title: Method for securing titanium cerebellar retractors.
abstract: BACKGROUND
  Traditional stainless steel retractors can interfere with electromagnetic neuronavigation and intraoperative magnetic resonance imaging (ioMRI). In such cases, titanium instruments are frequently used; however, they often shift during the procedure. The authors describe a simple technique, illustrated with intraoperative photographs, for securing titanium cerebellar retractors into place to keep both the retractors and tissues in their desired locations throughout a craniotomy.
  
  
  METHODS
  Titanium retractors were used by our institute's neurosurgical service during operations utilizing electromagnetic neuronavigation or ioMRI. Once the retractor was in the desired position, a 2-0 silk suture was placed around a retractor tong and tied outside the skin. Two sutures were placed on either side of the titanium retractor in the same fashion.
  
  
  RESULTS
  Retractors were subsequently noted to remain in their desired position throughout the operative procedure.
  
  
  CONCLUSIONS
  The authors describe a technique for securing titanium cerebellar retractors into their desired position during a craniotomy to minimize their movement during the procedure. This simple technique can help to eliminate a potential frequent source of surgeon frustration, and has proven to be quick to perform, safe, and practicable.
authors: Department of Neurosurgery, Roswell Park Cancer Institute, Buffalo, NY, USA ; Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Buffalo, NY, USA.
authors: Lindsay J
authors: LJ
authors: Lipinski
authors: Regis G
authors: RG
authors: Hoppenot
authors: Robert A
authors: RA
authors: Fenstermaker
authors: Andrew J
authors: AJ
authors: Fabiano
keywords: Cerebellar; intraoperative; magnetic resonance imaging; retractor; titanium