U.S. patent application number 14/218667 was filed with the patent office on 2014-07-24 for patient positioning support structure.
The applicant listed for this patent is Roger P. Jackson. Invention is credited to Roger P. Jackson.
Application Number | 20140201914 14/218667 |
Document ID | / |
Family ID | 38668395 |
Filed Date | 2014-07-24 |
United States Patent
Application |
20140201914 |
Kind Code |
A1 |
Jackson; Roger P. |
July 24, 2014 |
PATIENT POSITIONING SUPPORT STRUCTURE
Abstract
A patient support system includes independently adjustable
columns supporting a hinged bending or breaking patient support
structure. At least one column includes at least two sections. A
coordinated drive system provides for upwardly breaking and
downwardly breaking orientations of the two sections in various
inclined and tilted positions.
Inventors: |
Jackson; Roger P.; (Prairie
Village, KS) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Jackson; Roger P. |
Prairie Village |
KS |
US |
|
|
Family ID: |
38668395 |
Appl. No.: |
14/218667 |
Filed: |
March 18, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13902466 |
May 24, 2013 |
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14218667 |
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13317012 |
Oct 6, 2011 |
8719979 |
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13902466 |
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12460702 |
Jul 23, 2009 |
8060960 |
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13317012 |
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11788513 |
Apr 20, 2007 |
7565708 |
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12460702 |
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11159494 |
Jun 23, 2005 |
7343635 |
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11788513 |
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11062775 |
Feb 22, 2005 |
7152261 |
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11159494 |
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60798288 |
May 5, 2006 |
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Current U.S.
Class: |
5/610 |
Current CPC
Class: |
A61G 7/008 20130101;
A61G 13/08 20130101; A61G 13/0054 20161101; A61B 6/0407 20130101;
A61B 6/0421 20130101; A61G 13/02 20130101; A61G 7/001 20130101;
A61G 13/06 20130101; A61G 13/04 20130101; A61B 6/0487 20200801;
A61G 13/0036 20130101; A61G 13/0018 20130101 |
Class at
Publication: |
5/610 |
International
Class: |
A61G 13/04 20060101
A61G013/04; A61G 13/06 20060101 A61G013/06 |
Claims
1. A surgical table comprising: first and second vertical supports
spaced-apart from each other; a patient support extending between
the first and second supports and comprising first and second ends
opposite from each other and a joint intermediate a length of the
patient support; and first and second mechanical arrangements
respectively operably coupling the first and second ends to the
first and second vertical supports, wherein the first and second
mechanical arrangements are configured so the patient support can
pivot between the vertical end supports in a direction transverse
to the length of the patient support and articulate at the joint, a
change in a lengthwise distance between the first and second ends
of the patient support on account of the patient support
articulating at the joint being compensated for in a shared manner
by the first and second mechanical arrangements.
2. The surgical table of claim 1, wherein, when the patient support
articulates at the joint, a distance between the first and second
vertical supports does not change.
3. The surgical table of claim 1, wherein the surgical table is
configured such that the first and second ends are independently
adjustable with respect to height.
4. The surgical table of claim 1, wherein each vertical support of
the first and second vertical supports is independently adjustable
with respect to height so as to cause the first and second ends to
be independently adjustable with respect to height.
5. The surgical table of claim 4, wherein each vertical support of
the first and second vertical supports comprises a telescopic
configuration.
6. The surgical table of claim 1, wherein the patient support
comprises a first segment extending between the first end and the
joint and a second segment extending between the second end and the
joint, the first and second segments both comprising an open-frame
configuration defined by transversely spaced-apart longitudinally
extending frame members.
7. The surgical table of claim 1, wherein each of the first and
second mechanical arrangements comprises a rotation subassembly and
an angulation subassembly coupled to the rotation subassembly.
8. The surgical table of claim 7, wherein the rotation subassembly
enables the patient support to pivot between the vertical end
supports in the direction transverse to the length of the patient
support, and the angulation subassembly enables the patient support
to articulate at the joint such that angulation subassembly
compensates for a portion of the change in the lengthwise distance
between the first and second ends.
9. The surgical table of claim 8, wherein the angulation
subassembly is pivotally coupled to a respective vertical support
of the first and second vertical supports by the rotation
subassembly.
10. The surgical table of claim 8, wherein the rotation subassembly
comprises a pivot shaft extending in a direction of the length of
the patient support, each end of the first and second ends
pivotally coupled via such a pivot shaft to a respective vertical
support of the first and second vertical supports.
11. The surgical table of claim 10, wherein such a pivot shaft
enables the patient support to pivot between the vertical end
supports in the direction transverse to the length of the patient
support.
12. The surgical table of claim 11, wherein such a pivot shaft
projects from the respective vertical support.
13. The surgical table of claim 7, wherein the angulation
subassembly is located below the rotation subassembly when a
patient supporting surface of the patient support is facing
upward.
14. The surgical table of claim 7, wherein the angulation
subassembly comprises a pivot transverse to the length of the
patient support, a respective end of the first and second ends
pivoting about the pivot when the patient support articulates at
the joint.
15. The surgical table of claim 14, wherein the angulation
subassembly further comprise a mechanical configuration that acts
with the pivot to allow the angulation subassembly to compensate
for the portion of the change in the lengthwise distance between
the first and second end when the patient support articulates at
the joint.
16. The surgical table of claim 15, wherein the mechanical
configuration comprises a member with a slot in which the pivot is
received, the slot displacing along the pivot as the angulation
subassembly compensates for the portion of the change in the
lengthwise distance between the first and second end when the
patient support articulates at the joint.
17. The surgical table of claim 14, wherein the pivot is located
below the rotation subassembly when a patient supporting surface of
the patient support is facing upward.
18. The surgical table of claim 17, wherein a linear member extends
downward from the rotation subassembly to the pivot when a patient
supporting surface of the patient support is facing upward, the
linear member maintaining the pivot in a spaced-apart relation to
the rotation subassembly.
19. The surgical table of claim 18, wherein the rotation
subassembly comprises a pivot shaft extending in a direction of the
length of the patient support, the pivot shaft enabling the patient
support to pivot between the vertical end supports in the direction
transverse to the length of the patient support, the linear member
located between the pivot shaft and the pivot and maintaining the
pivot in a spaced-apart relation to the pivot shaft, the pivot
being located below the pivot shaft when the patient supporting
surface of the patient support is facing upward.
20. The surgical table of claim 1, wherein the first and second
mechanical arrangements are configured so the patient can make a
full rotation when pivoting between the vertical end supports in a
direction transverse to the length of the patient support.
21. The surgical table of claim 1, further comprising a drive
system that actively drives the joint in articulating the patient
support at the joint.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 13/902,466 filed May 24, 2013, which application is a
continuation of U.S. application Ser. No. 13/317,012 filed Oct. 6,
2011 entitled Patient Positioning Support Structure, which
application is a continuation of U.S. Ser. No. 12/460,702, filed
Jul. 23, 2009, now U.S. Pat. No. 8,060,960, which is a continuation
of U.S. Ser. No. 11/788,513, filed Apr. 20, 2007, now U.S. Pat. No.
7,565,708, which claims the benefit of U.S. Provisional Application
No. 60/798,288 filed May 5, 2006 and is also a continuation-in-part
of U.S. patent application Ser. No. 11/159,494 filed Jun. 23, 2005,
now U.S. Pat. No. 7,343,635, which is a continuation-in-part of
U.S. patent application Ser. No. 11/062,775 filed Feb. 22, 2005,
now U.S. Pat. No. 7,152,261. The disclosures of all the preceding
applications and patents are incorporated by reference herein.
BACKGROUND OF THE INVENTION
[0002] The present invention is directed to structure for use in
maintaining a patient in a desired position during examination and
treatment, including medical procedures such as imaging and surgery
and in particular to such a structure that allows a surgeon to
selectively position the patient for convenient access to the
surgery site and providing for manipulation of the patient during
surgery including the tilting, pivoting, angulating or bending of a
trunk of a patient in a supine, prone or lateral position.
[0003] Current surgical practice incorporates imaging techniques
and technologies throughout the course of patient examination,
diagnosis and treatment. For example, minimally invasive surgical
techniques, such as percutaneous insertion of spinal implants,
involve small incisions that are guided by continuous or repeated
intra-operative imaging. These images can be processed using
computer software programs that produce three dimensional images
for reference by the surgeon during the course of the procedure. If
the patient support surface is not radiolucent or compatible with
the imaging technologies, it may be necessary to interrupt the
surgery periodically in order to remove the patient to a separate
surface for imaging followed by transfer back to the operating
support surface for resumption of the surgical procedure. Such
patient transfers for imaging purposes may be avoided by employing
radiolucent and other imaging compatible systems. The patient
support system should also be constructed to permit unobstructed
movement of the imaging equipment and other surgical equipment
around, over and under the patient throughout the course of the
surgical procedure without contamination of the sterile field.
[0004] It is also necessary that the patient support system be
constructed to provide optimum access to the surgical field by the
surgery team. Some procedures require positioning of portions of
the patient's body in different ways at different times during the
procedure. Some procedures, for example, spinal surgery, involve
access through more than one surgical site or field. Since all of
these fields may not be in the same plane or anatomical location,
the patient support surfaces should be adjustable and capable of
providing support in different planes for different parts of the
patient's body as well as different positions or alignments for a
given part of the body. Preferably, the support surface should be
adjustable to provide support in separate planes and in different
alignments for the head and upper trunk portion of the patient's
body, the lower trunk and pelvic portion of the body as well as
each of the limbs independently.
[0005] Certain types of surgery, such as orthopedic surgery, may
require that the patient or a part of the patient be repositioned
during the procedure while in some cases maintaining the sterile
field. Where surgery is directed toward motion preservation
procedures, such as by installation of artificial joints, spinal
ligaments and total disc prostheses, for example, the surgeon must
be able to manipulate certain joints while supporting selected
portions of the patient's body during surgery in order to
facilitate the procedure. It is also desirable to be able to test
the range of motion of the surgically repaired or stabilized joint
and to observe the gliding movement of the reconstructed
articulating prosthetic surfaces or the tension and flexibility of
artificial ligaments and other types of dynamic stabilizers before
the wound is closed. Such manipulation can be used, for example, to
verify the correct positioning and function of an implanted
prosthetic disc or joint replacement during a surgical procedure.
Where manipulation discloses binding, sub-optimal position or even
crushing of the adjacent vertebrae, for example, as may occur with
osteoporosis, the prosthesis can be removed and the adjacent
vertebrae fused while the patient remains anesthetized. Injury
which might otherwise have resulted from a "trial" use of the
implant post-operatively will be avoided, along with the need for a
second round of anesthesia and surgery to remove the implant or
prosthesis and perform the revision, fusion or corrective
surgery.
[0006] There is also a need for a patient support surface that can
be rotated, articulated and angulated so that the patient can be
moved from a prone to a supine position or from a prone to a
90.degree. position and whereby intra-operative extension and
flexion of at least a portion of the spinal column can be achieved.
The patient support surface must also be capable of easy, selective
adjustment without necessitating removal of the patient or causing
substantial interruption of the procedure.
[0007] For certain types of surgical procedures, for example spinal
surgeries, it may be desirable to position the patient for
sequential anterior and posterior procedures. The patient support
surface should also be capable of rotation about an axis in order
to provide correct positioning of the patient and optimum
accessibility for the surgeon as well as imaging equipment during
such sequential procedures.
[0008] Orthopedic procedures may also require the use of traction
equipment such as cables, tongs, pulleys and weights. The patient
support system must include structure for anchoring such equipment
and it must provide adequate support to withstand unequal forces
generated by traction against such equipment.
[0009] Articulated robotic arms are increasingly employed to
perform surgical techniques. These units are generally designed to
move short distances and to perform very precise work. Reliance on
the patient support structure to perform any necessary gross
movement of the patient can be beneficial, especially if the
movements are synchronized or coordinated. Such units require a
surgical support surface capable of smoothly performing the
multi-directional movements which would otherwise be performed by
trained medical personnel. There is thus a need in this application
as well for integration between the robotics technology and the
patient positioning technology.
[0010] While conventional operating tables generally include
structure that permits tilting or rotation of a patient support
surface about a longitudinal axis, previous surgical support
devices have attempted to address the need for access by providing
a cantilevered patient support surface on one end. Such designs
typically employ either a massive base to counterbalance the
extended support member or a large overhead frame structure to
provide support from above. The enlarged base members associated
with such cantilever designs are problematic in that they may
obstruct the movement of C-arm mobile fluoroscopic imaging devices.
Surgical tables with overhead frame structures are bulky and may
require the use of dedicated operating rooms, since in some cases
they cannot be moved easily out of the way. Neither of these
designs is easily portable or storable.
[0011] Thus, there remains a need for a patient support system that
provides easy access for personnel and equipment, that can be
easily and quickly positioned and repositioned in multiple planes
without the use of massive counterbalancing support structure, and
that does not require use of a dedicated operating room.
SUMMARY OF THE INVENTION
[0012] The present invention is directed to a patient support
system that permits adjustable positioning, repositioning and
selectively lockable support of a patient's head and upper body,
lower body and limbs in up to a plurality of individual planes
while permitting tilting, rotation, angulation or bending and other
manipulations as well as full and free access to the patient by
medical personnel and equipment. The system of the invention
includes at least one support end or column that is height
adjustable. The illustrated embodiment includes a pair of
independently height-adjustable end support columns. The columns
may be independent or connected to a horizontally length-adjustable
base. One support column according to the invention may be coupled
with a wall mount or other stationary support. A patient support
structure is connected to and bridges substantially between the
pair of end supports. The support structure may be a frame or other
patient support having at least first and second hingeable or
pivotally connected portions, the first and second portions being
selectively lockable in a first substantially planar orientation
along a longitudinal axis of the support structure. The first and
second portions are also positionable and lockable in a plurality
of angles with respect to one another, with each portion being
movable to a position on either side of the first planar
orientation. In other words, the patient support structure is
capable of hinging or otherwise bending to form an angulation or
break, either upwardly or downwardly when the support structure is
in a substantially horizontal position and also when the support
structure is in an inclined position due to one of the support
columns raising one end of the structure higher than another end.
Of course, such a break may be from side-to-side when the support
structure is rotated about a longitudinal axis thereof.
[0013] In a particular illustrated embodiment, angulation or
breaking of the support structure is supported by a cable drive
system (tension band suspension) that supports angulation using
stationary end supports. Other embodiments include cantilevered
systems with connected or unconnected movable or telescoping base
supports. The first and second support structure portions may be in
the form of frames, such as rectangular frames or other support
structure that may be equipped with support pads for holding the
patient, or other structure, such as imaging tops.
[0014] The patient support structure and the support column or
columns are coupled with respective rotation, articulation or
angulation adjustment structure for positioning the first support
portion with respect to a first column or end support and with
respect to the second support portion and the second support
portion with respect to the second column or end support. Rotation
adjustment structure in cooperation with pivoting and height
adjustment structure provide for the lockable positioning of the
first and second patient support portions at a variety of selected
positions and articulations with respect to the support columns
including angulation coupled with Trendelenburg and reverse
Trendelenburg configurations as well as providing for patient roll
over in horizontal or tilted orientation. Lateral movement (toward
and away from a surgeon) may also be provided by a bearing block
feature. A pair of patient support structures (such as a support
frame and an imaging table) may be mounted between end supports of
the invention and then rotated in unison about a longitudinal axis
to achieve 180.degree. repositioning of a patient, from a prone to
a supine position.
[0015] Various objects and advantages of this invention will become
apparent from the following description taken in relation to the
accompanying drawings wherein are set forth, by way of illustration
and example, certain embodiments of this invention.
[0016] The drawings constitute a part of this specification,
include exemplary embodiments of the present invention, and
illustrate various objects and features thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] FIG. 1 is a perspective view of a patient support structure
according to the invention.
[0018] FIG. 2 is an enlarged and partial side elevational view of a
portion of the support structure of FIG. 2.
[0019] FIG. 3 is an enlarged and partial top plan view of the
support structure of FIG. 1.
[0020] FIG. 4 is an enlarged and partial perspective view of a
portion of the structure of FIG. 1.
[0021] FIG. 5 is an enlarged and partial side elevational view of a
portion of the structure of FIG. 1.
[0022] FIG. 6 is an enlarged and partial perspective view of a
portion of the structure of FIG. 1.
[0023] FIG. 7 is an enlarged and partial perspective view of a
first hinge of the structure of FIG. 1.
[0024] FIG. 8 is an enlarged and partial perspective view of a
cooperating second hinge of the structure of FIG. 1.
[0025] FIG. 9 is an enlarged and partial elevational view of the
hinge of FIG. 7.
[0026] FIG. 10 is an enlarged and partial perspective view of an
outer portion of the hinge of FIG. 7 with portions broken away to
show the detail thereof.
[0027] FIG. 11 is an enlarged and partial perspective view of an
inner portion of the hinge of FIG. 7 with portions broken away to
show the detail thereof.
[0028] FIG. 12 is an enlarged and partial perspective view of a
portion of the structure of FIG. 1 showing a cable drive motor and
winch cylinders.
[0029] FIG. 13 is a partial perspective view of a patient support
frame of the structure of FIG. 1.
[0030] FIG. 14 is a partial perspective view of a patient imaging
top for replacement with the patent support frame of FIG. 13.
[0031] FIG. 15 is a reduced perspective view of the structure of
FIG. 1 shown with an imaging top of FIG. 14 replacing the support
frame of FIG. 13 and shown in a planar inclined position.
[0032] FIG. 16 is a perspective view of the structure of FIG. 15
shown in a planar tilted position.
[0033] FIG. 17 is a perspective view of the structure of FIG. 15
shown in a planar inclined and tilted position.
[0034] FIG. 18 is a side elevational view of the structure of FIG.
15 shown in a symmetrical upward breaking position.
[0035] FIG. 19 is a side elevational view of the structure of FIG.
15 shown in a first inclined and upward breaking position.
[0036] FIG. 20 is a side elevational view of the structure of FIG.
15 shown in a second inclined and upward breaking position.
[0037] FIG. 21 is a side elevational view of the structure of FIG.
15 shown in a symmetrical downward breaking position.
[0038] FIG. 22 is a side elevational view of the structure of FIG.
15 shown in a first inclined and downward breaking position.
[0039] FIG. 23 is a side elevational view of the structure of FIG.
15 shown in a second inclined and downward breaking position.
[0040] FIG. 24 is an enlarged side elevational view of the
structure of FIG. 1 shown in an upward breaking, inclined and
tilted position.
[0041] FIG. 25 is a is a perspective view of a second embodiment of
a patient support structure according to the invention.
[0042] FIG. 26 is a perspective view of the patient support
structure of FIG. 25 shown tilted in an intermediate position
during a rotation as would be used for a patient rollover.
[0043] FIG. 27 is a perspective view of the structure of FIG. 25
shown further tilted in a second intermediate position during
rotation.
[0044] FIG. 28 is a perspective view of the structure of FIG. 25
shown after rotation to a final flipped position.
[0045] FIG. 29 is a front elevational view of a third embodiment of
a patient support structure according to the invention.
[0046] FIG. 30 is a front elevational view of a fourth embodiment
of a patient support structure according to the invention.
[0047] FIG. 31 is a perspective view of a fifth embodiment of a
patient support structure according to the invention shown in a
planar inclined position.
[0048] FIG. 32 is a perspective view of the structure of FIG. 31
shown in an inclined and upward breaking position.
[0049] FIG. 33 is a perspective view of the structure of FIG. 31
shown in a substantially symmetrical downward breaking
position.
DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
[0050] As required, detailed embodiments of the present invention
are disclosed herein; however, it is to be understood that the
disclosed embodiments are merely exemplary of the invention, which
may be embodied in various forms. Therefore, specific structural
and functional details disclosed herein are not to be interpreted
as limiting, but merely as a basis for the claims and as a
representative basis for teaching one skilled in the art to
variously employ the present invention in virtually any
appropriately detailed structure.
[0051] Referring now to the drawings, a patient positioning support
structure according to the invention is generally designated by the
reference numeral 1 and is depicted in FIGS. 1-12. The structure 1
includes first and second upright support piers or columns 3 and 4
which are illustrated as independent, stationary floor base support
structures as shown in FIG. 1 or may be connected to one another by
a non-telescoping base support as illustrated in the embodiment
shown in FIGS. 25-28. In some embodiments according to the
invention as shown, for example, in FIGS. 31-33, the base
connection places the columns in a selectively telescoping
relationship. It is also foreseen that in certain embodiments
according to the invention, one of the support columns may be
replaced by a conventional operating table support, or may even be
a wall mount. In the illustrated embodiment, the upright support
column 3 is connected to a first support assembly, generally 5, and
the upright support column 4 is connected to a second support
assembly, generally 6. Between them, the support assemblies 5 and 6
uphold an elongate and angulatable or breaking patient holding or
support structure, generally 10 and optionally, a removable patient
support structure that will be described with respect to another
embodiment of the invention. The illustrated support structure 10
includes a first frame section 12, a second frame section 14 with a
transverse support cross bar 15, and a pivot or hinge assembly,
generally 16. In the illustrated embodiment, the pivot assembly
further includes a cable drive system including a dual winch 18 and
cooperating cables 20.
[0052] The columns 3 and 4 are supported by outwardly extending
feet 22 that may or may not include spaced apart casters or wheels
(not shown) each equipped with a floor-lock foot lever for lowering
the feet 12 into a floor-engaging position as shown in FIG. 1. The
columns 3 and 4 each include two or more telescoping lift arm
segments 3a, 3b and 4a, 4b, respectively that permit the height of
each of the columns 3 and 4 to be selectively increased and
decreased in order to raise and lower all or a selected portion of
the connected patient support structure 10. It is foreseen that the
vertical supports 3 and 4 may be constructed so that the column 3
has a greater mass than the support column 4 or vice versa in order
to accommodate an uneven weight distribution of the human body.
Such reduction in size at the foot end of the system 1 may be
employed in some embodiments to facilitate the approach of
personnel and equipment.
[0053] Each of the support assemblies 5 and 6 generally includes a
rotation subassembly 26 and 26' and an angulation subassembly 27
and 27', respectively, that are interconnected as will be described
in greater detail below and include associated power source and
circuitry linked to a controller 29 (FIG. 1) for cooperative and
integrated actuation and operation. The rotational subassemblies 26
and 26' enable coordinated rotation of the patient support
structure 10 about a longitudinal axis. The angulation
subassemblies 27 and 27' enable the selective hinging or breaking
of the support 10 by the hinge assembly 16 at desired levels and
increments as well as selective tilting of the longitudinal axis of
the frame portion 12 or 14.
[0054] The rotation subassembly or mechanism 26 is shown in FIG. 5
and includes at least one motor housing 30 surmounting the support
column 3. In the illustrated embodiment, only one rotational motor
is provided, but it is foreseen that a cooperating motor may also
be mounted on the support column 4. A main rotational shaft 32
extends from the motor housing 30 that turns a rotation structure
33. The rotation structure 33 in turn rotates the connected patient
support 10 about a longitudinal axis as will be described in
greater detail below. The motor housing 30 contains a rotary
electric motor or other actuator drivingly engaged with the shaft
32. The rotation mechanism 26 is operated by actuating the motor
using a switch or other similar means. The rotation structure 33 is
fixed to the shaft 32 at a location spaced from the motor housing
30 and the support column 3 to provide clearance for rotation of
the connected patient support structure 10.
[0055] As shown in FIG. 5, the rotation structure 33 is attached to
a pair of translation posts or H-bar posts 40 disposed at either
end of the rotation structure 33. The posts 40 are each attached to
the structure 33 by a pin 42, bolt, or other fixing structure. A
plurality of cooperating apertures 44 formed in the posts 40
provide passageway for a pivot pin 46 to extend therethrough. The
pivot pin 46 is receivable in each cooperating pair of apertures 44
allowing for selective placement of a translation connector 48 that
is sized and shaped to be received between the pair of posts 40 and
also receive the pivot pin 46 therethrough. The pin 46 and
connector 48 are thus positionable in an orientation transverse to
the longitudinal extension of the support 10 at a variety of
heights to be selected by the surgeon and readily changeable, even
during surgery if necessary, to vary the height of the frame
section 12. The multiple location or height feature is also
advantageous when more than one frame or patent structure is
mounted in tandem as shown, for example in FIGS. 25-28. The
position of the frame or other structure may be desirably changed
to provide close proximity to an imaging top with a distance
between a patient support and an imaging top being expandable or
reduceable depending upon the size or other attributes of a patient
and surgical or other requirements. As illustrated in FIG. 5, the
connector 48 has a slot 50 for receiving the pivot pin 46.
[0056] The translation connector 48 is in turn attached to a pivot
connector 52. The pivot connector 52 includes first and second
outwardly opening and opposed slots 54 and 56. The first slot 54 is
sized and shaped for receiving the translation connector 48 and the
second slot is sized and shaped for receiving an end connection 58
of the frame section 12. The pivot connector 52 further includes a
through aperture or bore 60 running substantially perpendicular to
the slot 54 and communicating therewith. The aperture 60 is sized
and shaped to receive a pivot pin 62 therethrough, allowing for
some forward and rearward lateral movement of the attached frame
end connection 58 and thus the frame section 12, providing a degree
of freedom and clearance needed for rotation the patient support
about a longitudinal axis of a patient. The slot 56 is sized and
shaped to frictionally engage the frame end connection 58, thus
securely fixing the end connection 58 to the pivot connector 52.
The frame end connection 58 is in turn fixed to each of elongate
frame members 66 and 68 of the frame section 12. The frame members
66 and 68 are each hingedly connected to the hinge assembly 16 to
be described in greater detail below. Pivoting of the translation
connector 48 with respect to the pin 46 provides for selected
articulation of the frame section 12 (that includes the end
connection 58 and the frame members 66 and 68) and/or the entire
support 10 with respect to the support pier or column 3.
[0057] With reference to FIG. 6, at the support pier or column 4,
the support assembly 6 is substantially similar to the support
assembly 5 with the exception that the rotation subassembly 26' is
passive and therefore does not include a motor. However, the
support pier or column 4 preferably includes a powered mechanism to
provide selective height adjustment of the subassembly 26'. A
rotation structure 33' is spaced from and freely rotatable with
respect to the column 4. The structure 33' includes a shaft (not
shown) extending outwardly therefrom similar to the rotation shaft
32, the shaft being rotatingly received in an aperture in the
support column 4.
[0058] The rotation subassembly 26' and the angulation subassembly
27 otherwise include elements identical to or substantially similar
to the elements of the subassemblies 26 and 27. Specifically, H-bar
posts 40', pin 42', apertures 44', pivot pin 46', translation
connector 48', slot 50', pivot connector 52', end connector 58' and
pivot pin 62', are identical or substantially similar in form and
cooperate with other elements identically or substantially
similarly to what has been described previously herein with
respective H-bar posts 40, pin 42, apertures 44, pivot pin 46,
translation connector 48, slot 50, pivot connector 52, end
connector 58 and pivot pin 62.
[0059] The frame 14 further includes frame members 66' and 68' that
are each fixed to the end connector 58'. The frame members 66' and
68' are pivotably or hingedly connected to respective frame members
66 and 68 by the hinge assembly 16. Specifically, the frame member
66 is attached to the frame member 66' by the hinge mechanism 70
and the frame member 68 is attached to the frame member 68' by the
hinge mechanism 72. With particular reference to FIGS. 7 and 9-11,
the hinge mechanism 70 includes, an outer member 76 and an inner
member 78. The outer member 76 is fixed or may be integral with the
elongate frame member 66, while the inner member 78 is integral or
otherwise fixed to the frame member 66'. The outer member 76
further includes an extension 80 with a groove 82 for receiving and
guiding the cable 20. The extension 89 tapers in a direction from
the outer member interior 84 to the groove 82. The extension 89 is
configured to cause a slight upward break or bend of the support 10
when the extension 89 comes into contact with the cable 20 at the
groove 82. In that way, when the cables 20 are reeled in to shorten
the hypotenuse of the triangle formed by the cable, the section 12
and the section 14, the sections 12 and 14 move toward one another,
resulting in the upward break as illustrated, for example, in FIG.
18. The downward break illustrated, for example, in FIG. 21 is a
result of lengthening the cable 20 distance and allowing gravity to
drop the hinge 70. The extension 89 is shaped to extend slightly
inwardly toward a longitudinal axis A of the support 10, thereby
guiding the cable 20 along a path within a periphery of the frame
sections 12 and 14 when the extension 89 is in contact with the
cable 20 when in a downward breaking configuration directed toward
the cable with the cable 20 being received at the groove 82.
[0060] It is foreseen that where an upward breaking (only)
embodiment is desired according to the invention, the sections 12
and 14 may be positioned with respect to two end columns to always
include a slight upward break or bend at the hinge or pivot between
the sections 12 and 14. When the telescoping base is actuated to
move the columns toward one another, the sections 12 and 14 would
automatically further break upwardly and toward one another.
Downward breaking would not be possible in such an embodiment as
the maximum distance between the two end columns would still ensure
a slight upward break or hinge between the sections 12 and 14. Such
an embodiment would be acceptable for use because patient holding
pads could be positioned on the frames 12 and 14 such that the
patient would be in a substantially horizontal position even when
there is a slight upward bend or break at the hinge between the
sections 12 and 14.
[0061] Returning to the hinge 70 of illustrated embodiment, the
inner member 78 is slidingly and rotatably receivable in an
interior 84 of the outer member 76. The outer member has a pair of
pivot apertures 86 and the inner member has a pivot aperture 87,
the apertures cooperating to create a through bore for receiving a
pivot pin 88 through both the inner and outer hinge members. The
interior 84 includes a curved partially cylindrical surface 89 for
slidingly receiving a cooperating outer rounded and partially
cylindrical surface 90 of the inner member 78. The inner member 78
further includes a downward breaking stop or projection 92 that
limits a downward pivot (in a direction toward the cables 20) of
the hinge 70 in the event the cables 20 should fail. The stop 92
abuts against a surface 93 of the interior 84. In the illustrated
embodiment, the stop 92 limits the extent of rotation or hinging of
the section 66 with respect to the section 66' to about twenty-five
degrees. Upward pivot (in a direction away from the cables 20) is
limited by abutment of an inner planar surface 95 with a planar
surface 96 of the hinge inner member 78.
[0062] With particular reference to FIG. 8, the hinge mechanism 72
is substantially a mirror image of the hinge mechanism 70 and
therefore includes the following elements: a hinge outer member
76', and inner member 78', and extension 80' with a groove 82', and
interior 84' pivot apertures 86' and 88', a pivot pin 88', a curved
surface 89', and outer surface 90', a stop 92', an abutment surface
93', an inner planar surface 95' and a planar surface 96'. These
elements are substantially similar in shape and function to the
respective hinge outer member 76, inner member 78, extension 80,
groove 82, interior 84, pivot apertures 86 and 88, pivot pin 88,
curved surface 89, outer surface 90, stop 92, abutment surface 93,
inner planar surface 95 and planar surface 96 described herein with
respect to the hinge 70.
[0063] It is noted that other hinge or pivot mechanisms may be
utilized in lieu of the hinge assembly 16. For example, the
polyaxial joint 95 illustrated and described in Applicant's pending
U.S. patent application Ser. No. 11/062,775 filed Feb. 22, 2005,
and pending U.S. patent application Ser. No. 11/159,494 filed Jun.
23, 2005, may be incorporated into the patient support structure 10
at the break between the sections 12 and 14. Both of these U.S.
applications (Ser. Nos. 11/062,775 and 11/159,494) are hereby
incorporated by reference herein.
[0064] The cable drive system 18 includes a rotary motor 98
cooperating with and driving by rotation a pair of winch cylinders
99 disposed on either side of the motor 98. The motor 98 and
cylinders 99 are mounted to the end connector 58' located near the
support column 4. Each cable 20 is attached to one of the winch
cylinders 99 at one end thereof and to the end connector 58 at the
other end thereof. In a first longitudinal position wherein the
section 12 is substantially planar with the section 14, the cables
20 are wound about the winch cylinders 99 an amount to provide
enough tension in the cables 20 to maintain such a substantially
planar orientation and configuration, with the hinge extensions 82
and 82' being in contact with each of the cables 20. The motor 98
is preferably low speed and high torque for safely winding both of
the cables 20 simultaneously about the cylinders 99 to draw the
section 12 toward the section 14 to result in an upward breaking
configuration with the hinges 70 and 72 disposed in spaced relation
with the cables 20 and the hinges 70 and 72. The motor 98 may be
reversed, reversing the direction of rotation of the winch
cylinders 99 for slowly unwinding the cables 20 to a downward
breaking configuration. As the cables 20 unwind, gravity draws the
support sections 12 and 14 downward with the cables 20 being
received in the grooves 82 and 82' of the hinge extensions 80 and
80'. As the cables 20 slacken, the hinges 70 and 72 continue to
lower pressing down upon the cables 20.
[0065] It is noted that the frame sections 12 and 14 are typically
equipped with pads (not shown) or other patient holding structure.
Furthermore, with respect to FIGS. 13 and 14, the frame member
sections 66 and 68 of section 12 and the frame member sections 66'
and 68' of the section 14 may be replaced with substantially
rectangular imaging tops or sections 100 and 101' respectively.
Each of the sections 100 and 101' having elongate slots 101 formed
therein to allow for attachment of the hinge mechanisms 70 and 72
in a manner identical or substantially similar to what has been
described herein with respect to the frame sections 12 and 14.
[0066] With reference to FIGS. 15-17, the imaging sections 100 and
100' are illustrated, replacing the frame sections 12 and 14 of the
embodiment disclosed in FIGS. 1-12. Each of FIGS. 15-17 represent
configurations in which the cable drive 18 is tensioned such that
the sections 100 and 100' are kept in a substantially coplanar
configuration. FIG. 15 illustrates a configuration in which the
column 3 is telescoped upwardly with the frame sections hinging at
the support assemblies 5 and 6, resulting in an inclined position
or configuration of the entire patient support. In the illustrated
embodiment, the section 100 would preferably receive a patient's
head. Therefore, FIG. 15 illustrates a reverse Trendelenburg
position or orientation. FIG. 16 illustrates the sections 100 and
100' again in a substantially common plane with both sections being
rotated to a tilted position produced by a powered rotation of the
rotation the sub assemblies 26 and passive rotation of the assembly
26' with both columns 3 and 4 otherwise holding the sections 100
and 100' at the same height. FIG. 17 illustrates both tilting due
to rotation of the assemblies 26 and 26' and also a sloping or
inclined position with the column 4 being extended vertically.
Thus, FIG. 17 illustrates a Trendelenburg position or orientation
with both the sections 100 and 100' remaining in substantially the
same plane.
[0067] With reference to FIGS. 18-20, there is illustrated three
upward breaking or hinging configurations of the structure 1. FIG.
18 illustrates a symmetrical upward breaking configuration wherein
the columns 3 and 4 are holding the respective support assemblies 5
and 6 at substantially the same height with the cables 20 being
shortened by rotation of the winch motor to result in an upward
break in the hinge assembly 16. FIG. 19 illustrates the column 3
being extended to a maximum height and the cables reeled to shorten
a distance between the sections 100 and 100'. An example of such an
upward break with reverse Trendelenburg would be a head or column 3
height of 43 inches, a foot or column 4 height of 24 inches and a
35 degree upward break with zero degree roll. FIG. 20 illustrates
an upward breaking Trendelenburg with the column 4 being extended
to a maximum height.
[0068] With reference to FIGS. 21-23, there is illustrated three
downward breaking configurations of the structure 1. FIG. 21
illustrates a symmetrical downward breaking configuration wherein
the columns 3 and 4 are holding the support assemblies 5 and 6
respectively, at the same height with the cables 20 being unwound
or slackened to result in a downward break in the hinge assembly
16, the hinges 70 and 72 contacting the cables 20. FIG. 22
illustrates a downward breaking reverse Trendelenburg with the
column 3 being extended to a maximum height resulting in a patent's
head end being at a maximum height. FIG. 23 illustrates a downward
breaking Trendelenburg with the column 4 being extended to a
maximum height.
[0069] It is noted that in each of the configurations illustrated
in FIGS. 18-23, the sub assemblies 26 may be rotated in either
direction, resulting in a tilted or rotated as well as upwardly or
downwardly broken or hinged configuration. For example, FIG. 24
illustrates the structure 1 with support frame sections 12 and 14
positioned in a configuration similar to that illustrated in FIG.
19, but also including rotation, resulting in a tilting and
upwardly breaking configuration of the structure 1. An example of
the position illustrated in FIG. 24 would be: a head or column 3
height of 41 inches, a foot or column 4 height of 34 inches and a
35 degree upward break with 10 degree roll.
[0070] With reference to FIGS. 25-28, another structure, generally
102 according to the invention is illustrated. The structure 102
utilizes all of the elements described herein with respect to the
structure 1 and therefore the same references numerals are used for
the same elements or features. The structure 102 differs from the
structure 1 in that the H-bar posts 40 and 40' are replaced or
modified to be extended H-bar posts 40A and 40A', allowing for the
mounting of two elongate structure 10 and cooperating cable drives
18. In the embodiment shown in FIG. 25, one of the structures 10
includes the frame member 12 and 14 while the other structure is an
imaging top having sections 100 and 100'. As previously described
herein, the cooperating H-bar posts 40A and 40A' equipped with a
plurality of apertures allows for the placement of the support
structures 10 at a variety of locations. As illustrated in FIGS.
25-28, the structure 102 provides for the complete rotation and
thus a roll-over of a patient by actuation of the motor of the
rotation subassembly 26 using the controller 29. The structure 102
is further illustrated with a non-telescoping base support 110
fixed to each of the columns 3 and 4 and rollers or castors 112 at
the base of the structure 102.
[0071] With reference to FIGS. 29 and 30, another embodiment or
system according to the invention, generally 200 is illustrated.
The system 200 broadly includes an elongate length-adjustable base
202 surmounted at either end by respective first and second upright
support piers or columns 203 and 204 which are connected to
respective first and second support assemblies, generally 205 and
206. Between them, the support assemblies 205 and 206 uphold an
elongated breaking, hingeable or pivotable patient support
structure, generally 210. The structure is described in detail in
Applicants's pending U.S. patent application Ser. No. 11/062,775
filed Feb. 22, 2005, Ser. No. 11/159,494 filed Jun. 23, 2005, both
of which are incorporated by reference herein. The embodiment 200A
illustrated in FIG. 30 differs from the structure 200 only in that
the length-adjustable base 202 is replaced by a first base 220
attached to the pier 203 and a second base 222 attached to the pier
204. All of the bases 202, 220 and 222 include castors or rollers
230 or some other movable structure to allow the piers 203 and 204
to move toward and away from one another during upward or downward
breaking of the structure 210.
[0072] It is foreseen that cable drives as described herein, other
types of motor drives including screw drives, hydraulic systems,
and the like, may be utilized to facilitate both upward and
downward breaking of the support structure 210.
[0073] Another patient support structure according to the
invention, generally 301, is illustrated in FIGS. 31-33. The
structure 301 generally includes a horizontally telescoping floor
mounted base 302, a conventional or standard telescoping and
inclinable operating table support structure 304, a telescoping end
support or pier 306 and a hinged or pivotally upwardly and
downwardly breaking support structure 310 connected to both the
structure 304 and the pier 306. The patient support structure 310
further includes a first cantilevered section 312 and a second
section 314. The first section 312 is fixed to and extends from the
operating table support 304. The second section is attached to the
pier 306 by a hinge or pivoting assembly 320, such as the support
assembly 5 described herein with respect to the structure 1. The
hinge mechanism 316 disposed between the support sections 312 and
314 may be a conventional hinge, pivot, or pivot or hinge systems
previously described herein.
[0074] In use, the operating table support 304 utilizes electric or
other power means to move the support section 312 up and down and
at an incline, as is known in the art. In response to the movement
of the section 312, the section 314 also moves, resulting in upward
and downward breaking illustrated in FIGS. 32 and 33. In response
to the movement of the section 312, the electric powered
telescoping base 302 moves the pier 306 toward or away from the
support 304. The pier 306 includes a motor for raising and lowering
the pier at the connection 320.
[0075] As stated above with respect to other embodiments of the
invention described herein, it is foreseen that cable drives as
described herein, other types of drives including screw drives,
hydraulic systems, and the like, may be utilized to facilitate both
upward and downward breaking of the support structure 310.
[0076] It is to be understood that while certain forms of the
present invention have been illustrated and described herein, it is
not to be limited to the specific forms or arrangement of parts
described and shown.
* * * * *