A low-cost indigenous self-retaining perineal retractor: Design and early clinical evaluation.

Commercial self-retaining perineal retractors provide excellent exposure during anorectal and vaginal surgery but remain prohibitively expensive for many resource-limited hospitals. We designed an indigenous self-retaining perineal retractor using readily available materials, incorporating a re-usable stainless-steel ring, modified barbless fishing hooks, disposable Foley catheter traction strings and a novel self-locking slot mechanism. The device was prospectively evaluated in three patients undergoing colorectal and gynecological procedures. It provided stable self-retaining circumferential exposure, facilitated precise dissection and suturing and was not associated with device-related complications. Costing approximately US$10, this reusable system offers an affordable, versatile alternative for perineal surgery in low-resource settings.