Malleable Yu-Holtgrewe retractor blade (designed by H. Logan
Holtgrewe, George W. Yu and Genevieve N. Jacobs) fits on standard
Balfour or Bookwalter self-retaining retractors. The central groove
traps the bladder, Foley catheter and its balloon in position without
use of a laparotomy pad. For proper retraction, the Foley balloon
should be inflated to 40 ml.
The malleable blade is bent about 70 to 80 degrees to provide depth
of retraction. A slight bend in the 2 ends of the blade provides a
“toeing-in˝ effect, trapping the Foley catheter and balloon within the
bladder. After positioning the malleable blade, with the shaft of the
Foley catheter trapped in the groove, the arm of the blade is engaged
over the set screw of the self-retaining retractor and the blade is
pulled cephalad to the maximum desired position. The wing nut of
the retractor is then tightened. The additional maneuver of applying
posterior pressure with a sponge stick on the retracted and stretched
anterior prostate and bladder wall exposes the retropubic space.