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The need for clear vision in the depth of a small field is well recognized by every neurosurgeon. Operations on the brain and spinal cord must be performed within a very limited area, such as the transfrontal approach to the pituitary body, the section of the posterior root of the trigeminus, and certain suboccipital operations involving the cerebellopontile angle.
The lighted retractor has proved invaluable in exploring these deep recesses below the brain. The great problem at present concerns the matter of sponging within the depths of the wound, so as to give a clear view of the structures and landmarks presenting during the operation. The extreme friability of the cortical vessels has made it necessary to use the softest cotton pledgets, small enough to be introduced into the limited space concerned. A small amount of hemorrhage in the depth of the wound arrests the progress of the operation
Fay T. A NEW INSTRUMENT COMBINING SUCTION AND IRRIGATION FOR INTRACRANIAL SURGERY. JAMA. 1927;89(1):25-26. doi:10.1001/jama.1927.92690010001010