• Amedeo Piazza, Luca Ricciardi, Sokol Trungu, Stefano Forcato, Alessandro di Bartolomeo, Alba Scerrati, Massimo Miscusi, and Antonino Raco.
• Operative Unit of Neurosurgery, AOSA, Department of NESMOS, Sapienza, Rome, Italy; Department of Neurosurgery, IRCCS, Neuromed, La Sapienza, Pozzilli, Italy. Electronic address: amedeo.piazza@uniroma1.it.
• World Neurosurg. 2021 Sep 1; 153: 36-40.

BackgroundWe investigated the role of a self-retaining retractor system, commonly used in ear, abdominal, vascular, urologic and gynecologic surgeries: the Lone Star retractor system. We report our experience in using the Lone Star retractor in different brain surgeries, at a single neurosurgical department.MethodsIn 2019, patients who underwent brain surgery and in which the Lone Star Retractor System was used were considered for inclusion. Clinical and surgical data of included patients were prospectively collected. Postoperative VAS for local pain, and a properly designed intraoperative retractor stability score, were collected.ResultsOver 2019, the Lone Stare Retractor was used in 20 neurosurgical procedures: 9 high-grade glioma, 2 low-grade glioma, 4 cerebral metastases, and 5 meningiomas. Postoperative mean VAS score was 3.5 (range: 2-4). Intraoperative retractor stability score mean was 2 in frontal, 2 in pterional, 1.75 in subtemporal, 2 in interhemispheric, and 0.5 in suboccipital approaches. The Stony Brook Scar Evaluation Scale mean value was 4.4 (range: 3-5).ConclusionsIn our institutional experience, the Lone Star retractor showed many advantages in different brain procedures, when compared with standard fishhooks and other retractors.Copyright © 2021 Elsevier Inc. All rights reserved.

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