Purpose: Minimally invasive surgical approaches to renal and adrenal tumors
have gained increasing use. The addition of robotic assistance and mechani
cal devices has decreased the number of assistants required for these often
long cases. We describe an articulating arm retractor holder to aid in Liv
er and spleen retraction during laparoscopic surgery.
Materials and Methods: The articulating retractor holder consists of 4 comp
onents, including a base rod, flexible extension arm, stainless steel preci
sion clamp and table attachment. During laparoscopy the abdomen is visualiz
ed using standard approaches. The articulating retractor holder is clamped
to the table via the base rod and brought into the surgical field using ste
rile technique. A retractor is placed intracorporeally to elevate the Liver
or spleen and the handle is secured in place using the precision clamp.
Results: The articulating retractor holder was used in all right and approx
imately 50% of left laparoscopic cases. Adequate visualization was obtained
in all patients. There were no device failures or retractor related compli
cations.
Conclusions: The articulating retractor holder is a useful tool to aid in l
aparoscopic retraction that should be added to the urologist armamentarium.