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What are Surgical Retractors?

A. Pasbjerg
A. Pasbjerg

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.

Surgical retractors are available in a variety of sizes in order to accommodate both children and adults.
Surgical retractors are available in a variety of sizes in order to accommodate both children and adults.

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.

Retractors hold body tissues out of the way so that surgeons can reach organs or structures inside the body.
Retractors hold body tissues out of the way so that surgeons can reach organs or structures inside the body.

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.

The Balfour retractor is one type of surgical retractor.
The Balfour retractor is one type of surgical retractor.

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.

Surgical instruments can be sterilized by using an autoclave.
Surgical instruments can be sterilized by using an autoclave.

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.

Discussion Comments

jcraig

@jmc88 - I'm don't have any medical experience, but I'll take a shot from what I know from TV. The article did a good job explaining retractors. I think clamps would sort of do the opposite. Instead of spreading something apart, it would hold something closed.

When I have seen them, they have always been used to clamp a vein or artery shut to control blood flow. I'm sure, though, that for the locking retractors, you could say that they are able to clamp to a certain position and keep the part of the body exposed.

jmc88

@titans62 - Interesting observation about the vet tools. I know there are some vets that specialize in certain things like livestock, so I'm sure they have a whole set of special retractors that are much larger and designed for things like horses and cows. I'm sure they're very expensive, too.

I have heard of surgical clamps before. Are clamps and retractors the same thing, or is there a difference?

titans62

@kentuckycat - Rib spreaders definitely are an interesting device.

I know what you are talking about with the tool that keeps your mouth open. I'm sure that would fall into the category. It wouldn't have been surgery when you were getting the filling, but it certainly could be used in dental surgery.

When I was reading this, I was thinking about veterinary instruments. I'm sure a lot of the same tools that are used on humans could be used on animals, but I bet a vet would have to have a whole other range of surgical retractors both big and small. I'm sure the same tool that works on us wouldn't be very effective on a small bird or a horse.

kentuckycat

Rib spreaders always amazed me. If you have never seen them in use, and you can stand the view inside the body, they are definitely an interesting tool. They almost look like a medieval torture device, but they serve their purpose well.

When I went to the dentist to get a filling when I was a kid, she used some type of device to keep my mouth open while she was doing the work. Would this be considered a type of dental retractor, or are surgical retractors only used in real surgery?

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    • Surgical retractors are available in a variety of sizes in order to accommodate both children and adults.
      By: V&P Photo Studio
      Surgical retractors are available in a variety of sizes in order to accommodate both children and adults.
    • Retractors hold body tissues out of the way so that surgeons can reach organs or structures inside the body.
      By: Gennadiy Poznyakov
      Retractors hold body tissues out of the way so that surgeons can reach organs or structures inside the body.
    • The Balfour retractor is one type of surgical retractor.
      The Balfour retractor is one type of surgical retractor.
    • Surgical instruments can be sterilized by using an autoclave.
      By: redcarpett
      Surgical instruments can be sterilized by using an autoclave.