Use of rigid, fixed brain retactors is harmful for the brain

Abstract

While operating upon the brain, deep seated lesions need to be approached by using retractor’s system, due to the soft and gelatinous nature of the brain. Using a conventional rigid, fixed retractor system for brain retraction appears harmful. As an alternative Thudicam Nasal Speculum (TNS) retractors can be used. This study was aimed to explore the outcome of TNS retractors in brain surgery. The cross-sectional study was conducted at Ziauddin University hospital north campus and National Medical Center Defense, Karachi, Pakistan, during a period between August 2019 to March 2020. A total of 60 patients were included (42 males and 18 females), with a median age of 25 years. In all these cases intra-cranial hematoma were removed with unremarkable damage, in aneurysm clipping it was found useful, without damaging adjacent areas and extraction of brain tumors was found to be very easy and non-damaging to the surrounding brain tissue. Patients had a follow-up period of about 03 months and contusion, ischemia or brain edema was not present in any patient. Only one patient died during second month after surgery due to Ischemic stroke of contra-lateral MCA. The study concludes that using TNS retractors was very helpful and non-damaging to the brain.