Microvascular retractor: a new concept of retracting and repositioning cerebral blood vessels.
OBJECTIVE
In this technical note, we report our results with a newly designed retractor blade that can be directly applied for the retraction and repositioning of cerebral blood vessels and delicate neural structures.


METHODS
This new malleable retractor with a semicircular tip was designed to fit in the flexible arms of a self-retaining retractor system. After prototype evaluation and optimization in laboratory studies, we used the new retractor in 15 patients during surgical procedures that included retraction of the internal carotid artery during aneurysm clipping, expansion of the surgical window, and transposition of cranial nerves.


RESULTS
No intraoperative injuries occurred to neurovascular structures. The retractor blade remained stable on pulsating vessels during the procedure and largely preserved the vessel diameter.


CONCLUSIONS
The new retractor incorporates the existing advantages offered by flexible self-retaining retractor blades with those features that adapt to blood vessel retraction. Rather than concentrating force at one point as typical retractors do, the semicircular tip distributes the retraction force over multiple points along its circumference.
Department of Neurosurgery, University of South Florida, Tampa, Florida 33606, USA. ayoussef@hsc.usf.edu
A Samy
AS
Youssef
Harry R
HR
van Loveren
D000783:Aneurysm / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D002536:Cerebral Arteries / Q000601:surgery; D002550:Cerebral Veins / Q000601:surgery; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D006801:Humans; D008833:Microcirculation / Q000601:surgery*; D008846:Micromanipulation / Q000295:instrumentation* / Q000379:methods; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods; D008904:Miniaturization; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods