Page 17 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

Retractors
Appropriate retraction decreases surgical time and reduces
VetBooks.ir Hand-held retractors:
the risk of surgical complications.

• Senn retractors: These retractors have three sharp
prongs at one end and a right-angled fingerplate at the
other end (Figure 1.7). They are delicate instruments,
useful for retracting skin and superficial soft tissues
(e.g. in the neck).
• Seldin retractors: These are large and sturdy
periosteal elevator-like instruments; also useful to
break any remaining bony attachments after osteotomy Self-retaining retractors. 1 = Gelpi; 2 = West; 3 = Travers;
during mandibulectomy or maxillectomy procedures. 1.8 4 = Finochietto.
• Army–Navy, Parker–Kerr and Langenbeck
retractors: These are larger instruments with variously
• Finochietto retractors: These rib retractors have a
angled ends, enabling retraction of more tissue in ratchet and can be used for both intercostal and
deeper cavities. They are available in a selection of
sternotomy approaches. These retractors need to be
sizes. Army–Navy and Parker–Kerr retractors are extremely robust with deep, wide blades to spread
double-ended, whereas Langenbeck retractors have a
open the ribs and maintain rib retraction. Small,
single end (Figure 1.7).
• Skin hooks: These hooks are used for the retraction of medium and large sizes are available, so they may be
used in cats as well as large dogs.
delicate tissues.
• Malleable retractors: These retractors are versatile
Lip, cheek and tongue retractors:
because they can be moulded to the shape desired.
They are useful for retracting organs within the chest • Lip retractors: The tips of these retractors are plastic-
(organs are protected with a saline-soaked swab). coated to minimize trauma to the labial mucosa and lip
Malleable retractors are available in a variety of blade skin and can be adjusted by lightly bending. Lips can be
widths (2–5 cm). retracted for clear access to the upper and lower jaw.
• Cawood–Minnesota retractors: One end is straight
and flat, the other end is curved as a broad hook,
allowing retraction of the lip, cheek, tongue and tissue
flaps.
• A dental mirror or moistened tongue depressor can
also be used for retraction of the tongue and cheek.

Periosteal elevators
These are small narrow-tipped (2–6 mm) instruments
(Figure 1.9) used to deflect tissues that have adhered to
bone. They are very helpful in mobilizing and reflecting
the mucoperiosteum during periodontal flap procedures,
mandibulectomies, maxillectomies and palate surgeries.
The blade portion is used with the convex side against the
soft tissue, reducing the chance of tearing or puncturing
the flap. Larger instruments may be used to deflect tissue
from the field of operation and improve visibility. Periosteal
elevators come in various sizes and blade shapes (e.g.
Molt, West, Williger, Glickman, Seldin).
Hand-held retractors. 1 = Senn; 2 = Parker-Kerr; 3 = Army–
1.7 Navy; 4 = Langenbeck.
Self-retaining retractors: These instruments are able to
maintain themselves in a spread position and are very use-
ful during head and neck surgery (Figure 1.8).

• Gelpi retractors: These retractors have single-
pronged outwardly turning tips. Gelpi retractors
maintain tension using a grip-lock mechanism and are
available in small (14 cm) or large (17 cm) sizes, with
pointed or blunt tips. The blunt tips are preferable if
they are to be placed next to important nerves or
vessels.
• West, Weitlaner and Travers retractors: These
retractors have multiple tips, offering a wider surface
area for retraction. The tips can be pointed or blunt.
Travers retractors are larger (20 cm) than West or Periosteal elevators. 1 = Senn; 2 = Molt; 3 = Freer; 4 = Goldman-
Weitlaner retractors (14–16 cm). 1.9 Fox; 5 and 6 = feline.

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