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Israel rake retractor modification to improve exposure during oropharyngeal surgery on patients with larger body habitus

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Abstract

Purpose

Elective oropharyngeal surgery including tonsillectomy and uvulopalatopharyngoplasty performed for obstructive sleep apnea is increasingly performed on patients of larger body habitus. The use of the Crowe-Davis retractor in such patients may be complicated by a large barrel-chest making it difficult to anchor the retractor to the Mayo stand for suspension limiting oropharyngeal exposure. Here, we present a simple modification using the Israel Retractor to facilitate suspension of the Crowe-Davis mouth gag.

Methods

Operational instructions were followed for Israel retractor modification in oropharyngeal surgery.

Results

The Crowe-Davis retractor is able to anchor to the Israel retractor, whose prongs articulate on the Mayo Stand for suspension. This extension allows suspension of patients with larger body habitus in oropharyngeal surgery.

Conclusions

Use of the Israel retractor as an extension of the Crowe-Davis retractor handle provides an easy, quick, safe, and reliable method for placing patients of larger body habitus into suspension.

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Author information

Correspondence to Andrew M. Vahabzadeh-Hagh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Comment

This manuscript describes a technique for that is very simple and easy to incorporate to optimize visualization of the oropharynx with the Crowe-Davis retractor by incorporating the use of the Israel retractor which can be used to suspend on a Mayo Stand. This is an interesting and novel idea, and I am grateful to the authors for providing this interesting perspective. These insights may prove useful to many surgeons faced with the responsibility of operating on overweight and obese patients.

Soroush Zaghi

CA, USA

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Vahabzadeh-Hagh, A.M., Ramirez, E. Israel rake retractor modification to improve exposure during oropharyngeal surgery on patients with larger body habitus. Sleep Breath 21, 959–962 (2017). https://doi.org/10.1007/s11325-017-1569-3

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Keywords

  • Obstructive sleep apnea
  • Oropharynx
  • Sleep apnea
  • Sleep surgery