The present invention relates to a leg support for a surgical table, to a kit of parts for a leg support for a surgical table, to a method of configuring a leg support for a surgical table, to a surgical table comprising a leg support, and to a kit of parts for a surgical table. The leg support preferably is detachably connected or connectable to a surgical table.
Surgical tables comprising a base for standing on a floor, a column mounted on the base, and a tabletop mounted on the column and providing a patient support surface are well known. In one known surgical table, the tabletop is divided into multiple separate sections, the position of which relative to one another can be altered to vary the profile of the patient support surface, in order to best support a patient's body for surgery thereon or examination thereof. The separate sections comprise a head support, a torso support (comprised of an upper torso support and a lower torso support), and two leg supports. A lower end of the head support is mounted on an upper end of the upper torso support by means of a first pivot joint defining a transverse axis about which the head support can be displaced relative to the upper torso support. A lower end of the upper torso support is mounted on an upper end of the lower torso support by means of a second pivot joint defining a transverse axis about which the upper torso support can be displaced relative to the lower torso support. The leg supports are disposed beside each other in a transverse direction of the table, and respective upper ends of the leg supports are mounted on a lower end of the lower torso support. The leg supports are disconnectable and removable from the lower torso support to enable substitution of the two divided leg supports with a single leg support that is wider in the transverse direction and that preferably extends across the full width of the table.
The upper and lower torso supports share a common mattress that extends along the length of both torso supports in the longitudinal direction, and the common mattress is provided with a pair of spaced parallel grooves extending transversely across the width of the common mattress above and either side of the location of the second pivot joint between the upper and lower torso supports. The grooves permit flexing of the common mattress when the upper and lower torso supports are relatively inclined to each other by pivoting about the second pivot joint. The head support and the two leg supports each have a respective separate mattress.
A first one of the detachable leg supports has a support that supports the mattress, a connector for connecting the leg support to the lower torso support of the table, and an abduction joint that permits rotation of the support relative to the connector about an abduction axis, which is substantially perpendicular to the surface of the mattress. The leg support further has a lock that is operable to lock the support in one of a number of positions relative to the connector. The other of the detachable leg supports is similarly constructed, substantially as a mirror image to the first leg support. When the respective connectors of the two leg supports are each connected to the lower torso support, the connectors are fixed in position relative to the lower torso support and, by means of the respective abduction joints of the leg supports, the respective supports of the leg supports are rotatable about the respective abduction axes relative to the connectors and the lower torso support, in order to move apart from each other lower ends of the leg supports. The supports can then be locked in position relative to the connectors by operation of the locks.
When a patient is lying on the table with their legs on the respective leg supports, their legs are lifted and then, by means of the above-described arrangement, the position of the supports of the leg supports, relative to the connectors of the leg supports, are altered and the patient's legs are placed back down on the leg supports in a new position. As a result, the patient's legs may be supported by the supports in a position at which they are parallel or, alternatively, in a position at which they are spread apart from one another, i.e. abducted from the median plane of the rest of the patient's body, to enable a doctor or surgeon to access areas between the patient's legs. The leg supports can also be inclined using a hinged gas strut arrangement. This allows the patient's legs to be raised or lowered depending on the surgical procedure to be performed. Lowering the legs allows the patient to be positioned in the prone position for proctology or laminectomy type procedures, in which the patient is face down on the table with their legs bent behind them.
Surgery on obese patients is increasing. Gaining access to an obese patient's abdomen, for example to fit a gastric band or to carry out a bypass procedure, is particularly difficult when the patient is obese. Although the above-described known surgical table permits a patient's legs to be supported at a position at which they are spread apart from one another to aid access to their abdomen, there is a specific need for a surgical table, and a leg support therefor, that enables improved access to areas between a patient's legs.
Surgical tables and individual components thereof need periodically to be serviced and to be cleaned so as to remove any contamination therefrom. There is a still further need for a surgical table, and a leg support therefor, which enables improved access to areas between a patient's legs and which also is mechanically simple to aid servicing and cleaning.
As discussed above, it is advantageous for a leg support of a surgical table to be detachable from the table to enable substitution of the leg support with a different form of support. Often leg supports are removed from a surgical table, carried, and fitted to a surgical table by a member of hospital staff. There is a further need for a lightweight leg support for a surgical table which, when connected to the rest of the surgical table, enables improved access to areas between a patient's legs. The present invention avoids the disadvantages of the prior art.
A first aspect of the present invention provides a leg support for a surgical table, the leg support comprising: a connector for connecting the leg support to a surgical table; an intermediate member mounted on the connector by a first pivot joint defining a first axis about which the intermediate member is displaceable relative to the connector; and a support for supporting a leg of a patient, the support mounted on the intermediate member by a second pivot joint defining a second axis about which the support is displaceable relative to the intermediate member independently of displacement of the intermediate member relative to the connector about the first axis, the second axis being parallel to the first axis, and a plane normal to the second axis passing through both the intermediate member and the support.
Preferably, the intermediate member is displaceable relative to the connector only about the first axis. Preferably the support is displaceable relative to the intermediate member only about the second axis.
Preferably the support is displaceable relative to the connector only by one or both of displacement of the intermediate member relative to the connector about the first axis and displacement of the support relative to the intermediate member about the second axis.
The support may be displaceable relative to the intermediate member about the second axis between a position at which a body of the support abuts a body of the intermediate member and a position at which the body of the support does not abut the body of the intermediate member. Preferably the support is displaceable relative to the intermediate member about the second axis over an angle of at least 135 degrees, more preferably over an angle of at least 150 degrees, and most preferably over an angle of at least 165 degrees.
Optionally a plane normal to the first axis passes through both the intermediate member and the connector. Such a plane normal to the first axis may be coplanar with the plane normal to the second axis.
The intermediate member may be displaceable relative to the connector about the first axis between a position at which a body of the intermediate member abuts a body of the connector and a position at which the body of the intermediate member does not abut the body of the connector. Preferably the intermediate member is displaceable relative to the connector about the first axis over an angle of at least 135 degrees, more preferably over an angle of at least 150 degrees, and most preferably over an angle of at least 165 degrees.
The leg support may comprise a lock mechanism operable to fix one or both of the relative position of the intermediate member and the connector and the relative position of the support and the intermediate member. The lock mechanism may be operable through only a single action to fix both the relative position of the intermediate member and the connector and the relative position of the support and the intermediate member.
The support may comprise a resilient element upon which the leg of a patient is supportable. Such a resilient element may be detachably connected to the support.
Optionally the support comprises a body that has a first part mounted on the intermediate member by the second pivot joint and displaceable relative to the intermediate member about the second axis, and a second part that is mounted on the first part. The second part may be mounted on the first part by a third pivot joint defining a third axis about which the second part is displaceable relative to the first part. The third axis may be non-parallel to the second axis, such as perpendicular to the second axis. An angle between the second part and the first part may be controlled by one or more adjustable struts secured to and extending between the second part and the first part.
Preferably a distance between the first axis and the second axis is less than 20 cm, more preferably is less than 10 cm, more preferably is between 5 cm and 10 cm, more preferably is between 5 cm and 8 cm, and most preferably is about 6.5 mm.
The support may comprise a support element, which optionally is formed partially or wholly of radio translucent material. Such material may comprise one or more of a carbon fiber, reinforced polymer, polyoxybenzylmethylenglycolanhydride (or “Bakelite” (Registered Trademark) or filled phenolic resin).
The support element may have a width in a first direction perpendicular to the second axis and a length in a second direction that is perpendicular to the first direction, wherein the width and length of the support element together define an imaginary rectangular area. Preferably the imaginary rectangular area is not intersected by either of the first and second axes.
The support element may have a width in a first direction perpendicular to the second axis and a length in a second direction that is perpendicular to the first direction, wherein a distance between the first and second axes is less than the width of the support element. Preferably, a distance between the first and second axes is less than or equal to half the width of the support element. Most preferably, a distance between the first and second axes is less than or equal to a quarter of the width of the support element.
Preferably the width of the support element is between 20 and 35 cm. Preferably the length of the support element is between 40 and 80 cm.
Preferably the intermediate member excludes any resilient element upon which the leg of a patient is supportable.
The leg support may comprise an open chain consisting of, in order: the connector, the first pivot joint, the intermediate member, the second pivot joint, and the support. The open chain may have only two degrees of freedom. The open chain may be restricted to motion in only a single plane.
The support of the leg support may comprise a body that has a first part mounted on the intermediate member by the second pivot joint and displaceable relative to the intermediate member about the second axis, and a second part that is mounted on the first part by a third pivot joint defining a third axis about which the second part is displaceable relative to the first part In such a scenario, the leg support may comprise an open chain consisting of, in order: the connector, the first pivot joint, the intermediate member, the second pivot joint, the first part, the third pivot joint, and the second part. The open chain may have only three degrees of freedom. The open chain may be restricted to motion in only two planes.
A further aspect of the present invention provides a kit of parts for a leg support for a surgical table, the kit of parts comprising: a connector for connecting the leg support to a surgical table; an intermediate member mountable on the connector by a first pivot joint defining a first axis about which the intermediate member is displaceable relative to the connector; and a support for supporting a leg of a patient, the support mountable on the intermediate member by a second pivot joint defining a second axis about which the support is displaceable relative to the intermediate member independently of displacement of the intermediate member relative to the connector about the first axis, the second axis being parallel to the first axis, wherein the support is mountable on the intermediate member by the second pivot joint such that a plane normal to the second axis passes through both the intermediate member and the support.
A further aspect of the present invention provides a method of configuring a leg support for a surgical table, the leg support comprising a connector for connecting the leg support to a surgical table; an intermediate member mounted on the connector by a first pivot joint defining a first axis about which the intermediate member is displaceable relative to the connector; and a support for supporting a leg of a patient, the support mounted on the intermediate member by a second pivot joint defining a second axis about which the support is displaceable relative to the intermediate member independently of displacement of the intermediate member relative to the connector about the first axis, the second axis being parallel to the first axis, and a plane normal to the second axis passing through both the intermediate member and the support; the method comprising one or both of: displacing the intermediate member about the first axis relative to the connector; and displacing the support about the second axis relative to the intermediate member. Optionally the method comprises connecting the leg support to the surgical table by means of the connector prior to the, or both, displacing step(s).
A further aspect of the present invention provides a surgical table comprising a leg support according to the first aspect of the present invention.
A further aspect of the present invention provides a surgical table comprising a tabletop providing a patient support surface, the tabletop having a head support, a torso support and a leg support section arranged respectively in that order along a longitudinal direction of the tabletop between upper and lower ends of the tabletop, the leg support section having a leg support comprising: a connector by which the leg support is connected to the torso support; an intermediate member mounted on the connector by a first pivot joint defining a first axis about which the intermediate member is displaceable relative to the connector; and a support for supporting a leg of a patient, the support mounted on the intermediate member by a second pivot joint defining a second axis about which the support is displaceable relative to the intermediate member independently of displacement of the intermediate member relative to the connector about the first axis, the second axis being parallel to the first axis, and a plane normal to the second axis passing through both the intermediate member and the support.
The leg support section preferably comprises a pair of leg supports disposed beside each other in a transverse direction of the table. The, or each, leg support may be detachably connected to the torso support.
A further aspect of the present invention provides a kit of parts for a surgical table, the kit of parts comprising: a tabletop providing a patient support surface, the tabletop having a head support and a torso support arranged respectively in that order along a longitudinal direction of the tabletop between upper and lower ends of the tabletop; and a leg support comprising: a connector by which the leg support is connectable to the torso support; an intermediate member mounted on the connector by a first pivot joint defining a first axis about which the intermediate member is displaceable relative to the connector; and a support for supporting a leg of a patient, the support mounted on the intermediate member by a second pivot joint defining a second axis about which the support is displaceable relative to the intermediate member independently of displacement of the intermediate member relative to the connector about the first axis, the second axis being parallel to the first axis, and a plane normal to the second axis passing through both the intermediate member and the support.
Embodiments of the present invention will now be described by way of example with reference to the accompanying drawings, in which:
a is a schematic perspective view of the surgical table of
b is an enlarged schematic view of part of the surgical table of
a is a schematic plan view of the surgical table of
b is an enlarged schematic view of part of the surgical table of
a to 8d are schematic views of the underside of the leg support of
Referring to
The tabletop 10 is divided into three sections, namely a head support 14, a torso support (comprising an upper torso support 16 and a lower torso support 18) and a leg support section (comprising a pair of leg supports 20, 20b) arranged respectively in that order along a longitudinal direction of the tabletop between upper and lower ends of the tabletop. The leg supports 20, 20b are disposed beside each other in a transverse direction of the table. The head and leg supports 14, 20, 20b each have their own respective separate mattress 22, 24, 24b. The upper and lower torso supports 16, 18 have a common mattress 26 extending along the length of both supports 16, 18. The common mattress 26 is provided with a pair of spaced parallel grooves 28, 30 extending transversely across the width of the tabletop 10 above the location of a pivot joint 32 between the upper and lower torso supports 16, 18. This permits flexing of the common mattress 26 when the upper and lower torso supports 16, 18 are relatively inclined to each other by pivoting about a transverse axis defined by the pivot joint 32. The mattresses 22, 24, 24b, 26 are detachable from the table 2 for cleaning, repair or replacement of the mattresses 22, 24, 24b, 26 and for cleaning or servicing of the rest of the table 2.
The mattresses 22, 24, 24b, 26 each sit on top of a respective detachable cover (not shown), which preferably is made of an ABS polymer. In each leg support 20, 20b, the cover fits over the support element 420 and second part 406 of the support body 402, which are described below. The cover provides a smooth surface that may easy be wiped for cleaning purposes, specifically to remove fluids used or encountered during surgical procedures. In each leg support 20, 20b, retainers, such as screws or pegs, for detachably retaining the mattresses 24, 24b on the leg support 20, 20b, are fixed through the cover.
On the side of each leg support 20, 20b is provided a respective sidebar or rail, to which conveniently may be affixed various accessories used during surgical procedures or examinations. In each leg support 20, 20b, the sidebar is fixed to the support body 402 (and specifically to the second part 406 of the support body 402) through the cover.
A lower end 34 of the head support 14 is mounted on an upper end 36 of the upper torso support 16 by means of a second pivot joint 38 defining a transverse axis about which the head support 14 can be displaced relative to the upper torso support 16. The angle of inclination of the head support 14 is controlled by means of a pair of conventional adjustable struts 40, only one of which is shown in
The provision of the pivot joints 32, 38 permits the head, upper and lower torso supports 14, 16, 18 selectively to be inclined relative to adjacent supports 14, 16, 18 thereby to dispose the tabletop 10 in a selected configuration.
Optionally, a further pivot joint (not shown) is provided between a first part of the lower torso support 18 (to which the leg supports 20, 20b detachably connected) and a second part of the lower torso support 18. The further pivot joint would define a transverse axis about which the leg support(s) 20, 20b can be displaced relative to the second part of the lower torso support 18. The provision of this further pivot joint permits the whole of either or both leg supports 20, 20b selectively to be inclined relative to the lower torso support 18, thereby further increasing the number of permutations of the various supports 14, 16, 18, 20, 20b relative to one another, which in turn increases the versatility of the tabletop 10 for different procedures.
The leg supports 20, 20b of the table 2 will now be described in more detail, with reference to
The leg support 20 comprises a connector 200 for connecting the leg support 20 to the lower torso support 18 of the surgical table 2 of
When the connector 200 is connected to the rest of the surgical table 2, the anti-rotation projection 212 and the lock projection 206 respectively are received in a corresponding recess and hole in the face of the lower torso support 18 and then a locking element of the lower torso support 18, which locking element may be biased to a position at which it interferes with insertion of the lock projection 206 into the hole, locates in the groove 210 to prevent subsequent withdrawal of the lock projection 206 from the hole. The cooperation of the anti-rotation projection 212 and the recess prevents rotation of the body 202 relative to the lower torso support 18 about the longitudinal axis of the tubular member 208. The leg support 20 connected to the lower torso support 18 is shown in each of
The leg support 20 further comprises an intermediate member 300 comprising a rigid body 302. The intermediate member 300 is mounted on the connector 200 by a first pivot joint P1 defining a first axis A1 about which the intermediate member 300 is displaceable relative to the connector 200. That is, the intermediate member 300 is connected to the connector 200 only via the first pivot joint P1. The intermediate member 300 is displaceable relative to the connector 200 only about the first axis A1. That is, the intermediate member 300 is prevented from translation relative to the connector 200, and is prevented from displacement relative to the connector 200 about any other axis, whether parallel or non-parallel, such as perpendicular, to the first axis A1.
The first pivot joint P1 comprises a hinge having a first pivot pin 502 and a barrel 214 of the connector 200 rotatably mounted on the first pivot pin 502. The barrel 214 of the connector 200 is integrally formed with the body 202 of the connector 200 and is rotatable relative to the first pivot pin 502 about the first axis A1 at a first position on the first axis A1. Similarly, a barrel 304 of the intermediate member 300 is integrally formed with the body 302 of the intermediate member 300 and is rotationally fixed relative to the first pivot pin 502 about the first axis A1 at a second position on the first axis A1. The second position is axially spaced from the first position on the first axis A1, such that the barrels 214, 304 are spaced along the first pivot pin 502 in the direction of the first axis A1.
A first virtual plane normal to the first axis A1 passes through both the intermediate member 300 and the connector 200. That is, the body 302 of the intermediate member 300 and the body 202 of the connector 200 lie in a common plane that is normal to the first axis A1. Accordingly, the first pivot joint P1 permits displacement of the intermediate member 300 relative to the connector 200 about the first axis A1 only over an angle of less than 360 degrees. In this embodiment, the intermediate member 300 is displaceable relative to the connector 200 about the first axis A1 between a position at which the bodies 202, 302 of the connector 200 and the intermediate member 300 abut each other, as shown in
The leg support 20 further comprises a support 400 comprising a body 402. The body 402 comprises a first part 404 and a second part 406, each of which, respectively, is rigid. The support 400, i.e. the support 400 taken as a whole, is mounted on the intermediate member 300 by a second pivot joint P2 defining a second axis A2 about which the support 400 is displaceable relative to the intermediate member 300. More particularly, the first part 404 of the body 402 is mounted on the intermediate member 300 by the second pivot joint P2 and is displaceable relative to the intermediate member 300 about the second axis A2. That is, the support 400 (and more particularly the first part 404) is connected to the intermediate member 300 only via the second pivot joint P2. The second axis A2 is parallel to the first axis A1. The support 400 (and more particularly the first part 404) is displaceable relative to the intermediate member 300 only about the second axis A2. That is, the support 400 is prevented from translation relative to the intermediate member 300, and is prevented from displacement relative to the intermediate member 300 about any other axis, whether parallel or non-parallel, such as perpendicular, to the second axis A2.
The support 400 is displaceable relative to the intermediate member 300 about the second axis A2 independently of displacement of the intermediate member 300 relative to the connector 200 about the first axis A1. That is, relative displacement of the intermediate member 300 and the connector 200 does not cause relative displacement of the support 400 and the intermediate member 300. As such, it will be appreciated that the support 400 is displaceable relative to the connector 200 only by one or both of displacement of the intermediate member 300 relative to the connector 200 about the first axis A1, and displacement of the support 400 relative to the intermediate member 300 about the second axis A2.
The intermediate member 300 is rigid. That is, no portion of the member 300 is displaceable relative to another portion of the member 300. Preferably the intermediate member 300 consists of only one component, which comprises the body 302. The member 300 excludes any four bar linkage or other means for varying the relative positions of the first axis A1 and the second axis A2. That is, the first axis A1 is fixed as parallel to the second axis A2, and a distance between the first axis A1 and the second axis A2, in a direction normal to both of the first axis A1 and the second axis A2, is fixed. In this embodiment, this distance is about 6.5 cm. This distance preferably is less than 20 cm, more preferably is less than 10 cm, more preferably is between 5 cm and 10 cm, and most preferably is between 5 cm and 8 cm.
The second pivot joint P2 comprises a hinge having a second pivot pin 602 and a barrel 306 of the intermediate member 300 rotatably mounted on the second pivot pin 602. The barrel 306 of the intermediate member 300 is integrally formed with the body 302 of the intermediate member 300 and is rotatable relative to the second pivot pin 602 about the second axis A2 at a first position on the second axis A2. Similarly, a barrel 408 of the support 400 is integrally formed with the body 402 (and more particularly with the first part 404 of the body 402) of the support 400 and is rotationally fixed relative to the second pivot pin 602 about the second axis A2 at a second position on the second axis A2. The second position is axially spaced from the first position on the second axis A2, such that the barrels 306, 408 are spaced along the second pivot pin 602 in the direction of the second axis A2.
A second virtual plane normal to the second axis A2 passes through both the intermediate member 300 and the support 400. That is, the body 302 of the intermediate member 300 and the body 402 of the support 400 lie in a common plane that is normal to the second axis A2. Accordingly, the second pivot joint P2 permits displacement of the support 400 relative to the intermediate member 300 about the second axis A2 only over an angle of less than 360 degrees. In this embodiment, the support 400 is displaceable relative to the intermediate member 300 about the second axis A2 between a position at which the bodies 302, 402 of the intermediate member 300 and the support 400 abut each other, as shown in
Although other embodiments may vary, in the present embodiment a virtual plane normal to both the first and second axes A1, A2 passes through all of the connector 200, the intermediate member 300, and the support 400. That is, the first virtual plane is coplanar with the second virtual plane.
The combination of the first and second pivot joints P1, P2 and the intermediate member 300 are considered to comprise an articulated joint between the connector 200 and the support 400.
A first end of the second part 406 of the body 402 of the support 400 is mounted on the first part 404 of the body 402 by a third pivot joint P3 defining a third axis A3 about which the second part 406 is displaceable relative to the first part 404. The third axis A3 is perpendicular to the second axis A2 in this embodiment, although in other embodiments it may not be perpendicular. It is preferable that the third axis A3 be non-parallel to the second axis A2. A second, distal end of the second part 406 is a free end of the support 400 and of the leg support 20.
Secured to and extending between the first and second parts 404, 406 is an actuator or strut 418 of adjustable length, such as one of a hydraulic actuator, an electric actuator and a lockable gas spring. An angle between the second part 406 and the first part 404 is adjusted by altering a length of the strut 418. In this embodiment, the strut 418 comprises a lockable gas spring 418, which comprises a piston 418a and a piston body, or cylinder, 418b within which the piston 418a is movable. The interior of the cylinder 418b is divided into two portions by a sliding bulkhead attached to the piston 418a. A handle 410 is pivotally mounted on the second part 406 of the body 402, one end of a push link 412 is pivotally connected to the handle 410, and the other end of the push link 412 is connected to a nipple on the piston 418a. The connection of the handle 410 to the push link 412 is spaced on the handle 410 from the connection of the handle 410 to the second part 406. When the handle 410 is rotated, from its rest position shown in
The support 400 further comprises a support element 420, which in this embodiment is fixed to the second part 406 of the body 402 by means of screws 420a. The support element 420 is made at least partially, and preferably wholly, from radio translucent material(s). This permits a patient's leg, supported on the support element 420, to be x-rayed without a significant shadow being created on the resultant image by the support element 420. Such material may comprise one or more of a carbon fiber reinforced polymer, polyoxybenzylmethylenglycolanhydride (or “Bakelite” (Registered Trademark) or filled phenolic resin). Indeed, many polymer-based materials should have good radio translucent properties.
In this embodiment the support element 420 is a planar plate. However, in other embodiments, the support element 420 may be a substantially non-planar plate or not plate-like at all. For example, the support element 420 may comprise one or more bars extending from the second part 406 in a direction that is non-parallel to a dimension of the second part 406 extending between the distal end of the second part 406 and the third pivot joint P3. The support element 420 need only be suitable to support a mattress 24 (not shown in
In any case, the support element 420 has a maximum width (W) in a first direction perpendicular to the second axis A2, and a maximum length (L) in a second direction that is perpendicular to the first direction and parallel to the third axis A3. Preferably the width (W) is between 20 and 35 cm. Preferably the length (L) is between 40 and 80 cm. In this embodiment, the width (W) is 27 cm and the length (L) is 69.5 cm. Preferably, a distance between the first axis A1 and the second axis A2 is less than the width (W) of the support element 420. More preferably, the distance between the first axis A1 and the second axis A2 is less than or equal to half the width (W) of the support element 420. The length (L) and width (W) of the support element 420 together define an imaginary rectangular area. The first and second axes A1, A2 both lie outside of the imaginary rectangular area. That is, neither of the first and second axes A1, A2 intersects the imaginary rectangular area. Indeed, each of the first and second pivot joints P1, P2 and the intermediate member 300 lies outside of the imaginary rectangular area. Moreover, the second part 406 is disposed only along one side of the support element 420, such that the second part 406 lies outside of the imaginary rectangular area. As a result, none of the second part 406, the first and second pivot joints P1, P2, and the intermediate member 300 would create a significant shadow, were the support element 420 to be x-rayed. When the second part 406 is minimally inclined, or is parallel, to the first part 404, the imaginary rectangular area is preferably normal to the second axis A2.
Accordingly, the articulated joint comprising the first and second pivot joints P1, P2 and the intermediate member 300 is disposed away from the support element 420 outside of the imaginary rectangular area, such that the components of the articulated joint, and the underside of the support element 420, are easily accessible for servicing and cleaning thereof, and such as to provide a region (corresponding to the area of the imaginary rectangle) of x-ray transparency. Moreover, since the articulated joint is disposed wholly between the connector 200 and the first body 404 of the support 400, and not in overlap with the support element 420, the articulated joint is compact. Thus, the articulated joint adds minimal weight to the leg support 20, which permits the leg support 20 to be lightweight while, at the same time, in use enables improved access to areas between a patient's legs.
The connector 200, intermediate member 300, support 400 and the pivot joints P1, P2 therebetween can be considered as comprised in a mechanical linkage or kinematic chain. The connector 200, intermediate member 300 and support 400 are respective rigid bodies, or links, of the chain and the first and second pivot joints P1, P2 are the connections, or joints, between the links of the chain.
In the illustrated embodiment, the mechanical linkage, or kinematic chain, is an open chain that consists of the following five elements, in order as a series: the connector 200, the first pivot joint P1, the intermediate member 300, the second pivot joint P2, and the support 400. That is, the chain consists of the connector 200, the intermediate member 300 and the support 400 as respective links and the first and second pivot joints P1, P2 as respective joints. The connector 200 may be considered a ground link, at least when the leg support 20 is mounted on the lower torso support 18 of the table 2. The linkage or chain of these five elements has (only) two degrees of freedom (i.e. rotation of the intermediate member 300 relative to the connector 200 about the first axis A1, and rotation of the support 400 relative to the intermediate member 300 about the second axis A2, independently of rotation of the intermediate member 300 relative to the connector 200), and these five elements are restricted to motion in only a single plane.
As discussed above, the support 400 has a body 402 that comprises two relatively-movable parts 404, 406 (although, as discussed below, it is not essential that the body 402 has these two relatively-movable parts). The above-described embodiment thus may be considered to define a mechanical linkage, or kinematic chain, that is an open chain consisting of the following seven elements, in order as a series: the connector 200, the first pivot joint P1, the intermediate member 300, the second pivot joint P2, the first part 404, the third pivot joint P3, and the second part 406. That is, the chain consists of the connector 200, the intermediate member 300, the first part 404 and the second part 406 as respective links and the first, second and third pivot joints P1, P2, P3 as respective joints. The linkage or chain of these seven elements has (only) three degrees of freedom (i.e. the two degrees of freedom discussed above, and also rotation of the second part 406 relative to the first part 404 about the third axis A3, independently of rotation of the intermediate member 300 relative to the connector 200 and independently of rotation of the first part 404 relative to the intermediate member 300). The seven elements are restricted to motion in only two planes, which preferably are non-parallel to each other.
The leg support 20 further has a lock mechanism 700 that comprises independently-operable first and second locks 500, 600, as shown in
The first lock 500 comprises a first dog 504 that is fixed to the body 202 of the connector 200 by means of a pair of screws 504b so as to axially and rotationally fix the first dog 504 relative to the body 202. The first dog 504 is circular with the centre of the circle lying on the first axis A1. The first dog 504 is rotatable only with the body 202 about the first axis A1. The first dog 504 has a hole therein. The first pivot pin 502 is located in the hole and is movable along and about the first axis A1 relative to the first dog 504 and the body 202. The first dog 504 has an axial end facing the first pivot pin 502 and has a circumferential ring of teeth 504a projecting from an opposite second axial end thereof.
The first lock 500 further comprises a second dog 506 that is fixed to the body 302 of the intermediate member 300 so as to axially and rotationally fix the second dog 506 relative to the body 302 of the intermediate member 300. The pin 502 also is fixed relative to the body 302. The second dog 506 is rotatable only with the body 302 and the pin 502 about the first axis A1. The second dog 506 is circular with the centre of the circle lying on the first axis A1. The second dog 506 has a circumferential ring of teeth 506a on an axial end thereof, which ring of teeth 506a are coaxial with the ring of teeth 504a of the first dog 504.
A second, opposite end of the first pivot pin 502 has a threaded bore 502a therein, which bore 502a is aligned with the first axis A1. The first lock 500 further comprises a handle 508 comprising threaded shaft 508a, which is mated with the threaded bore 502a of the pin 502, and a lever 508b, which is rotationally fixed relative to the threaded shaft 508a and extends from the threaded shaft 508a in a radial direction from the first axis A1. Note that, in
In order to lock the position of the intermediate member 300 relative to the connector 200 (as shown in
In order to unlock the first lock 500, the handle 508 is rotated in the opposite direction, which creates slack in the assembly. The intermediate member 300 (with the pin 502 and second dog 506) may then be lifted by hand relative to the connector 200, which causes the teeth 504a, 506a of the dogs 504, 506 to disengage. Movement of the intermediate member 300 about the first axis A1 relative to the connector 200 is then permitted and, once the user has selected roughly a desired position of the intermediate member 300 relative to the connector 200 about the axis A1, the intermediate member 300 can be lowered to cause the teeth 504a, 506a of the dogs 504, 506 to reengage. The sets of teeth 504a, 506a each have a pitch (of 15°) in this embodiment) so, as the teeth 504a, 506a reengage, the intermediate member 300 is forced to adopt one of a plurality of available predetermined index angles relative to the connector 200. Once the teeth 504a, 506a are fully engaged, the first lock 500 may then be locked to axially lock the teeth 504, 506a relative to one another, as discussed above.
The second lock 600 is operable in the same way as the first lock 500 so, in the interests of conciseness, a detailed discussion thereof will not be given. In short, the support 400 is releasably lockable at one of a plurality of available predetermined index angles relative to the intermediate member 300, the selected index angle being independent of the position of the intermediate member 300 relative to the connector 200.
An alternative lock mechanism 800 for use in the illustrated embodiment is shown in
It will be appreciated that the above-described leg support 20 may be provided in the form of a kit of parts, with the intermediate member 300 being mountable on the connector 200 by the first pivot joint P1, and the support 400 being mountable on the intermediate member 300 by the second pivot joint P2, such that a plane normal to the second axis A2 passes through both the intermediate member 300 and the support 400.
A method of configuring a surgical table 2, including configuring the above-described leg support 20, will now be described with reference primarily to
The connector 200 of the leg support 20 is detachably connected to the lower torso support 18 of the surgical table 2 of
If locked, the first and second locks 500, 600 are unlocked, as described above with reference to
The intermediate member 300 is then displaced relative to the connector 200 about the first axis A1, and the support 400 is independently displaced relative to the intermediate member 300 about the second axis A2, to reach the position shown in
Displacement of the intermediate member 300 relative to the connector 200, and the independent displacement of the support 400 relative to the intermediate member 300, is continued until the position shown in
Optionally, the first lock 500 may now be actuated by a user to lock the position of the intermediate member 300 relative to the connector 200 at the position shown in
Displacement of the support 400 relative to the intermediate member 300 is continued until the position shown in
The second lock 600 may now be actuated by a user to lock the position of the support 400 relative to the intermediate member 300 at the position shown in
Although in the described method there is independent displacement of the intermediate member 300 relative to both the connector 200 and the support 400, in other embodiments the intermediate member 300 may be displaced relative to only one of the connector 200 and the support 400.
Naturally, a second leg support 20b that is identical to the above-described leg support 20, other than being a mirror-image thereof, also is detachably connected to the lower torso support 18 of the surgical table 2 of
Of course, one leg support 20 is manipulatable independently of the other leg support 20b, and the components of one of the leg supports 20, 20b need not be positioned and locked in the same state as components of the other of the leg supports 20, 20b.
If both leg supports 20, 20b are connected to the lower torso support 18 and placed in the state shown in
If both leg supports 20, 20b are connected to the lower torso support 18 and placed and locked in the state shown in
With a leg support 20 in the position shown in
With the intermediate member 300 at any position relative to the connector 200 and at any position relative to the support 400, the second part 406 of the support body 402 may be displaced relative to the first part 404 of the support body 402 about the third axis A3 in order to configure the mattress 24 as an inclined surface for receiving a patient's leg.
The leg supports 20 may be returned to the more compact position shown in
While the above method involves independently locking and unlocking independent first and second locks 500, 600, it will of course be appreciated that the first and second locks 500, 600 may be replaced by the alternative lock mechanism 800 described above with reference to
It will thus be appreciated that the provision of the articulated joint (i.e. the combination of the first and second pivot joints P1, P2 and the intermediate member 300) connecting the support 400 to the connector 200 enables the support 400 and associated mattress 24 to be moved further from its compact rest position (shown in
It will also be appreciated that the number of moving parts of the leg support 20 is minimal, while still providing improved access to areas between the patient's legs. As such, maintenance, and possible failure, of the leg support 20 may be minimized.
Various modifications can be made to the above-described embodiments without departing from the scope of the present invention.
For example, although the above-described leg supports 20 are disconnectable and detachable from the lower torso support 18 of the rest of the table 2, in an alternative embodiment one or both of the leg supports 20 may be fixed to the rest of the surgical table 2, and may not be disconnectable from the lower torso support 18, at least by a user of the table 2.
In other embodiments where the leg support is detachably connectable to a table, the means by which the connector is connectable to the table may differ from the arrangement discussed above. For example, the anti-rotation projection could be omitted and the tubular member of the lock projection could be of a non-circular cross section to prevent rotation of the body of the connector relative to the lower torso support about the longitudinal axis of the tubular member.
In contrast to the above-described embodiment, in an alternative embodiment the support body 402 may not comprise two parts 404, 406 connected together by the third pivot joint P3. That is, the third pivot joint P3 may be omitted and the above-described parts 404, 406 may be immovable relative to one another or integrally formed with one another as a single body part. Accordingly, in such an alternative embodiment, the support 400 would comprise a body 202 and the support element 420, of any one of the forms described above, would be fixed to the body 402 by means of screws 420a or otherwise. Moreover, in such an embodiment, preferably the imaginary rectangular area is normal to the second axis A2 and preferably the body 402, the first and second pivot joints P1, P2 and the intermediate member 300 lie outside of the imaginary rectangular area, similarly to the manner discussed above.
In contrast to the above-described embodiment, in an alternative embodiment the various cooperating dogs (e.g. 504, 506) do not have teeth. Rather, each of the dogs (e.g. dog 540) has a substantially smooth (or slightly roughened) surface that is able to frictionally engage a similar surface of a cooperating dog (e.g. dog 506). As such, the positions at which the intermediate member 300 may be locked relative to the connector 200 and relative to the support 400 are not predetermined according to the pitch of any teeth, but rather the intermediate member 300 may be locked at any angle relative to the connector 200 and at any angle relative to the support 400.
Also, the first and second pivot joints P1, P2 may take a different form to the barrel hinges described above. For example, the intermediate member 300 and the connector 200 may both be rotationally movable relative to the first pivot pin 502, and/or the intermediate member 300 and the support 400 may both be rotationally movable relative to the second pivot pin 602. Other forms of pivot joints P1, P2 could be employed. However, in order to keep the leg support 20 of simple, lightweight construction, it remains preferable that the intermediate member 300 be displaceable relative to the connector 200 only about the first axis A1, and similarly it remains preferable that the support 400 be displaceable relative to the intermediate member 300 only about the second axis A2.
Still further, the lock mechanism could take any suitable form other than the mechanisms 700, 800 discussed above. It is preferable that the position of the intermediate member 300 relative to each of the connector 200 and the support 400 be lockable. However, in some embodiments, no lock may be provided between the intermediate member 300 and one or both of the connector 200 and the support 400.
Still further, the leg support 20, 20b may include an on-board power supply, such as a tank of compressed or pressurised gas or liquid, a cell or battery, or a connector to which such an on-board power supply may be fitted. Such an on-board power supply or connector may be fluidly or electrically, as appropriate, connected to the strut as an energy supply for powering the strut to alter inclination of the second part 406 relative to the first part 404 of the support body 402.
Alternatively, or additionally, one or other of the tubular member 208 and the anti-rotation pin 212 may comprise a conduit for carrying an energy supply for the actuator 418. For example, the conduit may comprise a pipe or channel fluidly connected to the actuator 418 and through which may be conveyed a gas or liquid to the actuator. Alternatively, the conduit may comprise one or more electrically-conductive wires electrically connected to the actuator 418.
Number | Date | Country | Kind |
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1200979.1 | Jan 2012 | GB | national |