ANTERIOR CERVICAL RETRACTORS: SELF-RETAINING VS. TABLE MOUNTED VS. HAND HELD
by Stephanie Myers, Research + Development / Product Manager
Anterior cervical exposure can be accomplished using a variety of retractors which all carry their own pros and cons.
Self-retaining retractors, which Thompson does not manufacture, are the most common. Users often state that they are quick and simple to use. The drawback, many have told us, is that they tend to shift, which requires another hand to hold the retractor in place or multiple adjustments during the procedure. Some users have even told us that they need to retract more to get the self-retaining retractor to stay in place. In addition, the blades used with self-retaining retractors use teeth to grip the tissue. There is no other reason for toothed blades other than to keep the self-retraining retractor from shifting. Despite all of this, some have managed to “make them work” and especially enjoy their ultra-simple set-up.
Table mounted retractors, on the other hand, eliminate all of these issues.
Our customers find that exposure remains stable with no shifting and toothed blades are no longer required. Using table mounted retractors with independent arms, retraction pressure can be customized and independently adjusted on the medial and lateral sides of the spine. It is possible to put less pressure on critical anatomy because one side is not dependent upon the other. New users are often skeptical based on the appearance of the table-mounted retractor. The set-up appears difficult and it is larger than a self-retaining system. However, our users find that after a few uses, they become skilled at set up and save time in the end because fewer adjustments are required. Users also find that although it may feel larger, everything is adjustable so anything “in the way” can be moved. It’s also important to note that when using the Thompson Retractor, all retraction is initially done by hand so the user can use tactile feedback to gauge how much force is being applied. In addition, retractors can be easily released and locked again periodically and individually without complete loss of exposure to help permit blood flow. This is not possible on self-retaining retractors.
Finally, there are hand held retractors. Hand held retractors, like table mounted retractors, provide the benefit of independent retraction and also allow periodic release of retraction to permit blood flow with little interrupt to exposure. The disadvantage is that hand held retractors require staff to hold them. Extra persons can disrupt the work flow and obstruct the working area. Those holding the retractors can tire, move, and not always see what they are retracting. The surgeon also has less personal control over each retractor blade and cannot feel the retraction pressure. It should be noted that any of the Thompson Retractor blades for Anterior Cervical can be used as hand held blades by adding an S-Lock Angling Hand Held Adapter (call for more information) should hand held retraction be desired.
Please call us to put the Thompson Retractor to the test for your anterior cervical exposures with a Free 30 Day Trial.