A retractor system is a set of instruments a surgeon can use to hold tissues in place at the site of a procedure to clearly visualize and stabilize them while performing surgery. They act much like the hands of an assistant. This allows the doctor to focus on the task at hand, rather than on repositioning or holding tissue back while working. There are a number of styles of retractor system available from medical suppliers.
The most basic surgical retractors are hand-held tools. The surgeon or an assistant can place the tool and exert pressure to pull tissue back or hold it in place during a surgery. A retractor system can include bracing that will hold the instrument in place independently, with no need for an assistant. This frees up space around the surgical site and also limits the chance of incidents like a slipped or dropped retractor.
The design of a retractor system may vary, and surgeons often have a preference for specific procedures. Some systems work with minimally invasive surgery. They are very small, reflecting the size of the incisions in this type of surgery, and articulate with other surgical instruments so the surgeon can perform procedures in an area with limited range of movement and visibility. Other systems are much larger and can be used to hold open abdominal or chest incisions. Some act as spreaders to push tissues apart, while others simply hold them in place with clips and loops.
A disposable retractor system is designed for a single use. The doctor can remove the retractors from sterile packaging, place them, use them in the surgery, and discard them at the end. Other systems are reusable and are typically made from surgical grade steel. After the surgery, a technician needs to wash and autoclave them to sterilize them for the next patient. Part of this process includes placing the tools in sterile packaging with autoclave indicators so the surgeon will know the tool has been sterilized when she needs to use it again.
Surgeons learn about the different retractor types and their uses while in training. Many surgeons adopt the tools preferred by their mentors and in turn teach their students to use them. The tendency to pass on traditions can make it difficult to encourage adoption of a new surgical technique or system, especially among older practitioners.