New surgical retractor design combines advantages of speed, exposure
San Antonio, Texas (November 8, 2021) – As a veteran Navy trauma surgeon, Dr. Ramon Cestero has put a lot of people back together. He’s done multiple tours, working in combat zones in tough conditions, stopping bleeding in horribly injured soldiers and Marines, propping their abdomens open with a portable retractor, rapidly controlling life-threatening injuries, stabilizing them enough to get them to the next level of care.
In a combat zone, there were many challenges that simply had to be accepted – ORs were tents or “buildings of opportunity”, beds were litters or tables they could find, lighting sources were headlamps, blood products were very limited (they almost never had platelets that are vitally helpful in stopping bleeding), assistants were typically Marines or soldiers with no medical training. Under these circumstances medical personnel would have to work on patients who were as severely injured as a person could be and still be alive – blown up or shot with high-velocity weapons, often bleeding badly internally. To hold open the abdomen so that he could find the bleeding and stop it, Cestero would have to use the very simple, century-old portable retractor.
While he would work on the battlefield, often in a tent at night with shelling nearby, Cestero imagined a better retractor, one that could change shape according to the patient, giving him better visibility into their wounds.
“There are essentially two types of retractors for abdominal surgery used worldwide. One consists of two metal bars on a ratcheted system that you insert into the wound and quickly ratchet it open, but unfortunately it provides limited visibility,” Cestero said. The other type is a larger, more complicated device that gives a greater range of options in exposing a visible workspace in the body, but it requires an attachment to a table and takes time to set up and maneuver into place.
Either way, the surgical team loses something important.
“Why should a surgeon have to sacrifice either speed or exposure when a patient’s life is at risk?” he said.
Fast forward several years and head 7,500 miles west to San Antonio, Texas. Now a trauma surgeon with University Health and Professor of Surgery with UT Health San Antonio, Cestero worked with UT Health San Antonio’s Office of Technology Commercialization, and after partnering with an engineer, he built the better retractor he’d been visualizing. He subsequently founded Advanced Surgical Retractor Systems, Inc., to further develop and commercialize the TITAN Cestero Surgical Retractor (CSR).
The TITAN CSR was introduced last summer in University Hospital’s level 1 trauma center.
