This disclosure relates to patient interfaces and support systems. In particular, this disclosure relates to patient interfaces and support systems that facilitate access to a patient's underside during a medical procedure.
Non-invasive and minimally-invasive procedures are increasingly being developed and performed to diagnose and treat medical conditions. In particular, transmitting energy waves from a distance to a target tissue inside a patient's body has become a frequently used and effective means for imaging and treatment. Medical ultrasonography, the non-invasive delivery of ultrasound waves to a patient, is currently used to visualize the structure of muscles, tendons, internal organs, and pathological lesions inside a body. Therapeutic delivery of ultrasound waves has been shown to be effective in a wide variety of therapeutic interventions, including lithotripsy, drug delivery, cancer therapy, thrombolysis, and nerve ablation. Non-invasive delivery of focused energy may allow for more efficient delivery of energy to the target tissue, improved cost effectiveness of treatment, minimized trauma to the patient's body, and improved recovery time.
Delivering energy over a distance requires targeting accuracy and precision. To achieve accuracy and precision, a patient must remain relatively still during the procedure, so it is desirable for the patient to be relaxed and comfortable. Additionally, either the patient or the energy-delivering apparatus must be maneuverable to achieve proper alignment between the energy-delivering apparatus and the target tissue. However, current systems are inadequate to meet these requirements. With current systems, the patient typically lies in a prone or supine position on an examination table or other patient support having a continuous surface. The medical apparatuses used to perform the medical procedure are suspended above the patient and/or located on one or more carts adjacent to the patient. The presence of bulky medical apparatuses suspended above the patient can be unsettling to the patient, making it difficult for the patient to relax. Suspended equipment and side carts can also significantly limit a clinical team's workspace and range of movements. Such equipment may create risks of knocking into or tripping on equipment within an examination room. When performing procedures on both a right side and left side of a patient's body, the side carts may need to be moved from one side of the patient to another, which can be inconvenient and time-consuming. Additionally, suspended apparatuses often require costly installations and are not portable between examination rooms. Moreover, the anatomy of the human body may limit the access window of any medical procedure component, such as an ultrasound transducer, making it difficult to reach a target region inside a patient's body from a position above and external to the patient.
Thus, there is a need for new and useful systems and methods for performing a medical procedure on a patient lying on a patient support surface. One or more embodiments described herein provide such new and useful systems and methods.
One aspect of the disclosure is directed to an integrated patient platform configured to support a patient thereon during a medical procedure. The integrated patient platform of various embodiments includes two detachable modules, the two detachable modules comprising a front module and a back module. The front and back modules are each independently movable. The front and back modules are positionable in a first, coupled configuration for clinical procedures and positionable in a second, separated configuration for transportation. In the first, coupled configuration, the front and back modules are in electrical communication and attached such that a top surface of the front module and a top surface of the back module together form a patient support surface, wherein an examination window is disposed within the patient support surface and sized to accommodate a target region of a patient on which a medical procedure is to be performed from below.
In some such embodiments, the examination window is a clinically optimized size.
In some embodiments, the front module comprises a therapy delivery component and the back module comprises an imaging component. In other embodiments, the back module comprises a therapy delivery component and the front module comprises an imaging component.
The back module may include a housing configured to store the therapy delivery component. In some such embodiments, a sidewall of the housing includes an aperture sized to enable horizontal movement of the therapy delivery component from a stored position within the housing to a functional position outside the housing. The integrated patient platform of some embodiments includes a cable management system within the housing, the cable management system configured to facilitate unobstructed movement of the therapy delivery component from the stored position to the functional position.
In some embodiments, the examination window is disposed within the top surface of the front module, and the front module further comprises a workbench surface positioned at a clinically optimized distance below the examination window. In such embodiments, the imaging component may include an imager and an imaging arm, the imaging arm being coupled to the front module and moveable within a workspace between the workbench surface and the examination window. Some such embodiments further include an optical tracking camera mounted within the front module or back module, the optical tracking camera configured to wirelessly communicate with an optical sensor in the imager and an optical sensor in the therapy delivery component. The front module or back module may be sized such that the optical tracking camera is positioned an optimized distance away from each of the therapy delivery component and the imager when the therapy delivery component and the imager are in a functional position on the workbench surface. In some embodiments, the optical tracking camera is positioned 40-160 cm away from each of the therapy delivery component and the imager when the therapy delivery component and the imager are in the functional position.
In some embodiments, the front module and back module perform complementary functions and are configured to coordinate the complementary functions when in electrical communication. In some embodiments, the front module and the back module perform independent functions. In some embodiments, the front module and back module are independently adjustable, serviceable, upgradeable, and/or exchangeable. In some embodiments, the electrical communication between the front and back modules is established automatically in the first, coupled configuration.
Another aspect of the disclosure is directed to a method of performing a medical procedure on a patient lying on a patient support surface. In various embodiments, the medical procedure is performed below the patient, and the method includes positioning two detachable modules in a coupled configuration, wherein the two detachable modules comprise a front module and a back module. In various embodiments, the front and back modules are movable between the coupled configuration for clinical procedures and a separated configuration for transportation, and in the coupled configuration, the front and back modules are in electrical communication and attached such that a top surface of the front module and a top surface of the back module together form a patient support surface. In various embodiments, an examination window is disposed within the patient support surface and sized to accommodate a target region of a patient on which a medical procedure is to be performed. The method of various embodiments further includes: positioning the patient on the patient support surface such that the target region is positioned within or over the examination window, positioning a procedure module such that the procedure module is below the examination window and directed upward toward the target region, and activating the procedure module to perform a medical procedure on the target region from below the patient.
Another aspect of the disclosure is directed to an integrated patient platform. In various embodiments, the integrated patient platform includes a superior level surface and an inferior level surface. The superior level surface of various embodiments is configured to support a patient and includes at least two movable shutters configured to adjust a size and location of an aperture under the patient, the aperture disposed within the superior level surface. The at least two movable shutters may be independently adjustable. The inferior level surface of various embodiments is located below the aperture and forms a work bench configured to support a clinical procedure module. The superior level may be spaced a clinically optimized distance above the inferior level surface.
In some such embodiments, the clinically optimized distance is 20-50 cm; in some embodiments, the clinically optimized distance is 30 cm.
In some embodiments, the clinical procedure module that the work bench is configured to support is selected from one or more of: a therapy delivery component, an imaging component, an optical tracking camera, and an optical sensor.
The integrated patient platform of some embodiments additionally includes an interior level positioned below the superior level and disposed on a shared horizontal plane with the inferior level. The interior level is positioned within a housing, optionally behind a housing door, and is configured to support the clinical procedure module during transport.
Yet another aspect of the disclosure is directed to an integrated patient platform that includes a patient support surface positioned along a horizontal plane and comprising an anterior portion and a posterior portion, wherein the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween. In various embodiments, the integrated patient platform further includes: an anterior shutter coupled to the anterior portion; an anterior conveyor belt forming a loop around the anterior shutter; a posterior shutter coupled to the posterior portion; and a posterior conveyor belt forming a loop around the posterior shutter. The anterior and posterior shutters may each be movable along a plane parallel to the patient support surface and configured to extend into the examination window.
In some embodiments, the anterior shutter and posterior shutter are independently adjustable. The anterior and posterior shutters may be manually slideable, motorized and slideable, pneumatically actuated, or hydraulically actuated.
The integrated patient platform of some embodiments includes two or more anterior shutters and/or two or more posterior shutters. In some embodiments, the anterior conveyor belt is movably coupled to the anterior shutter such that the belt rotates when the anterior shutter moves along the plane. Additionally or alternatively, in some embodiments, the posterior conveyor belt is movably coupled to the posterior shutter such that the belt rotates when the posterior shutter moves along the plane.
The patient support surface of various embodiments is sized to accommodate a patient laying in a supine or prone position. In some embodiments, the integrated patient platform further includes an adjustable leg support positioned on the posterior surface of the patient support surface.
The integrated patient platform of some embodiments also includes a user interface configured to receive user inputs, wherein user inputs control the motion of the anterior and posterior shutters. The user interface may include a graphical user interface and a user input device. In some embodiments, the user input device is selected from a group consisting of: one or more keys, one or more buttons, a mouse, a keyboard, a toggle, a switch, a joystick, and a touchscreen.
An additional aspect of the disclosure is directed to an integrated patient platform that includes a patient support surface positioned along a horizontal plane. The patient support surface includes an anterior portion and a posterior portion, and the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween. In various embodiments, the integrated patient platform further includes: a shutter slidable along a plane parallel to the patient support surface and configured to adjust a size of the examination window; a workbench surface disposed below the examination window along a plane parallel to the horizontal plane of the patient support surface; and a housing below the anterior portion or the posterior portion of the patient support platform. The housing may define a storage space configured to store a procedure module in a stored position. In various embodiments, the housing includes an aperture sized to enable horizontal movement of a procedure module from the stored position within the housing to a functional position on the workbench surface.
The integrated patient platform of some embodiments also includes a procedure module, such as for example, an imaging component and/or a therapy delivery component. Additionally or alternatively, the integrated patient platform of some embodiments includes a patient-positioning camera supported by the workbench surface and pointed upward toward the examination window. Additionally or alternatively, the integrated patient platform may include a cable management system within the housing, the cable management system configured to facilitate unobstructed movement of the procedure module from the stored position to the functional position. In some embodiments, the integrated patient platform includes an anterior shutter coupled to the anterior portion and a posterior shutter coupled to the posterior portion.
Still another aspect of the disclosure is directed to an integrated patient platform that includes a patient support surface positioned along a horizontal plane. The patient support surface includes an anterior portion and a posterior portion, and the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween. The integrated patient platform of various embodiments further includes a shutter slidable along a plane parallel to the patient support surface, which is configured to adjust a size of the examination window. The integrated patient platform may include an anterior shutter coupled to the anterior portion and a posterior shutter coupled to the posterior portion. The integrated patient platform may also include a workbench surface disposed below the examination window along a plane parallel to the horizontal plane of the patient support surface, wherein the workbench surface is positioned 20-50 cm below the horizontal plane of the patient support surface. In some embodiments of the integrated patient platform, the workbench surface is positioned 30 cm below the horizontal plane of the patient support surface.
The integrated patient platform of some embodiments also includes a housing disposed below the patient support surface, wherein the housing is coupled to and supports the patient support surface. In such embodiments, the workbench surface and an edge of the shutter together define an open workspace. The open workspace may be further defined by sidewalls or side pillars of the housing. The integrated patient platform may further include a light source configured to illuminate the open workspace. The light source of some such embodiments includes one or more light emitting diodes disposed within one or more of the sidewalls or side pillars of the housing.
Another aspect of the disclosure is directed to a method of performing a medical procedure on a patient positioned in a supine or prone position. The medical procedure is performed below the patient and includes positioning a patient on an integrated patient platform. In various embodiments, the integrated patient platform on which the patient is positioned comprises: a patient support surface, which is positioned along a horizontal plane and includes an anterior portion and a posterior portion, wherein the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween; a shutter slidable within the examination window along a plane parallel to the patient support surface; and a workbench surface disposed below the examination window along a plane parallel to the horizontal plane of the patient support surface, wherein the workbench surface and an edge of the shutter together define an open workspace. In various embodiments, the method further includes: adjusting the position of the shutter so as to position the workspace under a target region of the patient; positioning a procedure module within the workspace such that the procedure module is directed upward toward the target region; and activating the procedure module to perform a medical procedure on the target region from the workspace below the patient. The method of some embodiments further includes observing an image output of a patient-positioning camera, the patient-positioning camera disposed within the workspace, to determine a position of the patient relative to the workspace.
In some embodiments, adjusting the position of the shutter includes adjusting a posterior shutter and an anterior shutter. In some such embodiments, adjusting the posterior shutter and the anterior shutter includes one or more of: moving the shutters sequentially, moving the shutters simultaneously, moving the shutters in opposite directions, moving the shutters in the same direction, and adjusting the shutters from a preset position. The preset position may be, for example, a closed state in which the anterior shutter touches or nearly touches the posterior shutter or a default open state sized and positioned to accommodate the target region of an average patient.
In some embodiments, the medical procedure includes medical imaging. In some embodiments, the medical procedure additionally or alternatively includes the application of a therapeutic or analgesic treatment. In some such embodiments, the treatment includes therapeutic ultrasound. In such embodiments, the treatment may include, for example, ablation of a nerve at or near a renal artery. In some embodiments, the integrated patient platform is configured to apply therapeutic ultrasound to one or more of: a liver, spleen, pancreas, fat, muscle, vertebral nerve, celiac artery, mesenteric artery, ureter, renal pelvis, calyx, and any other structure in the abdomen. In some embodiments, the treatment comprises lithotripsy. The target region of the patient may be, for example, a nerve at or near a renal artery or a kidney stone.
A further aspect of the disclosure is directed to an integrated patient platform. The integrated patient platform of various embodiments includes a patient support surface configured to support a patient during a medical procedure, the patient support surface having an aperture disposed therein, wherein the aperture forms an examination window below a patient. The integrated patient platform of various embodiments also includes an imaging arm positioned below the examination window, wherein the imaging arm: is configured to securely receive an imaging transducer, is moveable in multiple degrees of freedom, and is upwardly spring-loaded such that the imaging arm, when positioned below a patient, is drawn upward to exert pressure onto the patient's body.
In some embodiments, the patient support surface is formed of a radiolucent material.
In some embodiments, at least two of the following orientations of the imaging arm are adjustable: pitch, yall, roll, vertical orientation, horizontal orientation, and angle. In some embodiments, the imaging arm is movable in six degrees of freedom. Such an imaging arm may be manually movable in six degrees of freedom. In other embodiments, movement of the imaging arm is controllable through a robotic control system having six degrees of motion control. The integrated patient platform of some embodiments also includes a motor coupled to the imaging arm, wherein the motor is configured to drive automated position adjustment in at least one of the six degrees of freedom.
In some embodiments, the imaging arm includes a constant force spring to spring-load the imaging arm. Such an imaging arm may be spring-loaded with 1-12 lbs. of force.
In some embodiments, the integrated patient platform also includes a lock configured to restrict each degree of freedom of the imaging arm and fix the orientation of the imaging arm in space. The lock of some embodiments is configured to fix the orientation of the imaging arm with a single user input. The user input may be, for example, a push of a button. In some embodiments, the lock is a mechanical lock integrated into the imaging arm. The imaging arm may be configured to lock in a fixed position during operation of a treatment module.
The integrated patient platform of some embodiments additionally or alternatively includes the imaging transducer and a remote targeting monitor, wherein the imaging transducer is communicatively coupled to the remote targeting monitor. In some such embodiments, a virtual treatment region can be projected from the imaging transducer to the remote targeting monitor. The imaging transducer may be removably coupled to the imaging arm.
Additionally or alternatively, in some embodiments, the integrated patient platform also includes an optical tracking camera. In some such embodiments, the imaging arm further includes a first optical sensor disposed thereon, and the optical tracking camera is configured to wirelessly communicate with the first optical sensor. Such embodiments may also include a therapy module having a second optical sensor disposed thereon, wherein the optical tracking camera is further configured to wirelessly communicate with the second optical sensor.
In some embodiments, the integrated patient platform additionally or alternatively includes a therapy module, wherein the therapy module and the imaging arm are configured to be moveable together by a single operator. The therapy module may be moveable via a motorized mechanism. In some embodiments, the integrated patient platform is configured to communicate a relative position of the imaging transducer and the therapy module to enable positioning of the imaging transducer and the therapy module relative to one another. The relative position may be communicated on an electronic screen and/or via an audible output.
An integrated patient platform configured to support a patient thereon during a medical procedure, includes: two detachable modules, the two detachable modules comprising a front module and a back module, wherein: the front and back modules are each independently movable, the front and back modules are positionable in a first, coupled configuration for clinical procedures and positionable in a second, separated configuration for transportation, and in the first, coupled configuration, the front and back modules are in electrical communication and attached such that a top surface of the front module and a top surface of the back module together form a patient support surface, wherein an examination window is disposed within the patient support surface and sized to accommodate a target region of a patient on which a medical procedure is to be performed from below.
Optionally, the examination window is a clinically optimized size.
Optionally, the front module comprises a therapy delivery component and the back module comprises an imaging component.
Optionally, the back module comprises a therapy delivery component and the front module comprises an imaging component.
Optionally, the back module comprises a housing configured to store the therapy delivery component, and wherein a sidewall of the housing includes an aperture sized to enable horizontal movement of the therapy delivery component from a stored position within the housing to a functional position outside the housing.
Optionally, the integrated patient platform further includes a cable management system within the housing, the cable management system configured to facilitate unobstructed movement of the therapy delivery component from the stored position to the functional position.
Optionally, the examination window is disposed within the top surface of the front module, and wherein the front module further comprises a workbench surface positioned at a clinically optimized distance below the examination window.
Optionally, the imaging component comprises an imager and an imaging arm, the imaging arm being coupled to the front module and moveable within a workspace between the workbench surface and the examination window.
Optionally, the integrated patient platform further includes an optical tracking camera mounted within the front module or back module, the optical tracking camera configured to wirelessly communicate with an optical sensor in the imager and an optical sensor in the therapy delivery component.
Optionally, the front module or back module is sized such that the optical tracking camera is positioned an optimized distance away from each of the therapy delivery component and the imager when the therapy delivery component and the imager are in a functional position on the workbench surface.
Optionally, the optical tracking camera is positioned 40-160 cm away from each of the therapy delivery component and the imager when the therapy delivery component and the imager are in the functional position.
Optionally, the front module and back module perform complementary functions and are configured to coordinate the complementary functions when in electrical communication.
Optionally, the front module and the back module perform independent functions.
Optionally, the front module and back module are independently adjustable, serviceable, upgradeable, or exchangeable.
Optionally, the electrical communication between the front and back modules is established automatically in the first, coupled configuration.
An integrated patient platform includes: a superior level surface; and an inferior level surface, wherein the superior level surface is configured to support a patient and includes at least two movable shutters configured to adjust a size and location of an aperture under the patient, the aperture disposed within the superior level surface, wherein the inferior level is located below the aperture and forms a work bench configured to support a clinical procedure module, and wherein the superior level is spaced a clinically optimized distance above the inferior level surface.
Optionally, the clinically optimized distance is 20-50 cm.
Optionally, the clinically optimized distance is 30 cm.
Optionally, the clinical procedure module that the work bench is configured to support is selected from one or more of: a therapy delivery component, an imaging component, an optical tracking camera, and an optical sensor.
Optionally, the at least two movable shutters are independently adjustable.
Optionally, the integrated patient platform further includes an interior level positioned below the superior level and disposed on a shared horizontal plane with the inferior level.
Optionally, the interior level is positioned within a housing behind a housing door and is configured to support the clinical procedure module during transport.
An integrated patient platform includes: a patient support surface positioned along a horizontal plane and comprising an anterior portion and a posterior portion, wherein the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween; an anterior shutter coupled to the anterior portion; an anterior conveyor belt forming a loop around the anterior shutter; a posterior shutter coupled to the posterior portion; and a posterior conveyor belt forming a loop around the posterior shutter; wherein the anterior and posterior shutters are each movable along a plane parallel to the patient support surface and are configured to extend into the examination window.
Optionally, the anterior shutter and posterior shutter are independently adjustable.
Optionally, the integrated patient platform comprises two or more anterior shutters.
Optionally, the integrated patient platform comprises two or more posterior shutters.
Optionally, the anterior conveyor belt is movably coupled to the anterior shutter such that the belt rotates when the anterior shutter moves along the plane.
Optionally, the posterior conveyor belt is movably coupled to the posterior shutter such that the belt rotates when the posterior shutter moves along the plane.
Optionally, the patient support surface is sized to accommodate a patient laying in a supine or prone position.
Optionally, the integrated patient platform further includes an adjustable leg support positioned on the posterior surface of the patient support surface.
Optionally, the anterior and posterior shutters are: manually slideable, motorized and slideable, pneumatically actuated, or hydraulically actuated.
Optionally, the integrated patient platform further includes a user interface configured to receive user inputs, wherein user inputs control the motion of the anterior and posterior shutters.
Optionally, the user interface comprises a graphical user interface and a user input device.
Optionally, the user input device is selected from a group consisting of: one or more keys, one or more buttons, a mouse, a keyboard, a toggle, a switch, a joystick, and a touchscreen.
An integrated patient platform includes: a patient support surface positioned along a horizontal plane and comprising an anterior portion and a posterior portion, wherein the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween; a shutter slidable along a plane parallel to the patient support surface and configured to adjust a size of the examination window; a workbench surface disposed below the examination window along a plane parallel to the horizontal plane of the patient support surface; and a housing below the anterior portion or the posterior portion of the patient support platform, wherein the housing defines a storage space configured to store a procedure module in a stored position, and wherein the housing includes an aperture sized to enable horizontal movement of a procedure module from the stored position within the housing to a functional position on the workbench surface.
Optionally, the integrated patient platform further includes the procedure module.
Optionally, the procedure module is an imaging component.
Optionally, the procedure module is a therapy delivery component.
Optionally, the integrated patient platform further includes a patient-positioning camera supported by the workbench surface and pointed upward toward the examination window.
Optionally, the integrated patient platform further includes a cable management system within the housing, the cable management system configured to facilitate unobstructed movement of the procedure module from the stored position to the functional position.
Optionally, the integrated patient platform comprises an anterior shutter coupled to the anterior portion and a posterior shutter coupled to the posterior portion.
An integrated patient platform includes: a patient support surface positioned along a horizontal plane and comprising an anterior portion and a posterior portion, wherein the anterior and posterior portions are spaced a fixed distance from each other and together define an examination window therebetween; a shutter slidable along a plane parallel to the patient support surface and configured to adjust a size of the examination window; and a workbench surface disposed below the examination window along a plane parallel to the horizontal plane of the patient support surface, wherein the workbench surface is positioned 20-50 cm below the horizontal plane of the patient support surface.
Optionally, the workbench surface is positioned 30 cm below the horizontal plane of the patient support surface.
Optionally, the integrated patient platform comprises an anterior shutter coupled to the anterior portion and a posterior shutter coupled to the posterior portion.
Optionally, the integrated patient platform further includes a housing disposed below the patient support surface, wherein the housing is coupled to and supports the patient support surface.
Optionally, the workbench surface and an edge of the shutter together define an open workspace.
Optionally, the open workspace is further defined by sidewalls or side pillars of the housing.
Optionally, the integrated patient platform further includes a light source configured to illuminate the open workspace.
Optionally, the light source comprises one or more light emitting diodes disposed within one or more of the sidewalls or side pillars of the housing.
An integrated patient platform includes: a patient support surface configured to support a patient during a medical procedure, the patient support surface having an aperture disposed therein, wherein the aperture forms an examination window below a patient; and an imaging arm positioned below the examination window, wherein the imaging arm: is configured to securely receive an imaging transducer, is moveable in multiple degrees of freedom, and is upwardly spring-loaded such that the imaging arm, when positioned below a patient, is drawn upward to exert pressure onto the patient's body.
Optionally, the imaging arm is movable in six degrees of freedom.
Optionally, the integrated patient platform further includes a motor coupled to the imaging arm, wherein the motor is configured to drive automated position adjustment in at least one of the six degrees of freedom.
Optionally, at least two of the following orientations of the imaging arm are adjustable: pitch, yall, roll, vertical orientation, horizontal orientation, and angle.
Optionally, the imaging arm comprises a constant force spring to spring-load the imaging arm.
Optionally, the imaging arm is spring-loaded with 1-12 lbs. of force.
Optionally, the integrated patient platform further includes a lock configured to restrict each degree of freedom of the imaging arm and fix the orientation of the imaging arm in space.
Optionally, the imaging arm is configured to lock in a fixed position during operation of a treatment module.
Optionally, the integrated patient platform further includes the imaging transducer and a remote targeting monitor, wherein the imaging transducer is communicatively coupled to the remote targeting monitor.
Optionally, a virtual treatment region can be projected from the imaging transducer to the remote targeting monitor.
Optionally, the imaging transducer is removably coupled to the imaging arm.
Optionally, the integrated patient platform further includes an optical tracking camera.
Optionally, the imaging arm further comprises a first optical sensor disposed thereon, and wherein the optical tracking camera is configured to wirelessly communicate with the first optical sensor.
Optionally, the integrated patient platform further includes a therapy module, the therapy module having a second optical sensor disposed thereon, wherein the optical tracking camera is further configured to wirelessly communicate with the second optical sensor.
Optionally, the integrated patient platform further includes a therapy module, wherein the therapy module and the imaging arm are configured to be moveable together by a single operator.
Optionally, the therapy module is moveable via a motorized mechanism.
Optionally, the integrated patient platform is configured to communicate a relative position of the imaging transducer and the therapy module to enable positioning of the imaging transducer and the therapy module relative to one another.
The foregoing is a summary, and thus, necessarily limited in detail. The above-mentioned aspects, as well as other aspects, features, and advantages of the present technology will now be described in connection with various embodiments, with reference made to the following accompanying drawings:
The illustrated embodiments are merely examples and are not intended to limit the claimed invention.
The following description of the preferred embodiments is not intended to limit the claimed invention to these preferred embodiments, but rather to enable any person skilled in the art to make and use the claimed invention. Other embodiments may be utilized and modifications may be made without departing from the spirit or the scope of the subject matter presented herein. Aspects of the disclosure, as described and illustrated herein, can be arranged, combined, and designed in a variety of different configurations, all of which are explicitly contemplated and form part of this disclosure.
Throughout and within this specification, one or more publications may be referenced to more fully describe the state of the art. The disclosures of each of these references are incorporated herein by reference in their entireties as though they also form part of this disclosure.
Unless otherwise defined, each technical or scientific term used herein has the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs.
Disclosed herein are systems and methods for performing a medical procedure below a patient positioned in a supine or prone position.
The medical procedure may be non-invasive or minimally invasive. The medical procedure may include medical imaging (e.g., plain X-ray, computed tomography, magnetic resonance imaging, or ultrasound), for example, to view or examine one or more muscles, organs, or bone structures of a patient. The medical procedure may include a catheterization procedure, delivery of one or more injections, delivery of a therapeutic treatment, delivery of an analgesic treatment, or any other type of medical procedure. In some embodiments, the medical procedure includes ultrasonic imaging and/or therapy. In some embodiments, the medical procedure includes ablation of a nerve at or near a renal artery. Alternatively or additionally, the medical procedure may include applying therapeutic ultrasound to one or more of: a liver, spleen, pancreas, fat, muscle, vertebral nerve, celiac artery, mesenteric artery, ureter, renal pelvis, calyx, and/or any other structure in the abdominal or torso region. In some embodiments, the medical procedure includes lithotripsy.
In various embodiments, the system is configured to enable the performance of medical procedures below a patient's body. In some embodiments, a superior (i.e., top) level surface 20 of the integrated patient platform (also referred to as the patient support surface) is configured to support a patient lying in a prone or supine position, and an inferior (i.e., lower) level surface 22 of the integrated patient platform is configured to support one or more medical procedure components. In various embodiments, the superior level surface 20 includes an aperture 24 disposed therethrough, as shown in
In some embodiments, the system 10 is configured to deliver ultrasonic energy to treat and/or image a target region of a patient. While various embodiments included herein describe using the system for medical ultrasonic applications, the system can additionally or alternatively be used for any suitable applications, clinical or otherwise.
In some embodiments, the patient is positioned in a supine position. Positioning a patient in a supine position on the integrated patient platform facilitates underside access to one or more target regions on or near a patient's back side, for example, one or both kidneys, one or more nerves surrounding the renal artery, the spinal cord or column, and/or one or more other bone, organ, or muscle structures. In some embodiments, the patient is positioned in a prone position. Positioning a patient in a prone position on the integrated patient platform facilitates underside access to one or more target regions on or near a patient's front side, for example, one or both lungs, the heart, the stomach, one or more segments of intestines, one or more breasts, one or more ribs, and/or one or more other bone, organ, or muscle structures.
As shown in
While a system 10 with a front module 28 and a back module 26 are described herein, in other embodiments, the system may be formed of: a single integrated unit, a right side module and a left side module, or three, four, or more modules.
In various embodiments, an aperture (i.e., a gap or hole) 24 extends through the patient support surface 20. The portion of the patient support surface 20 positioned anterior to the aperture is referred to herein as the anterior portion 30b of the patient support surface 20, and the portion of the patient support surface 20 positioned posterior to the aperture 24 is referred to herein as the posterior portion 30a of the patient support surface 20. The aperture 24 may extend the entire width of the patient support surface 20 so as to completely split the anterior portion 30b of the patient support surface 20 from the posterior portion 30a of the patient support surface 20. In other embodiments, the aperture 24 does not extend the entire width of the patient support surface 20. In some such embodiments, the aperture 24 extends at least 50% of the width of the patient support surface 20; in some embodiments, the aperture 24 extends at least 70%, 80%, or 90% of the width of the patient support surface 20. In some embodiments, the aperture 24 is centrally located along the length of the patient support surface 20 such that an anterior portion 30b and a posterior portion 30a of the patient support surface 20 are equal in length. In other embodiments, the aperture 24 is more anteriorly located such that the length of the anterior portion 30b is less than 90%, less than 80%, less than 70%, or less than 60% the length of the posterior portion 30a.
In some embodiments, the top surface 20a of the front module 28 forms the anterior portion 30b of the patient support surface and the top surface 20b of the back module 26 forms the posterior portion 30a of the patient support surface. Alternatively, in other embodiments, such as shown in
In some embodiments, in the coupled configuration, the front 28 and back 26 modules are electrically coupled together. In some embodiments, an electrical communication between the front 28 and back 26 modules is established automatically during the process of physically coupling the modules together. For example, each module may include complementary electrical connections such as a plug and socket or other electrical pins and connectors, which enable electrical communications when physically engaged. In some embodiments, electrically coupling the front 28 and back 26 modules together may require manual pairing and/or coupling, for example by physically connecting a cable and plug from one module into an outlet or adaptor in the other module. Additionally or alternatively, once physically coupled, an electrical switch may need to be manually flipped in order to initiate electrical communication between the two modules.
In some embodiments, the front 28 and back 26 modules, when coupled together, perform independent, complementary functions. Alternatively, in some embodiments, the front 28 and back 26 modules are configured to perform some overlapping functions when coupled together.
As shown in
In some embodiments, one of the modules (e.g., the first/front module) functions as the imaging module. The imaging module includes, couples to, and/or stores an imaging component (described in more detail below). In some embodiments, the imaging module is configured to facilitate positioning of a target region of a patient relative to a medical procedure module for implementation of a medical procedure.
In some embodiments, the aperture (i.e., the gap) 24 between the anterior portion and the posterior portion of the patient support surface is a fixed size; however, at least two movable shutters 38 extend into the aperture 24, enabling adjustment of the effective size of the aperture 24 (i.e., enabling adjustment of an examination window). In various embodiments, the examination window is defined by a leading edge of the at least two movable shutters. The at least two movable shutters 38 are configured to adjust a size and location of the examination window under the patient. In some embodiments, one movable shutter (i.e., an anterior shutter) is coupled to the anterior portion 30b of the patient support surface and a second movable shutter (i.e., a posterior shutter) is coupled to the posterior portion 30a. Alternatively, as shown in
In some embodiments, the one or more movable shutters 38 are: manually slideable, motorized and slideable, pneumatically actuated, or hydraulically actuated. As shown, in some embodiments, one or more of the movable shutters 38 have a conveyor belt wrapped or looped around the shutter 38. In such embodiments, the conveyor belt fully or substantially covers a surface of the shutter 38 such that a patient's skin interfaces with the conveyor belt surface rather than the shutter surface when the patient is positioned on the patient support platform system 10. The conveyor belt of various embodiments is movably coupled to the shutter 38 such that the conveyor belt rotates as the movable shutter 38 extends or retracts along a plane parallel to the patient support surface 20. Such rotation of the conveyor belt allows the conveyor belt surface (i.e., the patient-interfacing surface) to effectively fall away from the patient's skin during retraction of the shutter and effectively roll up onto the patient's skin during extension of the shutter 38. The configuration of the conveyor belt around the shutter 38 reduces pulling or pinching of a patient's skin during shutter adjustment.
In various embodiments, a three-dimensional workspace exists within the integrated patient platform system and is sized and configured to allow a healthcare professional to work under the patient and position one or more medical procedure components below the patient. As shown in
In some embodiments, the workspace 44 is a clinically optimized size. For example, in some embodiments, the superior level surface (i.e., the patient support surface) 20 is spaced a clinically optimized distance above the inferior level surface (i.e., the workbench) 22, such that the depth of the workspace is clinically optimized. For example, the depth may be great enough to accommodate an imaging component and/or therapy-delivering component below a patient while also small enough to enable sufficient interfacing between the components and the underside of the patient. In some embodiments, the workbench 22 is positioned 20 to 50 cm below the horizontal plane of the patient support surface 20. In some embodiments, the workbench 22 is 20 to 25 cm, 25 to 30 cm, 30 to 35 cm, 35 to 40 cm, 40 to 45 cm, or 45 to 50 cm below the horizontal plane of the patient support surface 20, or any subrange therebetween. In some embodiments, the workbench 22 is positioned 28 to 32 cm below the horizontal plane of the patient support surface 20. In one embodiment, the workbench 22 is positioned 30 cm below the horizontal plane of the patient support surface 20. In various embodiments, at least a portion of the workbench 22 is positioned below the examination window 50, such that therapeutic and/or imaging ultrasound waves may be angled towards the target region of the patient and delivered without interference. The workbench 22 may be sized and configured to position and manipulate both a therapy delivery component 14 and imaging component 16 on or near the workbench 22 under the examination window 50, as shown in
In some embodiments, the front module 28 further includes a light source 48 configured to illuminate the three-dimensional workspace. For example, the light source 48 may include one or more light emitting diodes, incandescent lights, fluorescent lights, or high-intensity discharge lights. In some embodiments, the light source 48 is disposed within or on one or more of the sidewalls or side pillars of the housing 42. In one embodiment, light emitting diodes 48 are embedded within each of the side pillars 42 of the front module 28. In another embodiment, the light source is movable and slideably disposed in the housing of the front or back module.
In various embodiments, the imaging arm 54 is movable within the workspace 44. As shown in
In some embodiments, the imaging arm 54 includes one or more locking mechanisms to lock the imaging arm 54 and/or imager 52 in a fixed position. The locking mechanisms may be any suitable locking mechanism known in the art and may be actuated via any suitable, known actuation feature, including, for example, one or more knobs, push buttons, latches, and/or slide buttons. In some embodiments, pressing or manipulating a single button or other actuation feature may restrict movement in every degree of freedom. For example, in one embodiment, the imaging component 16 may be configured such that pressing a single button locks the imaging component 16 in place along all six degrees of freedom. In various embodiments, the imaging component 16 is reversibly lockable and configured to return to a movable state upon manipulating an actuation feature. Further, in some embodiments, the imaging component 16 is counterbalanced and/or spring-loaded upwardly toward the examination window such that the imaging arm 54, when positioned below a patient, is drawn upward to exert pressure onto the patient's body. In some embodiments, the imaging arm 54 is spring-loaded with 1 to 12 lbs. of force or any subrange or value therebetween. In one embodiment, the imaging arm 54 is spring-loaded with approximately 6 lbs. of force.
In some embodiments, the integrated patient platform system includes a patient-positioning camera 80. The patient-positioning camera 80 may be mounted or mountable to the workbench 22 or a sidewall or side pillar 42 of the front or back module. In some embodiments, the patient-positioning camera 80 is stored within a housing of the front or back module in a stored configuration and is movable into the workspace into an operational configuration. In various embodiments, the patient-positioning camera 80 is pointed upward toward the examination window 50 to capture an image of any objects or body portions positioned in or over the examination window. The patient-positioning camera functions to determine a position of the patient or target region of the patient relative to the workspace, workbench, examination window, therapy delivery component, and/or imaging component. The patient-positioning camera enables a healthcare provider to confirm that a patient is properly aligned on the patient support surface without needing to walk around the integrated patient platform to view the patient's position from multiple angles. The patient-positioning camera includes a camera and a mount, arm, or lever. In some embodiments, the patient-positioning camera is disposed within the workspace, for example, so that the camera may view and/or image the portion of the patient positioned in or over the examination window.
Further, one of the modules, for example, the imaging or front module, may include one more display screens 15 coupled thereto, as shown in
In some embodiments, as shown in
As shown in
In some embodiments, the back module 26 further functions to store the patient-positioning camera 80. For example, the arm or lever of the patient-positioning camera may be retracted into the housing of the back module to position the patient-positioning camera in a stored configuration and extended out of the housing into the workspace to position the patient-positioning camera in a functional or operational configuration.
In various embodiments, the optical tracking system enables concurrent imaging of a patient and targeted therapy delivery, wherein the therapy delivery is targeted based on the images received from the imager of the imaging component 16. For example, in some embodiments, the imager is an ultrasound transducer capable of delivering ultrasonic waves into a portion of a patient's body to image the internal structures within said portion of the body. In some such embodiments, the therapy delivery component 14 is configured to deliver focused, high energy therapeutic ultrasonic waves to a targeted region of the patient's body. By having two separate ultrasonic transducers and a system for tracking the orientation and position of each transducer relative to the other, the system enables a clinician to identify and track the targeted region of the patient's body while providing uninterrupted delivery of therapeutic energy to the targeted region.
The front module 28, back module 26, and workspace 44 are sized such that the optical tracking camera 70 is positioned an optimized distance away from each of the therapy delivery component 14 and the imaging component 16 when the therapy delivery component 14 and the imaging component 16 are in a functional position on the workbench surface. For example, in some embodiments, the optical tracking camera 70 is positioned 40-160 cm away from each of the therapy delivery component 14 and the imaging component 16 when the therapy delivery component 14 and the imaging component 16 are in the functional or operational position. In some embodiments, the optical tracking camera 70 is positioned 40 to 140 cm away from each of the therapy delivery component 16 and the imaging component 14, or any subrange therebetween. In some embodiments, the optical tracking camera 70 is positioned 40 to 50 cm, 50 to 60 cm, 60 to 70 cm, 70 to 80 cm, 80 to 90 cm, 90 to 100 cm, 100 to 110 cm, 110 to 120 cm, 120 to 130 cm, or 130 to 140 cm away from each of the therapy delivery component 16 and the imaging component 14.
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In some embodiments, all or substantially all functionality of the system can be controlled by a central user input device, such as a touchscreen. From the touchscreen, a user may be able to: control movements of the shutters to adjust the size and position of the aperture, activate an imaging component, observe the image generated by the imaging component, manipulate the position of the imaging component to locate a target region in a patient, direct a therapy delivery component to adjust its position so that it shares the same target as the imaging component, activate the therapy delivery component, and control the duration and intensity of the therapy delivered by the therapy delivery component.
The systems and methods of the preferred embodiments and variations thereof can be embodied and/or implemented, at least in part, by or on a machine with a computer-readable medium storing computer-readable instructions. The instructions are preferably executed by computer-executable components preferably integrated with the system. The computer-readable medium can be stored on any suitable computer-readable media such as RAMs, ROMs, flash memory, EEPROMs, optical devices (e.g., CD or DVD), disk drive, solid state drive, or other hard drives, floppy drives, or any suitable device. The computer-executable component is preferably a general or application-specific processor, but any suitable dedicated hardware or hardware/firmware combination can alternatively or additionally execute the instructions. For example, in various embodiments, one or more of the front module, back module, therapy delivery component, imaging component, optical tracking camera, and/or patient-positioning camera are specialized computerized systems containing a processor for executing specialized instructions for operation and memory for storing said specialized instructions. The computerized systems are controllable, at least in part, via user or system inputs.
As used in the description and claims, the singular form “a”, “an” and “the” include both singular and plural references unless the context clearly dictates otherwise. For example, the term “an anterior shutter” may include, and is contemplated to include, a plurality of anterior shutters. At times, the claims and disclosure may include terms such as “a plurality,” “one or more,” or “at least one;” however, the absence of such terms is not intended to mean, and should not be interpreted to mean, that a plurality is not conceived.
The term “about” or “approximately,” when used before a numerical designation or range (e.g., to define a length or width), indicates approximations which may vary by (+) or (−) 5%, 1% or 0.1%. All numerical ranges provided herein are inclusive of the stated start and end numbers. The term “substantially” indicates mostly (i.e., greater than 50%) or essentially all of a device, substance, or composition.
As used herein, the term “comprising” or “comprises” is intended to mean that the devices, systems, and methods include the recited elements, and may additionally include any other elements. “Consisting essentially of” shall mean that the devices, systems, and methods include the recited elements and exclude other elements of essential significance to the combination for the stated purpose. Thus, a system or method comprising essentially of the elements as defined herein would not exclude other materials, features, or steps that do not materially affect the basic and novel characteristic(s) of the claimed invention. “Consisting of” shall mean that the devices, systems, and methods include the recited elements and exclude anything more than a trivial or inconsequential element or step. Embodiments defined by each of these transitional terms are within the scope of this disclosure.
The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. Other embodiments may be utilized and derived therefrom, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments, and it will be readily apparent to those of ordinary skill in the art, in light of the teachings of these embodiments, that numerous changes and modifications may be made without departing from the spirit or scope of the appended claims.
This application is the national phase of International Patent Application No. PCT/US2015/039258, filed on Jul. 6, 2015, pending. The entire disclosure of the above application is expressly incorporated by reference herein.
Filing Document | Filing Date | Country | Kind |
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PCT/US15/39258 | 7/6/2015 | WO | 00 |