Saraj Retractor: A Novel Retractor System for Deep Seated Intracranial Surgeries and Its Comparative Analysis with Conventional Retractor System

BACKGROUND AND OBJECTIVES: Micro-neurosurgery and minimally invasive neurosurgery have become more common in intracranial procedures for lesions such as Intraventricular tumors, intracranial hematomas, and Posterior fossa tumors. Deep seated lesions require bidirectional retraction of normal overlying brain tissue for better surgical access. For past many decades, conventional retractor systems are in use without any significant modification or innovation. Here we are introducing a novel retractor system suitable for ergonomics of neurosurgeons without disturbing microscopic and endoscopic vision. METHODS: A total of eighty (80) patients of deep-seated intracranial lesions were included in the study between January 1, 2024 and April 1, 2025. Forty patients were operated by the Conventional retractor system and rest 14 were operated by our novel retractor system. Surgical and radiological parameters of both the retractor system were calculated and compared along with outcome assessment. CT perfusion was conducted pre- and post-operatively in both the groups. A questionnaire regarding assistance, ergonomics, and instrument handling compared to the conventional retractor system was performed. All patients were followed up for 3 months to observe for any new neurological deficits. RESULTS: In microsurgery for deep seated tumors, conventional retractor got replaced with our novel retractor system. The mean operative time with novel Saraj Retractor was similar as with conventional retractor. However, time of application and adjustment were reduced. The mean cerebral blood flow and mean transit time were similar in both the retractor groups without any ischemic changes on the surrounding brain parenchyma. There were no intra-operative complications directly related to the use of the device. CONCLUSION: Our Novel retractor system is facilitating safe separation of brain parenchyma bilaterally with minimal retraction pressure. It effectively reduces the time for assembly and attachment as compared to conventional retractor system. It reduces the surgeon's fatigue and minimizes the dependency on assistant surgeon.