Novel use of a Leyla-Yasargil retractor as an endoscope holder during endoscopic sinus surgery.

Abstract

The authors describe a novel way of fashioning an endoscope holder from a common retractor and an ear speculum. Using such a device during endoscopic sinus surgery leaves both of the surgeon's hands free to manipulate the instruments.

Introduction

When performing endoscopic sinus surgery, surgeons usually hold the rigid endoscope in their weak hand and manipulate the instruments with the other. In this brief article, we describe a novel method of fashioning a device that supports the endoscope so that both of the surgeon's hands are free to manipulate the instruments.

Technique

A Leyla-Yasargil retractor, an ear speculum, an ear speculum holder, and some plaster of Paris or dental molding material are required (figure 1). The endoscope is inserted through the ear speculum, and the speculum is filled with the plaster or dental molding material. As the plaster in the speculum sets around the endoscope, it creates a relatively durable impression; the modified speculum can then be reused for future surgeries.

[FIGURE 1 OMITTED]

Once the plaster has set, the endoscope can be removed. Then the speculum is attached to the speculum holder, the holder is attached to the retractor, and the retractor is attached to the operating table (figure 2). The retractor's flexible arm can be moved into any position by adjusting a wing screw. The endoscope is then re inserted through the speculum, placed into the nose, and fixed in any position the physician prefers.

[FIGURE 2 OMITTED]

To the best of our knowledge, our "invention" is not being used elsewhere. Other endoscope holders are commercially available for a price, but ours can be quickly crafted from readily available materials at minimal cost.

From the Department of Otolaryngology, University of Malaya Medical Center, Kuala Lumpur, Malaysia.

Reprint requests: Rajagopalan Raman MS, Professor, Department of Otolaryngology. University of Malaya Medical Center, 50603 Kuala Lumpur, Malaysia. Phone: [phone]; fax: [phone]; e-mail: [e-mail]