Millard Thimble Double Hook, 18 mm – Left Thumb

This is a retractor you wear. A ring fits over the thumb and carries the hooks, so retraction comes from a digit the surgeon is using anyway — no instrument occupies a hand, and no assistant is needed to hold one. In cleft lip repair, where the field is a few centimetres across and already crowded with needle holder, forceps and scissors, removing an instrument from the field is worth more than it sounds.

It also changes how the tension is controlled. A held retractor is adjusted by moving the whole arm; a thimble is adjusted by the thumb, which the surgeon is already using for fine positioning and which gives continuous, proprioceptive feedback on how hard the tissue is being pulled. Two hooks rather than one keep the lip element square rather than letting it rotate, which matters when the alignment of the vermilion border is the thing being judged.

Specifications