Self-retaining Retractor and Handrest System for Neurosurgery

Greenberg, Ian

doi:10.1227/00006123-198102000-00009

Cited by 50 publications

(14 citation statements)

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“…In the contemporary neurosurgical era, effective use of retractors has served as a cornerstone for microsurgical training, particularly for the treatment of vascular and skull base lesions. 4,21 Consequently, at most neurosurgical centers, retractors are used routinely when surgeons confront a deep intracranial lesion under the operating microscope. However, because retractor-induced tissue edema and injury remain sources of neurosurgical morbidity, the utility of fixed retraction comes at a price.…”

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confidence: 99%

The quiet revolution: retractorless surgery for complex vascular and skull base lesions

Spetzler¹,

Sanai²

2012

JNS

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Fixed retraction can be supplanted by dynamic retraction with surgical instruments, limiting the risk of retractor-induced tissue edema and injury. This quiet revolution has precipitated a major change in surgical techniques. Extensive dissection of arachnoidal planes, careful placement of the handheld suction device, patient positioning that enhances gravity retraction, the refinement of microsurgical instrumentation, and appropriate selection of the operative corridor all serve to obviate the need for fixed retraction in most intracranial procedures. Retractorless neurosurgery is an achievable goal, even when complex lesions of the vasculature and skull base are being treated.

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mentioning

confidence: 99%

The quiet revolution: retractorless surgery for complex vascular and skull base lesions

Spetzler¹,

Sanai²

2012

JNS

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“…First, the self-retaining retraction system by Greenberg was introduced in 1981. [ 6 ] However, the danger of brain infarction and brain damage due to excessive brain retraction pressure has been debated. Rosenorn et al .…”

Section: Discussionmentioning

confidence: 99%

Combination of the tubular retractor and brain spatulas provides an adequate operative field in surgery for deep-seated lesions: Case series and technical note

Otani¹,

Kurozumi²,

Ishida³

et al. 2018

Surg Neurol Int

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Background:Surgeries for deep-seated lesions are challenging because making a corridor and observing the interface between lesions and normal brain tissue are difficult. The ViewSite Brain Access System, which is a clear plastic tubular retractor system, is used for resection of deep-seated lesions. However, the tapered shape of this system may result in limitation of the surgical field and cause brain injury to observe the interface between lesions and normal tissue. In this study, we evaluated the usefulness of the combination of ViewSite and brain spatulas.Methods:Nine patients were retrospectively identified who underwent resection of deep-seated lesions with the combination of Viewsite and brain spatulas. We assessed the extent of resection, prognosis, and quantitative brain injury from postoperative diffusion-weighed imaging (DWI).Results:There were four total radiographically confirmed resections. Subtotal resection in four patients and partial resection in one with central neurocytoma were achieved because these tumors were strongly adherent to the choroid plexus and ependymal veins. Only one case of metastatic tumor relapsed 6 months after surgery. The mean postoperative high signal on DWI was 3.68 ± 0.80 cm3.Conclusions:The combination of ViewSite and brain spatulas provides wide and adequate operative fields to observe the interface between lesions and normal tissue, and to prevent brain injury from excessive retraction pressure on the brain derived from repositioning of the ViewSite. Postoperative 3D volumetric analysis shows minimal damage to normal brain tissue. This report may provide new insight into the use of the ViewSite tubular retractor.

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“…As discussed by the authors, whether the approach was contra- or ipsilateral, the use of fixed retractors and the sitting or semi-sitting position were essential in that early microsurgical era. 27–30 Growing concern about the potential complications (e.g., brain edema or injury, air embolism, pneumocephalus, etc.) 31–33 of those established techniques led to a progressive and firm transition toward the use of dynamic retraction 34 and/or retractorless surgery.…”

Section: Discussionmentioning

confidence: 99%

Contralateral Transfalcine Versus Ipsilateral Anterior Interhemispheric Approach for Midline Arteriovenous Malformations: Surgical and Anatomical Assessment

et al. 2018

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Self-retaining Retractor and Handrest System for Neurosurgery

Cited by 50 publications

References 0 publications

The quiet revolution: retractorless surgery for complex vascular and skull base lesions

The quiet revolution: retractorless surgery for complex vascular and skull base lesions

Combination of the tubular retractor and brain spatulas provides an adequate operative field in surgery for deep-seated lesions: Case series and technical note

Contralateral Transfalcine Versus Ipsilateral Anterior Interhemispheric Approach for Midline Arteriovenous Malformations: Surgical and Anatomical Assessment

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