Surgeons use a variety of instruments to hold back tissues so that the area of the body they are operating in is easily accessible. These instruments are collectively referred to as surgical retractors. They play a critical role during surgery, as they ensure that there is a clear view of the surgical site and also help keep the tissues being retracted from being damaged.
Surgical retractors come in a wide assortment of shapes, sizes, and designs. They are typically referred to in terms of the type of tissue or organ to be retracted; some examples include abdominal retractors, lung retractors, and skin retractors. Many varieties, such as the Balfour retractor, are named after the person who invented them.
While the basic purpose of all of these instruments is the same, their specific functions can vary. Some retractors keep the edges of an incision separated. Others hold back organs that may naturally block the operative field to give the surgeon clear access. Instruments used to force tissues apart and then hold them in position, such as rib spreaders, may also be considered retractors.
The two main types of surgical retractors are hand-held and self-retaining. Hand-held retractors are designed to be held by assistants during the surgical procedure. Self-retaining retractors can be adjusted and locked in place so they maintain their position without further manual intervention. Both types have advantages and disadvantages. While hand-helds can offer more flexibility than self-retaining styles, it may be more difficult to maintain the correct level of retraction with them.
There are many different shapes of surgical retractors, designed based on their function. Both the handles and the blades of retractors come in many styles. Blades can be straight or curved, narrow or wide, and have a smooth, hooked, or raked shape. Handles can include notches, rings, or hooks to make them comfortable and easy to handle. The instruments also come in a variety of sizes to accommodate surgery in all patients, from children to adults.
Stainless steel is often used to make surgical retractors, as it is very strong and easy to sterilize. It does have some drawbacks, however, which can be hazardous during a surgical procedure. It becomes very slippery when wet, conducts heat easily, and is highly reflective in bright light. To eliminate these issues, retractors can also be made of a variety of polymeric materials. Any material used to make a retractor needs to have the ability to be sterilized in an autoclave.