The present disclosure relates to an inflatable positioning equipment for positioning a patient during a surgical procedure.
During surgical procedures, for example heart, rectal or renal surgery, the patient's body must be regularly stretched at the site of the procedure to ensure optimal conditions for the surgeon. This is usually achieved by lifting a part of the patient's body and then depositing it on a roller, cushion or the like to obtain the stretched position necessary for the surgical procedure. Examples of such known positioning equipment can be found in the specialist book “Positioning techniques in the operating theater” (Lagerungstechniken im OP-Bereich) by Krettek and Aschemann, published in 2005 by Springer Medizin Verlag, see the non-patent literature N1 attached to the application.
However, these rolls or cushions based on gel or foam have several disadvantages. For example, they do not allow dynamic adjustment of the stretched position of the patient during the surgery. In addition, the patient must first be lifted and held by the surgical staff before the pad can be placed underneath.
There are also several surgical tables with a firmly integrated body stretcher. This is a bench with a foam pad, which can be moved between a recessed posture in the surgical table and an extended posture. Such benches are used in particular in renal surgery for stretching the renal area of a patient. An example of such a known body stretcher is presented in the non-patent literature N2 attached to the application.
However, these integrated body stretchers require a high level of constructive effort in the development and manufacture of the surgical table, which thus becomes more expensive. In addition, the location of the patient has to be adapted to the fixed body stretcher, which can be painful and uncomfortable for the patient depending on the body dimensions. The positioning members should adapt to the patient and not vice versa.
Inflatable storage rolls are known from the care sector. However, these are not suitable for surgical use, as they do not provide the necessary safety against unintentional lowering of the patient during the operation. If there is a sudden leak in such an inflatable care roll, it will slump down due to the escaping air. During an operation, this would lead to an uncontrolled change in the patient's position, so that the patient could be injured. An example of such a known inflatable care roll is presented in the non-patent literature N3 attached to the application.
Furthermore, document DE 314 727 A discloses a circular draw sheet. Documents DE 759 394 A and DE 377 767 A relate to mattresses or mattress parts. Document DE 20 2017 002 188 U1 reveals in its FIG. 4 a leg sheet, which is therefore not suitable for use in renal surgery. Document DE 2 103 499 A shows an alternating pressure lying cushion. Document US 2010/0089411 A1 shows a mattress-like patient positioning system with numerous air cells. The air cushion known from AT 137 152 B has a single air chamber.
In view of the prior art described above, one of the objects of the present disclosure is to provide a positioning equipment for use in surgery which both ensures sufficiently reliable and safe positioning of the patient and allows faster, easier and dynamic positioning of the patient during a surgical procedure.
According to the disclosure, this object is achieved by means of the positioning equipment according to claim 1.
An inflatable positioning equipment in the shape of an elongate roll for positioning a patient during renal surgical procedure can be intended to be placed in a suitable place on an operating table to serve as a support for a body part of a patient so that the renal area of the patient can be brought into an extended position necessary for the renal surgical procedure. The positioning equipment can comprise the following:
The inflatable positioning equipment can be characterized by the fact that it comprises a second air chamber system on the inside of the covering, which can be filled with air for inflating the covering. It can further be characterized in that the second air chamber system is fluidically separated from the first air chamber system so that a leak in one air chamber system cannot cause air loss in the other air chamber system.
By the providing of two separate air chamber systems, a local leakage in the positioning equipment, which always affects only one of the two air chamber systems, only leads to a slower and controlled slumping of the positioning equipment. It is also possible to counteract the slumping of the positioning equipment by pumping more air into the undamaged air chamber system.
As a result, the positioning equipment according to the disclosure is error-proof and suitable for use in surgery.
Exemplary embodiments of the positioning equipment according to the disclosure are given in the dependent claims.
For example, at least one of the two air chamber systems of the positioning equipment can have a plurality of air cells. Both air chamber systems can comprise several air cells each. The air cells of both air chamber systems can be arranged alternately within the covering.
The positioning equipment can extend along a longitudinal axis (X-X), wherein the air cells can be arranged in a row along this longitudinal axis.
In some embodiments the air cells can be disk-shaped.
At least one air chamber system can have a manifold for the supply of the air cells allocated to it. Each manifold can be realized as an elongated air bag. The positioning equipment can be transformed by inflating it from a flat rectangular shape in plan view into a bulging roll form.
The positioning equipment can have a drop-shaped or symmetrical, e.g. mushroom-shaped cross-section when inflated.
The positioning equipment can be provided with an air pressure monitoring means to monitor the level of air pressure in the two air chamber systems, such as a manometer.
The positioning equipment can comprise an air pump for inflating the covering.
In some embodiments, the positioning equipment can comprise a control device. The control device may be adapted to receive, for example, air pressure values from the air pressure monitoring means and to determine from the received air pressure values whether the air pressure in one of the air chamber systems is dropping. The control device can also be adapted to compensate, by means of the pump, for a drop in air pressure in one of the air chamber systems by increasing the air pressure in the other air chamber system, thus preventing a patient placed on the positioning equipment from lowering.
The positioning equipment can have a covering which is provided with a padding, e.g. made of foam.
The positioning equipment can comprise a T-piece for connecting an air pump to the two air chamber systems.
In some embodiments, the positioning equipment can have one lock valve per air chamber system, by means of which the associated air chamber system can be fluidically separated from an air source.
The positioning equipment can have a mushroom-shaped cross-section when inflated. Both air chamber systems can each comprise several air cells, wherein the air cells of both air chamber systems can be arranged alternately within the covering.
With reference to the figures, two exemplary embodiments of the positioning equipment according to the disclosure are now described, wherein:
The positioning equipment 10, when inflated as shown in
The positioning equipment 10 extends along a longitudinal axis X-X. It has a front side 10.1, a rear side 10.2, two longitudinal sides 10.3 and 10.4, an upper side 10.6 and an underside 10.7. The end areas of the longitudinal sides 10.3, 10.4 bear the reference sign 10.5.
The underside 10.7 serves as a contact surface with which the positioning equipment 10 rests on the operating table during use. The contact surface 10.7 is best formed to be flat in order to provide more safety against twisting or tilting of the positioning equipment 10. A flat forming also minimizes the sinking of the positioning equipment 10 into the padding of the operating table.
The longitudinal sides 10.3 and 10.4 preferably run straight when inflated and form a substantially right angle in relation to the underside 10.7. Thus, the longitudinal sides 10.3 and 10.4 run substantially vertically when in use on the operating table, whereby the positioning equipment 10 has a greater stroke between the deflated and the maximum inflated state than with curved longitudinal sides.
The positioning equipment 10 is connected to an air pump 16 via a T-piece 14. The T-piece 14 has two lock valves 18, each of which can be located in an air hose 19 of the T-piece 14. For example, one of the two air hoses 19 is connected in the end area 10.5 of one 10.3 of the two longitudinal sides of the positioning equipment 10, and the other air hose 19 is connected in the end area 10.5 of the opposite longitudinal side 10.4 of the positioning equipment 10. By placement of the air hoses 19 in this way, they cannot be squeezed out when the patient is lying on the positioning equipment 10.
Via the air pump 16, which can be a hand pump or a motor-driven pump, the positioning equipment 10 is inflated. The air is distributed via the T-piece 14 to two separate air chamber systems of the positioning equipment 10. With the lock valves 18, each of the two air chamber systems can be separated fluidically from the air pump 16.
It should be emphasized that the number of air chamber systems 22, 24 and the number of air cells 26 can be freely selected depending on the size of the positioning equipment 10, 20.
For example, pressure gauges 28 can be provided in the air cells 26 or in the air pipes. Such an air pressure monitoring means for monitoring the level of air pressure in the two air chamber systems 22, 24 can, for example, operate with pressure sensors 28. The pressure sensors 28 can transmit measured air pressure values to a control device 30. This can determine whether the air pressure in an air chamber system is dropping and initiate appropriate countermeasures. For example, the control device 30 could control the pump 16 to increase the pressure in the air chamber system not affected by the pressure drop until the original lifting height of the positioning equipment 10, 20 before the leakage and thus the original patient stretching is reached again.
Air pressure monitoring can be carried out alternatively or additionally by visual inspection, e.g. by the anesthetist, if the positioning equipment 10, 20 is equipped with a pressure indicator for each independent air chamber system. For example, such pressure indicators are located on the air hoses 19.
In some embodiments each manifold 31 is realized as an air bag extending in the direction of the longitudinal axis X-X from the front side 10.1 to the rear side 10.2. This air bag 31 can in particular be welded to the covering 12. This construction has two advantages over compressed air hoses: firstly, the air bags form no or hardly any artefacts on the X-ray image during X-ray. On the other hand, the patient lies more comfortably on the air bags 31, which are obviously suitable for X-ray imaging, than on hoses.
First of all, the inflatable positioning equipment 10, 20 is placed on the operating table in a deflated state at the appropriate place. In the deflated state, the positioning equipment 10, 20 has a rectangular shape in plan view.
The deflated condition of the positioning equipment 10, 20 is indicated by dotted lines in
If a leak occurs in the positioning equipment 10, 20 during operation, the surgical team can disconnect the affected air chamber system from the air supply by means of the associated lock valve 18. The pump 16 can then be used to supply the intact air chamber system with additional air to prevent the positioning equipment 10, 20 from sinking. This process can be carried out not only manually by the surgical staff but also fully automatically by means of the control device 30.
In addition, it is possible to dynamically adjust the position of patient P during the surgery using the positioning equipment 10, 20 according to the disclosure. For this purpose, the positioning equipment 10, 20 is simply accordingly inflated or deflated.
The end areas 10.5 of the two longitudinal sides 10.3, 10.4 of the inflatable positioning equipment 10, 20 can, for example, be defined without restriction as areas which are 10% or 20% of the length of the longitudinal sides 10.3, 10.4 and extend from the front side 10.1 or the rear side 10.2 to the center of the positioning equipment 10, 20. The end areas 10.5 can alternatively be defined as areas which are, for example, 5, 10 or 20 centimeters of the length of the longitudinal sides 10.3, 10.4 and are closest to the respective front side 10.1 or the rear side 10.2. The end areas 10.5 of the two longitudinal sides 10.3, 10.4 also correspond to the portions of the longitudinal sides 10.3, 10.4 where the two air hoses 19 of the T-piece 14 are connected.
The present disclosure also concerns a positioning equipment 10, 20 which comprises at least three separate air chamber systems 22, 24, each of the air chamber systems 22, 24 having separate ports for air hoses 19 and lock valves 18.
According to the disclosure, each air chamber system 22, 24 can comprise an individual manifold 31. Each manifold 31 can be fluidically connected via openings 33 both to an air hose 19 associated with it and to each of the plurality of air cells 26 of the air chamber system 22, 24.
Each manifold 31 can supply compressed air to its assigned plurality of air cells 26, e.g. via a single opening 33 connected to an air hose 19.
For example, the manifolds 31 are made of a soft and radiolucent material that can expand under pressure and shrink together with other parts of the positioning equipment 10, 20.
This disclosure also relates to methods for supporting and placing patients on a treatment table (e.g. an operating table) during a medical procedure. An exemplary method can comprise the following steps:
This exemplary method can be a renal surgical procedure in which the positioning equipment 10, 20 is placed on an operating table in a suitable place and then inflated to bring the patient's renal area into a stretched position.
In some methods two or more separate air chamber systems 22, 24 are inflated before and during the method. According to the disclosure, the method described above can include an additional step that is performed if one of the air chamber systems 22, 24 fails during a patient procedure. The additional step can be carried out as follows:
In some embodiments, the positioning equipment 10, 20 in the inflated state can have a length that is at least twice or at least three times its maximum thickness. In some embodiments, the positioning equipment 10, 20 can have a substantially straight and linear shape. In some embodiments, the positioning equipment 10, 20 can be elongated and, when inflated, have an oval, rectangular, mushroom, muffin, wedge, square, circular or aircraft wing-shaped cross-section.
In summary, the positioning equipment according to the disclosure offers, in particular, the following advantages:
Any placement of the positioning equipment on the operating table. The positioning equipment can be freely placed on the operating table and can be easily readjusted if necessary.
Polytraumatized patients: If indicated, any number of positioning equipment can be used on an operating table. This is not possible with the previous integrated body stretchers.
For example, the surface pressure on the patient is lower than with conventional body stretches due to the shape and composite structure of a compressible air body with a soft outer skin and the integrated foam.
Number | Date | Country | Kind |
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10 2017 125 485.4 | Oct 2017 | DE | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2018/079756 | 10/30/2018 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2019/086484 | 5/9/2019 | WO | A |
Number | Name | Date | Kind |
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5613254 | Clayman et al. | Mar 1997 | A |
Number | Date | Country |
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203841967 | Sep 2014 | CN |
204274906 | Apr 2015 | CN |
107224380 | Oct 2017 | CN |
2017064183 | Apr 2017 | WO |
Entry |
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International Search Report dated Jan. 31, 2019 during the prosecution of corresponding PCT application No. PCT/EP2018/079756, 2 pages. |
Number | Date | Country | |
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20200337928 A1 | Oct 2020 | US |