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Finochietto hand retractors
SURGEON’S
WORKSHOP
FINOCHIETTO HAND RETRACTORS HECTOR
BENSIMON,
JAY S. COPELAND,
M.D.
M.D.
From the Department of Urology, Veterans Administration Medical Center, Washington, D. C.
The internationally known Finochietto chest retractor is not only useful for thoracic surgeons but also for general surgeons and urologists who may use this retractor in abdominal surgery. Perhaps few surgeons know that the Finochietto brothers were born, educated, practiced, and taught surgery in Argentina, where their name is almost a legend. These two brothers, Enrique and Ricardo, complemented each other. Enrique, the older brother who died in 1949, initiated what was to become a surgical teaching center for postgraduates. He had a creative genius for surgical technique and instrumentation that Ricardo, his most faithful
FIGURE 1.
UROLOGY
/ FEBRUARY1987
Finochietto
disciple, made popular in the operating room and innumerable publications. Ricardo died in 1962. Enrique was a taciturn man who performed his superb surgical skills in an atmosphere of almost religious silence. His calmness and serenity, even in the presence of extreme technical difficulties, were legendary. His brother Ricardo was the opposite. He was an extrovert and a passionate man who kept all in the operating room apprised of the surgical technique that he or his brother was using. Ricardo was, in the pursuit of perfection, implacable with his assistants. However, when
hand-retractors,
/ VOLUMEXXIX,NUMBER2
long-blade series.
213
outside the operating room he became the teacher and generous friend whom all his disciples loved. In the 1930s and 1940s most of the important surgical centers in Buenos Aires were restricted to a small elite group of surgeons. The Finochiettos opened the doors of their service, creating a Surgical School for Graduates which was one of the first teaching programs in surgery in Argentina. At the Finochietto school, there was no discernible elitism or prejudice. Everyone was unified by a common goal: the pursuit of the highest standards in the practice of surgery. A few years later, first-generation disciples transmitted the teachings of Enrique and Ricardo Finochietto, the “Mayos from South America,” as the late Frank Lahey used to call them. The Finochietto hand retractors have a straight blade and a handle which is easy to grip. These retractors come in long-blade and wide-blade series. The long-blade series measures from 8 to 19.4 cm in length and 3 to 6.5 cm in width (Fig. 1). The wide-blade series measures from 8 to 15 cm in length and 6 to 12 cm in width. * Although the Deaver hand retractor is useful for large incisions, because of the curve of the blade it does not provide good exposure when the incision is narrow and deep. We have had
*Walter Lorenz Surgical Instruments, Inc., Center Drive, Jacksonville, Florida 32218.
214
9850
many years of experience with the Finochietto hand retractors, and we would like to share our satisfaction with our colleagues. The long-blade series of retractors are ideal for exposure of the renal pedicle, adrenal gland, and deep areas of the pelvic cavity during radical cystectomy and radical prostatectomy. The wide-blade retractors are useful in retracting small or large bowel and peritoneum as is usually required in doing an ileal conduit or retroperitoneal lymph node dissection. The ingenuity of the surgeon will decide when to use a narrow or a wide blade. During a radical nephrectomy, the hepatic flexure and transverse colon are held down with a large size, wide blade. We always start with a smaller size blade than that which is finally required. With satisfactory exposure obtained, the retractor is covered with a wet sponge neatly folded; the retractor is then placed over the sponge with a swift motion (retractorsponge-retractor). If considered necessary, the blade is replaced by a larger size. An identical maneuver is used in other areas such as in exposure of the deep pelvis. Surgery is an art of constant “rediscovery.” We believe that the Finochietto hand retractors will be a significant help to those who choose to use them. Room 2A118 VA Medical Center 50 Irving Street NW Washington, D. C. 20422
Interstate
UROLOGY
/ FEBRUARY
1987
I VOLUME
XXIX, NUMBER
2
WORKSHOP
FINOCHIETTO HAND RETRACTORS HECTOR
BENSIMON,
JAY S. COPELAND,
M.D.
M.D.
From the Department of Urology, Veterans Administration Medical Center, Washington, D. C.
The internationally known Finochietto chest retractor is not only useful for thoracic surgeons but also for general surgeons and urologists who may use this retractor in abdominal surgery. Perhaps few surgeons know that the Finochietto brothers were born, educated, practiced, and taught surgery in Argentina, where their name is almost a legend. These two brothers, Enrique and Ricardo, complemented each other. Enrique, the older brother who died in 1949, initiated what was to become a surgical teaching center for postgraduates. He had a creative genius for surgical technique and instrumentation that Ricardo, his most faithful
FIGURE 1.
UROLOGY
/ FEBRUARY1987
Finochietto
disciple, made popular in the operating room and innumerable publications. Ricardo died in 1962. Enrique was a taciturn man who performed his superb surgical skills in an atmosphere of almost religious silence. His calmness and serenity, even in the presence of extreme technical difficulties, were legendary. His brother Ricardo was the opposite. He was an extrovert and a passionate man who kept all in the operating room apprised of the surgical technique that he or his brother was using. Ricardo was, in the pursuit of perfection, implacable with his assistants. However, when
hand-retractors,
/ VOLUMEXXIX,NUMBER2
long-blade series.
213
outside the operating room he became the teacher and generous friend whom all his disciples loved. In the 1930s and 1940s most of the important surgical centers in Buenos Aires were restricted to a small elite group of surgeons. The Finochiettos opened the doors of their service, creating a Surgical School for Graduates which was one of the first teaching programs in surgery in Argentina. At the Finochietto school, there was no discernible elitism or prejudice. Everyone was unified by a common goal: the pursuit of the highest standards in the practice of surgery. A few years later, first-generation disciples transmitted the teachings of Enrique and Ricardo Finochietto, the “Mayos from South America,” as the late Frank Lahey used to call them. The Finochietto hand retractors have a straight blade and a handle which is easy to grip. These retractors come in long-blade and wide-blade series. The long-blade series measures from 8 to 19.4 cm in length and 3 to 6.5 cm in width (Fig. 1). The wide-blade series measures from 8 to 15 cm in length and 6 to 12 cm in width. * Although the Deaver hand retractor is useful for large incisions, because of the curve of the blade it does not provide good exposure when the incision is narrow and deep. We have had
*Walter Lorenz Surgical Instruments, Inc., Center Drive, Jacksonville, Florida 32218.
214
9850
many years of experience with the Finochietto hand retractors, and we would like to share our satisfaction with our colleagues. The long-blade series of retractors are ideal for exposure of the renal pedicle, adrenal gland, and deep areas of the pelvic cavity during radical cystectomy and radical prostatectomy. The wide-blade retractors are useful in retracting small or large bowel and peritoneum as is usually required in doing an ileal conduit or retroperitoneal lymph node dissection. The ingenuity of the surgeon will decide when to use a narrow or a wide blade. During a radical nephrectomy, the hepatic flexure and transverse colon are held down with a large size, wide blade. We always start with a smaller size blade than that which is finally required. With satisfactory exposure obtained, the retractor is covered with a wet sponge neatly folded; the retractor is then placed over the sponge with a swift motion (retractorsponge-retractor). If considered necessary, the blade is replaced by a larger size. An identical maneuver is used in other areas such as in exposure of the deep pelvis. Surgery is an art of constant “rediscovery.” We believe that the Finochietto hand retractors will be a significant help to those who choose to use them. Room 2A118 VA Medical Center 50 Irving Street NW Washington, D. C. 20422
Interstate
UROLOGY
/ FEBRUARY
1987
I VOLUME
XXIX, NUMBER
2