retractor

A retractor is a surgical instrument designed to hold back tissues or organs to reveal an operative field. Retractors can be handheld, requiring an assistant, or self-retaining, using a frame or ratchet to maintain exposure. They work by applying controlled traction to tissue while protecting it with blades, pads, or bumpers.

Handheld retractors have various blade shapes—curved, straight, or malleable—and are used by hand to gently pry tissue aside. Self-retaining retractors include several designs that lock in place to maintain exposure without continuous manual effort. Common self-retaining types include Weitlaner, Gelpi, and abdominal retractors such as the Balfour-style unit, each engineered for specific anatomical regions and exposure needs.

In surgery, retractors are used to expose organs and wounds, protect soft tissues from instruments, and facilitate visualization and suction. Special-purpose retractors exist for dental surgery (mouth retractors that expose the oral cavity) and for plastic, orthopedic, or abdominal procedures. The choice of retractor depends on exposure requirements, tissue thickness, and the risk of tissue injury.

Materials are typically stainless steel with polished or satin finishes, though disposable plastic or lighter alloys are used in some settings. Proper use requires careful placement, avoidance of excessive force, and periodic relief of pressure to prevent tissue ischemia, necrosis, or nerve injury. Maintenance includes thorough cleaning and sterilization between cases, with attention to sharp or delicate tips and locking mechanisms.

The term retractor derives from retraction, the act of pulling back. Retracting tissue is a foundational principle in surgery, supported by a range of instruments designed to optimize access, safety, and outcomes across procedures and specialties.