Paper Clip Microretractor

Halstedian principles call for adequate surgical exposure,[1] and effective retraction is fundamental to obtaining good exposure of the surgical field. Self-retaining retractors are a great help because they assist in maintaining the exposure needed for surgery without leading to the use of handheld retractors that deprive the assistant a direct view of the procedure.[2]

When performing routine microsurgical practice on laboratory animals, retractors may be found to be too bulky or not suitable considering the size of the surgical field.[3]

In our personal experience we wanted a single retractor that could be adapted to the different sizes of animals operated on while maintaining effectual retaining properties.

In our last microsurgical procedures (n = 96), implanting sciatic nerve tubes using mesenchymal stem cells on rats, we used as a retractor a simple paper clip (Herlitz 8859100, size 32 mm; Herlitz, Berlin, Germany) properly shaped at the base for different exigencies of retraction and different needs of distinct microsurgical approaches. The retaining clip is kept in place and stabilized using a 23-gauge needle (Abbott Laboratories, Abbott Park, IL; Fig. [1]).

Figure 1 Retaining paper clip in place. Due to its flexibility, it can be applied in different surgical fields and adapted to surgical exigencies.

This easy system of retraction avoids common problems of standard microretractors, such as sharp tips and stress on the wound.

This inexpensive device (Fig. [2]) is easy to mold. It can be discarded or it can be sterilized and reused like any other surgical instrument. It ensures an optimal surgical exposure in various microsurgical procedures without being bulky or stretching tissues.

Figure 2 Retaining paper clip compared with a usual microretractor.

REFERENCES

• 1 Burjet WC Surgical Papers by William Stewart Halstead. Baltimore, MD; Johns Hopkins Press 1924
• 2 Pearl C B, Aguillon A, McLaughlin E, Yu J. Inexpensive self-retaining retractor for minor surgical procedures.  Ann Plast Surg. 2003;  51(6) 633-635
• 3 Narayanan K, Ramasastry S S. A simple microretractor.  Microsurgery. 1987;  8(4) 247