An intragastric retractor

NEW INSTRUMENT

An lntragastric

Retractor JAMES

R. HINES,

ROBERT

It is often hard to locate the site of bleeding after upper gastrointestinal hemorrhage. Accurate inspection of the lining of the stomach is complicated by retained blood and secretions, redundant rugal folds, poor illumination, and retractors that can lacerate the mucosa. Even with an adequate gastrotomy small mucosal lacerations, small ulcers, tumors, and bleeding varices may go unrecognized. Figure 1 shows a retractor that can be inserted through a moderate sized gastrotomy. The sliding mechanism is pushed forward until the ribs are expanded to the desired size and the retractor is held in this position by tightening a wing screw. Gastric secretions and blood can be asnirated and the stomach irrigated with sterile saline. &The light, powered by an ordinary bronchoscopic battery box, can be slipped out of the holder for better illumination in any one area. Because of the limited number of ribs, a biopsy can be taken or a bleeding point oversewn while the retractor is in place. From the Department of Surgery, School, Chicago, Illinois.

Vol.

119, June 1970

Northwestern

University

MD,

FACS,

E. GEURKINK,

MD,

Chicago, FACS,

Illinois

Chicago,

Illinois

The model illustrated is 14 inches long and the eighteen gauge steel ribs are 7 inches long. The instrument is made of stainless steel and can be sterilized in an autoclave. While the current model has been used exclusively in gastric surgery, other sizes can be used in retraction of the urinary bladder or the remainder of the gastrointestinal tract.

Medical

Figure

1.

Surgical

expanding

arm dilator.

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