The present invention relates generally to medical equipment, and more particularly, to a surgical tray for operations on a patient's limb or extremity.
Many emergency room and other surgical operations require a doctor to operate on a patient's limb or extremity. Hands are some of the most commonly operated upon extremities because they are required to complete many tasks and activities and are thus highly at risk to injury. For example, approximately 10 percent or more of typical emergency room operations involve some form of acute hand surgery. Operating on a hand requires a great deal of care because tendons, nerves, and blood vessels must all be meticulously rejoined to assure proper alignment of any lacerated tissues. Additionally, microsurgical techniques are generally required because the tissues that make the functions of the hand possible are small by nature. Control of the position of a patient's hand and fingers during surgery is therefore an important aspect of a successful operation.
Current techniques for performing hand surgery in the emergency room and elsewhere are inefficient and frustrating. For example, when a patient is rushed into the emergency room with deep laceration or similar hand injury, a surgeon must arrange the patient in the proper position for surgery and gather the necessary materials. Typically this requires positioning the hand on an arm table adjacent to a hospital bed and arranging it in a manner that provides the surgeon with easy access to the intended surgical site. Maintaining the hand in a desired position can be a difficult task when qualified assistants are not readily available, which is often the case during late-night, weekend, or very busy emergency room situations.
Additionally, gathering the necessary supplies from various areas in the emergency room prior to operation can be a burdensome task. Due to a lack of centralized storage, the surgeon may find himself or herself walking back and forth between the patient and various areas of the room to gather surgical tools, sutures, needles, gauze, and other items required to complete the surgery. The surgeon may experience additional frustration if supply amounts have not been maintained or if items have changed locations.
As a result of the manner by which items are gathered for surgery, the surgical operation itself becomes more difficult. For example, the various items are typically contained in individual packages and are not designed to be collectively organized in any particular manner. After all of the packages are opened and the items are placed together on a separate instrument table or the like, the surgeon may have to sort through any resulting clutter on the table to find the instrument he or she is looking for. The clutter typically increases throughout the operation as surgeon uses different tools and instruments and places them back on the table. Any increased operating time resulting from the lack of instrument management increases the overall cost of the surgery and can compromise the quality of the operation. Additionally, the lack of instrument management increases the potential of accidental injury from exposed scalpel blades and the like.
Use of the tools themselves can also be a challenging task. In particular, areas of tissue on the hand typically obstruct access to the surgical site being operated upon. As a result, surgical stays and retractors are used to pull the tissue back. Because assistants are not always available to hold the stays during an operation, many surgeons place some sort of retractor frame around the surgical site. The frames typically include notches that are spaced about a peripheral edge and adapted to secure a portion of the surgical stays, as shown in U.S. Pat. No. 4,274,398. Although such frames may slightly facilitate the surgical operation, they are better suited for (and were originally developed for) areas of the body other than limbs and merely represent an improvised solution for hand surgeries. The ability to use a stay to retract tissue in a desired three-dimensional direction is limited by the spacing of the notches and their position relative to the tissue.
During the course of the operation, the surgeon must take measures to maintain a sterile surgical site. This typically involves disinfecting and irrigating the surgical site and draining any resulting fluids. Oftentimes the drainage is done in an ad-hoc manner by merely placing a plastic bin or basin under the patient's hand. Such a technique, however, may not sufficiently capture the fluids due to splashing while the fluids are being applied. Moreover, the bin or basin may not be large enough to cover the entire area where drainage is likely to occur and can create a mess when attempting to dispose of its contents. As a result, the surgeon has a more difficult time maintaining a sterile surgical site and reducing his or her own exposure to potentially contaminated and biohazardous fluids.
Although several attempts have been made to facilitate surgical operations on a patient's extremities, these attempts merely focus on one or few of the challenges associated with the operations and do not adequately ease the burden on surgeons. For example, many surgeons use a sheet of metal (typically aluminum or lead) cut into the shape of a hand to help stabilize and position a patient's extremities. After using straps or the like to attach the patient's hand to the metal sheet, the sheet can be bent into desired positions by applying sufficient force. Variations of this type of hand device are shown in U.S. Pat. Nos. 4,798,195, 5,560,375, and 5,855,209. Despite the improvements in stability, however, such devices do not adequately address the challenges associated with tissue retraction, instrument management, and fluid management. Indeed, assistants are still typically required to keep an incision open or to hold nerves, blood vessels, and tendons or the like during surgery.
The same can be said with respect to various surgical tables or trays that have been developed facilitate surgery on a patient's extremities. In particular, although most of the tables provide some means for securing a hand or the like during surgery, the tables still limit the manner by which surgical stays may be used to retract tissue. As shown in U.S. Pat. Nos. 3,779,211, 4,082,257, 4,807,864, and 6,077,221, the tables typically include notches around a peripheral edge to secure a portion of the surgical stays. This row of notches, or “Scott fencing,” suffers from the same drawbacks as the notched framing discussed above—the desired direction of retraction is limited by the spacing of the notches and their position in 3 dimensions relative to the tissue. If blood vessels need to be held in a particular manner or if tissue needs to be retracted in a direction away from the plane formed by the fencing and surgical table, one or more assistants will be needed to manually complete these tasks.
As can be appreciated, there is a need for a surgical tray that helps reduce the frustration surgeons currently experience when attempting to operate on a patient's limb or extremity. A surgical tray is needed to address the issues of hand positioning, tissue retraction, instrument and sharps management, and irrigation/waste fluids management without significantly compromising the comfort and wellbeing of the patient.
The present invention overcomes the foregoing and other shortcomings and drawbacks of surgical trays heretofore known. While the invention will be described in connection with certain embodiments, it will be understood that the invention is not limited to these embodiments. On the contrary, the invention includes all alternatives, modifications and equivalents as may be included within the spirit and scope of the present invention.
The present invention provides a surgical tray that facilitates surgical operations on a patient's limb or extremity. In particular, the surgical tray is configured to retain a patient's limb and retract tissue or the like to reduce the surgeon's reliance upon medical assistants to complete a surgical operation. The surgical tray is also configured to provide an organized, sterile field for an operation by incorporating integral irrigation/waste fluids management, instrument management, and sharps management.
To this end, a surgical tray according to the invention generally comprises a surgical site board adapted to support a portion of a patient's body, such as a hand. The site board also includes a plurality of apertures. A retention device or retraction device is removably securable in at least one of the apertures to retain or retract a portion of the patient's body. More specifically, a retention device is configured to overlap and retain a portion of the patient's body, such as the patient's fingers. The retention device may therefore be a rigid component shaped for this purpose or a component moldable to a desired shape. For example, the retention device may include an anchor configured to be inserted into one of the apertures and a body portion formed from a malleable sheet of material. Alternatively, the retention device may comprise a pliable wire configured to be at least partially inserted into one of the apertures and a cushioning layer surrounding at least a portion of the wire.
The retraction device, on the other hand, is configured to retract tissue or the like to provide the surgeon with increased access to the intended surgical site on the patient's extremity. In general, the retraction device comprises a post member configured to be retained in one of the apertures and a surgical stay configured to be secured to the post member. Similar to the retention device, the post member may be a rigid component or a component moldable to a desired shape. For example, in one embodiment, the post member includes a body having edges and a plurality of notches spaced along the edges. The notches are configured to retain a portion of the surgical stay during a surgical operation. Thus, the surgical stay may be secured to the appropriate notch depending upon the desired angle of retraction in each of the x, y, and z planes.
In another aspect of the invention, the surgical tray further includes a housing configured to support the surgical site board. The housing defines a basin positioned below the site board for collecting any fluids that may drain through the plurality of apertures during a surgical operation. For example, irrigation fluid applied to the surgical site, or bodily fluids, may drain through the apertures into the basin. Gutters and run-off guides may be provided around the site board to direct drainage fluids into the basin as well. The basin may be drained manually after an operation, using an integrated pour spout or aperture, or continuously during the operation by attaching a vacuum hose or drain to a port communicating with the basin. Thus, in addition to helping prevent the spillage of blood, disinfectants, and washes, the integrated fluid management system of the surgical tray may retain waste liquids and other fluids for convenient disposal.
The housing may also include one or more storage compartments positioned proximate to the site board. The storage compartments may contain all of the medications and instruments commonly needed for surgery on a patient's extremity, including sutures, disinfectants, dressing materials, anesthetics, and the retention and retraction devices discussed above. Thus, the surgical tray reduces the need for a surgeon to walk back and forth between various areas in an operating room to gather the necessary materials for a surgical procedure. If desired, the storage compartments may be sterilized and sealed when the surgical tray is produced so that the surgeon need only open the compartments to make sterile surgical instruments readily available for use.
During an operation, the surgical instruments and suture needles may be inserted into one or more foam pads received by the housing. For example, one or more foam islands may be received by the housing adjacent to the site board. Scalpels, scissors, forceps, and other surgical instruments are supported by the foam when inserted therein so that they are readily available for use or reuse during an operation. Alternatively, the foam islands, other areas of the housing, or the site board itself may include a plurality of pre-formed holes or slots for receiving the surgical instruments.
By virtue of the foregoing, there is thus provided a surgical tray that reduces the time and frustration occasionally experienced by surgeons when preparing for and performing a surgical operation on a patient's limb or extremity. The retention and retraction devices cooperate with the apertures in the site board to secure the extremity and provide the surgeon with visual access to the intended surgical site without relying upon additional personnel. Integrated fluid management improves overall cleanliness during operations and facilitates disposal of contaminated waste liquids, while integrated sharps and instrument management helps increase overall efficiency and prevents misplacement of items. In addition, safety is promoted by providing containment of biohazardous liquids and protection from exposure to needles, scalpels, and other sharps.
These and other objects and advantages of the present invention will be made apparent from the accompanying drawings and the description thereof.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with a general description of the invention given above, and the detailed description given below, serve to explain the principles of the invention.
With reference to
Both the site board 12 and housing 14 may be constructed from plastic, although other materials are possible as well. For example, the site board 12 or housing 14 may alternatively be constructed from foam or a similar material. In one embodiment, the housing 14 is adapted to receive one or more foam pads or islands 20 for the management of sharps and other surgical instruments. The foam islands 20 may be a polyurethane, polyethylene, or similar foam having a density sufficient to support the instruments at the angles with which they are inserted therein. For example,
To further facilitate instrument management during surgical operations, the housing 14 may also include a plurality of pre-formed slots or holes 36 adapted to receive scissors 38 and other surgical instruments. The slots 36 may be provided in a predetermined matrix array and at desired angles in the housing 14. Preferably the slots 36 are formed in a compressible material such as foam and define openings sized to provide a close fit for the common instruments provided with the tray 10 or commonly used during surgery. Although
In one embodiment, a special type of foam island and slot array is provided in the housing 14 to manage sharps (including suture needles, scalpel blades, and other sharp objects) during a surgical operation. More specifically and with reference to
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The retention device 54 (
The retraction device 58 of
Although specific embodiments of retention and retraction devices according to the invention are described above, those skilled in the art will appreciate that a wide variety of shapes and configurations are possible for such devices. For example, the retraction device 60 (
No matter which manner of irrigating the surgical site is employed, however, the irrigation fluid 146 and bodily fluids may drain through the apertures 34 into a basin 160 (
While the invention has been illustrated by the description of one or more embodiments thereof, and while the embodiments have been described in considerable detail, they are not intended to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. The invention in its broader aspects is therefore not limited to the specific details, representative apparatus and methods and illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the scope or spirit of Applicants' general inventive concept.
The present application claims the filing benefit of U.S. Provisional Application Ser. No. 60/688,036, filed Jun. 7, 2005, the disclosure of which is hereby incorporated herein by reference in its entirety.
Number | Date | Country | |
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60688036 | Jun 2005 | US |