used during orthopedic, gynecological, and urological procedures.
Fan retractors:
Fan retractors are surgical instruments that have a number of blade-like arms that can be spread apart to hold back tissues and organs.
The arms are typically adjustable and can be positioned to provide access to different parts of the surgical site.
Fan detractorsare
most commonly used in orthopedic, spinal, and neurosurgical procedures.
Tissue retractors:
Tissue retractors are surgical instruments used to separate or hold apart the tissue in a surgical site.
These retractors can be flat or curved and come in a variety of shapes and sizes to meet the needs of different procedures. Tissue retractors are used in general, plastic, orthopedic, and gynecological surgeries.
Abdominal retractors:
Abdominal retractors are surgical instruments used to hold open the abdominal cavity during surgeries.
They are typically used during abdominal surgeries, such as appendectomies, hernia repairs, and abdominal wall reconstruction.
Abdominal retractors come in different designs and can be self-retaining or require manual assistance to hold open the surgical site.
Categories of retractor in Ob/Gyn
Retractors are a type of surgical instrument classified into two main categories:
Hand Retractors and Self Retaining Retractors.
Hand Retractors, also known as manual retractors, require manual assistance during a procedure, either by an assistant, robot, or the surgeon.
On the other hand, Self Retaining Retractors have a mechanism, such as a screw, ratchet, or clamp, that allows them to hold tissue securely without the need for manual support.
This provides the surgeon with two free hands.
Retractors are part of the “Retracting and Exposing” instruments used in the operating room.
They are often named after the organ or area of the body they are used for.
For instance, abdominal retractors or self retaining abdominal retractors are used for the abdomen, and there are specific skin retractors for the skin.
Read also : Different types of Forceps and their Uses- Medical instrument.
This list showcases a sample of retractors from both categories, without any particular order.
Each one is of great value and necessary for the medical field.
Manual Retractors
Senn Retractor – a double-ended retractor used primarily for retracting surface tissue, commonly used in plastic surgery and procedures in the small bones and joints, as well as thyroidectomy and neck dissection.
Army-Navy Retractor – used for retracting shallow incisions and for small to large wounds, including abdominal operations.
Ribbon (Malleable) Retractor – used for retracting deep wounds and can be bent to different shapes to hold tissue in place.
Hohmann Retractor – used in orthopedic procedures to expose bones.
Farabeuf Retractor – a general-purpose handheld retractor that can be used in various procedures, including dentistry, wrist and hand procedures, and hernia repair.
Meyerding Retractor – often used to retract tissue and muscles in spinal and neurosurgical procedures, such as laminectomy.
Deaver Retractor – used to retract deep abdominal or chest incisions and commonly used in procedures such as Cholecystectomy and Truncal Vagotomy to retract the right lobe of the liver and the left lobe of the liver respectively.
Richardson retractor – used to retract incisions in the abdominal or chest region, holding back multiple layers of deep tissue. It is one of the most commonly used general retractors.
Self-retaining retractors
These are instruments that maintain their shape and position once set in place. Some popular examples include
The Weitlaner – which is frequently used in basic plastic surgery and large bone and joint procedures.
The Balfour Abdominal Retractor – used to retract wound edges during deep abdominal procedures.
The Finochietto Rib Retractor – designed specifically for separating ribs during thoracic surgery.
The Hip Retractor System – offered by Millennium Surgical is a self-retaining retractor that allows the assisting personnel to be free and provides excellent exposure during hip arthroplasty and hip fracture surgery.
The Gelpi retractor – is often used in smaller surgical sites, particularly in spine surgery.
How many categories of retractors are there?
There are two main categories of retractors: hand-held and self-retaining. Hand-held retractors enable an assistant to manipulate tissue away from the surgical tools and safeguard crucial elements during the operation.
Which retractor is used during OB GYN procedures?
The Doyen Retractor is a handheld device mainly utilized in OB/GYN abdominal procedures, including hysterectomies, c-section births, and operations for ectopic pregnancies.
Read also: Cesarean section | instruments names and functions.