Department of Neurosurgery, Central India Institute of Medical Sciences, Nagpur, India.
World Neurosurg. 2010 Feb;73(2):123-7. doi: 10.1016/j.surneu.2009.01.031. Epub 2009 Aug 6.
Self-retaining brain retractors are commonly used during intracranial surgery, and they are indispensable during microneurosurgery. There is a common severe complication due to the use of self-held retractors, that is, formation of a hemorrhagic infarct area in the brain region exposed to traction. All the more, present retractor systems are fixed and rigid and obstruct surgeons during surgery. Sometimes these retractors create glare in the microscope that distracts the surgeon. We hereby propose a simple and easy method of retraction of brain especially the temporal lobe using the transsylvian approach and vermis using the transvermian approach.
This is retrospective analysis of 47 patients in 4 years in which we have used our stitch retractor. We have analyzed their outcome, postoperative scan, and ease of performing surgery.
In 47 patients, there was only 1 postoperative contusion, and the longest period it was kept for is 6 hours. The other advantage was that it does not obstruct in any way while doing dissections and surgery. There was no glare while operating under a microscope.
We hereby propose a simple and easy method of retraction of brain especially the temporal lobe using the transsylvian approach and vermis using the transvermian approach. It is minimally traumatic, reducing insult to the brain. It allows the surgeon to dissect without any obstruction and glare in the way. The biggest advantage of the present stitch retractor is that it is very cheap and simple to use.
在颅内手术中，通常会使用自固式脑牵开器，在微创手术中更是不可或缺。由于使用自固式牵开器，会导致一个常见的严重并发症，即暴露于牵引下的脑区域形成出血性梗死区。更有甚者，现有的牵开器系统是固定和刚性的，会在手术中妨碍外科医生。有时这些牵开器会在显微镜下产生眩光，分散外科医生的注意力。我们在此提出一种使用经外侧裂入路牵拉脑，特别是颞叶，以及使用经蚓部入路牵拉小脑的简单易行的方法。
这是对 4 年来使用我们的缝线牵开器的 47 名患者的回顾性分析。我们分析了他们的手术结果、术后扫描结果以及手术操作的难易程度。
在 47 名患者中，只有 1 名患者术后出现脑挫裂伤，最长保持时间为 6 小时。另一个优点是，在进行解剖和手术时，它不会以任何方式造成妨碍。在显微镜下操作时，没有眩光。
我们在此提出一种使用经外侧裂入路牵拉脑，特别是颞叶，以及使用经蚓部入路牵拉小脑的简单易行的方法。它的创伤最小，减少了对大脑的损伤。它允许外科医生在没有任何妨碍和眩光的情况下进行解剖。目前这种缝线牵开器的最大优势在于它非常便宜且易于使用。
