Introduction: Self-retaining retractors provide surgical exposure while preserving two-handed dexterity, and are commonly used instruments in open surgery. We present a brief history of several physicians who developed self-retaining retractors which remain in use today, namely Balfour, Thompson, and Bookwalter. Methods: Literature review was performed of primary and secondary sources regarding the Balfour, Thompson, and Bookwalter retractors, as well as the lives of the physicians whose names they bear. Results: Donald C. Balfour was born in Toronto in 1882 and joined the Mayo brothers in Rochester, Minnesota as a pathology assistant after completing his medical training. He went on to join the surgical staff, eventually heading the section of general surgery in 1912. In the same year he published his seminal article in Annals of Surgery detailing a “spreading retractor” which “holds its position firmly when introduced.” After tuberculosis forced him to give up his clinical practice, Balfour focused the remainder of his career on education and surgical training, going on to co-found the American Board of Surgeons and serve as president of the American College of Surgeons. Richard C. Thompson was born in Fresno in 1919. He studied medicine at Stanford and completed his internship at Yale. Thompson was not a surgeon but an anesthesiologist. The idea for his innovative eponymous retractor came to him in 1959 when he saw a colleague secure a gag to the drape with a clamp during a tonsillectomy, freeing his hands. He paired a metal bar with a post affixed to the bedrail and patented his retractor in 1965. Eventually, the use of his retractor system expanded to general surgery as a tool for hands-free abdominal exposure. John R. Bookwalter was born in Ohio and completed surgical residency and cardiothoracic fellowship in Boston after earning his degree from Harvard. In 1973, he opened a practice in Vermont, quickly realizing the challenges of maintaining exposure without assistance. This, paired with a disdain for holding retractors he developed in training, motivated him to devise his eponymous retractor. Taking advantage of access to a metallurgy workshop gained in the Army, he began developing his device, which was patented in 1979. It included a single-post design, over-the-drape setup, and a novel ratcheting method. He marketed his retractor to other surgeons, and it quickly achieved widespread use in abdominopelvic procedures. Conclusions: The contributions made to urology by Drs. Balfour, Thompson, and Bookwalter prevail to this day, as their retractors remain important instruments in the modern operating room. SOURCE OF Funding: None
