Surgical Rotation--my arms are killing me...

[babyruth]

What is the easiest or most efficient way to hold retractors for a couple of hours without having your arms fall off?

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[Zuwie]

My advices would be:
1) Get as loose-fitting gloves as possible. Try gloves 1/2-1 size bigger than those you are using now
2) A lot of times when you hold the retractor you don't have to tense your muscles. So don't unless they tell you to.
3) Make sure the table is not too high for you. Get a step if necessary.
Hope that helps

 

[mysophobe]

Waterski. Use your body weight by leaning back to take pressure off your arms. Just don't fall down.

 

[Dr JPH]

Use an "open hand" grip...if you know what I mean.

So rather than grabbing the retractor and holding it like a baseball bat or golf club, hold it in your hand so that it is looped around the palm and your fingers are free.

This way you can grasp it tighter when you need to or when you need to reposition it, but you can move all your fingers without releasing tension on the retractor.

 

[Dr JPH]

Pretend the curve in the hemostat is the curve in the retractor.

If it is too far down my hand into my fingers then I need to keep my fingers curled & clenched in order to hold the retractor. Your hand will get tired quickly.

Now...have the curve in the retractor curled around the meaty part of your hand. This way you can keep tension, still move your fingers but easily grab it with your fingers if you need to reposition.

 

[babyruth]

Thanks guys, every little bit helps.

 

[nabeya]

my hands and arms go numb after awhile and they dont feel like a part of my body anymore after holding retractors.

What is the easiest or most efficient way to hold retractors for a couple of hours without having your arms fall off?

 

[njbmd]

What is the easiest or most efficient way to hold retractors for a couple of hours without having your arms fall off?

Hi there,
Once your retractor has been placed by the operating surgeon get into the best position where you can be the most relaxed. If this is impossible, just ask when you can shift your weight. Most good surgeons will not want you to retract with full weight for two hours in one position. (That's what the Balfour and Buckwalter are for)

Try not to get into any position where your knees or back are locked. Get a step-up if you are not high enough. Breathe so that you can relax your shoulders.

The tip about the gloves is very important. If your gloves are too tight, your hands will go numb very quickly. Also, make sure that your surgical gown is big enough across the shoulders. Go up a size if it is pulling when you lean over slightly.

Try to get into the case so that the time passes faster.

njbmd 🙂

 

[dynx]

When I originally read through this thread I thought, "yeah, retracting sucks"
Then, last night, we did a hip replacement on a 350lb lady. That was the biggest f-ing leg I have ever seen, and due to issues with her hip it had to be held up manually and rotated in specific ways that seemed intentionally designed to f*ck up my back. Every muscle in my upper body was sore this morning and my lower back is still tweaked, when I rounded on her this morning, her hip was a bit sore and she let me know that we need to pay more attention to pain control, you see...she had a bit of trouble sleeping last night. So in conclusion, my empathy level for you and her is running a little low right now.

 

[edmadison]

Another tip, keep you elbows in close to your body if you can. This will give your arms some support.

Ed

 

[zxcv1234]

If you have some time, strength training should help.

 

[carrigallen]

Most of it is posture, I think. Keep elbows close, your lats flexed, your back straight, chin up and stay comfortable. Don't be afraid to alternate your grip every 10 minutes, and/or let a resident take over when you need it. I know a resident who got cubital tunnel neuropathy from retracting for too long. You can also try a different retractor - I dislike the Deaver retractor.

 

[Roux-en-Y]

pre-dose w/ nsaid in anticipation. also, abdominal strength training ; a strong abdomen takes pressure off your back.

 

[babyruth]

Thanks guys. The farther I got into this rotation the better I got with holding retractors so it wouldn't kill me. But I guess I benefited because now my arms are pretty buff. I also would shift my weight alot on my feet which seemed to help.

 

[JunkintheTrunk]

i'm thinking of taking steroids for my surg rotation...will that help?

 

[mysophobe]

Keep your knees slightly bent, don't have your wrists at weird angles, don't squeeze the retractor too hard, and don't pull excessively when you don't need to do so. It also helps to keep an eye on the action--when they're doing something on the other side of the field, or they're just waiting, you can relax. I'd advise against trying to use a different retractor. The attending wants that one for a specific reason; he's not picking them with your preference in mind.

 

[MossPoh]

Most of it is posture, I think. Keep elbows close, your lats flexed, your back straight, chin up and stay comfortable. Don't be afraid to alternate your grip every 10 minutes, and/or let a resident take over when you need it. I know a resident who got cubital tunnel neuropathy from retracting for too long. You can also try a different retractor - I dislike the Deaver retractor.

Almost sounds like you are describing how to do a proper deadlift.