RayTractAb-C: A novel multipurpose adjustable self-retaining retractor system for cytoreductive surgery and...

Peritoneal surface malignancies (PSMs), such as pseudomyxoma peritonei, mesothelioma, and advanced metastases from ovarian, colorectal, gastric cancers, and sarcomatosis, are often categorized as terminal stage IV diseases. Cytoreductive surgery (CRS) combined with Hyperthermic intraperitoneal chemotherapy (HIPEC) has revolutionized outcomes, improving five-year survival rates to 50%-60% in selected cohorts, with up to 15% of patients achieving cure. A central component of CRS is total peritonectomy, which demands extensive exposure of the abdominal and subdiaphragmatic surfaces. However, specialized retractors designed for this purpose are currently limited to costly international systems, priced between ₹15-50 lakhs, and are largely unavailable in resource-constrained regions. The RayTractAb-C system has been developed as a cost-effective, multipurpose, self-retaining retractor specifically designed for CRS and HIPEC. The device includes a modular rail clamp, adjustable horizontal rod with arms, and six curvilinear blades engineered for pelvic, abdominal, and chest wall retraction. This configuration enables simultaneous exposure of multiple compartments, reduces reliance on surgical assistants, and facilitates safer and more efficient peritonectomy. RayTractAb-C has demonstrated significant ergonomic and practical advantages during prototyping, with anticipated benefits in accessibility, cost reduction, and surgical independence. Further clinical evaluation is warranted to assess its role in standardizing CRS-HIPEC procedures across diverse surgical settings.