Self-Retaining Ratchet Eases Retraction During Surgery

A next-generation surgical ratchet for the Bookwalter retractor system provides multiple configurations and reliable retraction in any position.

The Bookwalter Self-Retaining Rotilt Ratchet, built through collaboration with surgeons and operating room professionals, is a low-profile ratchet that features locking tilt and locking rotation in seven indexed positions along an arc of 60 degrees. The mechanism rotates the tilt ratchet, allowing the retractor blades to toe in in planes other than the flat plane of the system ring, adding another degree of freedom. This is critically important in retracting deep tissues, and permits precise blade placement while retaining the ability to quickly reposition the blade when necessary.


The Bookwalter Retractor System includes an over-the-drapes table post, an oval ring, and retractor blades placed on ratchet bars with straight and rotating ratchet mechanisms, which help to held the retractors and toe them in, much as a hand-held retractor. The tilt ratchet mechanism is released on the side rather, than at the back, facilitating the use of the ring for rectal, vaginal, and orthopedic surgery, where the ring is perpendicular to the floor. The Bookwalter Self-Retaining Rotilt Ratchet is a product of Symmetry Surgical (Warsaw, IN, USA), and is compatible with all legacy Bookwalter Retractor System components.

“By combining rotation, tilt, and self-retraction into a single ratchet, we've created a device that more closely mimics the natural toe-in motion of handheld retractors while retaining the benefits of table-mounted ring retractors,” said John Bookwalter, MD, the surgeon-inventor of the Bookwalter Retractor System. “The Self-Retaining Rotilt Ratchet is the product of three decades of innovation and continuous improvement.”

“Symmetry Surgical is dedicated to collaborating with our customers and responding to surgeon and clinician needs with new innovations,” said Chris Huntington, COO of Symmetry Surgical. “Our customers appreciated the features available with past generations of Bookwalter ratchets. By combining the best elements of our legacy ratchets into the new Self-Retaining Rotilt Ratchet, we're providing greater value in the surgical market and helping clinicians deliver exceptional patient care.”

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