Araştırma Makalesi
BibTex RIS Kaynak Göster

Improvement of Working Volume and Applications of Retractors Used in Surgical Operations

Yıl 2024, Cilt: 3 Sayı: 1, 14 - 23, 30.03.2024
https://doi.org/10.59518/farabimedj.1415269

Öz

Retractor systems are crucial in assisting physicians during surgical operations, ensuring optimal access to the surgical site, holding necessary equipment, and facilitating various procedures such as holding open wounds, stretching tissues, and removing them from the surgery site. Currently, retractors are tailored to specific anatomical regions. For instance, thyroid surgery presents unique challenges due to the gland's location and proximity to vital structures. Accessing the thyroid tissue amid the complexities of the neck region, which includes muscles like sternohyoid, sternothyroid, thyrohyoid, and omohyoid, requires careful retraction for a safe and effective procedure. The success of thyroid surgery relies on distinguishing the thyroid gland from surrounding structures, precisely determining surgical margins, and ensuring a clear view of the surgical field to mitigate potential complications. In this study, two distinct retractor holder designs, versatile for various operations, were developed and evaluated for their working volume, degrees of freedom in design, and applicability in surgical procedures. These designs aim to contribute to improving surgical outcomes, reducing complications, and general advances in the field of surgical instrumentation

Kaynakça

  • Tang R, Ma LF, Rong ZX, et al. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods. Hepatobiliary Pancreat Dis Int. 2018;17(2):101-112. doi:10.1016/j.hbpd.2018.02.002
  • Older J. Anatomy: A must for teaching the next generation. Surgeon. 2004;2(2):79-90. doi:10.1016/S1479-666X(04)80050-7
  • Chidambaram S, Stifano V, Demetres M, et al. Applications of augmented reality in the neurosurgical operating room: A systematic review of the literature. J Clin Neurosci. 2021;91:43-61. doi:10.1016/j.jocn.2021.06.032
  • Greenfield JP, Cobb WS, Tsouris AJ, Schwartz TH. Stereotactic minimally invasive tubular retractor system for deep brain lesions. Neurosurgery. 2008;63(4 SUPPL.):334-340. doi:10.1227/01.NEU.0000334741.61745.72
  • Kossmann T, Jacobi D, Trentz O. The use of a retractor system (SynFrame) for open, minimal invasive reconstruction of the anterior column of the thoracic and lumbar spine. Eur Spine J. 2001;10(5):396-402. doi:10.1007/s005860100330
  • Echeverry N, Mansour S, MacKinnon G, Jaraki J, Shapiro S, Snelling B. Intracranial Tubular Retractor Systems: A Comparison and Review of the Literature of the BrainPath, Vycor, and METRx Tubular Retractors in the Management of Deep Brain Lesions. World Neurosurg. 2020;143:134-146. doi:10.1016/j.wneu.2020.07.131
  • Tae K. Transoral robotic thyroidectomy using the da Vinci single-port surgical system. Gland Surg. 2020;9(3):614-616. doi:10.21037/GS.2020.03.37
  • Park JO, Lee D hyun, Kim MR, Kim SY, Han JH, Sun D Il. Transoral endoscopic thyroidectomy using a self-retaining retractor as an alternative to carbon dioxide gas insufflation: A comparative analysis of 131 cases. Oral Oncol. 2021;121(July):105463. doi:10.1016/j.oraloncology.2021.105463
  • Tiwari R. Comparison of Normal Retractor and Inbuilt Suction Retractor in Third Molar Surgery to Develop a Neo Retractor: An Original Research. J Maxillofac Oral Surg. 2023;22(S2). doi:10.1007/s12663-023-02037-9
  • Espinosa A, Ringel MJ, Heiselman JS, et al. Modeling retraction for breast conserving surgery guidance. In: Linte CA, Siewerdsen JH, eds. Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE; 2023:78. doi:10.1117/12.2655662
  • Owaki T, Kijima Y, Yoshinaka H, et al. Present status of endoscopic mastectomy for breast cancer. World J Clin Oncol. 2015;6(3):25-29. doi:10.5306/wjco.v6.i3.25
  • Soybir G, Fukuma E. Endoscopy Assisted Oncoplastic Breast Surgery (EAOBS). J Breast Heal. 2015;11(2):52-58. doi:10.5152/tjbh.2015.2520
  • Lahey FH. Lahey thyroid retractor. Published online 1931.
  • Engelberg M. Device and method for atraumatic dilatation. Published online 1998.
  • Richardson WS. The evolution of early appendectomy as standard treatment from appendicitis: What we can learn from the past in adopting new medical therapies. Am Surg. 2015;81(2):161-165. doi:10.1177/000313481508100228
  • Landreneau RJ, Pigula F, Luketich JD, et al. Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg. 1996;112(5):1346-1351. doi:10.1016/S0022-5223(96)70150-2
  • Brearley S, Watson H. Towards an efficient retractor handle: An ergonomic study. Ann R Coll Surg Engl. 1983;65(6):382-384.
  • Nigicser I, Oldfield M, Haidegger T. Stability and Retraction Force Verification of a New Retractor Design for Minimally Invasive Surgery. INES 2021 - IEEE 25th Int Conf Intell Eng Syst Proc. Published online 2021:183-188. doi:10.1109/INES52918.2021.9512925
  • Tak TO, Park JS, Kuk MG, Kim DH, Sin SE, Choi S. Driving Mechanism Design of a Motorized Seat Belt Retractor. J Ind Technol. 2006;26(A):55-61.
  • Roca E, Gobetti A, Cornacchia G, Vivaldi O, Buffoli B, Ramorino G. An expandable chamber for safe brain retraction: new technologies in the field of transcranial endoscopic surgery. J Zhejiang Univ Sci B. 2023;24(4):326-335. doi:10.1631/jzus.B2200557
  • Lalich IJ, Olsen SM, Ekbom DC. Robotic microlaryngeal surgery: Feasibility using a newly designed retractor and instrumentation. Laryngoscope. 2014;124(7):1624-1630. doi:10.1002/lary.24443
  • Dujovny M, Ibe O, Perlin A, Ryder T. Brain retractor systems. Neurol Res. 2010;32(7):675-683. doi:10.1179/016164110X12644252260439
  • Pérez Davila S, González Rodríguez L, Chiussi S, Serra J, González P. How to sterilize polylactic acid based medical devices? Polymers (Basel). 2021;13(13):1-18. doi:10.3390/polym13132115
  • Ramot Y, Haim-Zada M, Domb AJ, Nyska A. Biocompatibility and safety of PLA and its copolymers. Adv Drug Deliv Rev. 2016;107:153-162. doi:10.1016/j.addr.2016.03.012
  • Zagzoog N, Reddy K (Kesh). Modern Brain Retractors and Surgical Brain Injury: A Review. World Neurosurg. 2020;142:93-103. doi:10.1016/j.wneu.2020.06.153
  • Services H, Resources H, Administration S, Bureau HIVA. // Ahead O F the C Urv E //. Published online 2012:1-70.
  • Steele PRC, Curran JF, Mountain RE. Current and future practices in surgical retraction. Surgeon. 2013;11(6):330-337. doi:10.1016/j.surge.2013.06.004
  • https://www.tekno-medical.com/fileadmin/media/Flyer/TK_SUR-RS-0001_Retractor_Systems.pdf, access date:31.01.2024
  • https://www.tutkusaglik.com/strongarm-sistem-65mm-nathanson-kancalar-kob-30cm-kol-paslanmaz-celik-delrin-tutucular-300.html, acces date: 31.01.2024

Cerrahi Operasyonlarda Kullanılan Ekartörlerin Çalışma Hacmi ve Uygulamalarının Geliştirilmesi

Yıl 2024, Cilt: 3 Sayı: 1, 14 - 23, 30.03.2024
https://doi.org/10.59518/farabimedj.1415269

Öz

Ekartör sistemleri, cerrahi operasyonlar sırasında hekime yardımcı olması, cerrahi bölgeye optimum erişimin sağlanması, gerekli ekipmanların bulundurulması, açık yaraların tutulması, dokuların gerilmesi, ameliyat alanından uzaklaştırılması gibi çeşitli işlemlerin kolaylaştırılmasında önemli bir rol oynamaktadır. Şu anda ekartörler belirli anatomik bölgelere göre uyarlanmıştır. Örneğin tiroid cerrahisinde, bezin konumu ve hayati yapılara yakınlığı nedeniyle benzersiz zorluklar içermektedir. Sternohiyoid, sternotiroid, tirohiyoid ve omohyoid gibi kasları içeren boyun bölgesinin karmaşıklıkları arasında tiroit dokusuna erişim, güvenli ve etkili bir prosedür için dikkatli bir şekilde geri çekilmeyi gerektirir. Tiroit cerrahisinin başarısı, tiroit bezinin çevre yapılardan ayırt edilmesine, cerrahi sınırların kesin olarak belirlenmesine ve olası komplikasyonları azaltmak için cerrahi alanın net bir şekilde görülebilmesine bağlıdır. Bu çalışmada, çeşitli operasyonlar için çok amaçlı, iki farklı ekartör tutucu tasarımı geliştirilmiş ve çalışma hacimleri, tasarımdaki serbestlik dereceleri ve cerrahi işlemlerde uygulanabilirlikleri açısından değerlendirilmiştir. Bu tasarımlar ile cerrahi sonuçların iyileştirilmesine, komplikasyonların azaltılmasına ve cerrahi enstrümantasyon alanında genel ilerlemelere katkıda bulunmayı amaçlamaktadır.

Teşekkür

The designs developed in this study have been applied for patent protection with the patent number 2022/016858. The patent application process was facilitated with the assistance of the Technology Transfer Application Research Center at Karadeniz Technical University.

Kaynakça

  • Tang R, Ma LF, Rong ZX, et al. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods. Hepatobiliary Pancreat Dis Int. 2018;17(2):101-112. doi:10.1016/j.hbpd.2018.02.002
  • Older J. Anatomy: A must for teaching the next generation. Surgeon. 2004;2(2):79-90. doi:10.1016/S1479-666X(04)80050-7
  • Chidambaram S, Stifano V, Demetres M, et al. Applications of augmented reality in the neurosurgical operating room: A systematic review of the literature. J Clin Neurosci. 2021;91:43-61. doi:10.1016/j.jocn.2021.06.032
  • Greenfield JP, Cobb WS, Tsouris AJ, Schwartz TH. Stereotactic minimally invasive tubular retractor system for deep brain lesions. Neurosurgery. 2008;63(4 SUPPL.):334-340. doi:10.1227/01.NEU.0000334741.61745.72
  • Kossmann T, Jacobi D, Trentz O. The use of a retractor system (SynFrame) for open, minimal invasive reconstruction of the anterior column of the thoracic and lumbar spine. Eur Spine J. 2001;10(5):396-402. doi:10.1007/s005860100330
  • Echeverry N, Mansour S, MacKinnon G, Jaraki J, Shapiro S, Snelling B. Intracranial Tubular Retractor Systems: A Comparison and Review of the Literature of the BrainPath, Vycor, and METRx Tubular Retractors in the Management of Deep Brain Lesions. World Neurosurg. 2020;143:134-146. doi:10.1016/j.wneu.2020.07.131
  • Tae K. Transoral robotic thyroidectomy using the da Vinci single-port surgical system. Gland Surg. 2020;9(3):614-616. doi:10.21037/GS.2020.03.37
  • Park JO, Lee D hyun, Kim MR, Kim SY, Han JH, Sun D Il. Transoral endoscopic thyroidectomy using a self-retaining retractor as an alternative to carbon dioxide gas insufflation: A comparative analysis of 131 cases. Oral Oncol. 2021;121(July):105463. doi:10.1016/j.oraloncology.2021.105463
  • Tiwari R. Comparison of Normal Retractor and Inbuilt Suction Retractor in Third Molar Surgery to Develop a Neo Retractor: An Original Research. J Maxillofac Oral Surg. 2023;22(S2). doi:10.1007/s12663-023-02037-9
  • Espinosa A, Ringel MJ, Heiselman JS, et al. Modeling retraction for breast conserving surgery guidance. In: Linte CA, Siewerdsen JH, eds. Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE; 2023:78. doi:10.1117/12.2655662
  • Owaki T, Kijima Y, Yoshinaka H, et al. Present status of endoscopic mastectomy for breast cancer. World J Clin Oncol. 2015;6(3):25-29. doi:10.5306/wjco.v6.i3.25
  • Soybir G, Fukuma E. Endoscopy Assisted Oncoplastic Breast Surgery (EAOBS). J Breast Heal. 2015;11(2):52-58. doi:10.5152/tjbh.2015.2520
  • Lahey FH. Lahey thyroid retractor. Published online 1931.
  • Engelberg M. Device and method for atraumatic dilatation. Published online 1998.
  • Richardson WS. The evolution of early appendectomy as standard treatment from appendicitis: What we can learn from the past in adopting new medical therapies. Am Surg. 2015;81(2):161-165. doi:10.1177/000313481508100228
  • Landreneau RJ, Pigula F, Luketich JD, et al. Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg. 1996;112(5):1346-1351. doi:10.1016/S0022-5223(96)70150-2
  • Brearley S, Watson H. Towards an efficient retractor handle: An ergonomic study. Ann R Coll Surg Engl. 1983;65(6):382-384.
  • Nigicser I, Oldfield M, Haidegger T. Stability and Retraction Force Verification of a New Retractor Design for Minimally Invasive Surgery. INES 2021 - IEEE 25th Int Conf Intell Eng Syst Proc. Published online 2021:183-188. doi:10.1109/INES52918.2021.9512925
  • Tak TO, Park JS, Kuk MG, Kim DH, Sin SE, Choi S. Driving Mechanism Design of a Motorized Seat Belt Retractor. J Ind Technol. 2006;26(A):55-61.
  • Roca E, Gobetti A, Cornacchia G, Vivaldi O, Buffoli B, Ramorino G. An expandable chamber for safe brain retraction: new technologies in the field of transcranial endoscopic surgery. J Zhejiang Univ Sci B. 2023;24(4):326-335. doi:10.1631/jzus.B2200557
  • Lalich IJ, Olsen SM, Ekbom DC. Robotic microlaryngeal surgery: Feasibility using a newly designed retractor and instrumentation. Laryngoscope. 2014;124(7):1624-1630. doi:10.1002/lary.24443
  • Dujovny M, Ibe O, Perlin A, Ryder T. Brain retractor systems. Neurol Res. 2010;32(7):675-683. doi:10.1179/016164110X12644252260439
  • Pérez Davila S, González Rodríguez L, Chiussi S, Serra J, González P. How to sterilize polylactic acid based medical devices? Polymers (Basel). 2021;13(13):1-18. doi:10.3390/polym13132115
  • Ramot Y, Haim-Zada M, Domb AJ, Nyska A. Biocompatibility and safety of PLA and its copolymers. Adv Drug Deliv Rev. 2016;107:153-162. doi:10.1016/j.addr.2016.03.012
  • Zagzoog N, Reddy K (Kesh). Modern Brain Retractors and Surgical Brain Injury: A Review. World Neurosurg. 2020;142:93-103. doi:10.1016/j.wneu.2020.06.153
  • Services H, Resources H, Administration S, Bureau HIVA. // Ahead O F the C Urv E //. Published online 2012:1-70.
  • Steele PRC, Curran JF, Mountain RE. Current and future practices in surgical retraction. Surgeon. 2013;11(6):330-337. doi:10.1016/j.surge.2013.06.004
  • https://www.tekno-medical.com/fileadmin/media/Flyer/TK_SUR-RS-0001_Retractor_Systems.pdf, access date:31.01.2024
  • https://www.tutkusaglik.com/strongarm-sistem-65mm-nathanson-kancalar-kob-30cm-kol-paslanmaz-celik-delrin-tutucular-300.html, acces date: 31.01.2024
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Akif Cinel 0000-0001-9479-7222

Huseyin Ipek 0000-0003-0835-2978

Altuğ Uşun 0000-0003-0773-9548

Kutay Çava 0000-0002-3438-5418

Mustafa Aslan 0000-0003-2299-8417

Erken Görünüm Tarihi 13 Mart 2024
Yayımlanma Tarihi 30 Mart 2024
Gönderilme Tarihi 5 Ocak 2024
Kabul Tarihi 12 Şubat 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 3 Sayı: 1

Kaynak Göster

AMA Cinel A, Ipek H, Uşun A, Çava K, Aslan M. Improvement of Working Volume and Applications of Retractors Used in Surgical Operations. Farabi Med J. Mart 2024;3(1):14-23. doi:10.59518/farabimedj.1415269

*Dergiye gönderilecek yazılar aşağıda verilen örnek dosyalara göre hazırlanmalıdır. Dergi formatına uygun hazırlanmayan yazılar Yazar(lar)a iade edilecektir.

1. ÖZGÜN MAKALE ŞABLONU/ORIJINAL ARTICLE TEMPLATE

2. OLGU SUNUMU ŞABLONU/CASE REPORT TEMPLATE

3. DERLEME ŞABLONU/REVİEW TEMPLATE

4. BAŞLIK SAYFASI/TİTLE PAGE

5. TELİF HAKKI TRANSFER FORMU/COPYRİGHT TRANSFER FORM

6. KAPAK YAZISI /COVER LETTER

**Uluslararası Tıp Dergileri Editörler Kurulu (ICMJE) yönergesi