Handgrip-detachable soft tissue retractor for microsurgery: technical note

OBJECTIVE: We developed a modified soft tissue retractor for preventing problems that occur outside of the microscopic view field during microsurgery. INSTRUMENTATION AND OPERATIVE PROCEDURE: The characteristics of the modified soft tissue retractor are detachable handgrips, which can be easily released and fixed with the manipulation of an equipped button, and a new lock adjuster, which changes its form and position so that it is withdrawn into a corner space between both arms in proportion to the open angle of the arms. The retractor is used with handgrips, as in the conventional method, until the microsurgery begins. When microsurgery begins, the handgrips are released. We have used this retractor in 45 microsurgeries and 42 burr-hole surgeries, such as stereotactic or endoscopic operations. RESULTS: The detachable handgrips can resolve problems caused by handgrips and a lock lever in conventional retractors, such as interference with the free movement of the microsurgical operator's hands, restriction of operative approach angle or direction of the light axis of a microscope, and catching or tangling of instrument cords and thin thread. In addition to microsurgery, it was beneficial in burr-hole surgeries, because operators can manipulate instruments, such as a stereotactic arm or an endoscope, without having to handle the retractor handgrips. CONCLUSION: Our modified soft tissue retractor is very useful for performing steady and safe microsurgery.