An Innovative Self-retaining Retractor For Head And Neck Thyroid Surgery

Objective:Through analyzing the data from mechanical retraction and lifting during thyroid surgeries, to develop a self-retaining retractor for head and neck surgery.Methods:From January 2013 through August 2013,100 thyroid disease patients who underwent surgery in the hospital were observed. Data for depth of tissue retraction and angle of planar displacement in thyroidectomy, and lymph node dissection in the area of isthmus/prelaryngeal, paratracheal, suprasternal were measured. In this paper, we provided both a ground foundational data and a general overview of designing a novel retractor for head and neck surgery.Results:①The observation and measurements were proceed successfully in 100 patients who underwent surgery. ②During thyroid surgery, the horizontal movement of retracting blades was recorded and it was an oval motion track centered around the thyroid gland. ③The depth of tissue retraction in thyroidectomy were (superior pole 4.13±0.08cm, middle pole3.55±0.03cm, inferior pole 3.55±0.04cm), in central compartment lymph node dissection were (isthmus/prelaryngeal 3.49±0.07cm, paratracheal 4.21±0.11cm, suprasternal 3.34±0.05cm).④The planar displacement angle of retracting blade from the incision were (superior pole45.33±0.20°, middle pole 21.11±0.84°, inferior pole21.77±1.93°) in thyroidectomy, in central compartment lymph node dissection (isthmus/prelaryngeal 73.58±1.80°, paratracheal 23.27±1.45°, suprasternal 43.20±0.88°)Conclusion:Currently, mechanical traction is commonly used in thyroid surgery. Centered around the gland, mental retractors move in a track of oval shape at the incision level and suspend the subplatysmal flap in angles (0-75°) in order to establish sufficient exposure and room for the procedure. By analyzing the mechanical data from the surgical retraction, we designed a self-retaining retractor. It is constructed by a horizontal oval ring and blades (length 3-5cm) connected by hinges. This self-retaining retraction device is designed to provide steady and continuous exposure for thyroid surgery.