The Experts below are selected from a list of 171 Experts worldwide ranked by ideXlab platform
Mehmet Daneyemez - One of the best experts on this subject based on the ideXlab platform.
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the use of a simple Self Retaining Retractor in the endoscopic endonasal transsphenoidal approach to the pituitary macroadenomas technical note
Neurosurgery, 2013Co-Authors: Murat Kutlay, Engin Gonul, Yusuf Izci, Ozkan Tehli, Caglar Temiz, Ilker Solmaz, Mehmet DaneyemezAbstract:BACKGROUND: During tumor removal in the endoscopic endonasal approach to pituitary adenomas with a significant suprasellar extension, the early descent of diaphragma sellae obscuring the visualization of the surgical field is a surgical challenge. OBJECTIVE: To describe a simple diaphragma retraction technique to eliminate this problem. METHODS: A transparent flexible material (a strip of polypropylene) was used as a Self-Retaining Retractor to elevate the redundant diaphragma and to maintain the diaphragma elevation. This technique was performed in 3 patients who had pituitary adenoma with suprasellar extension. The degree of tumor removal was determined by a combination of surgeon's intraoperative impression and the postoperative magnetic resonance imaging obtained 3 months later. RESULTS: The technique was performed very easily and no complication was observed owing to this technique and Self-Retaining Retractor. Total tumor removal was achieved in 2 patients with this technique and subtotal removal in 1 patient. CONCLUSION: This technique was effective and practicable to elevate the diaphragma sellae during the tumor removal phase of transsphenoidal surgery. This simple Self-Retaining Retractor may support the neurosurgeon's skill by providing control of the entire surgical field and adequate working space. It may also eliminate the risks of blind curettage during surgery.
Garner P Johnson - One of the best experts on this subject based on the ideXlab platform.
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femoral neuropathy secondary to the use of a Self Retaining Retractor report of three cases and review of the literature
Diseases of The Colon & Rectum, 1995Co-Authors: Robert C Brasch, Anthony J Bufo, Paul F Kreienberg, Garner P JohnsonAbstract:PURPOSE: Three recent cases of femoral neuropathy at our institution following colorectal surgery have been ascribed to the use of the Self-Retaining BookwalterTM Retractor. The pathophysiology of neural injury includes compression, stretch, transection, ligation, iliopsoas hematoma, ischemia, and cement encapsulation. The Alm of this study is to provide a comprehensive review of femoral nerve anatomy and mechanism of Retractor injury. METHODS: The relationship of the femoral nerve to the lateral blade of the BookwaiterTM Retractor was evaluated during colorectal surgery and in cadaveric dissections. RESULTS: The lateral blade of the Self-Retaining Retractor was observed to either compress or impinge the intrapelvic portion of the femoral nerve. CONCLUSION: The incidence of postoperative femoral neuropathy is likely underestimated because a majority of cases are Self-limited. This debilitating iatrogenic injury can be prevented with a thorough understanding of femoral nerve anatomy and careful placement of Self-Retaining Retractor blades.
Murat Kutlay - One of the best experts on this subject based on the ideXlab platform.
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the use of a simple Self Retaining Retractor in the endoscopic endonasal transsphenoidal approach to the pituitary macroadenomas technical note
Neurosurgery, 2013Co-Authors: Murat Kutlay, Engin Gonul, Yusuf Izci, Ozkan Tehli, Caglar Temiz, Ilker Solmaz, Mehmet DaneyemezAbstract:BACKGROUND: During tumor removal in the endoscopic endonasal approach to pituitary adenomas with a significant suprasellar extension, the early descent of diaphragma sellae obscuring the visualization of the surgical field is a surgical challenge. OBJECTIVE: To describe a simple diaphragma retraction technique to eliminate this problem. METHODS: A transparent flexible material (a strip of polypropylene) was used as a Self-Retaining Retractor to elevate the redundant diaphragma and to maintain the diaphragma elevation. This technique was performed in 3 patients who had pituitary adenoma with suprasellar extension. The degree of tumor removal was determined by a combination of surgeon's intraoperative impression and the postoperative magnetic resonance imaging obtained 3 months later. RESULTS: The technique was performed very easily and no complication was observed owing to this technique and Self-Retaining Retractor. Total tumor removal was achieved in 2 patients with this technique and subtotal removal in 1 patient. CONCLUSION: This technique was effective and practicable to elevate the diaphragma sellae during the tumor removal phase of transsphenoidal surgery. This simple Self-Retaining Retractor may support the neurosurgeon's skill by providing control of the entire surgical field and adequate working space. It may also eliminate the risks of blind curettage during surgery.
Kenneth L Brayman - One of the best experts on this subject based on the ideXlab platform.
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development and evolution of Self Retaining Retractors in surgery the example of the bookwalter Retractor
Journal of The American College of Surgeons, 2015Co-Authors: Justin Barr, Kenneth L BraymanAbstract:One of America’s prodigious inventors, scientists, and founding fathers, Benjamin Franklin, suggested that “without continual growth and progress, such words as improvement, achievement, and success have no meaning.” He believed that scientific contributions should be used to increase efficiency and improve the human condition, sentiments that continue to motivate innovators. By inventing a universally applicable, Self-Retaining, table-fixed Retractor, John Bookwalter markedly advanced a field that had seen dozens of ephemeral designs during the preceding 70 years. He aspired to improve the safety and efficacy of abdominal and pelvic surgery and enhance the learning environment for students and trainees. Subsequent modifications to the post, rings, and ratchets made the device easier and more flexible to use, thereby broadening its acceptance. As it became the most common Self-Retaining Retractor in the United States, the Bookwalter helped transform the practice of surgery. Its history is interwoven into that of the last two generations of surgeons and epitomizes innovation in response to need; its future, however, in a profession increasingly dominated by minimally invasive techniques, remains less certain.
Robert C Brasch - One of the best experts on this subject based on the ideXlab platform.
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femoral neuropathy secondary to the use of a Self Retaining Retractor report of three cases and review of the literature
Diseases of The Colon & Rectum, 1995Co-Authors: Robert C Brasch, Anthony J Bufo, Paul F Kreienberg, Garner P JohnsonAbstract:PURPOSE: Three recent cases of femoral neuropathy at our institution following colorectal surgery have been ascribed to the use of the Self-Retaining BookwalterTM Retractor. The pathophysiology of neural injury includes compression, stretch, transection, ligation, iliopsoas hematoma, ischemia, and cement encapsulation. The Alm of this study is to provide a comprehensive review of femoral nerve anatomy and mechanism of Retractor injury. METHODS: The relationship of the femoral nerve to the lateral blade of the BookwaiterTM Retractor was evaluated during colorectal surgery and in cadaveric dissections. RESULTS: The lateral blade of the Self-Retaining Retractor was observed to either compress or impinge the intrapelvic portion of the femoral nerve. CONCLUSION: The incidence of postoperative femoral neuropathy is likely underestimated because a majority of cases are Self-limited. This debilitating iatrogenic injury can be prevented with a thorough understanding of femoral nerve anatomy and careful placement of Self-Retaining Retractor blades.