Retractor Hook [Neurosurgery Wiki]

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====== Retractor Hook ======

**[[Retractor]] [[hook]]** (also known as a surgical hook retractor) is a handheld or self-retaining surgical instrument used to hold back soft tissue, muscle, skin, or organs to provide better exposure of the surgical field.

===== Purpose and Function =====
  * To retract tissue or anatomical structures during surgical procedures.
  * Allows the surgeon unobstructed visualization and access to the target area.
  * Reduces the need for manual retraction by assistants.

===== Types =====

=== By Design ===
  * **Sharp hook**: Penetrates fascia or muscle. Used in spinal, orthopedic, or neurosurgical exposure.
  * **Blunt hook**: Retracts softer structures without trauma (e.g., vessels or nerves).
  * **Skin hook**: Fine and delicate, used in plastic or ophthalmic surgery.

=== By Configuration ===
  * **Handheld**: Requires manual control by assistant or surgeon.
  * **Self-retaining**: Mounted or attached to retraction systems (e.g., Leyla arm, Greenberg system).

===== Common Examples =====
  * **Cushing hook**
  * **Cloward hook**
  * **Hohmann retractor (with hook tip)**
  * **Adson hook**
  * **Miyake nerve hook**

===== Surgical Uses =====
  * **Neurosurgery**: Retraction of dura, nerve roots, brain parenchyma.
  * **Orthopedic surgery**: Exposure of joints, bones, and ligaments.
  * **ENT and plastic surgery**: Fine tissue handling with minimal trauma.
  * **Spinal surgery**: Retraction of paraspinal muscles, lamina, or dura.

===== Key Considerations =====
  * Must avoid excessive pressure to prevent tissue ischemia or nerve damage.
  * Sharp hooks must be used carefully to prevent accidental puncture.
  * Always assess anatomical relationships before placement.
  * Should be cleaned and inspected regularly to maintain sharpness and integrity.

===== Related Instruments =====
  * Langenbeck retractor
  * Rake retractor
  * Deaver retractor
  * Nerve root retractor
  * Malleable retractor