Every surgeon develops her or his standard methodology to common pathologies in which different practices are achieved and which instrument and tool are used to accomplish individual tasks.
Much energy is devoted to mastering the surgical skills and mounting an operational rhythm. What often perceived, slight consideration to historic origin and importance of instruments that make the work conceivable.
For this, Freer Elevator presents an exciting example. Many of us are unaware with the history of this elevator and the actual significance of its name. The most erroneously it was assumed that “Freer” denotes to instrument function, but not belongs to its eponymous source. We endeavor to provide the basis of historical standpoint and specific uses of the instrument in this short piece of information.
Historical Perspective of Freer Elevator
This versatile instrument was designed by Dr. Freer and his colleagues due to the increasing demand for an instrument in neurosurgery. They were directly approached to instrumentation makers with an impression and explained to them the specified uses to get the final version after some iterations. The instrument designed by Dr. Freer was only used for nose and ear surgeries.
But the instrument has advanced over many years and the modern
version is now used for a range of surgical procedures. It is now available in
dull or sharp versions on a long or short handle. Typically it was designed to
be one-sided, but in the modern era, it is evolved into a double-ended
structure.
This amazing instrument is not only acknowledged due to its versatile uses in many fields but has an amazing history of its origin mentioned above. Initially, it was specifically made for use in neurosurgical procedures that need separation and elevation of periosteum and many other soft tissues.
Now,
it is considered a multipurpose instrument and used not only for elevation but
for scraping bones and dissections. The double-ended structure features both
sharp and blunt blades making it more versatile and ideal for a wide range of
patient needs.
Uses of Freer Elevator in General Surgeries
It is specifically used in neurosurgery, although it can also frequently use for otolaryngological, orthopedic, and general surgeries. The versatility of this instrument makes it best for macro-dissections.
The
delicate shape of elevator lends it to countless uses, including removal of
intervertebral disc fragments, renal tumors resectionining, and elevation of
nasal septal mucosa and periosteum.
The instrument is also named as Freer mucopericondrium
elevator or Freer septum elevator. The blades of the instrument have a gentle
curve to make elevation and dissections easy. The instrument shaft has
crenellations along one set of studs to improve the handling.
Some common uses are listed here
- To dissect interface between soft tissues and hard structure
- For dissection of the nail bed and periorbital, and scar tissue dissection in redone spine surgeries
- Combination of two elevators used to retract soft tissues before resectioning of renal tumors in urology procedures.
- Help in developing soft tissue passageway below the ribs.
- Useful cranial and spinal surgeries.
- Extremely useful for displaced bony fragments.
- Allow elevation of dura mater and nasal septal flap
- Carry out disc fragments in micro-discectomy
- The modified form is also helpful for safe alloplasts placement in the subcutaneous dissection pocket.
After reviewing all possible uses of this versatile instrument, we believe that this innovative tool presents a better way to insert the non-rigid facial grafts and alloplasts.
It helps in reducing the
technique-related complications of kinking, migration, and asymmetry. It also
reduced the chances of tissue trauma and other unnecessary surgical exposure.
Also Read : Joseph Elevator
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