Design of a Quantitative Method for Assessing Neurosurgical Retractor Efficacy

Access to deep-seated brain lesions (e.g., tumors, aneurysms, hematomas, and other malformations) is challenging due to the potential for retraction-induced injury. Traditionally, neurosurgeons use dissection and blade retractors to push apart tissue to visualize and operate on target lesions. These blades apply focal pressure onto the brain, resulting in ischemia, edema, and parenchymal trauma, leading to complications in up to 29% of cases. Newer retractors, such as the NICO BrainPath and CortiTech Radiex have been developed to reduce this chance of injury. However, there is insufficient clinical data that supports their efficacy. Thus it is difficult for healthcare providers to justify switching to these new tools. As a result, adoption of a novel brain retractor requires quantitative evidence of the device’s efficacy. Through the use of a design-thinking process, a set of design requirements as well as an early prototype pressure and clinical outcomes. To that end, photographed under a microscope. Several markers can then be detected. For example, neuron necrosis in an H&E stain often presents as a condensed purple spot, which can be contrasted with healthy neurons that are wider spots with a light pink color. Thus, this paper describes the design of a clinically relevant method for quantifying neuronal damage resulting from the insertion of retraction tools.