EP2890351A1 - Patient positioning support apparatus with virtual pivot-shift pelvic pads, upper body stabilization and fail-safe table attachment mechanism - Google Patents
Patient positioning support apparatus with virtual pivot-shift pelvic pads, upper body stabilization and fail-safe table attachment mechanismInfo
- Publication number
- EP2890351A1 EP2890351A1 EP13833588.0A EP13833588A EP2890351A1 EP 2890351 A1 EP2890351 A1 EP 2890351A1 EP 13833588 A EP13833588 A EP 13833588A EP 2890351 A1 EP2890351 A1 EP 2890351A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- patient
- support structure
- patient support
- frame
- base
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/02—Adjustable operating tables; Controls therefor
- A61G13/08—Adjustable operating tables; Controls therefor the table being divided into different adjustable sections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/0036—Orthopaedic operating tables
- A61G13/0054—Orthopaedic operating tables specially adapted for back or spinal surgeries
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/02—Adjustable operating tables; Controls therefor
- A61G13/04—Adjustable operating tables; Controls therefor tiltable around transverse or longitudinal axis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/101—Clamping means for connecting accessories to the operating table
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/104—Adaptations for table mobility, e.g. arrangement of wheels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/121—Head or neck
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/122—Upper body, e.g. chest
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/123—Lower body, e.g. pelvis, hip, buttocks
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
- A61G13/1235—Arms
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/128—Rests specially adapted therefor; Arrangements of patient-supporting surfaces with mechanical surface adaptations
- A61G13/1285—Rests specially adapted therefor; Arrangements of patient-supporting surfaces with mechanical surface adaptations having modular surface parts, e.g. being replaceable or turnable
Definitions
- the present invention is direct to structures for supporting a patient in a desired position during examination and treatment, including medical procedures such as imaging and surgery and in particular to such a structure that allows a surgeon to selectively position the patient for convenient access to the surgery site for manipulation of the patient during surgery including the tilting, pivoting, angulating or bending of a trunk and additionally or alternatively joint of a patient in a supine, prone or lateral-decubitus position, while simultaneously maintaining the patient's head in a convenient location for anesthesia and substantially
- minimally invasive surgical techniques such as percutaneous insertion of spinal implants, involve small incisions that are guided by continuous or repeated intra-operative imaging and that are frequently associated with navigation technologies. These imaging and navigation techniques can be processed using computer software programs that produce two or three
- the patient support structure, apparatus, system or device is not radiolucent or configured to be compatible with the imaging technologies, it may be necessary to interrupt the surgery periodically in order to remove the patient to a separate structure for imaging
- the patient support structure be constructed to provide optimum access to the surgical field by the surgery team. Some procedures require positioning of portions of the patient's body in different ways at different times during the procedure.
- the patient support surfaces should be adjustable and capable of providing support in different planes for different parts of the patient's body as well as different positions or alignments for a given part of the body.
- the patient support should be adjustable to provide support in separate planes and in different alignments for the head and upper trunk portion of the patient's body, the lower trunk and pelvic portion of the body as well as each of the limbs independently.
- surgery may require that the patient or a part of the patient be repositioned during the procedure while in some cases maintaining the sterile field.
- surgery is directed toward motion preservation procedures, such as by installation of artificial joints, soft or dynamic stabilization implants, spinal ligaments and total disc prostheses, for example, the surgeon must be able to manipulate certain joints while supporting selected portions of the patient ' s body during surgery in order to facilitate the procedure. It is also desirable to be able to test the range of motion of the surgically repaired or stabilized joint and to observe the gliding movement of the reconstructed articulating prosthetic surfaces or the tension and flexibility of artificial
- Such manipulation can be used, for example, to verify the correct positioning and function of an implanted prosthetic disc, spinal dynamic longitudinal connecting member, interspinous spacer or joint replacement during a surgical procedure .
- manipulation discloses binding, sub-optimal position or even crushing of the adjacent vertebrae, for example, as may occur with
- the prosthesis can be removed and the adjacent vertebrae fused or otherwise treated while the patient remains anesthetized. Damage which might otherwise have resulted from a "trial" use of the implant post-operatively will be avoided, along with the need for a second round of anesthesia and surgery to remove the implant or prosthesis and perform the revision, fusion or corrective surgery.
- a patient support structure that can be rotated, articulated and angulated so that the patient can be moved or rolled from a supine position to a prone position, or from a lateral-decubitus to a supine position, or from a prone position to a position with the hips and knees flexed or extended, and whereby intra-operative extension and flexion of at least a portion of the spinal column can be achieved to change lumbar lordosis.
- the patient support structure must also be capable of cooperating with the biomechanics of the patient for easy, selective adjustment without necessitating removal of the patient or causing substantial interruption of the procedure.
- structure should also be capable of rotation about an axis in order to provide correct positioning of the patient and optimum accessibility for the surgeon as well as imaging equipment during such sequential procedures, and also without translating the patient's head, which could disrupt connection of the patient with anesthesia equipment, and also without undesirably distracting or compressing the patient's spine during angulation or rotation of the patient's pelvis around the hips .
- Orthopedic procedures may also require the use of an open frame, instead of a closed table top, that allows a prone patient's belly to hang
- Articulated robotic arms are increasingly employed to perform surgical techniques. These units are generally designed to move short distances and to perform very precise work. Reliance on the patient support structure to perform any necessary gross movement of the patient can be beneficial, especially if the movements are synchronized or coordinated. Such units require a surgical support surface capable of smoothly performing the multi-directional movements which would otherwise be performed by trained medical personnel. There is thus a need in this application as well for
- While conventional operating tables generally include structure that permits tilting or rotation of a patient support surface about a longitudinal axis, previous surgical support devices have attempted to address the need for access by providing a cantilevered patient support surface on one end.
- Such designs typically employ either a massive base to counterbalance the extended support member or a large overhead frame structure to provide support from above.
- the enlarged base members associated with such cantilever designs are problematic in that they can and do obstruct the movement of C-arm and O-arm mobile fluoroscopic imaging devices and other equipment.
- Surgical tables with overhead frame structures are bulky and may require the use of dedicated operating rooms, since in some cases they cannot be moved easily out of the way. Neither of these designs is easily portable or storable. More recent orthopedic surgical tables require complicated mechanisms to provide translation of the patient's trunk while manipulating the patient's lower body during surgery.
- More recent and advanced articulating surgical tables are available, and include an open frame patient support for positioning with upper and lower body support portions joined by centrally located and spaced apart hinges.
- these surgical tables enable bending the patient at the waist or hips, maintaining the vertical height of the surgical site can be difficult.
- These tables can also cause significant translation of the patient's trunk toward and away from anesthesia, which is undesirable.
- These tables also require complex translation compensation structural mechanisms to prevent potential patient injury.
- the present invention is directed to patient support structures that permit adjustable positioning, repositioning and selectively lockable support of a patient's head and upper body, lower body and limbs in up to a plurality of individual planes while permitting tilting, rotation, flexion, extension, angulation, articulation and bending, and other manipulations as well as full and free access to the patient by medical personnel and equipment .
- An embodiment of the present invention is directed to patient support structures that permit adjustable positioning, repositioning and selectively lockable support of a patient's head and upper body, lower body and limbs in up to a plurality of individual planes while permitting tilting, rotation, flexion, extension, angulation, articulation and bending, and other manipulations as well as full and free access to the patient by medical personnel and equipment .
- inventions may be cantilevered or non-cantilevered apparatus, such as in the case of a dual-column base, and includes at least a prone patient support structure that is suspended above a floor, that is adapted to cooperate with the patient's biomechanics so as to allow positioning of the patient's hips and knees in a neutral position, a flexed position and an extended position.
- the apparatus allows positioning of the patient parallel with the floor or in Trendelenburg or reverse Trendelenburg surgical positions, and optionally while also tilting or rolling the patient with respect to the floor, along a horizontal axis, and while simultaneously maintaining the patient's head in a suitable location for anesthesia, without substantial horizontal translation, and also while preventing undesired spinal distraction or compression.
- the patient support structure of the present invention includes an open frame that allows the patient's belly to fall, extend, depend or hang downwardly therethrough between a pair of spaced opposed, or spaced apart and opposed, and somewhat centrally located radially sliding or gliding joints that enable flexion and extension of the prone patient's hips and knees with respect to a virtual pivot point located on or above patient pelvic support pads.
- the pelvic pads are sized, shaped and configured to follow an arc of motion associated with the joint and defined by a radius.
- the joint joins the pelvic pads with a lower body or lower extremity support structure or frame.
- the prone patient support structure includes one or more hip-thigh or pelvic pads attached to one or both of the joints and an adjustable torso support with a chest pad slidingly attached to a fixed rigid outer frame.
- the torso support, chest pad and hip-thigh pads are the torso support, chest pad and hip-thigh pads.
- the apparatus of the present invention may also include a supine patient support structure comprised of two sections and suspended above the floor. The sections are connected at a pair of spaced opposed hinges that angulate and translate.
- the supine patient support structure is size, shaped and configured for positioning the patient in an angulated or articulated and non-articulated prone, supine or lateral position and for performing a sandwich-and-roll procedure, wherein the patient is rolled over 180-degrees between supine and prone positions.
- the surgical table of the present invention may also include a base that is sized, shaped and configured to hold the prone and supine patient supports above the floor and also to provide for vertical translation or height adjustment of one or both of the patient support structures as well as three degrees of freedom with respect to movement of the patient support structure relative to a roll axis, a pitch axis and a yaw axis.
- the surgical table of the present invention may also include a fail-safe connection mechanism for connecting a patient support structure to the base while simultaneously preventing incorrect disconnection of a patient support structure from the base, which could cause the support structure to collapse and result in patient injury.
- the patient support structure can also provide for a length adjustment with respect to the base when the structure is angulated or the ends are pivoted so as to put the structure into a Trendelenburg or reverse Trendelenburg position.
- a patient support apparatus for supporting a patient in a prone position during a surgical procedure
- the apparatus includes an open fixed frame that is suspended above a floor, and a pair of spaced opposed radially sliding joints that cooperate with the frame, wherein each joint includes a virtual pivot point and an arc of motion spaced from the virtual pivot point, and the joints are movable along the arc so as to provide a pivot shift mechanism for a pair of pelvic pads attached to the joints.
- the joints are movable between a first position and a second position with respect to the virtual pivot point, the arc of motion and the floor.
- the virtual pivot point is located within a patient supported on the apparatus.
- the virtual pivot point is located at a contact point between a patient supported on the apparatus and a hip-thigh pad.
- the hip-thigh pad is joined with a joint.
- the virtual pivot point is located adjacent to a spine of a patient supported on the apparatus .
- the virtual pivot point includes a height above the floor; wherein the height is substantially constant during movement of the joint with respect to the virtual pivot point.
- the height is adjustable.
- the virtual pivot point is associated with a first pitch axis, such as an axis of
- each joint includes a radius that extends from the virtual pivot point in a plane substantially perpendicular to the first pitch axis, such that the radius defines at least a portion of the arc of motion.
- the apparatus further includes a hip- thigh pad joined with one of the joints so as to be movable about the virtual pivot point and with respect to the arc of motion.
- At least a portion of the hip- thigh pad glides along the arc of motion.
- the apparatus further includes a lower extremity support structure joined with the joints such that the lower extremity support structure is movable with respect to the virtual pivot point and between a first position and a second position.
- the apparatus further includes a chest pad attachable to a head-end portion of the frame .
- the apparatus further includes a hip- thigh pad associated with a lower-body side of the joint; wherein the chest pad is associated with an upper- body side of the joint, so as to be opposed to and spaced a distance from the hip- thigh pad.
- the distance between the chest pad and the hip- thigh pad is substantially constant during movement of the joint between a first position and a second position.
- the distance between the chest pad and the hip- thigh pad is slightly variable during movement of the joint.
- the hip-thigh pad in a further embodiment, the hip-thigh pad
- the apparatus further includes a lower extremity support structure joined with the joints such that the lower extremity support structure is movable with respect to the virtual pivot point.
- the lower extremity support structure includes a femoral support and a lower leg cradle.
- the femoral support includes an adjustable sling.
- the femoral support and the lower leg cradle are pivotably connected so as to be movable between a first position and a second position; and wherein when in the first position, the femoral support and the lower leg cradle are in a neutral position; and when in the second position, the femoral support and the lower leg cradle are in a flexed position.
- the lower leg cradle is non- incrementally adjustable with respect to the femoral support and between the neutral position and a maximally flexed position.
- the lower leg cradle is continuously adjustable with respect to the femoral support and between the neutral position and a maximally flexed position.
- the lower leg cradle is incrementally adjustable with respect to the femoral support.
- the femoral support and the lower leg cradle are joined by a pair of spaced opposed lower leg hinges .
- the chest pad is slidably adjustable with respect to a length of the frame.
- the chest pad is attachable to the frame .
- the chest pad is lockable.
- the chest pad is located adjacent to the joints.
- the chest pad includes at least two chest pads.
- the frame includes head-end portion; and the chest pad is adjustable along a length of the frame head-end portion and between a first location adjacent to an outer-end of the frame head-end portion and a second location adjacent to the joints.
- the chest pad is substantially radiolucent.
- the hip-thigh pad includes a pair of hip- thigh pads spaced apart with respect to the frame so as to provide a space for at least a portion of a patient's body to be positioned therebetween.
- the hip-thigh pad is substantially radiolucent.
- the apparatus further includes a base.
- the base includes a pair of laterally spaced vertical translator subassemblies, each vertical translator subassembly including an upper end portion and a lower end portion; and a crossbar joining the lower end portions of the vertical translator subassemblies such that the vertical translator subassemblies are spaced apart a constant distance; wherein the frame is suspended from upper end portions of the vertical translator subassemblies.
- the base includes a pair of connection subassemblies, each of connection subassemblies including: a ladder attachment structure or connector portion; and a ladder or attachment upright attached to the ladder attachment structure .
- the ladder is removably attached to the ladder attachment structure.
- the ladder is lockably attached to the ladder attachment structure .
- the ladder includes a set of ladders, the set of ladders including a pair of standard length ladders .
- the ladder includes at least one additional ladder selected from the group consisting of standard length ladders and extended- length ladders.
- the apparatus further includes a T-pin associated with at least one of a second pitch axis and a third pitch axis; wherein the T-pin joins an outer end of the frame with the base.
- the frame is pivotable about the T-pin with respect to a joined vertical translator subassembly in response to vertical movement of the joined vertical translator subassembly.
- the frame is positionable in a Trendelenburg position and a Reverse Trendelenburg position.
- vertical translator subassembly upper end portions includes a rotation subassembly.
- At least a portion of the frame is cantilevered.
- the frame foot-end portion includes: a translation compensation subassembly.
- the frame includes: a longitudinally extending roll axis.
- the frame is rotatable about the roll axis an amount of between about 1° and about 360°.
- the frame is continuously adjustable with respect to the roll axis and between a non- rolled orientation and an orientation associated with rolling an amount of about 360° about the roll axis.
- the frame is adapted to rotate with respect to the roll axis so as to be rolled an amount of about 180°, so as to be positioned in an inverted orientation or position.
- the frame is non- incrementally rotatable, pivotable or rollable about or around the roll axis .
- the frame is lockable in a rolled position.
- the apparatus further includes a supine patient support structure suspended above the floor.
- the supine patient support structure includes an open frame that is articulatable at a pair of spaced opposed hinges; and at least, one of a set of body support pads and a closed table-top.
- the body support pads, the elongate table pad and the table- top are substantially
- the supine patient support structure is positionable in a decubitus position.
- the supine patient support structure is spaced from and opposed to the frame.
- vertical translation subassemblies includes a rotation
- subassembly adapted to roll the frame about a longitudinally extending roll axis.
- the hip-thigh pad includes a hip- thigh pad mount joining the hip- thigh pad with one of the joints.
- the apparatus includes a fail-safe mechanism.
- a method of positioning a patient on a patient support in a prone position comprising the steps of placing a patient on a supine patient support suspended above a floor, such that the patient is in a substantially supine position; sandwiching the patient between the supine patient support and a prone patient support suspended above the supine patient support; and rolling the patient an amount of about 180° with respect to a longitudinally extending roll axis, such that the patient is in a substantially prone position.
- the method includes
- the step of sandwiching the patient between the supine patient support and a prone patient support includes attaching the prone patient support to a pair of spaced opposed ladder attachment structures .
- the patient positioning support structure of the present invention is configured and arranged to
- the present invention provides a prone patient support structure that avoids a pair of spaced opposed hinges that translate and angulate, while cooperating with the patient's biomechanics to position the patient in and to move the patient's spine between neutral, flexed and extended positions while
- the present invention provides such structures that allow for simultaneous rolling or tilting of the patient.
- the present invention provides such structure wherein the base support is located at an end of the patient support structure, so as to allow for patient positioning and clearance for access to the patient in a wide variety of orientations. In some embodiments, the present invention provides such
- the present invention provides a fail-safe structure that prevents patient injury due to certain operator errors.
- the present invention provides such apparatus and methods that are easy to use and especially adapted for the intended use thereof and wherein the apparatus are comparatively inexpensive to make and suitable for use.
- present invention is directed to a base for supporting and suspending a patient support structure above the floor, such as for supporting a patient during a surgical procedure.
- the base includes a pair of spaced opposed vertical translation subassemblies
- each vertical translation subassembly is substantially constant during operation of the patient support structure, such that the vertical translation subassemblies do not move closer or farther apart during table operation.
- Each of the vertical translation subassemblies includes a base portion and an off-set elevator subassembly that extends upwardly from the base portion.
- the vertical translation subassemblies each include an elevator, such as a primary elevator and a rotation subassembly.
- the base includes a
- each of the rotation subassemblies includes first and second rotation motor
- the first rotation motor subassembly includes a first shaft that extends parallel to the cross-bar and is adapted for releasable attachment of the patient support structure thereto.
- the second rotation motor subassembly includes a second shaft that joins the first rotation motor subassembly with an elevator of a respective vertical
- FIG. 1 is a perspective view of a patient
- positioning support system 5 of the present invention in one embodiment, including a base 10 and a prone patient support structure 15.
- FIG. 2 is a perspective view of a base 10 of the patient positioning support system of FIG. 1, including a pair of laterally spaced opposed vertical translator subassemblies 16, 16 * .
- FIG. 3 is a perspective view of a prone patient support structure 15 of the patient positioning support system of FIG. 1.
- FIG. 4 is right side view of the patient positioning support system of FIG. 1. It is noted that the head-end of the patient positioning support system is located on the right-hand side of the page, and the right and left sides of the patient positioning support system are associated with the right and left sides of a patient positioned in a prone position on the patient support structure.
- FIG. 5 is a top view of the patient positioning support system of FIG. 4. In this view, the right side of the patient positioning support system is located on the right- hand side of the page.
- FIG. 6 is a bottom view of the patient positioning support system of FIG. 4.
- FIG. 7 is an enlarged head-end or front view of the patient positioning support system of FIG. 4.
- FIG. 8 is an enlarged foot-end or rear view of the patient positioning support system of FIG. 4.
- FIG. 9 is a left side view of the patient
- FIG. 10 is an enlarged perspective view of a ladder 100 of the patient positioning support system of FIG. 1.
- FIG. 11 is an enlarged perspective view of a T-pin 101 of the patient positioning support system of FIG. 1.
- FIG. 11a is an enlarged cross-sectional view of a portion of the T-pin to show greater detail of positioning of the locking portion thereof, taken on line 11a- 11a of Fig. 11.
- FIG. 12 is an enlarged perspective view of a torso support subassembly 362, or upper body support structure, of the patient positioning support system of FIG. 1.
- FIG. 13 is an enlarged perspective view of a
- FIG. 14 is an enlarged cross-sectional perspective of the patient positioning support system connection and rotation subassemblies of FIG. 13, the cross -section being taken along the line 14-14 of FIG. 5, with portions of the ladder broken away.
- FIG. 15 is an enlarged perspective view of the rotation block 57, including the ladder connection
- FIG. 16 is a front view of the rotation block of FIG. 15.
- FIG. 17 is a first side view of the rotation block of FIG. 15.
- FIG. 18 is a second side view of the rotation block of FIG. 15.
- FIG. 19 is a top view of the rotation block of FIG. 15.
- FIG. 20 is a bottom view of the rotation block of FIG. 15.
- FIG. 21 is a reduced back view of the rotation block of FIG. 15.
- FIG. 22 is a back view of the ladder connection subassembly of FIG. 13.
- FIG. 23 is a perspective view of the patient
- FIG. 24 is an enlarged right side view of the patient positioning support system of FIG. 23.
- FIG. 25 is an enlarged head-end view of the patient positioning support system of FIG. 23.
- FIG. 26 is an enlarged foot-end view of the patient positioning support system of FIG. 23.
- FIG. 27 is a top view of the patient positioning support system of FIG. 23.
- FIG. 28 is a perspective view of the patient
- FIG. 29 is an enlarged right-side view of the headend of the patient positioning support system of FIG. 24, with portions broken away.
- FIG. 30 is an enlarged right-side view of the foot- end of the patient positioning support system of FIG. 24, with portions broken away.
- FIG. 31 is a perspective view of the patient
- FIG. 32 is an enlarged right side view of the patient positioning support system of FIG. 31.
- FIG. 33 is a top view of the patient positioning support system of FIG. 31.
- FIG. 34 is a head-end view of the patient
- FIG. 35 is a foot-end of the patient positioning support system of FIG. 31.
- FIG. 36 is a perspective view of the patient
- FIG. 37 is an enlarged right side view of the headend of the patient positioning support system of FIG. 32, with portions broken away.
- FIG. 38 is an enlarged right side view of the foot- end of the patient positioning support system of FIG. 32, with portions broken away.
- FIG. 39 is a perspective view of the patient
- FIG. 40 is an enlarged right side view of the patient positioning support system of FIG. 39.
- FIG. 41 is a top view of the patient positioning support system of FIG. 39.
- FIG. 42 is a head-end view of the patient
- FIG. 43 is a foot-end view of the patient
- FIG. 44 is an enlarged cross-section of the patient positioning support system of FIG. 39, with the cross -section being taken along the line 44-44 of FIG. 41, and with portions broken away.
- FIG. 45 is another perspective view of the patient positioning support system of FIG. 39.
- FIG. 46 is yet another perspective view of the patient positioning support system of FIG. 39.
- FIG. 47 is an enlarged perspective view of the patient positioning support system of FIG. 39, with portions broken away.
- FIG. 48 is a perspective view of the patient positioning support system of FIG. 39, wherein the prone patient support structure is rolled 25° toward the left side of the patient positioning support structure.
- FIG. 49 is a reduced left side view of the patient positioning support system of FIG. 48.
- FIG. 50 is an enlarged right side view of the patient positioning support system of FIG. 48.
- FIG. 51 is an enlarged top view of the patient positioning support system of FIG. 48.
- FIG. 52 is an enlarged head-end view of the patient positioning support system of FIG. 48.
- FIG. 53 is an enlarged bottom view of the patient positioning support system of FIG. 48.
- FIG. 54 is an enlarged foot-end view of the patient positioning support system of FIG. 48.
- FIG. 55 is a perspective view of the patient
- FIG. 56 is an enlarged right side view of the patient positioning support system of FIG. 55.
- FIG. 57 is an enlarged top view of the patient positioning support system of FIG. 55.
- FIG. 58 is an enlarged bottom view of the patient positioning support system of FIG. 55.
- FIG. 59 is an enlarged head-end view of the patient positioning support system of FIG. 55.
- FIG. 60 is an enlarged view of the foot-end of the patient positioning support system of FIG. 56.
- FIG. 61 is an enlarged view of the foot-end of the patient positioning support system of FIG. 56, with portions broken away.
- FIG. 62 is an enlarged right-side view of the headend of the patient positioning support system of Fig. 56, with portions broken away.
- FIG. 63 is an enlarged side view of the patient positioning support system of FIG. 1, with the prone patient support structure positioned in the lowest possible position with respect to the floor F, and such that the legs and hips of a patient positioned thereon would be substantially non- flexed, non-extended and parallel with the floor.
- FIG. 64 is an enlarged perspective view of the foot- end of the patient support structure FIG. 3 with the lower extremity support structure 344 positioned so as to extend the legs and hips of a patient supported thereon, and with
- FIG. 65 is view of the patient positioning support structure of Fig. 64 with portions shown in phantom so as to show additional detail thereof.
- FIG. 66 is an enlarged side view of the patient positioning support structure of FIG. 3 positioned so as to extend the hips and legs of a patient supported thereon.
- FIG. 67 is a view of the patient positioning support structure of FIG. 66 positioned in a neutral position so as to support the legs of a patient substantially parallel with the floor, such that the hips and legs are non- flexed and non- extended .
- FIG. 68 is a view of the patient positioning support structure of Fig. 66 positioned so as to flex the legs and hips of a patient supported thereon.
- FIG. 69 is an enlarged overlaid cross-sectional schematic of the patient positioning support structures of FIGS. 66, 67 and 68 taken along the line 69-69 of FIG. 5.
- FIG. 70 is an enlarged side view of the patient positioning support structure of FIG. 4 overlaid with an enlarged phantom side view of the patient positioning support structure of FIG. 56, so as to compare changes in the
- FIG. 71 is an enlarged side view of a joint of the prone patient support structure of FIG. 3.
- FIG. 72 is another enlarged side view of a joint of the prone patient support structure of FIG. 3.
- FIG. 73 is yet another enlarged side view of a joint of the prone patient support structure of FIG. 3.
- FIG. 74 is an enlarged side view of the prone patient support structure of FIG. 3, with portions broken away.
- FIG. 75 is another enlarged side view of the prone patient support structure of FIG. 3, with portions broken away.
- FIG. 76 is an enlarged perspective view " of a portion of the joint of the prone patient support structure of FIG. 3, with portions not shown.
- FIG. 77 is a perspective view of a portion of the joint of FIG. 75.
- FIG. 78 is an enlarged perspective view of a
- FIG. 79 is an enlarged head-end view of the leftside joint and attached hip-thigh pad of the prone patient support structure of FIG. 3, with portions not shown.
- FIG. 80 is an enlarge perspective view of the leftside joint with attached hip-thigh pad, and portions not shown so as to show greater detail thereof.
- FIG. 81 is an inner side view of the joint of FIG. 79.
- FIG. 82 is a top view of the joint of FIG. 79.
- FIG. 83 is a rear view of the joint of FIG. 79.
- FIG. 84 is an outer side view of the joint of FIG.
- FIG. 85 is a forward view of the joint of FIG.
- FIG. 86 is a perspective view of the patient
- FIG. 87 is a right-side view of the patient
- FIG. 88 is a top view of the patient positioning support system of FIG. 85.
- FIG. 98 is a bottom view of the patient positioning support system of FIG. 85.
- FIG. 90 is an enlarged head-end view of the patient positioning support system of FIG. 85.
- FIG. 91 is a foot-end view of the patient
- FIG. 92a is a reduced foot-end view of the patient positioning support system of FIG. 85, the patient support structures being positioned to begin the sandwich-and-roll procedure to roll a patient over from a supine position to a prone position ' .
- FIG. 92b is foot-end view of the patient positioning support system of FIG. 91, wherein the supine patient support structure is attached to the base by an extended length, or long, ladder instead of a standard length ladder.
- FIG. 93a is a foot-end view of the patient positioning support system of FIG. 92a, wherein the patient support structures has been rolled about 25°.
- FIG. 93b is a perspective view of the patient positioning support system of FIG. 92a.
- FIG. 93c is a right-side view of the patient positioning support system of FIG. 92a.
- FIG. 94a is a foot-end view of the patient positioning support system of FIG. 92a, wherein the patient support structures has been rolled about 130°.
- FIG. 94b is a perspective view of the patient positioning support system of FIG. 94a.
- FIG. 94c is a right-side view of the patient positioning support system of FIG. 94a.
- FIG. 95a is a foot-end view of the patient positioning support system of FIG. 92a, wherein the patient support structures has been rolled about 180°.
- FIG. 95b is a perspective view of the patient positioning support system of FIG. 95a.
- FIG. 95c is a right-side view of the patient positioning support system of FIG. 95a.
- FIG. 96 is a top view of the patient positioning support system of FIG. 95b.
- FIG. 97 is a bottom view of the patient positioning support system of FIG. 95b.
- FIG. 98 is an enlarged head-end view of the patient positioning support system of FIG. 95b.
- FIG. 99 is a foot-end view of the patient
- FIG. 100 is a perspective view of the patient positioning support system of FIG. 91.
- FIG. 101 is an enlarged right-side view of the patient positioning support system of FIG. 100.
- FIG. 102 is a perspective view of a patient
- positioning support system of the present invention in another embodiment, including a supine patient support structure attached to a base using standard length ladders.
- FIG. 103 is perspective view of a supine patient support structure 15' of the present invention, in one embodiment .
- FIG. 104 is a right-side view of the supine patient support structure of FIG. 103.
- FIG. 105 is a top view of the supine patient support structure of FIG. 103.
- FIG. 106 is a bottom view of the supine patient support structure of FIG. 103.
- FIG. 107 is an enlarged head-end view of the supine patient support structure of FIG. 103.
- FIG. 108 is an enlarged foot-end view of the supine patient support structure of FIG. 103.
- FIG. 109 is a top view of the open breaking frame of the supine patient support structure of FIG. 103, including a pair of spaced opposed hinges .
- FIG. 110 is perspective view of the supine patient support structure of FIG. 103 attached to a base using
- FIG. Ill is an enlarged head-end view of the patient positioning support structure of FIG. 110.
- FIG. 112 is a perspective view of the patient positioning support structure of FIG. 110, wherein the supine patient support structure is in a lateral -decubitus position.
- FIG. 113 is a head-end view of the patient
- FIG. 114 is a perspective view of the patient positioning support structure of FIG. 110, wherein the supine patient support structure is in a hinge down position.
- FIG. 115 is an enlarged head-end view of the patient positioning support structure of FIG. 114.
- FIG. 116 is an enlarged bottom perspective view of a portion of the supine patient support structure of FIG. 102 showing the spaced opposed, or spaced apart, hinges 376.
- FIG. 117 is a side view of one the hinges of FIG. 116.
- FIG. 118 is a side view of the hinge of FIG. 117 with shrouding not removed, so as to show detail of the worm gear drive of the hinge .
- FIG. 119 is a bottom view of the hinge of FIG. 118.
- FIG. 120 is a perspective view of the hinge of FIG. 118.
- FIG. 121 is a top cross -sectional view of the headend of the patient positioning support structure of FIG. 57, the cross-section being taken along the line 121-121 of FIG. 7.
- FIG. 122 is an enlarged left side view of the headend of the patient positioning support structure of FIG. 28.
- FIG. 123 is an enlarged top view of the patient positioning support structure of FIG. 122.
- FIG. 124 is an enlarged left side view of the foot- end of the patient positioning support structure of FIG. 28.
- FIG. 125 is an enlarged top view of the patient positioning support structure of FIG. 124.
- FIG. 126 an enlarged perspective view of a vertical translation subassembly 20 of the base of FIG. 2 showing a first step in attaching a standard length ladder to the vertical translation subassembly.
- FIG. 127 is a side view of the vertical translation subassembly of FIG. 126.
- FIG. 128 is a perspective view of the vertical translation subassembly of FIG. 126 showing a second step in attaching the ladder to the vertical translation subassembly.
- FIG. 129 is a side view of the vertical translation subassembly of FIG. 128.
- FIG. 130 is a perspective view of the vertical translation subassembly of FIG. 126 showing a third step in attaching the ladder to the vertical translation subassembly.
- FIG. 131 is a side view of the vertical translation subassembly of FIG. 130.
- FIG. 132 is a perspective view of the vertical translation subassembly of FIG. 126 showing a fourth step in attaching the ladder to the vertical translation subassembly.
- FIG. 133 is a side view of the vertical translation subassembly of FIG. 132.
- FIG. 134 is an illustration showing a perspective view of a patient positioning support system of the present invention, in another embodiment, wherein the patient
- positioning support system is positioned to begin a sandwich- and-roll procedure, wherein a patient in a supine position, on the supine patient support structure of FIG. 103, is rolled over to a prone position, on the prone patient support
- FIG. 135 is an illustration showing the patient positioning support structure of FIG. 134 after a 180 -degree roll, with respect to a longitudinal roll axis, has been initiated.
- FIG. 136 is an illustration showing the patient positioning support structure of FIG. 134 after the 180 -degree roll has been completed. In this position, the prone patient support structure supports the patient, and the supine patient support structure can be removed from the patient positions and support system of the present invention.
- FIG. 137 is an illustration showing a first step in removing or disconnecting the patient positioning support structure of FIG. 136 from the base, showing removal of a first of the T-pins that attach the supine patient support structure to the base.
- FIG. 138 is an illustration of the patient
- FIG. 137 positioning support structure of FIG. 137 showing removal of a second of the T-pins attaching the supine patient support structure to the base.
- FIG. 139 is an illustration of the patient
- FIG. 138 positioning support structure of FIG. 138 showing an initial step in removing the supine patient support structure from the base, wherein both T-pins are removed.
- FIG. 140 is an illustration of the patient
- FIG. 139 showing an
- FIG. 141 is an illustration of the patient positioning support structure of FIG. 140 showing the supine patient support structure fully removed from the base.
- FIG. 142 is an illustration of the patient
- FIG. 141 showing an
- FIG. 143 is an illustration of the patient
- FIG. 142 positioning support structure of FIG. 142 showing a further intermediate step in removing the first ladder from the base.
- FIG. 144 is an illustration of the patient
- FIG. 145 is an illustration of the patient
- FIG. 146 is an illustration of the patient
- FIG. 145 positioning support structure of FIG. 145 showing a further intermediate step in removing the second ladder from the base .
- FIG. 147 is an illustration of the patient
- FIG. 148 is an illustration of the patient positioning support structure of FIG. 147, wherein
- first and second ladders are removed from the base.
- FIG. 149 is a perspective view of a patient
- positioning support system of the present invention in still another embodiment, including a supine patient support structure attached to a base by a pair of extended- length ladders, wherein the supine patient support is attached to the lowest position of the extended- length ladders, such as for lateral decubitus positioning of a patient thereon.
- FIG. 150 is an illustration showing the patient positioning support system of FIG. 149, wherein a first of the T-pins is in the process of being removed so as to disconnect the head-end of the supine patient support structure from the base .
- FIG. 151 is an illustration of the patient
- FIG. 152 is an illustration of the patient
- FIG. 153 is an illustration of the patient
- FIG. 154 is an illustration of the patient
- FIG. 155 is an illustration of the patient
- FIG. 156 is an illustration of the patient
- FIG. 157 is an illustration of the patient
- FIG. 158 is an illustration of the patient
- FIG. 159 is an illustration of the patient positioning support system of FIG. 158, showing the standard length ladders both attached to the base and bringing in the prone patient support structure to be attached to the standard length ladders, with portions of the prone patient support structure broken away.
- FIG. 160 is an illustration of the patient
- the head-end of the prone patient support structure is attached to the associated ladder by a T-pin and the foot-end of the prone patient support structure is aligned with the ladder in preparation to being attached to the ladder using a T-pin, such that the foot-ends of the prone and supine patient support structures are attached to the same end of the base .
- FIG. 161 is an illustration of the patient
- FIG. 162 is an illustration of the patient
- FIG. 161 showing the prone patient support structure fully connected to the base and bringing in the torso support structure.
- FIG. 163 is an illustration of the patient
- FIG. 162 showing an initial step in attaching a torso support structure to the prone patient support structure, wherein the torso support structure is placed over the bottom of the upper body portion of the prone patient support structure.
- FIG. 164 is an illustration of the patient
- FIG. 165' is an illustration of the patient
- the patient positioning support system of FIG. 164 showing the torso support structure being attached to the prone patient support structure with quick release or spring loaded pins.
- the patient positioning support system is configured and arranged, or prepared, to begin the sandwich-and-roll procedure, such as to roll over a supine patient, on the supine patient support structure, to a prone position on the prone patient support structure .
- FIG. 166 is an illustration of the patient
- FIG. 167 is an illustration of the patient
- FIG. 168 is an illustration of the patient positioning support system of FIG. 167, showing yet another intermediate step in the sandwich-and-roll procedure, wherein the roll has progressed farther than that shown in FIG. 167.
- FIG. 169 is an illustration of the patient
- FIG. 170 is a head-end top perspective view of an embodiment of a supine lateral patient support.
- FIG. 171 is a foot-end top perspective view of the supine lateral patient support of FIG. 170.
- FIG. 172 is a head-end bottom perspective view of the supine lateral patient support of FIG. 170.
- FIG. 173 is an enlarge head-end view of the supine lateral patient support of FIG. 170.
- FIG. 174 is an enlarged foot-end view of the supine lateral patient support of FIG. 170.
- FIG. 175 is an enlarged top view of the supine lateral patient support of FIG. 170.
- FIG. 176 is a right side view of the right side of the supine lateral patient support of FIG. 170.
- FIG. 177 is a left side view of the left side of the supine lateral patient support of FIG. 170.
- FIG: 178 is a bottom view of the supine lateral patient support of FIG. 170.
- FIG. 179 is a head-end top perspective view of a non-breaking supine lateral patient support 1000 in one embodiment .
- FIG. 180 is a foot-end top perspective view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 181 is a head-end bottom perspective view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 182 is an enlarge head-end view of the nonbreaking supine lateral patient support of FIG. 179.
- FIG. 183 is an enlarged foot-end view of the nonbreaking supine lateral patient support of FIG. 179.
- FIG. 184 is a top view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 185 is a right side view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 186 is a left side view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 187 is a bottom view of the non-breaking supine lateral patient support of FIG. 179.
- FIG. 188 is a head-end top perspective view of a breaking supine lateral patient support 1100 in an embodiment.
- FIG. 189 is a foot-end top perspective .view of the breaking supine lateral patient support of FIG. 188.
- FIG. 190 is a head-end bottom perspective view of the breaking supine lateral patient support of FIG. 188.
- FIG. 191 is an enlarge head-end view of the breaking supine lateral patient support of FIG. 188.
- FIG. 192 is an enlarged foot-end view of the
- FIG. 193 is a top view of the breaking supine lateral patient support of FIG. 188.
- FIG. 194 is a right side view of the breaking supine lateral patient support of FIG. 188.
- FIG. 195 is a left side view of the breaking supine lateral patient support of FIG. 188.
- FIG. 196 is a bottom view of the breaking supine lateral patient support of FIG. 188.
- FIG. 197 is a head-end top perspective view of a prone lateral patient support 1200 in an embodiment.
- FIG. 198 is a foot-end top perspective view of the prone lateral patient support of FIG. 197.
- FIG. 199 is a head-end bottom perspective view of the prone lateral patient support of FIG. 197.
- FIG. 200 is an enlarge head-end view of the prone lateral patient support of FIG. 197.
- FIG. 201 is an enlarged foot-end view of the prone lateral patient support of FIG. 197.
- FIG. 202 is a top view of the prone lateral patient support of FIG. 197.
- FIG. 203 is a right side view of the prone lateral patient support of FIG. 197.
- FIG. 204 is a left side view of the prone lateral patient support of FIG. 197.
- FIG. 205 is a bottom view of the prone lateral patient support of FIG. 197.
- FIG. 206 is a perspective view of a base 1310 of the present invention.
- FIG. 207 is a perspective view of the base of FIG. 206, including an attached prone patient support structure and an attached supine patient support structure.
- FIG. 208 is a reduced perspective view of a supine patient support structure for attachment to the base of FIG. 206.
- FIG. 209 is a side view of the supine patient support structure of FIG. 208.
- FIG. 210 is a perspective view of a prone patient support structure for attachment to the base of FIG. 206.
- FIG. 211 is a side view of the prone patient support structure of FIG. 210.
- FIG. 212 is an enlarged outboard perspective view of a vertical translation subassembly of FIG. 206.
- FIG. 213 is an inboard perspective view of a
- FIG. 214 is a side view of a vertical translation subassembly of FIG. 206.
- FIG. 215 is an opposite side view of a vertical translation subassembly of FIG. 206.
- FIG. 216 is a top perspective view of a vertical translation subassembly of FIG. 206.
- FIG. 217 is an inboard view of a vertical
- FIG. 218 is an inboard perspective view of a vertical translation subassembly of FIG. 206.
- FIG. 219 is view of a vertical translation
- FIG. 220 is a side view of the base of FIG. 206, including an attached supine patient support structure, wherein the primary elevators are equally partially outwardly telescoped, the secondary elevators are equally raised to the highest point, and the supine patient support structure is substantially parallel with the floor.
- FIG. 221 is a side view of the base of FIG. 220, wherein the primary elevators are equally fully inwardly telescoped, lowered or closed, the secondary elevators are equally lowered to the lowest possible point, and the patient support structure is lowered to the lowest possible position and is also substantially parallel with the floor.
- FIG. 222 is an enlarged side view of the base of FIG. 221, including an attached prone patient support structure, configured and arranged so as to support a patient for a sandwich-and-roll procedure to transfer a patient between the prone and supine patient support structures.
- FIG. 223 is a reduced side view of the base and supine patient support structure of FIG. 220, showing the patient support structure tilted about the longitudinally- extending roll axis R, in a first orientation, and with respect to the floor.
- FIG. 224 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure tilted in a second orientation that is opposite to the orientation shown in FIG. 223.
- FIG. 225 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure positioned with the ends at equal heights and also in an upward articulated or breaking position, and also wherein the primary elevators are equally fully inwardly telescoped or closed, the secondary elevators are equally lowered to the lowest possible point, and the patient support structure is lowered to the lowest possible position and is also substantially parallel with the floor.
- a configuration or position is useful for positioning a patient in a lateral decubitus position, which is used in certain surgical procedures, wherein the surgical site is located at a comfortable height for the surgeon to work.
- FIG. 226 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure positioned so as to be substantially- parallel, or not rolled or tilted, with the floor and also in a downwardly articulated or breaking position, and also wherein the primary elevators are equally fully outwardly telescoped or opened, the secondary elevators are equally raised to the highest possible point, and the patient support structure is raised to the highest possible position and is also substantially parallel with the floor.
- FIG. 227 is a side view of the base and supine patient support structure of FIG. 225, showing the patient support structure tilted in the first orientation.
- FIG. 228 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure in a Trendelenburg position.
- FIG. 229 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure in a Trendelenburg position and also tilted in a first direction.
- FIG. 230 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure in a reverse Trendelenburg position.
- FIG. 231 is a side view of the base and supine patient support structure of FIG. 220, showing the patient support structure in a reverse Trendelenburg position and also tilted in a second direction that is opposite to the first direction of FIG. 229.
- FIG. 232 is a side view of the base of FIG. 206, including an attached prone patient support structure, wherein the primary elevators are equally telescoped closed, the secondary elevators are equally raised, and the prone patient support structure is substantially parallel with the floor.
- FIG. 233 is a side view of the base of FIG. 232, wherein the primary elevators are equally partially telescoped open, the secondary elevators are fully raised to the highest possible point, and the prone patient support structure is substantially parallel with the floor.
- FIG. 234 is a side view of the base of FIG. 232, wherein both the primary and secondary elevators are raised as high as possible, and the prone patient support structure is substantially parallel with the floor.
- FIG. 235 is a side view of the base of FIG. 233, showing the prone patient support structure in a flexed position wherein the hips and knees of a patient supported thereon would be flexed.
- FIG. 236 is a side view of the base of FIG. 233, showing the prone patient support structure in an extended position wherein the hips and knees of a patient supported thereon would be extended.
- FIG. 237 is another side view of the base of FIG. 233, showing the prone patient support structure in an
- FIG. 238 is a side view of the base of FIG. 233, wherein the prone patient support structure is tilted or rolled in a first orientation or dire.ction.
- FIG. 239 is a side view of the base of FIG. 233, wherein the prone patient support structure is tilted or rolled in a second orientation or direction that is opposite to the first orientation shown in FIG. 238.
- FIG. 240 is a head-end perspective view of a base 1410 for supporting a patient support structure in another embodiment .
- FIG. 241 is a foot-end perspective view of the base of FIG. 240.
- FIG. 242 is a side view of the base of FIG. 240.
- FIG. 243 is a top view of the base of FIG. 240.
- FIG. 244 is another side view of the base of FIG. 240.
- FIG. 245 is a bottom view of the base of FIG. 240.
- FIG. 246 is an enlarged inboard perspective view of the head-end vertical translation subassembly of the base of FIG. 240.
- FIG. 247 is an enlarged outboard perspective view of the head-end vertical translation subassembly of the base of FIG. 240.
- FIG. 248 is an enlarged inboard perspective view of the foot-end vertical translation subassembly of the base of FIG. 240.
- FIG. 249 is an enlarged outboard perspective view of the foot-end vertical translation subassembly of the base of FIG. 240.
- FIG. 250 is an enlarged fragmentary side view of portions of the rotation subassembly and the secondary
- FIG. 251 is an enlarged inboard perspective view of a rotation block and a standard length ladder connected thereto of the base of FIG. 240.
- FIG. 252 is an enlarged fragmentary perspective view of the rotation block and the standard length ladder of FIG. 241, with portions shown in phantom to show greater detail thereof .
- FIG. 253 is an enlarged perspective view of an upper reversibly locking ladder attachment member of the rotation block FIG. 241.
- FIG. 254 is an enlarged view of lower reversibly locking ladder attachment member of the rotation block FIG. 241.
- FIG. 255 is a head-end top perspective view of a prone patient support structure 1600 in another embodiment, including a torso support structure.
- FIG. 256 is another head-end top perspective view of the prone patient support structure of FIG. 255.
- FIG. 257 is a foot-end top perspective view of the prone patient support structure of FIG. 255.
- FIG. 258 is a head-end bottom perspective view of the prone patient support structure of FIG. 255.
- FIG. 259 is a head-end bottom perspective view of the prone patient support structure of FIG. 255 with the torso support structure removed.
- FIG. 260 is a foot-end bottom perspective view of the prone patient support structure of FIG. 255.
- FIG. 261 is another foot-end bottom perspective view of the prone patient support structure of FIG. 255.
- FIG. 262a is an enlarged head-end view of the prone patient support structure of FIG. 255.
- FIG. 262b is another enlarged head-end view of the prone patient support structure of FIG. 255.
- FIG. 263 is an enlarged head-end top view of the prone patient support structure of FIG. 255.
- FIG. 264a is an enlarged foot-end view of the prone patient support structure of FIG. 255.
- FIG. 264b is another enlarged foot-end view of the prone patient support structure of FIG. 255.
- FIG. 265 is an enlarged foot -end top view of the prone patient support structure of FIG. 255.
- FIG. 266a is a reduced left side view of the prone patient support structure of FIG. 255.
- FIG. 266b is another reduced left side view of the prone patient support structure of FIG. 255.
- FIG. 267 is a reduced right side view of the prone patient support structure of FIG. 255.
- FIG. 268a is a reduced top view of the prone patient support structure of FIG. 255.
- FIG. 268b is another reduced top view of the prone patient support structure of FIG. 255.
- FIG. 269a is a bottom view of the prone patient support structure of FIG. 255.
- FIG. 269b is another reduced bottom view of the prone patient support structure of FIG. 255.
- FIG. 270 is another head-end top perspective view of the prone patient support structure of FIG. 255, with portions of the torso support structure removed to show greater detail of the frame .
- FIG. 271 is a foot-end top perspective view of the prone patient support structure of FIG. 270.
- FIG. 272 is a reduced top view of the prone patient support structure of FIG. 270.
- FIG. 273 is a reduced bottom view of the prone patient support structure of FIG. 270.
- FIG. 274 is a reduced right side view of the prone patient support structure of FIG. 270.
- FIG. 275 is a reduced left side view of the prone patient support structure of FIG. 270.
- FIG. 276 is an enlarged head-end top perspective view of the head-end portion of the prone patient support structure of FIG. 255, and the torso support structure showing greater detail thereof.
- FIG. 277 is enlarged head-end top perspective view of the head-end portion of the prone patient support structure of FIG. 276, with portions shown in phantom, to show greater detail thereof.
- FIG. 278 is another enlarged head-end top
- FIG. 276 perspective view of the head-end portion of the prone patient support structure of FIG. 276, with portions shown in phantom, to show greater detail thereof.
- FIG. 279a is an even more enlarged head-end top perspective view of the head-end portion of the prone patient support structure of FIG. 276, with portions cut away and shown in phantom, to show greater detail thereof.
- FIG. 279b is another even more enlarged head-end top perspective view of the head-end portion of the prone patient support structure of FIG. 276, with portions cut away and shown in phantom, to show greater detail thereof.
- FIG. 280 is an enlarged fragmentary perspective view of a joint of the prone patient support structure of FIG. 255.
- FIG. 281a is a side view of the joint of FIG. 280 with the hip- thigh pad and hip pad mount removed.
- FIG. 281b is an enlarged view of the joint of Fig. 280, with portions shown in phantom.
- FIG. 282 is an enlarged fragmentary side perspective view of the prone patient support structure of FIG. 255 with portions broken away and portions shown in phantom to show greater detail thereof .
- FIG. 283 is an enlarged fragmentary perspective view of the structure shown in FIG. 282 with portions shown in phantom to show greater detail thereof.
- FIG. 284a is an enlarged view of joint of the prone patient support structure of FIG. 282 with portions shown in phantom to show greater detail thereof.
- FIG. 284b is another enlarged view of joint of the prone patient support structure of FIG. 282 with portions shown in phantom to show greater detail thereof .
- FIG. 284c is another enlarged view of joint of the prone patient support structure of FIG. 282 with portions broken away to show greater detail thereof.
- FIG. 285 is an enlarged perspective view of a portion of the joint of the prone patient support structure of FIG. 282.
- FIG. 286 is another perspective view of the joint of FIG. 285.
- FIG. 1 is a top perspective view of the patient positioning support system 5 of the present invention, which includes a base, generally 10, and a patient support structure or table top, generally 15t, such as but not limited to at least one of a prone patient support structure 15, a supine patient support structure 15' (FIGS. 86, 110, 170, 179 and 188) and an alternatively sized, shaped and configured patient support structure.
- the patient positioning support system 5 includes a head-end 18, a foot-end 19, left-hand and right-hand sides 298, 300, and top and bottom sides, which for discussion purposes are denoted relative to the sides of a patient's body when the patient is positioned in a prone position on the prone patient support structure 15.
- the right side of the patient is on the right-hand side of the table 5.
- the left-hand and right-hand sides 298 and 300 may simply be referred to as the left side 298 and the right side 300.
- the top and bottom sides may be referred to as the upper and lower sides.
- the patient support system 5 also includes a
- the roll axis R extends longitudinally along a length of the patient support system 5, and intersects the head- and foot-ends 16 and 16', respectively, of the base 10.
- the base head-end 16 includes a first vertical translation axis VI (FIG. 2) and a first yaw axis Yl .
- the base foot- end 16' includes a second vertical translation axis V2 and a second yaw axis Y2.
- the patient support structure 15 ⁇ includes three pitch axes, wherein the first pitch axis PI is associated with a patient's hips, the second pitch axis P2 is associated with the head-end 18 of the patient support structure 15 ⁇ , and therefore with the patient's head, and the third pitch axis P3 is associated with the foot-end 19 of the patient support structure 151, and therefore with the
- the roll, pitch and yaw axes, R, Pn and Yn (FIGS. 1-3), of the patient positioning support system 5 are axes about which rotational movement of at least a portion of the patient positioning support system 5 can occur, and therefore are functionally analogous to the roll, pitch and yaw axes of an airplane .
- rotational movement is a broad term and is used in its ordinary sense, including, without limitation tilting, rolling, angulating or articulating the patient support 15 t about one or more of the roll axis R, the pitch axes Pn, and the yaw axes Yn. It is noted that rotational movement may occur at one or more of these axes, and that such movements may occur sequentially, simultaneously, or a combination thereof.
- roll and tilt as used herein, are broad terms and are used in their ordinary sense, including, without limitation movement of the patient support structure about the roll axis R.
- the amount of roll or tilt of the patient support structure 15 ⁇ is measurable in degrees, similar to the manner in which the roll of an aircraft about its roll axis is measured. Tilting is a type of rolling, and the term “tilt” is generally used to refer to rolling an amount of about ⁇ 30° or less. At these low amounts of roll, the patient support 15 ⁇ is generally locked in that position to improve access to the surgical site. Consequently, the term “roll” tends to be used for greater amounts of rotational movement about the R axis, such as about +180°, such as is described elsewhere herein.
- rotational movement refers to upward and downward breaking, angulation or pivoting of the hinges located at or associated with PI. This type of rotational movement may also be referred to as angulation or articulation, and is also measurable in degrees.
- rotational movement refers to movement of the patient support 15 ⁇ about one of P2 and P3. This type of rotational movement modifies an angle that is formed by, or defined by, the patient support structure 15 + and the adjacent vertical translation
- This particular type of rotational movement occurs when the patient support structure 15+ breaks upwardly or downwardly at PI, and additionally or alternatively when the patient support structure 15+ is placed in a Trendelenburg or reverse Trendelenburg position. It is noted that
- rotational movement at P2 is often accompanied by rotational movement at P3.
- vertical translation is a broad term and is used in its ordinary sense, including, without limitation upward and downward movement with respect to the vertical translation axes Vn, which are associated with up and down lifting and lowering the head- and foot-ends 18, 19 of the patient support structure 15+, such as with the primary or secondary elevators, which are described in greater detail below.
- the movements of the patient positioning support system 5, with respect to the head and foot-ends, left and right-hand sides, and top and bottom sides, as well as with respect to the roll, pitch, yaw and vertical translation axes, R, Pn, Yn and Vn, respectively, can be one or more of synchronous or sequential, active or
- FIG. 2 is a perspective view of a base 10 of the patient positioning support system 5, in an exemplary
- the base 10 may also be referred to as a base structure or base subassembly.
- the base 10 is adapted to support the patient support structure 15 ⁇ above the floor F (FIG. 4) .
- the base 10 includes structure that is adapted to lift and lower, tilt, roll, rotate and, additionally or alternatively, angulate at least a portion of the patient support structure 15 ⁇ relative to the floor F, so as to position a patient's body in a desired position for a medical procedure, such as is described in greater detail below.
- the base 10 includes at least one vertical
- the base includes a vertical elevator, a telescoping pier, a vertical translator, or the like.
- the base includes a vertical
- translation subassemblies 20 are joined by a longitudinally extending supportive cross-bar 25 or beam.
- the vertical translation subassemblies 20 are generally identical and face one another, or are mirror images of one another, though this is not required in all
- translation subassemblies 20 may have an alternative
- the telescoping riser of the vertical translation subassemblies may be off-set, or not centered over the foot or base portion, such as is
- one or both of the vertical translation subassemblies 20 may be
- the cross-bar 25 is a substantially rigid support that joins and holds the vertical translation subassemblies 20 in spaced opposed relation to one another.
- the cross-bar 25 is non-adjustable. However, in some other embodiments, the cross-bar 25 is removable or telescoping, so that the vertical translation subassemblies 20 can be moved closer together, such as for storage. In certain embodiments, the cross-bar 25 is longitudinally adjustable so that the vertical translation subassemblies 20 can be moved closer together or farther apart, such as, for example, to support or hold different patient support structures 15 of various lengths or configurations, such as but not limited to interchangeable or modular patient support structures 15. In certain other embodiments, there patient positioning support system 5 does not include a cross-bar 25. Numerous cross-bar 25 variations are foreseen.
- the cross-bar 25 may be telescoping, and additionally or alternatively removable, such that the cross-bar 25 can be lengthened, shortened, or removed, such as for storage of the base 10. It is foreseen that the cross-bar 25 can include a mechanism (not shown) for locking the cross-bar 25 at a selected length.
- cross-bar 25 may include motorized means (not shown) for lengthening or shortening the cross-bar 25.
- the vertical translation subassemblies 20 are substantially laterally non- movable with respect to one another, either closer together or farther apart, once a patient support structure 15 ⁇ has been attached to or joined with the base 10, and during use or operation of the patient positioning support system 5.
- each vertical translation subassembly 20 includes a lower portion 30, an upper portion 35 and a vertical translation axis VI or V2 that extends upwardly from the floor F so as to be substantially
- the lower portion 30 includes a lower support structure 40, such as a base portion or a foot, and a riser assembly 45.
- the riser assembly 45 includes a
- the riser assembly 45 may be off -set with respect to the lower support structure 40.
- At least one of the vertical translation subassembly upper portions 35 includes a rotation subassembly, generally 50, that enables tilting and rolling of the patient support structure 15 ⁇ about the roll axis R, such as is described below.
- the roll axis R extends longitudinally between the upper portions 35.
- the rotation subassembly 50 includes a mechanical rotation motor 55 (Fig. 250) , a rotation shaft 56 (Fig. 21) and a rotation or ladder connection block 57.
- the rotation motor 55 may be any motor known in the art that is strong enough to rotate the patient support structure 15+ about the roll axis R and optionally to lock the patient support structure 15 ⁇ in a tilted orientation with respect to the floor F. Harmonic motors are particularly useful as the rotation motor due to their strength.
- the rotation subassembly 50 may be constructed such as described in U.S. Patent No. 7,152,261, U.S. Patent No. 7,343,635, U.S. Patent No. 7,565,708, U.S. Patent No. 8,060,960, or U.S.
- the motor 55 is enclosed or shrouded by a housing 60, with front and back portions 61, 62, a top portion 63, opposed side portions 64 and an optional front plate or rotation plate 65, so as to be protected thereby.
- the rotation shaft 56 extends through the housing front portion 61, as is described below.
- FIG. 121 which is a top cross- section of the patient positioning support system 5 taken along line 121-121 of FIG. 7, the rotation shaft 56 is
- the rotation shafts 56, of the opposed vertical translation subassembly upper portions 35, are each movable with respect to an
- Each rotation shaft 56 includes inner and outer portions, 70, 71, respectively (Fig. 121). The rotation shaft inner portion 70 is engaged by and cooperates with the
- rotation motor 55 so as to be rotatable, turnable or rollable in either the clockwise or counter-clockwise directions, such as is illustrated in FIGS. 92a-95a, FIGS. 134-136, and FIGS. 165-169.
- the outer portion 71 of the rotation shaft 56 includes a substantially cylindrical side surface 76 with opposed side surface openings (not shown) , an outer or inboard face 77 and a through-channel 78 that joins the side surface openings and extends through the outer portion 71 so as to form a bore- like structure.
- a substantially cylindrical side surface 76 with opposed side surface openings (not shown)
- an outer or inboard face 77 and a through-channel 78 that joins the side surface openings and extends through the outer portion 71 so as to form a bore- like structure.
- the through-channel 78 of the rotation shaft outer portion 71 is sized to receive a yaw pin 79 therethrough, so as to join the shaft outer portion 71 with the associated rotation block 57.
- the rotation shaft outer portion 71 extends out of the housing 60 and in an inboard direction toward the upper portion 35 of the opposed vertical translation subassembly 20.
- the outer portion 71 is joined with the rotation block 57, also referred to as a connection member or first portion, by the yaw pin 79, inner connector shaft, peg, post or connector, that extends through the shaft outer portion through-channel 78 and into the rotation block 57.
- Each yaw pin 79 is coaxial with a respective yaw axis Yl or Y2, so as to enable the rotation block 57 to rotate at least a small amount about the yaw axis Yl or Y2.
- One or more bushings 80 sleeve at least a portion of the yaw pin 79, such as is shown in FIGS. 13-22 and 121, so as to reduce friction and to secure the yaw pin 79 to the shaft outer portion 71.
- the rotation block 57 may be connected to the rotation shaft 56 by an alternative structure that also permits movement about the yaw axis Yn, such as but not limited to a universal joint. It is also foreseen that the rotation block 57 may be connected to the rotation shaft 56 by a structure that prevents such yaw, and that yaw may be provided in another part of the patient positioning support structure 5.
- a rotation plate 65 joins the inner and outer portions 70 and 71 of the rotation shaft 56.
- the rotation plate 65 may also be referred to as an optional front plate 65 of the housing 60.
- the rotation plate 65 may be integral with or separate from the rotation shaft 56.
- the housing front portion 61 includes, and is optionally integral with, the rotation plate 65, which functions as a face plate that covers and protects the inboard side 85 of the rotation motor 55. It is foreseen that the patient positioning support system 5 may include no front or rotation plate 65.
- the base 10 includes a pair of connection
- connection subassembly 75 for reversible attachment with a patient support structure 15 ⁇ .
- connection subassembly 75 for reversible attachment with a patient support structure 15 ⁇ .
- connection subassemblies 57 are each joined with one of the vertical translation subassemblies 20, such as but not limited to by a respective rotation subassembly 50.
- the rotation block 57 also referred to as a ladder connection block 57, is reversibly or removably
- connection subassemblies 57 provide structure for
- the head-end and foot-end rotation blocks 57 are substantially identical, or mirror images of one another; however, it is foreseen that one or both of the blocks 57 may have an
- connection subassemblies 57 provide structure for at least some vertical translation, or height adjustment, of an attached patient support structure 15+, such as is described below. Further, the two connection subassemblies 57 cooperate with each other and optionally with the patient support structure 15t, to provide structure for a fail-safe structure or mechanism, such as is described below.
- the failsafe substantially blocks incorrect detachment of an attached patient support structure 15 ⁇ , wherein such incorrect
- detachment can result in catastrophic collapse of at least a portion of the patient positioning support system 5 and patient injury.
- each rotation block 57 is generally block-shaped or rectangular and includes spaced and opposed (or spaced opposed) front and rear faces 105, 110 (FIG. 18), spaced opposed top and bottom faces 115 and spaced opposed end faces 120 (FIG. 16) .
- the faces may also be referred to as sides, ends, surfaces or portions.
- the faces of each pair of opposed faces, such as the front and rear faces 105, 110, the top and bottom faces 115, and the end faces 120 are substantially parallel with one another; but, it is. foreseen that this may not be the case in other embodiments .
- the rotation block front face 105 includes a front surface 123 (FIG. 15) with a centrally located front opening 125 and at least one rail-receiving groove 127 or channel (FIG. 14) .
- the front 105 includes a pair of parallel rail-receiving grooves 127, which are denoted as first and second rail-receiving grooves 128 and 129, respectively, with reference to the figures.
- first rail-receiving groove 128 may also be referred to as an upper rail-receiving groove
- the second rail-receiving groove 129 may be referred to as a lower rail- receiving groove 129.
- the terms "first" and "second”, and “upper” and “lower” are names or identifiers used to
- Each rail-receiving groove 127 includes a contoured inner surface 130 and an outer lip 131.
- the inner surface 130 and lip 131 are sized, shaped and configured to receive an upper rail 133 of a ladder 100, 100' therein.
- the upper rail 133 is substantially cylindrical with a circular cross -section. Accordingly, the groove inner surface 130 and lip 131 are sized, shaped and configured to reversibly receive therein and to engage the cylindrical upper rail 133. In some embodiments, the
- the rotation block rear face 110 includes a rear (or back) surface 134 (FIG. 22) and a centrally located rear (or back) opening 135.
- the surface 134 is generally flat and planar, but may include some non-planar portions, in some embodiments .
- the block front and rear openings 125, 135 are joined by a block through-bore 140 or channel that is sized, shaped and adapted to receive at least a portion of the rotation shaft 56 therein, whereby by the block 57 is attached to the rotation shaft 56.
- the rotation shaft 56 extends through the block through-bore 140.
- the rotation block through-bore 140 includes an inner surface 145 (FIG. 16) , with upper, lower and side surfaces 150, 155 and 160, respectively, and one or more engagement surfaces 165 that are shaped to engage one or more portions of the rotation subassembly 50, such as but not limited to the rotation shaft outer portion .71.
- the engagement surfaces 165 include at least one partially cylindrical bushing engagement surface 170 and an optional substantially planar engagement surface 175 (see FIGS. 15 and 22) . While in the illustrated embodiment the rotation block through-bore 140 is generally box-shaped, it is foreseen that the through-bore 140 may have other shapes, such as but not limited to cylindrical, conical and prismatic shapes.
- the rotation block 57 is joined with the rotation shaft outer portion 71 (FIGS. 14 and 121) .
- the shaft outer portion 71 extends into and optionally through the block through-bore 140.
- a yaw pin, peg or post 79 attaches, fixes, joins or connects the through-bore 140 with the shaft outer portion 71.
- the yaw pin 79 extends through the shaft through channel 78 and into the side surface 160 of the block through- bore 140.
- One or more of the engagement surfaces 165 contacts and engages the surface 183 of the yaw pin 79.
- One or more bushings 80 may be received over or around the yaw pin 79, so as to provide spacing. This attachment ensures that rotation of the rotation shaft 56 rotates the rotation block 57.
- one or more bushings 80 are received over the yaw pin 79.
- the bushings 80 provide for at least some engagement between the yaw pin 79 and the bushing engagement surfaces 170 and optionally additional engagement surfaces 165, 175 of the block through-bore 140.
- the bushings 80 space 'or separate the rotation shaft 56 from the inner surface 145 of the block through-bore 140. Further, the bushings 80 can provide a snug and secure fit or connection between the rotation shaft 56 and the rotation block 57.
- each of the rotation blocks 57 is attached to a respective shaft 75 so as to provide a space 180 or distance between the block rear face 110 and the housing front 61.
- This space 180 is particularly important, as described below, because the rotation block 57 is adapted to yaw or rotate about the associated yaw axis Yl or Y2, such as is indicated by the double-headed directional arrow 185.
- This yaw motion brings a portion of the block rear face 110 closer to the housing front 61, and the space 180 must be sufficient to prevent the structures from contacting or bumping into each other, wherein such contact between the block rear face 110 and the housing front 61 could inhibit free, or smooth, rotation of the block 57 with respect to the roll axis R.
- the space 180 is sufficient to substantially block or prevent contact between the block rear face 110 and the housing front 61 when the respective rotation block 57 rotates about the respective yaw axis Yl or Y2. It is foreseen that the rotation block 57 may be rigidly fixed to the rotation shaft 56, so as to prevent, disallow or block yaw at this location. In such
- yaw may be additionally or alternatively provided in one or both of the patient support structure 15 t and the base 10. It is foreseen that the patient positioning support system 5 can be adapted and configured such that yaw is no longer necessary and therefore not provided.
- each rotation block 57 is attached to or joined with a respective rotation shaft outer portion 71 of the vertical translation subassembly 20.
- translation subassemblies 20 are rotated in synchronization, toward either the left-hand side or right-hand side of the patient positioning support system 5 and also at the same speed.
- Each of the rotation shafts 56 rotates an attached block 57 clockwise or counter-clockwise, which in turn rotates the attached ladders 100 or 100' about the roll axis R. As the ladders 100 or 100' are rotated in unison, they
- the block through-bore 140 is located so as to enable the rotation shaft outer portion 71 to smoothly and evenly rotate the ladder connection block 57 with respect to the roll axis R .
- a shaft through-channel 78 pierces or extends through the shaft outer portion 71.
- the yaw pin 79 extends through both the rotation block through-bore 140 and the rotation shaft through-channel 78 so as to join, fix, connect or attach the rotation shaft outer portion 71 with the ladder connection block 57.
- the yaw pin 79 is substantially coaxial with the associated yaw axis Yn, so as to enable the ladder connection block 57 to be rotated, articulated or pivoted either
- the yaw axis Yn extends out of the page, so as to be substantially perpendicular to the plane of the page.
- the cylindrical yaw pin 79 includes a circular cross-section. It is foreseen that the yaw pin 79 may have any other shaped cross-section that enables the ladder connection block 57 to sufficiently pivot about the yaw axis Yn, and thereby to prevent buckling of the patient positioning support system 5 when the patient support structure 15 ⁇ is placed in a
- Trendelenburg or reverse Trendelenburg position and is also rolled or tilted about the roll axis R, such as is shown in FIGS. 28 and 36.
- a roll axis R such as is shown in FIGS. 28 and 36.
- Each rotation block 57 includes at least one ladder connection structure 190, or ladder connection subassembly, which is complementary in size, shape and configuration with a block connection structure 191, or block connection
- the block connection structures 191, of the ladders 100, 100' are described below. Cooperation between the block's ladder connection structure 190 and the ladder's block connection structure 191 enables removable attachment, engagement or mating of a ladder 100, 100' to the block 57.
- the ladder connection structure 190, of the rotation block 57 includes the rail- receiving groove 127 (described above) and a pair of ladder engagement pegs 195. As shown in FIG. 16, each of the engagement pegs 195 extends outwardly from an associated rotation block end face 120. The pegs 195 are positioned on the end faces 120 so as to be coaxially aligned with one another. Further, the pair of pegs 195 are positioned so as to cooperate with the associated rail -receiving groove 127.
- the rotation block 57 includes two ladder connection structures 190.
- the rotation block 57 includes two pairs of engagement pegs 195, such as upper and lower pairs 200, 205 of pegs 195, or a first pair 200 of pegs 195 and a second pair 205 of pegs 195.
- the upper pair 200 of pegs 195 is associated with the upper or first rail-receiving groove 128, and the lower pair 205 of pegs 195 is associated with the lower or second rail-receiving groove 129.
- the upper pegs 200 are coaxial with one another and spaced from the first rail -receiving groove 128, and the lower pegs 205 are coaxial with one another and spaced from the second rail-receiving groove 129, such that a ladder 100 or 100' can be engaged either with the upper pair of pegs 200 and the upper groove 128 or with the lower pair of pegs 205 and the lower groove 129.
- Engagement or connection of a rotation block 57 and a ladder 100 or 100' is described in greater detail below.
- the ladders 100, 100' which may also be referred to as "H-frames," are substantially rigid and facilitate or provide attachment of a patient support structure 15 ⁇ , such as but not limited to a prone patient support structure 15 and a supine patient support structure 15', to the base 10 of the patient positioning support system 5.
- positioning support system 5 includes at least one pair of ladder structures or ladders.
- the ladders may be a provided in a variety of lengths, such as but not limited to standard and non-standard lengths.
- Ladders having a standard length are denoted by the number 100
- ladders having a nonstandard length are generally denoted by the number 100' , so as to distinguish between the sizes for discussion purposes.
- Non-standard length ladders 100' include a length that is relatively longer or shorter than a standard length ladder 100.
- FIG. 10 illustrates an exemplary standard length ladder 100.
- An exemplary pair of extended length ladders 100' is shown in FIGS. 110-115.
- the ladders 100, 100' are provided in one of two lengths, a standard length ladder 100 and non-standard length ladder 100', wherein the non-standard length ladder 100' includes an extended length, or a length greater than that of the standard length ladder 100. It is foreseen that ladders 100' of other, non-standard lengths can be provided.
- pairs of matched ladders 100 or 100', or two ladders 100 or 100' having substantially the same length are attached to the opposed rotation blocks 57.. It is foreseen that miss-matched pairs of ladders 100, 100' could be attached to the rotation blocks 57.
- the ladder 100 or 100' may be permanently attached to the patient support structure 15+, and therefore non-removable . It is foreseen that a non-standard length ladder 100 ' may be used instead of a standard length ladder 100 in some circumstances. It is foreseen that other or alternative attachment structures may be substituted for the ladders 100, 100' to removably connect the patient support structure 15+ to the base 10. In some circumstances these other attachment structures may be permanently attached to the respective patient support structure 15 ⁇ .
- Each ladder 100, 100' includes a pair of rigid spaced opposed ladder side members, generally denoted by the number 231.
- the pair of ladder side members 231 are joined at or near their upper ends 232 also referred to as connection ends, by the upper rail 133 described above.
- the ladder side members 231 are joined by a second or lower rail 234.
- the ladder 100 or 100' may include additional stabilizing rails (not shown) .
- Each ladder side member 231 includes inner and outer faces or sides 235 and 236, respectively, and inboard and outboard faces or sides 237 and 238, respectively. As shown in FIGS. 1, 101 and 102, when a ladder 100, 100' is attached to the base 10, the ladder connection block or rotation block 57 and also, or alternatively, to a patient support structure 15+, the inboard faces 237 are positioned toward or closer to the patient support structure 15+ . Similarly, the outboard faces 238 are positioned toward the associated, attached or connected vertical translation subassembly 20.
- the ladder side members 231 each include an engagement peg receiving groove 239 that is complementary in shape and cooperates with the peg 195.
- the engagement peg receiving groves 239 are cut into the inner faces 235 of the ladder side members 231, and extend from the outboard side 238 toward the inboard side 237 so as to provide a peg-receiving channel 240 with an opening 241 and a peg- engaging chamber 243.
- the peg-receiving channel 240 is sized and shaped to removably slidingly receive a ladder engagement peg 195 therein.
- the two channels 240 are generally or substantially parallel with one another, and are located to as to engage a pair of ladder engagement pegs 195 such as but not limited to pair 200 and pair 205, such as are shown in FIG. 16.
- the peg-engaging chamber 243 is sized and shaped to lockingly engage the peg 195 received in the channel 240.
- the ladder engagement peg receiving grooves 239 and the associated ladder engagement pegs 195 may be attached to the alternate or opposite structure so long as the ladder 100, 100' can be removably attached to the base 10.
- the ladder may include the pegs 195 and the rotation block 57 may include the grooves 239.
- alternative attachment structures may be used to
- FIGS. 126-133 illustrate attaching a standard sized ladder 100 to an upper pair of pegs 200 of a rotation block 57, the steps of which are substantially similar for
- the ladder channel openings 241 are aligned with the block pegs 195, such as the upper pair 200 of pegs 195, such as is indicated by the directional arrow denoted by the numeral 245.
- the openings 241 are correctly aligned with the upper pair of pegs 200 by orienting, tilting or tipping the ladder 100 such that the lower rail 234 is located more inboard than the upper rail 133. Accordingly, when in this position, the lower rail 234 is spaced or located higher from the floor F than the upper rail 133.
- the peg- receiving channel openings 241 are placed, installed or engaged around the upper pegs 200, such that the upper pegs 200 are effectively inserted into the openings 241.
- the peg- receiving channels 240 are then slid, moved or placed around the pegs 200, such that the pegs 200 are slid or moved along or through the channels 240, such as by tilting or rotating the lower end of the ladder 100 in an outboard direction, such as is indicated by the directional arrow denoted by the numeral 246.
- the ladder 100 is moved or tilted until it comes into a vertical orientation or configuration, such as that shown in FIGS. 130 and 131.
- the ladder upper rail 133 fits into and engages the ladder connection groove 127 on the front face 105 of the rotation block 57, and the outer surface 205 of the upper rail 133 frictionally engages the groove surface 203.
- the pegs 200 are substantially engaged by, or located or received within, the respective channel chambers 243.
- siibassemblies 20 provide a fail-safe mechanism that prevents improper disconnection of an attached or engaged patient support structure 15 ⁇ from the base 10.
- This fail-safe mechanism includes two components. First, the ladders 100 and 100' cannot be disconnected from the base 10 unless no patient support structure 15 t is attached thereto. Second, the ladders 100 and 100' must be disconnected or removed from the base 10 by performing the attachment steps in reverse order. Accordingly, the ladder lower ends 233 must be tilted in an inboard direction, before the respective ladder upper ends 232 can be disconnected or disengaged from the rotation block 57.
- Other fail-safe mechanisms, structures or subassemblies are foreseen.
- the rotation block 57 includes at least one locking mechanism, structure or device, generally 250, adapted to lock the ladder upper rail 133 in the engaged rail-receiving groove 127.
- the locking mechanism 250 can be actuated or engaged as an optional step in attaching the ladder 100, 100' to the rotation block 57.
- Figs. 132-133 illustrate attaching a ladder 100 to a rotation block 57.
- the rotation block 57 includes upper and lower pairs of lock mechanisms 250.
- Each lock mechanism 250 includes an inner locking portion 255 and a handle 260 that extends outwardly from the front face 105 of the rotation block 57.
- the inner locking portion 255 can be swiveled into and out of the opening 265 of the associated rail-receiving groove 127, or ladder connection groove, by manually turning or rotating the associated handle 260 on the front face 105 of the rotation block 57, such that the lock 250 is engaged or closed. It is foreseen that the lock mechanisms 250 could be motorized and controlled by software or otherwise mechanically actuateable.
- Closing the locks 250 prevents or blocks removal, disengagement, detachment or disconnection of the upper rail 133 from the engaged, attached or connected first rail-receiving groove 128.
- the lock mechanisms 250 To disconnect the ladder 100, 100' from the first rail-receiving groove 128, the lock mechanisms 250 must be opened,
- the lock mechanism 250 it is foreseen that the lock mechanism 250 must be substantially opened prior to attachment or installation of a ladder 100 or 100' with the rotation block 57.
- the patient positioning support system 5 is adapted, configured and arranged for reversible attachment of up to two ladders 100, 100', such as upper and lower ladders, to each rotation block 57.
- two such ladders 100, 100' attached to a single rotation block 57 are substantially vertically opposed to one another and also co-planar with one another.
- a pair of ladders 100 or 100' attached to the two opposed rotation blocks 57 at either end of the base 10, such as a pair of ladders 100 or 100' attached to either the first rail -receiving grooves 128 or the lower rail- receiving grooves 129 are substantially opposed to and parallel with one another.
- a plane that runs parallel with and through the ladder side members 231 is substantially
- the rotation block. 57 is sized, shaped and configured such that when two ladders 100, 100' attached thereto, their upper ends 232 kiss or contact one another. It is foreseen that, in some embodiments, the upper ends 232 may not contact one another, depending upon the location or placement of the upper and lower pairs 200, 205 of ladder engagement pegs 195.
- Attaching two ladders 100, 100' to each of the rotation blocks 57 of the patient positioning support system 5 enables attachment of two patient support structures 15 i, such as for example a prone patient support structure 15 and a supine patient support structure 15', such as is described elsewhere herein.
- a patient can be positioned on a first of two patient support structures 15 ⁇ , such as for a first surgical procedure, and then transferred to the second of the two patient support structures 15 ⁇ , such as for performing a second surgical procedure with the patient in a 'different body position.
- Such transferring of a patient between the two patient support structures 15+ can be
- the ladders 100, 100' are sized, shaped, configured and arranged for attachment to a patient support structure 15 ⁇ in addition to the base 10.
- Each ladder side member 231 includes a plurality of spaced through-bores 270 joining its respective inner and outer faces 235 and 236.
- the through- bores 270 of the opposed ladder side members 231 are sized, shaped and located or aligned such that pairs of opposed through-bores 270 can removably or reversibly slidingly receive the rod portion 102 of a T-pin 101 therethrough.
- through-bores 275 and 280 are coaxially aligned such that a single, or the same, T-pin 101 is receivable therethrough (e.g., a single T-pin 101 is receivable through both of the through-bores 275 and 280) .
- the base includes a plurality of axes, including a longitudinally extending roll axis R, at least one vertical axis denoted by the letter Vn, wherein n is an integer indicating, identifying or denoting a particular or specific vertical axis, and at least one yaw axis denoted by the letter Yn, wherein n is an integer indicating a particular or specific yaw axis.
- the base 10 is configured and arranged for movement with respect to these axes, such as is described below and elsewhere herein.
- the roll axis R extends longitudinally along a length of the patient positioning support system 5. In particular, the roll axis R extends between the outer portions 71 of the rotation shafts. In an exemplary embodiment, when the upper portions 35 of the opposed vertical translation subassemblies 20 are located substantially equidistant from the floor F, such as is shown in FIG. 4, the roll axis R is substantially coaxial with the rotation shafts 56. In another exemplary embodiment, when the upper portions 35 are not equidistant from the floor F, such as is shown in FIGS. 24 and 32, the roll axis R intersects the rotation shaft outer portions 71.
- the roll axis R is movable to numerous
- the base 10 is adapted to tilt, roll, turn over, or rotate the patient support structure 15 t such as but not limited to the prone patient support structure 15 and the supine patient support structure 15' about or around the roll axis R.
- the patient support structure 15 can be reversibly rolled or tilted an amount or distance of between about 1° and about 360°, such as relative to a plane intersecting the roll axis J? wherein the plane is parallel with the floor F, or such as relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ may be tilted a distance of about 5°, about 10°, about 15°, about 20°, about 25°, about 30°, about 35° , or about 40° about . the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R, so as to provide improved access to a surgical site.
- the patient support structure 15 ⁇ may be tilted a distance of about.45°, 50°, 55°, 60°, 65°, 70°, 75°, 80°, 85°, 90°, 95° or 100° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ may be tilted a distance of about 110°, 115°, 120°, 125°, 130°, 135°, 140°, 145°, 150°, 155°, 160°, 165°, 170°, 175° or 180° about the roll axis J?, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ may be rolled a distance of more than 180° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ can be rolled clockwise or counter-clockwise, or toward either the left-hand or the right-hand side with respect to the roll axis R.
- both the prone and supine patient support structure 15 and 15' may be attached to the base 10 and rolled toge6ther with respect to the roll axis R.
- FIGS. 92a, 93a, 94a and 95a illustrate rolling the prone and supine patient support structures 15, 15' about the roll axis R, in one embodiment, wherein the patient support structures 15, 15' are reversibly attached to a base 10, such as but not limited to during a sandwich-and-roll procedure.
- the supine patient support structure 15' is below the roll axis R and the prone patient support structure 15 is above the roll axis R.
- FIG. 93a the prone and supine patient support structures 15 and 15' are tilted about the roll axis R, or toward the right of the page, a distance of about 25°.
- FIGS. 92a, 93a, 94a and 95a illustrate rolling the prone and supine patient support structures 15, 15' about the roll axis R, in one embodiment, wherein the patient support structures 15, 15' are reversibly attached to a base 10, such as but not limited to during a sandwich-and-roll procedure.
- FIGS. 94a- 94c illustrate rolling the prone and supine patient support structures 15 and 15' even farther about the roll axis R, a distance of about 130°, such as if the patient is being rolled over in a sandwich-and-roll procedure.
- FIGS. 94a- 94c illustrate rolling the prone and supine patient support structures 15 and 15' even farther about the roll axis R, a distance of about 130°, such as if the patient is being rolled over in a sandwich-and-roll procedure.
- 95a, 95b and 95c show the positions of the prone and supine patient support structures 15, 15' after completion of an 180° roll.
- the supine patient support structure 15' is located above the roll axis R and the prone patient support structure 15 is below the roll axis R, and a patient thereon would be facing downward toward the floor F.
- the patient positioning support system 5 is configured and arranged to roll the prone and supine patient support structures 15, 15' a full 360° about the roll axis R in at least one direction, so as to return to the orientation shown in FIG. 92a.
- the base 10 is adapted to roll the patient support structures 15, 15' backwards, or in a reverse direction, about the roll axis R, so as to be rolled a suitable distance, so as to position the patient in an
- orientation associated therewith such as but not limited to the positions shown in FIGS. 92a through 95c.
- Each vertical translation subassembly 20 includes a vertical translation axis, which is denoted by VI or V2.
- Vertical translation or movement, of at least a portion of the patient positioning support apparatus 5 may occur along one or both of the vertical translation axes VI and V2.
- the vertical translation subassembly 20 on the right side of FIG. 2 raises and lowers the associated upper portion 35 along the first vertical translation axis VI.
- the vertical translation subassembly 20 on the left side of FIG. 2 raises and lowers the associated upper portion 35 along the second vertical translation axis V2.
- translation may be synchronous or asynchronous, such as is described in greater detail below.
- Each vertical translation subassembly 20 includes maximum and minimum translation or lift distances.
- the maximum lift distance is the maximum amount, most or highest the riser assembly 45 can be telescoped outwardly or upwardly, or extended.
- the maximum lift distance is the highest that the rotation shaft outer portion 71 (Fig. 14) can be spaced from or above the floor F.
- FIG. 4 shows both of the upper portions 35
- FIG. 50 shows both of the vertical translation subassemblies 20 in a maximally outwardly telescoped, raised, opened or fully open configuration, orientation or position with respect to their respective vertical translation axis VI, V2 and also with respect to the floor F.
- the minimum lift distance is the minimum amount, least, farthest downward, or the lowest the riser assembly 45 can be telescoped downwardly or inwardly, contracted or closed.
- the minimum lift distance is the lowest height that the rotation shaft outer portion 71 can be spaced, located or extended above the floor F.
- translation subassemblies 20 are in a maximally inwardly telescoped, lowered, closed, contracted, or fully closed configuration, orientation or position, with respect to their respective vertical translation axis VI, V2 and also with respect to the floor F, such that the upper portions 35 are both located as close to the floor F as possible.
- the vertical translation subassemblies 20 are sized, shaped, arranged, configured, or adapted to move, translate, or lift and lower the rotation shaft outer portion 71
- this vertical translation is incremental.
- the vertical translation subassembly 20 includes a ratchet mechanism (not shown) that controls the intervals of lift, and an operator must select a number of discrete intervals for the upper portion 35 to be moved.
- this vertical translation is non- incremental, or continuous, between the maximum and minimum lift positions or distances.
- the vertical translation subassembly 20 includes a screw-drive mechanism (not shown) that smoothly lifts and lowers the upper portion 35 an amount determined by an operator, wherein the amount of movement includes no discrete intervals or
- the vertical translation subassemblies 20 can be moved in the same direction or in opposite directions.
- the vertical translation subassemblies 20 can be any vertical translation subassemblies 20. Further, the vertical translation subassemblies 20 can be any vertical translation subassemblies 20.
- both of the vertical translation subassemblies 20 are positionable at substantially equally telescoped positions, relative to their respective vertical translation axis VI, V2 and the floor F, and wherein the telescoped positions are between the fully open and fully closed positions.
- the roll axis R is substantially parallel with the floor F.
- the vertical translation subassemblies 20 are movable in opposite directions, and additionally or alternatively, positionable at different heights.
- the vertical translation subassemblies 20 can be moved and placed such that one of the upper portions 35 is located farther from the floor F, or higher than, the opposed upper portion 35.
- FIG. 23 shows the head-end upper portion 35 fully opened, and the foot-end upper portion 35 is closed, such that attached prone patient support structure 15 is positioned in a reverse Trendelenburg
- the upper portions 35 do not both intersect a single horizontal plane running parallel with the floor F; or the upper portions 35 are not at the same, relative to the floor F.
- Fig. 32 shows another example, wherein the head-end vertical translation subassembly 20 is telescoped closed, and the foot-end vertical translation subassembly 20 is fully opened, such that the attached prone patient support structure 15 is in a Trendelenburg position.
- both of the vertical translation subassemblies 20 are
- the vertical translation subassemblies 20 can be operated singly or together, and synchronously or
- one of the vertical translation subassemblies 20 may be telescoped, expanded, lifted or moved, while the opposed vertical translation subassembly 20 is not telescoped or moved, or is held or maintained immobile.
- both of the vertical translation may be telescoped, expanded, lifted or moved, while the opposed vertical translation subassembly 20 is not telescoped or moved, or is held or maintained immobile.
- subassemblies 20 are moved in the same or opposite directions at the same time, and at the same or different rates of vertical movement. Numerous variations are foreseen.
- Operation of the vertical translation subassemblies 20 is generally coordinated and controlled electronically, or synchronized, such as by a computer system (not shown) that interacts with one or more motion sensors (not shown)
- automatic electronic control (not shown) of the patient positioning support system 5, or the drive system can be turned off, or at least temporarily disconnected, so that one or more portions of the patient positioning support system 5 can be moved manually.
- at least the step of rolling the patient over is usually
- the clutch is re-engaged, so that the patient positioning support system 5 can mechanically perform
- Each of the vertical translation subassemblies 20 includes a yaw axis Yn .
- the vertical translation subassemblies 20 includes a yaw axis Yn .
- subassemblies 20 include the yaw axes Yl and Y2, respectively.
- the patient support structure 15 t such as but not limited to a prone patient support structure 15, is
- the yaw axes Yl and Y2 are substantially perpendicular to the floor F and substantially parallel with the vertical axes VI and V2.
- the yaw axes Yl and Y2 are not perpendicular to the floor F or with the vertical axes VI and V2.
- Such rotational movement prevents buckling or collapse of the patient positioning support system 5 when the patient support structure 15 ⁇ , such as but not limited to a prone or supine patient support structure 15, 15', is placed in certain positions, such as but not limited to a
- the rotation block 57 (Fig. 15) is sized, shaped and arranged to as to rotate or pivot about the associated yaw axis Yn. As the connection block 57 pivots about the yaw axis Yn, the rear face 110 does not
- the rotation block 57 is spaced a sufficient distance from the rotation plate 65 and additionally or alternatively the housing front 61 so as to substantially prevent such contact therebetween from happening.
- the rotation block 57 and the rotation subassembly 50 are sized, shaped and configured to allow or enable the rotation block 57 to be rotated a small angle about the yaw axis Yn, so as to prevent the patient positioning support system 5 from
- the patient positioning support system 5 is adapted for movement with respect to the roll, yaw and vertical translation axes R, Yn and Vn, respectively. With respect to two or more of these axes, such movement may occur
- one of the vertical translation subassemblies 20 may telescope upwardly, so as to lift the attached end of the patient support structure 15 ⁇ , such as but not limited to a prone or supine patient support structure 15 or 15', while the rotation subassembly 50 simultaneously or concurrently rolls the patient support structure 15 t a
- movement with respect to two or more of these axes is sequential.
- the rotation subassembly 50 is movably attached to the connection subassembly 75 so as to enable both rotational movement of at least a portion of the connection subassembly 75 about the roll axis R and also rotational movement of at least a portion of the connection subassembly 75 about an associated yaw axis Yn.
- the rotation subassembly 50 is attached to the respective rotation block 57 by an attachment that allows that rotation block 57 to pivot about the yaw axis Yn.
- the connection subassembly 75 can be joined or attached to the rotation subassembly 50 using a variety structures or mechanisms known in the art, so long as rotation of the connection subassembly 75 with respect to the roll and yaw axes R, Yn is maintained.
- rotation about both the roll and yaw axes R, Yn is smooth and non- incremental .
- rotation about the roll axis R is
- rotation about the roll axis R may be active, such as mechanically actuated or driven, or rotation about the roll axis R may be passive, such as manually rolling the patient support structure 15 t about the roll axis R.
- the rotation shaft outer portion 71 extends into and optionally through the rotation block through-bore or through-channel 140, and is attached, joined or fixed thereto.
- Rolling or rotation of the rotation shaft 56 due to actuation of the rotation subassembly 50, causes rotation of the rotation block 57 about the roll axis R, in either a clockwise or a counterclockwise direction.
- Rolling of the rotation shaft 56 can rotate the rotation block 57 a distance of between about 1° and about 360° in either a clockwise or a counter clockwise direction, such that a patient on the patient support structure 15 ⁇ can be rolled over or tilted, such as is described elsewhere herein.
- the patient positioning support system 5 includes at least one patient support structure 15 ⁇ , such as but not limited to prone and supine patient support structures 15, 15'.
- the patient is not limited to prone and supine patient support structures 15, 15'.
- the patient is not limited to prone and supine patient support structures 15, 15'.
- positioning support system 5 includes one or more additional patient support structures, such as but not limited to a patient support structure adapted to hold a patient of a different size, such as but not limited to a pediatric
- the patient positioning support system 5 includes one or more additional patient support structures 15 t, such as but not limited to a patient support structure adapted for a specific medical procedure, some of which are described in greater detail below. It is foreseen that a patient support structure 15 t may be configured and arranged to include one or more modular or interchangeable portions . [0475]
- the patient support structure 15 ⁇ is suspended above the floor F. In a further embodiment, the patient support structure 15 ⁇ is attached to and supported by or suspended by the base 10.
- Each patient support structure 15+ such as but not limited to the prone and supine patient support structures 15, 15' described below, includes a plurality of pitch axes, which are denoted by Pn, wherein n is an integer that indicates or denotes a specific or particular pitch axis.
- Pn is an integer that indicates or denotes a specific or particular pitch axis.
- the prone and supine patient support structures 15, 15' each include first, second and third pitch axes, which are denoted by PI, P2 and P3 , respectively.
- the first pitch axis PI is located between and spaced from the second and third pitch axes P2 and P3. All three pitch axes PI, P2 and P3 run substantially perpendicular to a
- the pitch axes PI, P2 and P3 may be either parallel with the floor F or intersect the floor F.
- the patient support structure 15* is adapted, configured and arranged for rotational movement about each of the pitch axes PI, P2 and P3.
- the first pitch axis PI is located so as to be associated with rotational movement at or near a patient's hips.
- the first pitch axis PI enables positioning of a patient in a prone position such that the hips are flexed or extended.
- the second and third pitch P2 and P3 axes are associated with rotational movement of the patient support structure 15 ⁇ about the respective axis relative to the base 10, and wherein the second pitch axis P2 is associated with head- end of the patient support structure 15+ and P3 is associated with the foot-end of the patient support structure 15 ⁇ . This enables placing the patient in either a Trendelenburg position or a reverse Trendelenburg position, such as is described in greater detail below.
- the prone patient support structure 15 is sized, shaped, configured and arranged, or otherwise adapted, for supporting a patient (not shown) in a prone, or face-down, position during a medical procedure, such as but not limited to imaging and surgical procedures.
- FIGS. 1, 3-9, 23-100, 121-125, 134-148 and 159-169 illustrate exemplary embodiments of the prone patient support structure 15.
- Alternatively- sized, shaped, configured and arranged, or otherwise adapted prone patient support structures 15 are foreseen.
- the prone patient support structure 15 of the present invention includes a first pitch or pivot axis PI that is associated with virtual pivot points 248.
- the virtual pivot points 248 are a pair of virtual pivot points, which may be located so as to be spaced and opposed to one another.
- the first pitch axis PI intersects the virtual pivot points 248.
- At least a portion of the prone patient support structure 15 is rotatable about the first pitch axis PI wherein such rotational movement is indicated by the double-headed directional arrow 284.
- the virtual pivot points 248 are each located at a point of contact between the patient's skin and a surface of a hip- thigh pad 286, also referred to as pelvic pads or pelvic support pads.
- the hip- thigh pads 286 are sized, shaped and located so as to hold, support and pad the hips or pelvis of a prone patient
- the virtual pivot points 248 and the associated first pitch axis PI are located above or below the exemplary virtual pivot points 248 and first pitch axis PI depicted in FIG. 3. Additionally or alternatively, in some embodiments, the virtual pivot points 248 and the
- associated first pitch axis PI are located more toward the head-end 288 or more toward the foot-end 290 of the patient positioning support structure 15, than the exemplary virtual pivot points 248 and first pitch axis PI depicted in FIG. 3.
- the prone patient support structure 15 includes second and third pitch or pivot axes P2 and P3 that are associated with its head and foot-ends, and which are
- the prone patient support structure 15 is sized, shaped and arranged to provide for rotation of the prone patient support structure 15 about the second pitch axis P2, such as is indicated by the double-headed directional arrow 292.
- the prone patient support structure 15 is adapted to rotate about the second pitch axis P2 relative to the floor F.
- the prone patient support structure 15 is sized, shaped and arranged to provide for rotation of the prone patient support structure 15 about the third pitch axis P3 , such as is indicated by the double-headed directional arrow 294.
- the prone patient support structure 15 is adapted to rotate about the third pitch axis P3 relative to the floor F.
- the maximum amounts of rotation at P2 and P3 is determined by, or dependent upon, the minimum and maximum heights of the vertical translator upper ends, such as but not limited to the minimum and maximum heights of the connection subassembly connection to the rotation subassembly.
- the prone patient support structure 15 is adapted to pivot, rotate or move about P2 and P3 when reversibly placed in and moved between numerous positions relative to the floor F. For example, in a first position, or orientation, the patient support structure 15 is positioned such that an upper body portion 288, 306A, 308A thereof, or the torso of a patient supported thereon is substantially parallel with the floor F. In a second position, the upper body portion of the prone patient support structure 15, or the torso of a patient supported thereon, is substantially non-parallel with the floor F.
- the patient support structure 15 is movable between the first and second positions. For example the prone patient support structure 15 may be moved to and placed in
- Trendelenburg and reverse Trendelenburg positions such as a shown in FIGS. 31 and 23, respectively.
- the prone patient support structure 15 When moving the prone patient support structure 15 between the first and second positions, the prone patient support structure 15 must rotate about both P2 and P3. Generally, this pivoting movement about P2 and P3 is simultaneous, thought not necessarily at the same rate. It is foreseen that such movement may be incremental or non- incremental , such as but not limited to between maximally angled Trendelenburg and reverse Trendelenburg positions relative to the floor F. Rotation about the second and third pitch axes P2 and P3 is discussed in greater detail below. It is noted that an infinite number of non- incremental positions may exist between the minimum and maximum positions. It is also noted that a finite number of incremental positions may exist between the minimum and maximum positions. It is noted that in some embodiments the supine patient support structure 15 ' is movable in a substantially similar manner to that of the prone patient support structure 15. Prone Patient Support Structure ; Frame
- the prone patient support structure 15 includes an open fixed frame 296 (Fig. 3) that is suspended above the floor F.
- the frame 296 is substantially rigid and strong, and able to withstand substantial forces applied thereto.
- radiolucent so as to not interfere with imaging.
- the frame 296 is attachable to the base 10, such that the base 10 holds or suspends the frame 296 above the floor F.
- the frame 296 can also be suspended above the floor F using any other useful structure known in the art, such as but not limited to an attachment structure that connects the frame 296 with the ceiling, with a wall, or with a combination thereof.
- the frame 296 is suspended or held above the floor F using another base known in the art. Numerous configurations are foreseen.
- the illustrated base 10, or any other useful base known in the art can also suspend either the prone patient support 15 alone or both the prone and supine patient supports 15 and 15' together above the floor F. As described below, the prone and supine patient support structures 15, 15' can both be
- the prone patient support structure frame 296 includes left-hand and right-hand sides, generally 298 and 300 respectively, a head-end 302 and a foot-end 304.
- left side of the patient is near or at the frame left- hand side 298.
- the patient's right side of the patient is located near or at the frame right-hand side 300.
- the frame 296 also includes left-hand and right-hand frame portions 306 and 308, respectively, which are spaced apart and opposed to or opposite one another, and extend longitudinally with respect to the prone patient support structure 15.
- the left-hand and right-hand frame portions 306, 308 are substantially parallel with one another.
- the frame head-end and foot-end frame members 310 and 312 hold or maintain the left-hand and right-hand frame portions 306, 308 in spaced relation to one another .
- Each of the head-end and foot-end frame members 310, 312 includes an attachment structure 314 structure adapted for attachment to the base 10 and also to enable angulation of the patient support structure 15 relative to the base 5 at the second and third pivot axes P2 and P3. Attachment of the patient support structure 15 head-end 302 to a vertical translation subassembly 20 using a T-pin 101 (Fig. 11) and the like is described below.
- T-pin 101 associated with the frame head-end 310 is substantially- coaxial with the second pitch axis P2.
- the T-pin 101 associated with the frame foot-end 312 is substantially coaxial with the third pitch axis P3.
- the head-end frame member 310 includes an attachment structure 314 that includes a T-pin engaging member 316 with a through-bore 318 extending therethrough.
- the through-bore 318 is sized and shaped to reversibly slidingly receive a T-pin 101 therethrough.
- the T-pin engaging member 316 is a substantially cylindrical tube- like member. However, it is foreseen that the T-pin engaging member 316 may have any other useful shape known in the art.
- the head-end attachment structure 314 is attached to a ladder 100 or 100' by aligning the T-pin engaging member through-bore 318 with a pair of ladder through-bores 270 (Fig.
- the frame foot-end 304 is connected or attached to a second or foot-end vertical translator 20 in a substantially similar manner to the frame head-end 302.
- the foot- end frame member 312 includes another attachment structure 314 that also includes a T-pin engaging member 316 with a through- bore 318 extending therethrough.
- the through-bore 318 is sized and shaped to reversibly slidingly receive a T-pin 101 therethrough.
- the T-pin engaging member 316 is a substantially cylindrical tube-like member. However, it is foreseen that the T-pin engaging member 316 may have any other useful shape known in the art.
- structure 314 is attached to a ladder 100 or 100' by aligning the T-pin engaging member through-bore 318 with,a pair of ladder through-bores 270, such as through-bores 275 and 280, such that the through-bore 318 is located between the through- bores 275 and 280 and the three through-bores 275, 280 and 318 are substantially coaxial. Then, a T-pin 101 is inserted into and through the three through-bores 275, 280 and 318 so as to be engaged thereby. With respect to the foot-end 304 of the frame 296, when the T-pin 101 and through-bores 275, 280 and 318 are engaged, they are also coaxial with the third pitch axis P3.
- the T-pin engaging members 316 are sized, shaped and configured to pivot or rotate about an engaged T-pin 101, so as to rotate, pivot, angulate or articulate about the associated pitch axis P2 or P3.
- the head-end T-pin is sized, shaped and configured to pivot or rotate about an engaged T-pin 101, so as to rotate, pivot, angulate or articulate about the associated pitch axis P2 or P3.
- the foot-end T-pin engaging member 316 pivots counter-clockwise about the engaged T-pin 101, as indicated by the arrow 292.
- the foot-end T-pin engaging member 316 pivots counter clockwise about another T-pin 101, as indicated by the arrow 294.
- the head-end T-pin engaging member 316 pivots clockwise about the engaged T-pin 100, as indicated by the arrow 292.
- the foot -end T-pin engaging member 316 pivots
- T-pin 101 An exemplary T-pin 101 is shown in FIGS. 11 and 11a. It is noted that T-pins 101 are used to connect both of the head- and foot-ends 302, 304 of both the. prone and supine patient support structures 15, 15' to the vertical translation subassemblies 20 using the ladders 100 and optionally the ladders 100', but such T-pins 101 are not shown in many of the attached figures.
- Each T-pin 101 includes a shaft 102, a T- shaped handle 103 and a locking member 104. As shown in FIG. 11a, the locking member is positionable in a locking position, shown in phantom, and a non- locking position.
- the locking member 104 may be positively held in the locking or nonlocking positions by a mechanism (not shown) such as a detent mechanism. It is foreseen that the patient support structures 15, 15' may include alternatively configured attachment structures 314 and T-pins 101. Additional information about T-pins can be found in co-pending U.S. Patent Application No. 13/507,618, filed June 18, 2012.
- the patient support structure 15° can be moved to numerous positions wherein said structure is or is not parallel with the floor F. Since the illustrated base 10 is fixed in position by the cross-bar 25, such that the vertical translation subassemblies 20 cannot move relative to one another, a change in the height of one or both of the vertical translation subassemblies 20 changes the distance between the rotation subassemblies 50, such as the rotation blocks 57, the yaw pins 79, and the like. Accordingly, when this distance increases or decreases, the length of the patient support structure 15° must change a similar or
- the patient support structure 15° changes its length and therefore includes a translation compensation subassembly 320 (FIG. 3) , described below.
- each translation compensation subassembly 320 includes a translation rod 322 that joins the foot-end 290 of the associated frame portion 306 or 308 with the foot-end frame member 312.
- the translation rods 322 are adapted to telescope outwardly and inwardly from the
- the translation compensation subassembly 320 also includes a translation driver 324 located within the frame portions 306 or 308 that actuates the telescoping of the translation rod 322.
- the frame 296 of the present invention may be adapted to be used with a variety of translation compensation subassemblies, such as but not limited to those described in U.S. Patent No. 7,565,708, U.S. Patent No. 8,060,960, or U.S. Patent Application No. 60/798,288, U.S. Patent Application No.12/803 , 173 , U.S. Patent Application No .12/803 , 192 , or U.S. Patent Application No. 13/317,012, instead of the illustrated translation compensation subassembly 320.
- the in- frame compensation subassembly 320 of the present invention provides the advantage of a low profile.
- the translation compensation subassembly 320 of the present invention is actively driven and infinitely adjustable between a maximally outwardly telescoped configuration and a closed configuration. Passive translation compensation mechanisms are also foreseen. Translation compensation mechanisms that are not in-line with the frame 296 are also foreseen. It is noted that the supine patient support structure 15' may include a similar translation compensation subassembly 320.
- the prone patient support structure 15 includes a pair of spaced opposed angularly turning or gliding joints, generally 326, that provide a pivot-shift mechanism for moving the pelvic pads 286.
- the joints 326 are generally centrally located along a length of the frame 296 and cooperate with the frame 296 of the prone patient support structure 15.
- the joints 326 are located along the length of the frame 296 so as to be associated with the first pitch axis PI .
- the joints 326 are spaced apart and opposed to one another, so as to allow a portion of a
- each joint 326 includes a point 248 that is intersected by the first pitch axis PI and an arc of motion, denoted by AOM, that is spaced a distance, or radius r, from the virtual pivot axis 248. Since the points 248 may be spaced from the associated joint 326 (described below) , they may be referred to as a virtual pivot points 248 or as a virtual pivot axis 248.
- the virtual pivot axis defined by points 248 may be synonymous with the first pitch axis PI.
- the radius r of the arc of motion AOM extends from the virtual pivot axis 248 to the arc of motion AOM in a plane that is substantially perpendicular to the first pitch axis PI.
- the radius r defines at least a portion of the arc of motion AOM.
- Each joint 326 includes a first joint component 328, a second joint component 330, and a third joint component 332.
- the first and third joint components 328, 332 each include a plurality of teeth that are adapted such that the rack teeth 328 of the first joint component 328 cooperatively engage the teeth 332 of the third joint component 332.
- the third joint component 322 is
- first and second joint components 328 and 330 each include a guide track component with a weight-bearing gliding surface, 328a and 330a (FIG. 75) respectively, wherein the guide track components cooperatively slidingly mate to enable the first joint component 328 to glide or slide, and therefore rotate, with respect to the second joint component 330 and also about the respective virtual pivot axis 248.
- Alternative joint configurations and components are foreseen so long as the function of moving the joint 326 with respect to the virtual pivot axis 248 in maintained.
- the joints 326 are movable along the arc of motion AOM. Since each hip-thigh pad 286 (FIG. 3) is attached to the first joint components 328, movement of the first joint component 328 associated with a hip-thigh pad 286, with respect to the virtual pivot axis 248 and the arc of motion AOM glidingly or slidingly moves, pivots or rotates the hip- thigh pad 286 about the virtual pivot axis 248 and also a portion of the hip-thigh pad 286 along the arc of motion AOM, such as is described in greater detail below.
- a joint 326 can be configured such that the virtual pivot axis 248 is located higher or lower, or more to the left-hand or the right-hand side of the page, than depicted, such as but not limited to exemplary alternative virtual pivot axes 248a, 248b and 248c.
- the arc of motion AOM include
- components of the joint 326 are sized, shaped and configured to move the attached hip- thigh pad 286 so as to follow an alternative arc of motion AOM, such as by including at least one of an alternatively located virtual pivot axes 248 or an alternative length radius r.
- the prone patient support structure 15 may include joints 326 adapted for use with a pediatric patient, a very tall patient, or a patient with certain spinal anomalies.
- the patient positioning support system 5 is provided with at least two prone patient support structures 15, wherein a first of the prone patient support structures 15 includes "standard" joints 326 that are useable with most patients, and a second of the prone patient support structures 15 includes non-standard or alternatively configures joints 326 for use with pediatric patients, very tall patients, patients with certain spinal anomalies, and the like.
- the prone patient support structure 15 includes modular joints 326 that are interchangeable or adjustable to provide the ability to use a single prone patient support structure 15 with adult and pediatric patients, short, medium and tall patients, and the like.
- the joints 326 are movable between a first position and a second position with respect to the virtual pivot axis 248, the arc of motion AOM and the floor F.
- the first and second positions are selected by an operator, so as to move the patient's hips between flexed positions, extended
- the first and second joint components 328 and 330 are located and oriented so as to position a patient's hips in a neutral position.
- the first and second joint components 328 and 330 are located and oriented so as to position a patient's hips in an extended position.
- the first and second joint components 328 and 330 are located and oriented so as to position a patient's hips in a flexed position.
- first joint component 328 may be moved with respect to the second joint component 330, so as to be moved from the orientation or configuration shown in FIG. 70 to the orientation shown in FIG. 71, wherein such movement or motion is indicated by arrow 334.
- first joint component 328 may be moved with respect to the second joint component 330, so as to be moved from the orientation shown in FIG. 70 to the orientation shown in FIG. 72, wherein such movement or motion is indicated by arrow 336.
- the first joint component 328 includes maximum positions, with respect to the second joint component 330 wherein the patient's hips are maximally flexed and maximally extended.
- the maximum positions are selected so as to cooperate with the patient's biomechanics, such that the patient's spine and additionally or alternatively hips can be flexed and extended a maximum amount.
- These maximum amounts of flexion and selections are selected so as not to injure the patient, but also to provide a desirable amount of lordosis for a given spinal surgery, such as is known in the art.
- the virtual pivot axis 248 is located within a patient supported on the prone patient support structure 15.
- the joints 326 may be sized, shaped and configured to align the virtual pivot axis 248 within the patient, such as near the lumbar spine or on or near the pelvis.
- the first pitch axis PI passes through the patient.
- the virtual pivot axis 248 is located adjacent to the spine of a patient supported on the patient positioning support system 5.
- the virtual pivot axis 248 is located at a contact point between a patient supported on the prone patient support structure 15 and a hip-thigh pad 286.
- the virtual pivot axis 248 may be located where the patient's skin contacts the surface of the hip-thigh pad 286. Since the hip-thigh pads 286 are moldable or
- the weight of the patient can cause the hip- thigh pads to be compressed, thereby effectively moving the virtual pivot axis 248 above the hip-thigh pads 286 and into the patient's body, in some embodiments.
- a virtual pivot axis 248 located at a contact point between the patient's skin and a surface of the hip-thigh pad 286 is associated with a first pitch axis PI that passes through the patient's body.
- the hip-thigh pads 286 are joined with the associated joints 326.
- the hip-thigh pads 286 are
- pad attachment surfaces 340 of the pad mounts 338, face generally toward, or are oriented toward, the roll axis R, also referred to as being oriented in an inwardly or central direction.
- the pad attachment surfaces 340 are attached to the undersides 342 of the pads 286.
- the hip pad undersides 342 are contoured so as to not obstruct movement of the joints 326 or to undesirably contact the frame 296, which could disrupt operation of the joints 326.
- the virtual pivot axis 248 is positioned at a height or distance, denoted by Dl, above the floor F, such as is shown in FIGS. 4, 24, 32, 40, 56, 65-67, 69.
- the height Dl is substantially constant during, or throughout, movement of the joint 326 with respect to the virtual pivot axis 248.
- the patient positioning support structure 5 is positioned such that the joints 326 are in a neutral position (FIG 4) , such that a patient's hips and spine are neither flexed or extended, and the virtual pivot axis 248 is spaced a distance Dl above the floor F.
- the operator adjusts the patient positioning support system 5 such that the virtual pivot axis 248 is located at a selected height Dl above the floor F, such as but not limited to 48-inches (122 cm) , for example.
- the selected height Dl is a convenient and additionally or
- Dl can be other heights, such as but not limited to a height Dl between minimum and maximum distances above the floor F, wherein the minimum and maximum distances provide a range of selectable infinitely adjustable heights Dl.
- the height Dl is associated with the locations of the upper portions 35 of the vertical translation subassembly 20. Accordingly, the minimum and maximum heights Dl are associated with the vertical translation subassemblies 20 being closed and maximally outwardly telescoped, respectively.
- the height Dl of the virtual pivot axis 248 remains unchanged, or stays 48-inches (122 cm) from the floor F.
- the joints 326 are actuated and moved from the neutral position of FIG. 4 to the position shown in FIG. 56, wherein the hips and knees of the patient would be extended, the height Dl of the virtual pivot axis 248 still remains substantially unchanged, or 48- inches (122 cm) from the floor F.
- the patient positioning support structure 5 is also configured such that the patient's hips and knees can be kept in the neutral position described above, and also the
- patient's body can be positioned in either a Trendeleburg position, such as is shown in FIG. 32, or a reverse
- Trendelenburg position such as is shown in FIG. 24.
- FIG. 65 depicts the prone patient support structure 15 including joints 326 positioned so as to maximally extend the patient's hips and knees, and the virtual pivot axis 248 is located a distance Dl above the floor F.
- FIG. 66 depicts the prone patient support structure 15
- joints 326 positioned so as to maintain the
- FIG. 67 depicts the prone patient support structure 15 including joints 326 positioned so as to
- the joints 326 are actuated, they are movable between a plurality of selectable positions, the plurality of
- selectable positions being between and including the positions shown in FIGS. 70-72 and FIGS. 65-67, without substantially changing the heights Dl of the virtual pivot axis 248 of the joints 326.
- the height Dl of the virtual pivot axis 248 is adjustable.
- the height Dl can be adjusted by actuating one or both of the vertical translation
- each the hip-thigh pad 286 glides along the associated arc of motion AOM, such as, for example, when the associated joint moves to and between the positions shown in FIGS. 70-72 and FIGS. 65-67.
- the prone patient support structure 15 includes a lower extremity support structure 344.
- the lower extremity support structure 344 is adapted to support the legs of the patient on the prone patient support structure 15.
- the lower extremity support structure 344 is also adapted to move the patient's legs between the neutral, flexed and extended positions, and to support the legs when the legs are in those positions. For example, in FIG. 39, the lower extremity support structure 344 is rotated downwardly by the joints 326, such that the hips would be flexed. In another example, in FIG. 55, the lower extremity support structure 344 is rotated upwardly by the joints 326, such that the hips would be extended .
- the lower extremity support structure 344 includes an upper leg support portion or femoral support 346 (FIG. 3) , and a lower leg support portion or lower leg cradle 348 that are joined or pivotably connected by a pair of knee hinges 350, so as to be movable between a first position and a second position; and wherein when in the first position, the femoral support 346 and the lower leg cradle 348 are in a neutral position; and when in the second position, the femoral support 346 and the lower leg cradle 348 are in a flexed position.
- the lower leg cradle 348 is continuously adjustable with respect to the femoral support 346 and between the neutral position and a maximally flexed position. In other embodiments, the lower leg cradle 348 is continuously adjustable with respect to the femoral support 346 and between the neutral position and a maximally flexed position.
- the lower leg cradle 348 is incrementally adjustable with respect to the femoral support 346. In other embodiments, the lower leg cradle 348 is continuously adjustable with respect to the femoral support 346.
- the knee hinges 350 are spaced from and opposed to one another, and also enable flexion and extension of the patient's knees between the first and second positions.
- the knee hinges 350 may be active, or powered, or the knee hinges 350 may be passive, or un-powered, such as but not limited to spring hinges.
- the upper leg support portion 346 includes a pair of spaced opposed rails 352 with a thigh support sling 354 suspended therebetween.
- the thigh support sling 354 is adjustable, such that the height of the thighs is adjustable.
- the thigh support sling 354 is removable, such as for cleaning, replacement and
- the thigh support sling 354 like other components of the patient positioning support structure, such as but not limited to the frame 396, the hip-thigh pads 286, and the joints 326 may be covered with a disposable, or washable, covering or drape provided as part of a draping kit (not shown) , such as is known in the surgical arts.
- the draping kit may also include one or more pillow structures, for filling the thigh support sling 354, so as to support the thighs in a more preferred orientation.
- the spaced opposed rails 352 are fixedly joined with the joint first components 328, such as is shown in FIGS. 65- 67. And accordingly, in addition to glidingly moving the hip- thigh pads 286 with respect to the arc of motion AOM, the joints 326 also move, pivot or rotate the rails 352, and therefore the lower extremity support structure 344 ⁇ , about the first pitch axis PI. Accordingly, as the joints 326 move, or are selectively moved, from a neutral position, such as is shown in FIG. 66, to the maximally extended position, and such as is shown in FIG. 65, the patient's hips become
- the operator can adjust the amount of hip extension, by selecting an extended position of the joints 326. Further, as the joints 326 move, or are selectively moved, from the neutral position, shown in FIG. 66, to the maximally flexed position, such as is shown in FIG. 67, the patient's hips become progressively more flexed, until the maximum flexed position is reached. It is noted that, due to the provision of knee hinges 350, the knees may also be flexed and extended together with the flexion and extension of the hips. However, it is foreseen that the lower extremity support structure 344 may be configured without knee hinges 350, such that the knees do not flex or extend.
- the lower leg support portion 348 is a frame adapted for supporting the lower legs of the patient.
- the lower leg support portion 348 may include one or more cross-pieces 356 adapted for holding pillows or pads (not shown) or for attachment of the patient's lower legs thereto.
- the lower leg support portion 348 may include one or more guide members 358 adapted to guide movement of the lower leg support portion 348 and additionally or alternatively actuation of passive knee hinges 350.
- guide members 358 contact and slide along a guide track 360 of the foot-end portions of the frame 296, or the foot ends 304 of the left-hand and right- hand frame portions 306, 308, such as is shown in FIGS. 44-54. It is foreseen that in some embodiments the frame 296 may not include guide tracks 360.
- the knee hinges 350 may be actively driven, or powered, such that the knee hinges 350 operate without the need to guide tracks 360 or guide members 358.
- the lower extremity support structure 344 is joined with the joints 326 such that the lower extremity support structure 344 is movable with respect to the virtual pivot axis 248 and between the first and second positions, such as described above.
- the patient positioning support structure 5 of the present invention includes a torso support structure 362 that is received on and attachable to a head-end portion 302 of the frame 296 of the prone patient support structure 15, so as to support the head and torso of a patient thereon.
- the torso support structure 362 includes a support body or frame 364 with a substantially transparent or radio- transparent face shield 366, a chest pad 368 attached to the support body 364 and a plurality of lockable brackets 370 that are adapted for releasable connection to the frame 296.
- a pair of adjustable arm support boards 372, such as are known in the art, is attachable either to the support body 364 or optionally to the frame 296 of the patient support structure 15.
- a ring-shaped pillow or similar structure may be placed on the face shield 366 so as to support the
- the chest pad 368 is somewhat compressible and substantially radiolucent .
- the chest pad 368 includes two or more chest pads 368.
- the chest pad 368 may be covered with a cover or drape (not shown) , such as is described elsewhere herein.
- the position of the chest pad 368 is slidably adjustable along a length of the head-end portion 302 of the frame 296.
- the torso support structure 362 can be slid or. moved along the frame head-end portions 302, or along a length thereof, so as to position the chest pad 368 in a suitable location with respect to the patient's body and biomechanics. Once the chest pad 368 is in a suitable position along the frame 296, the torso support structure 362 can be locked into place on the frame 296, such as by actuating reversibly lockable brackets 370.
- positioning support system 5 is being assembled for a sandwich-and-roll procedure, the patient is face up on the supine support structure 15' , described below, and the prone patient support structure 15 is positioned over or on top of the patient, such that the patient is sandwiched between the two structures 15 and 15'. Then, the torso support structure 362 is placed onto the frame 296, such that the chest pad 368 is located between the sides of the frame 296, or between the left-hand and right-hand frame portions 306, 308, and against the patient's chest. The location of the chest pad 368 is adjusted by sliding it along the length of the frame 296 upper portion 302.
- the brackets 370 are locked or otherwise engaged so as to fix the position of the torso support structure 362 with respect to the frame 296.
- the patient's arms are positioned and removably attached or strapped onto adjustable arm boards 372 of the torso support structure 362, and then the sandwiched patient can be rolled over about the roll axis R.
- the hip-thigh pads 286 are associated with a lower-body side of the joints 326 and the chest pad 368 is associated with an upper-body side of the joints 326. Accordingly, the hip-thigh pads 286 are opposed to and spaced a distance from the chest pad 368.
- each hip- thigh pad 286, or of each joint 326 is spaced a distance D2 from the chest pad 368.
- the distance D2 between the pivot axis 248 and the chest pad 368 is substantially- constant.
- the hip pads 286 may translate
- the hip pads 286 move back to the starting position, such as by longitudinally translating a distance D3 toward the foot-end of the system 5 such as toward the foot end 16' of the base 10 or toward the foot end 19 of the prone patient support structure 15.
- the distance D2 between the chest pad 368 and the hip-thigh pads 286 is substantially constant during movement of the joints 326 between a first position and a second position, or toward and away from the head-end 16 of the base 10 when moving between neutral and angulated positions. In other embodiments, the distance D2 between the chest pad 368 and the hip-thigh pads 286 is slightly variable during movement of the joints 326.
- the present invention includes a supine patient support structure 15' that is suspended above the floor F, such as is illustrated in FIGS. 102-116.
- the patient positioning support structure 5 of the present invention includes a base 10 that supports or suspends the supine patient support structure 15' above the floor F.
- the supine patient support structure 15' is removably
- the supine patient support structure 15' includes an open frame 374 that is articulatable or breakable at a pair of spaced opposed hinges 376, and at least one of a set of body support pads (not shown) , such as is known in the art, and a closed table-top 378 (FIG. 102) .
- the supine patient support structure 15' also includes head- and foot-ends 288', 290', and left-hand and right-hand sides 298', 300'.
- the closed table-top 378 includes a head portion 380 and a foot portion 382, and may be covered by one or more flat pads 384.
- the body support pads, the elongate table pad 384 and the table-top 378 are
- the supine patient support structure 15' includes head-end and foot-end ladder connection subassemblies 190'.
- the ladder connection subassemblies 190' are configured and arranged so as to be substantially the same in structure and function as the ladder connection
- other ladder connection subassemblies 190' are used.
- the ladder subassemblies 190' are attached to the rotation blocks 57 by either a pair of standard length ladders 100 (FIG. 10) or a pair of extended length ladders 100' (FIG. 101) using a pair of T-pins 101 (FIG. 11) , such as is described with respect to the ladder connection
- T-pins 101 are coaxial with second and third pitch axes P2 and P3 of the supine patient support structure 15' , similar to that described above with respect to the prone patient support structure 15, whereby the supine patient support structure 15' can rotate or pivot about the second and third pitch axes P2 and P3.
- each hinge 376 of the supine patient support structure 15' pivot about a first pivot axis PI. As shown in FIGS. 116-120, each hinge 376 includes pivotably connected first and second hinge members 388 and 390,
- a shroud or housing 394 covers and protects the worm drive 392.
- the worm drive 392 is also partially covered by a frame portion 396 that joins the second hinge member 390 with the frame 374 of the supine patient support structure 15 1 .
- the frame 374 includes one or more of the first and second hinge members 388, 390, and the frame portion 396.
- the hinges 376 may be entirely separate from but connected to the frame 374.
- the worm drive 392 is a gear arrangement in which a worm 398, which is a gear in the form of a screw or helical thread, meshes with a worm gear 400.
- a worm 398 which is a gear in the form of a screw or helical thread
- a worm drive 392 can reduce rotational speed or allow higher torque to be transmitted. Additionally, a worm gear drive is a one-way mechanism in that the work 398 can turn the worm gear 400, but usually not vice versa. In the illustrated embodiments, the worm drive 392 is actuated by a motor 402 and the amount of pivot about the first pitch axis PI is selectable by controlling the amount of rotation of the work 398.
- the supine patient support structure 15' is reversibly positionable in a lateral - decubitus position, such as is shown in FIGS. 112-113.
- a lateral -decubitus position the patient may be positioned on their side, such that the patient is bent at the waist, with the head and feet lower than the hips.
- a lateral -decubitus position is essential for certain spinal surgeries, such as is known in the art.
- the supine patient support structure 15' is typically joined with the base 10 using the extended- length ladders 100' .
- the extended- length ladders 100' are useful for positioning the patient in a lateral -decubitus position while spacing the surgical site, and therefore spacing the first pitch axis Pi and the hinges 376, a suitable distance D4 from the floor F, such that the surgeon can perform the surgery comfortably.
- the patient positioning support system 5 includes a supine patient support structure 15', such as is shown in FIGS. 102-108, that is used for positioning a patient (not shown) in a supine or lateral position, such as is described elsewhere herein.
- a first pitch axis PI is associated with the pair of spaced opposed hinges 376.
- the supine patient support structure ' 15' also includes second and third pitch axes P2 and P3 that are associated with its head and foot-ends, which are generally denoted by the numerals 18' and 19' (FIG. 104) respectively.
- the left and right-hand sides of the supine patient support structure 15' are designated 298' and 300' , and are also associated with the left and right sides, respectively of the patient in a supine position.
- the two left- hand sides 298 and 298' of the prone and supine patient support structures 15 and 15' are spaced from each other, on the front and back sides of the patient, such as is shown in FIGS. 92a through 98.
- the two right-hand sides 300 and 300' of the prone and supine patient support structures 15 and 15' are also spaced from each other, on the front and back sides of the patient .
- the vertical translation subassemblies 20 can be raised or upwardly- telescoped, such as to raise the ends 18', 19' of the supine patient support structure 15' . While moving to the position shown in FIG. 114, the height of the surgical site D4 is maintainable by pivoting the hinges 376 downwardly.
- the supine patient support structure 15' includes an in-frame translation compensation subassembly 320' that is substantially similar to the translation compensation
- a translation rod 322' which is most easily seen in FIG. 112, that is actively extended and retracted, or
- the supine patient support structure 15' includes a translation compensation subassembly 320' that is located outside of the frame 374. It is foreseen that in some embodiments, the supine patient support structure 15' includes a translation compensation subassembly 320' similar to but not limited to translation compensation
- the supine patient support structure 15' is spaced from and opposed to the frame 296 of the prone patient support structure 15.
- both the prone and supine patient support structures 15 and 15' are attached to the base 10.
- a space S (FIG. 100) between the prone and supine patient support structures 15 and 15' is adjustable.
- the space S can be modified by moving one of the patient support structures 15 or 15' away from, or toward, the opposed patient support structure.
- a first T-pin 101 FIG. 11
- the invention includes a base 10 with a pair of spaced opposed vertical translation subassemblies 20 that are optionally joined by a cross-bar 25.
- the patient positioning support structure 5 is adapted such that the vertical translation subassemblies 20 are not substantially laterally movable with respect to one another during operation of the patient
- the patient positioning support structure 5 also includes a prone patient support structure 15 removably attached to the base 10 by connection subassemblies 75 located at the head- and foot-ends 18, 19 of the prone patient support structure 15.
- positioning support structure 15 includes a pair of spaced opposed gliding or sliding joints 326.
- the joints 326 each include a virtual pivot axis 248, and arc of motion AOM (FIG. 72) attached thereto and a radius r.
- the joints 326 are attached to hip-thigh pads 286 and are sized, shaped,
- the hips of a patient on the prone patient support structure 15 can be flexed and extended about the virtual pivot axis 248, thereby enabling flexion and translation of the hips
- the virtual pivot axis 248 is associated with a selectable location or height for the surgical site, wherein the height of virtual pivot axis 248 is spaced a first
- the patient positioning support structure 5 is adapted to substantially maintain the first distance Dl.
- the positioning support system 5 includes a roll axis R, about which the prone patient support structure 15 can be tilted or rotated. When the supine patient support structure 15' is attached to the base 10, the supine patient support structure 15' can also be tilted or rotated about the roll axis R.
- the patient positioning support system 5 includes a pair of vertical translation axes VI and V2 (FIG. 2) , wherein each of the vertical translation axes VI and V2 is associated with one of the vertical translation subassemblies 20. Additionally, the patient positioning support system 5 includes a pair of yaw axes Yl and Y2 associated with the connection subassemblies 75.
- the yaw axes Yl and Y2 allow for generally small amounts of rotation of the patient support structure 15 or 15' thereabout when the patient support structure 15 or 15' is placed in a Trendelenburg or reverse Trendelenburg position and also tilted about the roll axis R.
- the prone patient support structure 15 includes the releasably attachable and lockable torso support structure 362 with a chest pad 368.
- the location of the chest pad 368 is slidably adjustable along a length of the prone patient support structure 15, as indicated by the straight double-headed arrow (FIG. 4) above the torso support 362 that is generally parallel with the roll axis R.
- the patient positioning support system 5 is configured and arranged to move and place the patient support structure 15 or 15' in a reverse
- Trendelenburg position such as but not limited to by
- Dl in FIG. 24 is substantially equal to Dl in FIG. 4.
- the roll axis R is substantially parallel with the floor F.
- the roll axis R sloped upwardly from the floor F from the foot-end 19 to the head-end 18, moving from left to right across the page. It is noted that when the patient support structure 15 is moved from the position of Fig. 4 to the position shown in FIG.
- the distance between the virtual pivot axis 248 and a point of the chest pad 368 does not change substantially. Also, in the configuration of FIG. 24, the patient support structure 15 had not substantially pivoted about either of the yaw axes Yl or Y2. In the position shown in FIG. 24, the patient support structure 15 does pivot about the second and third pivot axes P2 and P3 , which is most easily seen in FIGS. 24, 29 and 30, and is indicated by arrows 292 and 294.
- FIGS. 31-38 show the patient positioning support structure in a Trendelenburg position. This positioning is achieved by telescoping the vertical translation subassemblies 20 in opposite directions from those associated with placing the patient positioning support structure in a reverse
- Dl of FIG. 32 is substantially equal to Dl of FIGS. 4 and 24.
- Figs. 39-47 illustrate the configuration of the patient positioning support structure 5 with the patient support structure 15 in a neutral position and the joints 326 rotated such that the lower extremity support structure 344, or lower body support structure, is adjusted so as to flex the hips and knees of a patient thereon.
- Dl of FIG. 40 is substantially equal to Dl of FIGS. 4, 24 and 32.
- FIGS. 48-54 illustrate the patient positioning support structure 5 with the patient support structure 15 in a neutral position and the joints 326 rotated such that the lower body support structure 344 is adjusted so as to flex the hips and knees of a patient thereon and also such that the patient support structure 15 is rolled or tilted about, or approximately, 25° about, or around, the roll axis R. Such tilting can proved improved access to the surgical site.
- the patient support structure 15 can also be tilted when the legs are extended, such as is described elsewhere herein.
- Figs. 55-65 illustrate the patient positioning support structure 5 in a reverse Trendelenburg position and with the joints 326 rotated such that the lower body support structure 344 is adjusted so as to extend the hips and knees of a patient thereon.
- the distance Dl of FIGS. 56 is substantially equal to the distance Dl of FIGS. 4, 24, 32 and 40.
- the head-end vertical translator 20 is telescoped upwardly, so as to raise the head-end 18 of the patient support structure 15, and the foot-end vertical translator 20 is telescoped downwardly, so as to lower the foot-end 19 of the prone patient support structure 15.
- the present invention also provides a method of positioning a patient on a patient positioning support system 5 in a prone position, various steps of which are shown in FIGS. 134-169.
- the method includes a first step of placing a patient on a supine patient support 15' suspended above a floor F by a base structure 10 (FIG. 2) , such that the patient is in a substantially supine position.
- a second step such as is shown in FIGS 134-139 and 160- 169, the patient is sandwiched between the supine patient support 15' and a prone patient support 15 suspended above the supine patient support 15' .
- the patient and patient support structures 15 ' and 15 are rolled an amount of about 180 -degrees with respect to a longitudinally extending roll axis R, such that the patient is in a substantially prone position, such as to but not limited to as is shown in the sequence of FIGS. 134 through 136.
- the supine patient support 15' is removable.
- the rotation motor 55 or actuation system of the patient positioning support system 5 is disconnected or temporarily inactivated, such as but not limited to by dis-engaging a clutch, such as is known in the art, and such that a group of personnel can manually roll the interconnect patient support structures 15 1 and 15 with the patient therein about the R axis (FIG. 2) .
- the clutch is reengaged, such that the patient support structure 15 can be further positioned for the surgical procedure that is to be performed.
- the steps of the method are performed in reverse as was described above. Accordingly, the patient is again sandwiched between the prone and supine patient support structures 15 and 15', and rolled back over to a supine position on the supine patient support structure 15' .
- the patient can be transferred to a gurney or other mobile support structure, or repositioned on the supine patient support structure 15', such as for a lateral-decubitus surgical procedure.
- the step of sandwiching the patient between the supine patient support 15' and the prone patient support 15 includes attaching the prone patient support 15 to a pair of spaced opposed connection
- subassemblies 75 such as by ladders 100 attached to rotation subassemblies 50 associated with the base head-end 16 and foot-end 16' of the support base 10 (FIG. 13).
- FIGS. 170-178 illustrate another embodiment 900 of a breaking supine lateral patient support 15'.
- the patient support 900 includes head-end and foot-end portions 905 and 910 for supporting and positioning a patient in a supine position, such as described herein.
- the head-end portion 905 includes a frame portion 915 and a solid planar top structure, member or portion 920, or table top, non- removably attached thereto, as well as left and right side accessory attachment members 925.
- the foot-end portion 910 also includes a frame portion 930 and a solid planar top structure, member or portion 935, or table top, non-removably attached thereto, as well as left and right side accessory attachment members 940.
- the head end portion 905 is joined with the foot-end portion 910 by a pair of spaced apart opposed hinges, generally 376, such as are described herein. .
- the patient support 900 includes an attachment structure 314 for attachment to a ladder 100 or 100', such as is described elsewhere herein.
- the foot-end frame portion 930 includes an in-line or in- frame, longitudinal translation compensation subassembly, generally 955, that is substantially similar to the translation compensation subassembly 320 described elsewhere herein.
- the patient support 900 is adapted to support the patient both supine or lateral positions.
- the patient support 900 includes the pair of space opposed hinges 376, such as is described elsewhere herein.
- the patient support 900 operates, angulates, breaks or articulates from 0° to about 40° hinge apex in an upward direction.
- the patient support 900 operates so as to support the patient when the hinges operate,
- the patient support 900 includes
- the illustrated patient support 900 is adapted to function with a patient weight of up to 600-pounds. Additionally, the patient support 900 provides for translation compensation during hinge apex up and down positioning, such as by an in- frame translation compensation subassembly 320, such as is described elsewhere herein. Further, the patient support 900 includes attachment structure 314 for attachment to the base structure 10, such as is described above or as described herein.
- FIGS. 179-187 illustrate a non-breaking or fixed frame patient support 1000, for supporting a patient in a non- angulated supine, prone or lateral positions.
- the patient support 1000 includes head-end and foot-end support portions 1005 and 1010.
- the patient support 1000 also includes a support frame or frame portion 1015 and a removably attached solid planar top structure, member or portion 1019, or table top. Reversibly engageable clamps 1020 removably or
- the frame portion 1015 includes a pair of spaced spars
- each of the spars 1021 includes a transition portion 1026 that is contoured so as to curve, bend or bow outwardly when moving along a length of each of the spars 1021, such as along a central portion thereof, when moving along the spar 1021 in a direction from the head end toward the foot end thereof, as indicated by the directional arrow 1027. It is noted that the frame portion 1015 is nonbreaking as it includes no hinges.
- Each of the left-hand and right-hand sides of the frame portion 1015, of the head-end support portion 1005, includes at least one accessory attachment member 1030, for attachment of accessories for supporting limbs of the patient, such as is known in the art.
- the patient support 1000 includes an attachment structure 1053 for removable or reversible attachment to a ladder 100 or 100', such as is described elsewhere herein. It is foreseen that the ladders 100 or 100' may be integral, and therefore nonremovable, with the attachment structures 1053 at one or both of the outboard ends 1050. Alternatively, the attachment structure 1053 may be configured substantially similarly to the attachment structure 314, 316 described above. It is foreseen that in other patient supports described herein, the ladder and the attachment structure may also be integral or non-detachable .
- the frame portion 1015 includes an in-line or in- frame, longitudinal translation compensation subassembly, generally 1055 (FIG. 180) , that is substantially similar to the translation
- the illustrated patient support 1000 is adapted to function or operate with a patient weight up to about 600- pounds .
- Removable flat tops 1019 are incorporated into the patient support 1000.
- the patient support 1000 is adapted to provide for supine patient positioning and for prone patient positioning.
- the patient support 1000 is adapted for
- the patient support 1000 is adapted for attachment of adjustable pelvic support structures, such as are known in the art.
- the patient support 1000 is adapted for attachment of adjustable leg supports, such as are known in the art.
- the flat tops 1019 include rails 1030 for Clark Socket attachments.
- the patient support 1000 includes attachment points for attachment to the base structure 10, such as at the outboard ends 1050.
- FIGS. 188-196 illustrate yet another embodiment 1100 of a breaking supine lateral patient support 15' .
- the patient support 1100 includes head-end and foot- end portions 1105 and 1110 for supporting and positioning a patient in a supine position, such as described herein.
- the head-end portion 1105 includes a frame portion 1115 and a solid planar top structure, member or portion 1120, or table top, removably attached thereto by reversibly actuatable clamps 1121 (FIG. 190) , as well as left and right side
- the foot-end portion 1110 also includes a frame portion 1130 and a solid planar top structure, member or portion 1135, or table top, removably attached thereto by additional reversibly actuatable clamps 1121, as well as left and right side accessory attachment members 1140.
- the top structures 1120 and 1135 rest or are attached on top of the respective frame portions 1115 and 1130, and are substantially wider than the respective frame portions 1115 and 1130, such that the hinges therebetween (described below) are at least partially covered by the frame portions 1115 and 1130. It is foreseen that the top structures 1120 and 1135 may be wider than is shown, so as to support larger than average patients.
- the head end portion 1105 is joined with the foot- end portion 1110 by a pair of spaced apart opposed hinges, generally 1145, such as are described herein.
- the patient support 1100 includes an attachment structure 314 for attachment to a ladder 100 or 100', such as is described elsewhere herein.
- the foot-end frame portion 1130 includes an in-line or in- frame, longitudinal translation compensation subassembly, generally 1155, that is substantially similar to the translation compensation subassembly 320 described elsewhere herein.
- FIGS. 197-205 illustrate another embodiment of a prone patient support 1200 that is substantially similar to the prone patient support 15 described above. Accordingly, this prone patient support 1200 is numbered the same way as the first prone patient support 15.
- the phone patient support 1200 includes modified joints 326, or hinges, and hip-thigh pads 286.
- the joints 326 include a motor subassembly 1205 that is positioned on an outer side 1210 of the frame 296. This contrasts with the motor subassemblies 333 of the first prone patient support 15, most easily seen in FIGS.
- each motor subassembly 333 is located on the inner side of the joints 326 or the frame 296, so as to be located under the respective hip-thigh pads 286.
- each hip-thigh pad 286 includes a small forward hip pad 286a (FIGS. 199, 202 and 203) .
- the forward hip pad 286a provides additional support to the patient's pelvis and protects the patient from the forward end of the joint subassembly.
- hip-thigh pads 286 and the forward hip pads 286a comprise a patient pelvis support assembly that is adapted to position or extend the patient's pelvis at an angle from between about 0° and about 25° under power.
- Patient chest or torso support 362 is manually- adjustable along a length of the frame 296, such as is
- the chest support 362 is manually lockable in place along a length of the frame head-end portion 302, so as to substantially prevent movement along an axis parallel to the patient's centerline, or with respect to the roll axis R (FIG. 2) .
- the prone patient support 15 or 1200 is constructed of resilient and strong materials such that a patient weighing up to 600 -pound can be safely supported, positioned for a surgical procedure and rolled between prone and supine positions, such as is described above. It is noted that the foot -end 304 of the frame 296 is wider than the head-end 302 of the frame 296, so as to accommodate the lower extremity support structure 344
- the prone patient support 1200 includes attachment subassemblies 314, 316 for attachment to the base structure 10, such as is describe above with respect to the prone patient support 15.
- the prone patient support 1200 provides for
- the patient's lower limbs are supported in a fixed position relative to the patient's pelvis, such as is
- the prone patient support 1200 provides support to shins and feet during both flexion and extension of patient's hips, such as is described above with respect to the first prone patient support 15. Further, the prone patient support 1200 allows the patient pelvis to rotate about a fixed, virtual axis during flexion and extension, such as pivot axis PI.
- FIGS. 206-239 illustrate another patient positioning and support system, generally 5, for supporting and
- the off-set base 1310 is sized, shaped, configured and adapted for suspending hone, one or both of a prone patient support structure 15 and a supine patient support structure 15' above the floor F at a convenient position and orientation for a medical procedure. It is noted that the off-set base 1310 is similar to the base 10.
- the off-set base 1310 includes head and foot-ends 16, 16', left and right-hand sides, and top and bottom sides, which for discussion purposes- are denoted relative to the sides of a patient's body when the patient is positioned in a prone position on the prone patient support structure 15.
- the base 1310 also includes a plurality of axes, including but not limited to a roll axis R, a pitch axis PE, and two vertical translation axes Vl 0 and V2 0 , which are most easily seen in FIGS. 206, 207, 212-219, 228 and 230, and are discussed in greater detail below.
- the patient support structures 15 and 15' each include head and foot ends 18, 18' and 19, 19', respectively, and first, second and third pitch axes which are denoted by PI, P2 and P3 respectively.
- FIG. 206 is a perspective view of an off-set base 1310 of the present invention, in an exemplary embodiment.
- the off -set base 1310 may also be referred to as a base structure or base subassembly.
- the base 1310 is adapted to support the patient support structure 15+. above the floor F.
- the base 1310 includes structure that is adapted to lift and lower, tilt, roll, rotate and, additionally or alternatively, angulate at least a portion of the patient support structure 15 ⁇ relative to the floor F, so as to position a patient's body in a desired position for a medical procedure, such as is described in greater detail below.
- the movements of the patient positioning support system 5, with respect to the head and foot-ends, left and right-hand sides, and top and bottom sides, as well as with respect to the axes can be one or more of synchronous or sequential, active or passive, powered or non-powered, mechanically linked or synchronized by software, and continuous, such as but not limited to within a range, or incremental, and such as is described in greater detail below.
- the base 1310 includes a pair of spaced opposed vertical translation subassemblies 20, also referred to as vertical elevator assemblies, telescoping piers, vertical translators, or the like.
- the vertical translation subassemblies 20 may be generally identical and face one another, though it is foreseen that the base 1310 may include only a single vertical translation subassembly 20 and that one or both vertical translation subassemblies 20 may have an alternative structure.
- one of the vertical translation subassemblies 20 may be constructed such as described in U.S. Patent No. 7,152,261, U.S. Patent No. 7,343,635, U.S. Patent No. 7,565,708, U.S.
- the cross-bar 25 is a substantially rigid support that joins and holds the vertical translation subassemblies 20 in fixed spaced opposed relation to one another.
- the cross-bar 25 may be non-adjustable .
- the cross-bar 25 is removable or telescoping, so that the vertical translation subassemblies 20 can be moved closer together, such as for storage.
- the cross-bar 25 is longitudinally adjustable so that the vertical translation subassemblies 20 can be moved closer together or farther apart, such as, for example, to support or hold different patient support structures 15 ⁇ of various lengths or
- patient positioning support system 5 may not include a cross-bar 25. Numerous cross-bar 25 variations are foreseen.
- the illustrated vertical translation subassemblies 20 are substantially longitudinally non-movable with respect to one another, either closer together or farther apart, once a patient support structure 15+ has been attached to or joined with the base 1310, and during use of the patient positioning support system 5.
- a vertical translation subassembly 20 of the present invention includes lower and upper portions, generally 30 and 35 respectively, a lower support structure 40, such as a base portion or a foot, and an off-set elevator subassembly 1341 extending therefrom.
- the off-set elevator subassembly 1341 extends upwardly from a first end 1342 of the lower support structure 40 and includes at least a primary elevator portion 1343 and optionally a secondary elevator portion 1344.
- the second end 1342' of the lower support structure 40 extends from the first end 1342 so as to be parallel with the floor F and
- the off -set elevator subassemblies 1341 are spaced and opposed to one another so as to be located on opposite sides of the roll axis R relative to one another, so as to substantially stabilize the patient positioning and support system 5.
- the primary elevator portion 1343 includes a primary vertical translation axis Vl 0 and riser assembly 45 with a mechanical drive system or mechanism (not shown) , such as is known in the art, that lifts and lowers the upper portion 35 along the primary vertical translation axis Vl 0 relative to the floor F. Movement of the primary elevator portion 1343 may be controlled by a computer (not shown) so as to be synchronized with movements of other portions or components of the patient positioning and support system 5.
- the secondary elevator portion 1344 includes a secondary vertical translation axis V2 0 and a mechanical drive system or mechanism (not shown) , such as is known in the art that lifts and lowers an attached rotation subassembly 50, described below, along the secondary vertical translation axis V2 0 relative to the floor F. Movement of the secondary elevator portion 1344 may be controlled by a computer (not shown) so as to be synchronized with movements of other portions or components of the patient positioning and support system 5.
- the rotation subassembly 50 of the base 1310 enables tilting of the patient support structure 15 t about the pitch axis PE, such as is described below. Movement about each of the axes R and PE is associated with a rotation motor.
- the rotation subassembly 50 includes first and second mechanical rotation motors 55 (FIG. 206) and 55' (FIGS. 215, 216) joined with first and second rotation shafts 56 and 56' (FIGS. 215, 216), respectively.
- a first rotation motor subassembly includes the first motor and shaft 55, 56, which are associated with the roll axis R and provide for tilting and rolling of an attached patient support structure 15 ⁇ about the roll axis R. It is noted that the first shaft 56 is coaxial with the roll axis R.
- a second rotation motor subassembly includes the second motor and shaft 55', 56' (FIG. 218), which are associated with the pitch axis PE and provide for angulating or articulating an attached patient support structure 15 ⁇ about the pitch axis PE.
- the second shaft 56' is coaxial with the pitch axis PE, perpendicular to the roll axis R and substantially parallel with the floor F.
- the second shaft 56' is operably joins the first shaft 56 with the secondary elevator portion 1344, so as to rotate the first shaft 56 about the pitch axis PE, thereby moving the first shaft 56, and the associated roll axis R, to an orientation that is non-parallel with, or angulated with respect to, the floor F.
- the roll axis R to can be moved from a first position or orientation that is substantially parallel with the floor F, such as is shown in FIG. 220, to a second portion or orientation that is not substantially parallel with the floor F, such as is shown in FIGS. 228 and 230, such as when the patient support structure 15 t is placed in a
- Trendelenburg or a reverse Trendelenburg position.
- the motors 55, 55' may be any motor known in the art that is appropriate to rotate the patient support structure 15 t with respect to the roll axis R and pitch axes PE, and optionally to lock the patient support structure 15 ⁇ in a tilted or angulated orientation with respect to the floor F. Harmonic motors are particularly useful as the rotation motor due to their high torque. Alternatively, the rotation
- subassembly 50 may be constructed such as described in U.S. Patent No. 7,152,261, U.S. Patent No. 7,343,635, U.S. Patent No. 7,565,708, U.S. Patent No. 8,060,960, or U.S. Patent
- the base 1310 includes a pair of connection
- connection subassembly 75 for reversible attachment with a patient support structure 15 ⁇ .
- connection subassembly 75 for reversible attachment with a patient support structure 15 ⁇ .
- the rotation block 57 also referred to as a ladder connection block 57, is reversibly attachable or connectable to at least one ladder structure 100, which in turn is reversibly
- connection subassemblies 75 provide structure for
- the head-end and foot-end rotation blocks 57 are substantially identical; however, it is foreseen that one or both of the blocks 57 may have an alternative size, shape and additional or alternative configuration.
- connection subassemblies 75 provide structure for at least some vertical translation, or height adjustment, of an attached patient support structure ISt. Further, the two connection subassemblies 75 cooperate with each other and optionally with the patient support structure 15 t to provide structure for a fail-safe structure or mechanism that blocks incorrect or unintended detachment of an attached patient support structure 15 ⁇ , wherein such incorrect detachment can result in catastrophic collapse of at least a portion of the patient positioning support system 5 and patient injury.
- Each rotation block 57 is attached to or joined with the first rotation shaft 56, wherein the first rotation shaft is substantially coaxial with the roll axis R.
- the rotation shafts 56 of the opposed vertical translation subassemblies 20 are rotated in synchronization, toward either the left-hand side or right-hand side of the patient positioning support system 5 and also at the same speed.
- Each of the rotation shafts 56 rotates an attached block 57 clockwise or counterclockwise, which in turn rotate a pair of attached ladders 100 about the roll axis R. As the ladders 100 rotated in unison, they cooperatively rotate a patient support structure 15 ⁇ that is attached therebetween. It is noted that one of the
- rotation shafts 56 could be passive, such that rotation occurs on bearings without a motor.
- the ladders 100 may be provided in one of two lengths, a standard length ladder 100 and non-standard length ladder 100', wherein the non-standard length ladder 100' includes an extended length, or a length greater than that of the standard length ladder 100. It is foreseen that ladders 100' of other, nonstandard lengths can be provided.
- pairs of matched ladders 100, or two ladders 100 having substantially the same length are attached to the opposed rotation blocks 57. It is foreseen that miss-matched pairs of ladders 100, 100' could be attached to the rotation blocks 57.
- subassemblies 20 provide a fail-safe mechanism that prevents improper disconnection of an attached or engaged patient support structure 15 ⁇ from the base 1310.
- This fail-safe mechanism includes two components. First, the ladders 100 cannot be disconnected from the base 1310 unless no patient support structure 15 ⁇ is attached thereto. Second, the ladders 100 must be disconnected or removed from the base 1310 by tilting the ladder ends farthest from the attached rotation block 57 in an inboard direction, before the respective ladder engaged ends can be disconnected or disengaged from the rotation block 57.
- Other fail-safe mechanisms, structures or subassemblies are foreseen.
- two ladders 100 such as upper and lower ladders
- two such ladders 100 attached to a single rotation block 57 are substantially vertically opposed to one another and also co-planar with one another.
- a pair of ladders 100 attached to the two opposed rotation blocks 57 at either end of the base 10 are substantially opposed to and parallel with one another.
- a plane that runs parallel with and through the ladder is substantially perpendicular to the floor F .
- Alternative configurations are foreseen.
- the rotation block 57 is sized, shaped and configured such that when two ladders 100 attached thereto, their upper or connection ends kiss or mutually contact one another. It is foreseen that, in some
- the upper ends may not contact one another.
- Attaching two ladders 100 to each of the rotation blocks 57 of the patient positioning support system 5 enables attachment of two patient support structures, such as for example a prone patient support structure 15 and a supine patient support structure 15'.
- a patient can be positioned on a first of two patient support structures 15 t, such as for a first surgical procedure, and then transferred to the second of the two patient support structures 15 ⁇ , such as for performing a second surgical procedure with the patient in a different body position.
- Such transferring of a patient between the two patient support structures 15, 15' can be performed in numerous ways, including but not limited to a sandwich-and-roll procedure, such as has been described above and which is described below.
- the ladders 100 are sized, shaped, configured and arranged for attachment to a patient support structure 15 ⁇ in addition to the base 1310.
- the roll axis R extends longitudinally along a length of the base 1310 such that, when the upper portions 35 are located substantially equidistant from the floor F, such as is shown in FIG. 220, the roll axis R is substantially coaxial with the upper portion rotation shafts 56. In another example, when the upper portions 35 are not equidistant from the floor F, such as is shown in FIGS. 228 and 330, the roll axis R is still coaxial with the first rotation shafts 56 but is also positioned at an angle with respect to the floor F.
- the base 1310 is adapted to tilt, roll, turn over, or rotate the patient support structure 15+ about or around the roll axis R.
- the patient support structure 15 ⁇ can be reversibly rolled or tilted an amount or distance of between about 1° and about 360°, such as relative to a plane
- the patient support structure 15 ⁇ may be tilted a distance of about 5°, about 10°, about 15 °, about 20° , about 25°, about 30°, about 35° , or about 40° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R, such as but not limited to so as to provide improved access to a surgical site.
- the patient support structure 15 ⁇ may be tilted a distance of about 45°, 50°, 55°, 60°, 65°, 70°, 75°, 80°, 85°, 90°, 95° or 100° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ may be tilted a distance of about 110°, 115°, 120°, 125°, 130°, 135°, 140°, 145°, 150°, 155°, 160°, 165°, 170°, 175° or 180° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R.
- the patient support structure 15 ⁇ may be rolled a distance of more than 180° about the roll axis R, relative to a starting position associated with a plane parallel with the floor F, wherein the plane intersects with the roll axis R .
- the patient support structure 15 ⁇ can be rolled clockwise or counter-clockwise, or toward either the left-hand or the right-hand side with respect to the roll axis R.
- the supine patient support structure 15' can also be reversibly tilted or rolled about the roll axis R, either alternatively to or additionally with the prone patient support structure 15.
- the patient positioning support system 5 is configured and arranged to roll the prone and supine patient support structures 15, 15' a full 360° about the roll' axis J? in at least one direction, so as to return to the orientation shown in FIG. 91a.
- the base 1310 is adapted to roll the patient support structures 15 t backwards, or in a reverse direction, about the roll axis R, so as to be rolled a suitable angle, so as to position the patient in an
- orientation associated therewith such as but not limited to the positions shown in FIGS. 92a through 95c.
- Each vertical translation subassembly 20 includes a vertical translation axis associated with each of the primary and secondary elevator portions 1343 and 1344, respectively, which are denoted by Vl 0 and V2 0 .
- Vertical translation or movement, of at least a portion of the patient positioning support apparatus 5 may occur along one or both of the
- the primary elevator 1343 raises and lowers the associated upper portion 35 along with the secondary elevator 1344 parallel with the axes Vl 0 and V2 0 .
- the secondary elevator portion 1344 raises and lowers the rotation assembly 50 along the second vertical axis V2 0 .
- Such vertical translation may be synchronous or asynchronous, and may be controlled by a computer (not shown) and associated software.
- Each vertical translation subassembly 20 includes maximum and minimum vertical translation or lift distances.
- the maximum lift distance is associated with the .maximum amount, most or highest the rotation subassembly 50 can be raised or upwardly lifted, such as is shown in FIG. 234.
- the minimum lift distance is the minimum amount, least, farthest downward, or the lowest the rotation subassembly 50 can be moved downwardly or lowered, such as is shown in FIG. 221.
- the vertical translation subassemblies 20 are sized, shaped, arranged, configured, or adapted to vertically move, translate, or lift and lower the rotation subassembly 50, and therefore an attached end of a patient support structure 15 t, between the maximum and minimum lift positions.
- this vertical translation is incremental.
- the vertical translation subassembly 20 may include a ratchet mechanism or other stepped mechanism that controls intervals of lift, and an operator must select a number of discrete intervals for the upper portion 35 to be moved.
- this vertical translation is non- incremental, or continuous, between the maximum and minimum lift positions or distances.
- the vertical translation subassembly 20 may include a screw-drive mechanism that smoothly lifts and lowers the upper portion 35 an amount determined by an operator or by a control computer (not shown) , wherein this amount of movement determined includes no discrete intervals or distances.
- the vertical translation subassemblies 20 can be moved in the same direction or in opposite directions .
- the vertical translation subassemblies 20 can be any vertical translation subassemblies 20. Further, the vertical translation subassemblies 20 can be any vertical translation subassemblies 20.
- both of the vertical translation subassemblies 20 are positionable at substantially equally raised positions, relative to their respective vertical translation axis Vl 0 and V2 0 and the floor F, and wherein the raised positions may be between the fully open and fully closed positions. When in this position, the roll axis R is substantially parallel with the floor F.
- both of the vertical translation subassemblies 20 may be positionable at
- the prone and supine patient support structures 15 and 15 1 are attached to the base 1310 and positioned for a sandwich-and-roll
- both the prone and supine patient support structures 15 and 15 ' are substantially parallel with the floor F.
- FIGS. 223-224 illustrate an embodiment in which both of the vertical translation subassemblies 20 are actuated so as to raise the supine patient support structure 15 1 such that the structure 15' is substantially parallel with the floor F.
- the supine patient support structure 15' is rotated or rolled about the roll axis R toward the left- hand side of the 298 of the supine patient support structure 15'.
- FIG. 224 shows the supine patient support structure 15 1 rotated or rolled about the roll axis R toward the right-hand side 300 of the supine patient support
- FIG. 225 shows both of the primary and secondary elevators 1343 and 1344 of both of the vertical translation subassemblies 20 lowered and the supine patient support structure 15 1 broken upwardly or pivoted in a counterclockwise direction about the first pitch axis PI, as
- FIG. 225 shows the vertical translation
- Fig. 225 also shows pivoting movement associated with the second and third pitch axes P2 and P3 , as indicated by arrows 292 and 294, respectively .
- both of the vertical translation subassemblies 20 are maximally raised. Additionally, the supine patient support structure 15 ' is broken downwardly or such that counter-clockwise pivoting . movement has occurred about the first pitch axis PI, as indicated by the arrow 284, at the spaced opposed hinges 376.
- FIG. 226 illustrates counter-clockwise pivoting movement at the second axis P2 , as indicated by arrow 292, and clockwise pivoting movement at the third axis P3 , as indicated by arrow 294, such as is described above.
- FIG. 227 illustrates another embodiment, wherein in addition to being upwardly broken in a manner similar to that shown in FIG. 225, the supine patient support structure 15' is rolled about the roll axis R toward the left-hand side 298 of the system 5.
- FIG. 227 further illustrates counter-clockwise pivoting movement at the second axis P2, as indicated by arrow 292, and clockwise pivoting movement at the third axis P3 , as indicated by arrow 294, such as is described above.
- translation subassemblies 20 are movable in opposite
- FIG. 330 shows the upper portion 35 joined with a head-end of the attached supine patient support structure 15' with the
- the upper portions 35 do not both intersect a single plane running parallel with the floor F; or the upper portions 35 are non-parallel with one another, relative to the floor F.
- the vertical translation subassemblies 20 can be operated singly or together, and synchronously or
- one of the vertical translation subassemblies 20 may be telescoped, or moved, while the opposed vertical translation subassembly 20 is not telescoped or moved, or is held immobile.
- both of the vertical translation subassemblies 20 may be moved in the same or opp site directions at the same time. Numerous variations are foreseen.
- Operation of the vertical translation subassemblies20 is generally coordinated and controlled electronically, or synchronized, such as by a computer system (not shown) that interacts with one or more motion sensors (not shown)
- FIG. 228 illustrates an embodiment wherein the headend vertical translation subassembly 20 is lowered to a closed position, and the foot-end vertical translation subassembly 20 is fully opened, such that the supine patient support
- the supine patient support structure 15' is in the Trendelenburg position of FIG. 228 and also rolled toward the left-hand side 298 of the system 5 about the roll axis R.
- FIG. 230 illustrates an embodiment in which the supine patient support structure 15' is positioned in a reverse Trendelenburg position by lowering the foot end 19' and raising the head end 18'.
- counterclockwise rotational movement about the foot-end and head-end pitch axes PE is illustrated by arrows 1312 and 1313
- the supine patient support structure 15' has been positioned in the reverse Trendelenburg position of FIG. 230 and also rolled about the roll axis R toward the right-side 300 of the system 5. It is noted that in the embodiments of FIGS. 230 and 231, the translation compensation subassembly 320 has functioned to increase the length of the supine patient support structure 15 1 .
- Figs. 235-239 show positioning of a prone patient support structure 15, such as that described above, attached to or joined with the off-set base 1310 of the illustrated invention.
- FIG. 232 illustrates an embodiment wherein the primary elevator portions 1343 of the vertical translation subassemblies 20 are substantially fully lowered and the secondary elevator portions 1344 are partially lowered, such that the roll axis R is substantially parallel with the floor F. Further, there is no pivotal or rotational movement with respect to the axes PE, PI, P2, P3 or R .
- FIG. 233 illustrates an embodiment similar to the embodiment shown in FIG. 232, except that the vertical translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised, so as to raise the prone patient support structure 15 relative to the floor F.
- the secondary translation subassemblies 20 have been partially opened or raised,
- FIG. 234 illustrates a further embodiment similar to the embodiments shown in FIGS. 232 and 233, except that the vertical translation subassemblies 20 have been fully opened or raised, so as to raise the prone patient support structure 15 as high as possible relative to the floor F.
- the vertical translation subassemblies 20 have been fully opened or raised, so as to raise the prone patient support structure 15 as high as possible relative to the floor F.
- both the primary and secondary elevator portions 1343, 1344 have been fully raised.
- FIG. 235 illustrates an embodiment of the prone patient support structure 15 positioned so as to flex a patient's spine or hips.
- the joints 326 have been actuated so as to produce counter-clockwise pivoting about the first pitch axis PI, as indicated by the arrow 284, whereby the lower extremity support structure 344 is rotated downward, and knee hinges 350 (FIG. 3) are actuated so as to bend the patient's knees, such as is described above.
- FIG. 236 illustrates an embodiment of the prone patient support structure 15 positioned so as to extend a patient's spine or hips.
- the joints 326 have functional in response to clockwise rotation of the lower extremity support 344 with respect to the first pitch axis PI, as indicated by the arrow 284, whereby the lower extremity support structure 344 is rotated upward, and knee hinges 350 function to straighten the patient's knees, such as is
- FIG. 237 illustrates another embodiment of the prone patient support structure 15 positioned so as to extend a patient's spine or hips, similar to that shown in FIG. 237.
- the patient support structure 15 is positioned in the same orientation or configuration as shown in FIG. 236.
- the base 1310 is positioned as is shown in FIG. 235.
- FIGS. 238-239 illustrate embodiments similar to that shown in FIG. 233, except that FIG. 238 illustrates rotational movement of the prone patient support structure 15 about the roll axis J? toward the left-hand side 298 of the system 5, and FIG. 239 illustrates rotational movement about the roll axis R toward the right-hand side 300 of the system 5.
- Figures 240-254 illustrate another embodiment of an off- set base 1410 for supporting a prone or supine patient support structure 15, 15' of the patient positioning support system 5.
- the base 1410 is substantially similar to the base 1310, and is therefore numbered in the same manner as the base 1310. Accordingly, the description of the base 1410 is similar to that of base 1310.
- the second off-set base 1410 differs from the first off- set base 1310, described above, in that the head-end and foot-end vertical translation subassemblies are different.
- the second off-set base 1410 includes two non- identical vertical translation subassemblies 20, a foot-end vertical translation subassembly denoted by 20a and a head-end vertical translation subassembly denoted by 20b.
- the foot-end vertical translation subassembly 20a is substantially similar to the vertical translation
- the foot-end vertical translation subassembly 20a includes lower and upper portions 30, 35, a lower support or base portion 40, an offset primary elevator subassembly 1441, a secondary elevator portion 1444, a telescoping riser assembly 45, a rotation subassembly 50 with a rotation motor 55, rotation shaft 56 (FIG. 250) and rotation block 1557, a connection subassembly 75 and a standard length ladder 100.
- at least a portion of the foot-end vertical translation subassembly 20a electronics (not shown) is housed in a housing 1460 located on the lower support 40, so as to be located below the rotation motor 55.
- head-end vertical translation subassembly 20b is substantially similar to the vertical translation subassemblies 20 of the base 1310 and to the foot- end vertical translation subassembly 20a, the electronics (not shown) of the head-end vertical translation subassembly 20b have been moved from the lower support 40, to another location in the head-end vertical translation subassembly 20b.
- this relocation of at least some of the electronics provides for greater freedom and space for
- the patient's head stays substantially in the same location, so as to provide optimal access for anesthesia and to prevent accidental removal of anesthesia equipment from the patient, such as might occur if the patient's head moved away from its initial location, such as for example farther away from the associated vertical translation subassembly 20b.
- the rotation subassembly 50 of the head-end vertical translation subassembly 20b, has also been moved out of the way of anesthesia personnel. Most notably the rotation motor 55, and additionally or alternatively portions of the secondary elevator portion 1444, has been moved toward the back and underneath the rotation subassembly. For example, as shown in FIGS. 240, 248 and 249, the rotation motor 55 of the foot-end vertical translation subassembly 20a extends
- the top surface of the lower support 40 includes a downwardly
- recessed portion or area 40a that provides a space, chamber or clearance region, the opening and sides of which are sized and shaped to receive therein the lower end of the motor 1444, 55, whereby the lower end of the motor 1444, 55 is substantially prevented from bumping into the lower support 40 when the vertical translation subassembly 20b is in its lowest position.
- This enables the rotation block 57 to be lowered closer to the floor than if there was no such recessed portion 40a.
- the base 1410 includes a telescoping or retractable cross-bar 25' (FIG. 240), instead of a stationary cross-bar 25.
- the telescoping cross-bar 25' can be closed or retracted, such that the vertical translation subassemblies 20 can be moved closer together, such as for storage or for adjusting the distance between the vertical translation subassemblies 20 to accommodate a shorter patient, such as but not limited to a child.
- the telescoping cross-bar 25' is
- the telescoping cross-bar 25' cannot be substantially lengthened or shortened, such that the vertical translation subassemblies 20 remain substantially non-movable, or in substantially in the same location or place.
- the telescoping cross-bar 25' may be removable, or the base 1410 may include a non-telescoping cross-bar 25, such as is described elsewhere herein.
- the telescoping base 25' may be incorporated into the base of any other patient positioning and support system known in the art .
- FIGS. 250 through 254 illustrate the modified rotation subassembly 1550, with at least some portions of the rotation motor 55 extending behind and below the rotation subassembly housing 60.
- the portions of the worm gear drive system, generally 392, are shown.
- the rotation block 1557 and ladder 100 are similar to the rotation block and ladder described in US. Provisional Patent Application No.
- the rotation block 1557 includes a new failsafe table attachment subassembly, generally 15135, which includes a ladder engagement pin 15140, that is received into a pin engagement channel, generally 15145, of the block 1557 and also into a pin engagement through-bore 15150 of the ladder 100. Accordingly, the ladder engagement pin 15140 reversibly joins the block 1557 with the ladder 100, such as is shown in FIG. 251.
- the fail-safe table attachment subassembly 15135 also includes a locking ladder attachment member 15120 mounted on the outboard side of the rotation block 1557, and that releasably locks an upper cross-bar 15155 of the ladder 100 into a cross-bar receiving groove 15160 of the block 1557.
- the fail-safe table attachment subassembly 15135 includes a reversibly opening, spring-loaded lock member, generally 15165, which includes a housing 15170, a reversibly locking hook member 15175 and a spring member 15180 (FIGS. 253 and 254). As shown in FIGS.
- the housing 15170 includes an inwardly extending housing recess portion or area 15185 that is sized and shaped to house or receive therein the spring 15180 and the inner portion 15190 of the hook member 15175.
- the housing recess portion 15185 includes a surface 15195.
- the spring 15180 engages an axle or pin 15200 at each of its ends 15205.
- An outer pin 15210 is attached to the hook member inner portion 15190, and an inner pin 15251 is located in an inner area of the housing recess portion 15185.
- the outer and inner pins 15210, 15215 are spaced apart such that the spring 15180 is biased, and
- the hook member 15175 When the hook member 15175 is in the locked position, its inner engagement surface 15185 engages or contacts the outer surface 15190 of the upper cross-bar 15155, such as is shown in FIG. 251.
- the spring 15180 is sufficiently strong that the hook member 15175 is strongly pulled into the locked position. To release or remove the upper cross-bar 15155 from the channel 15160, the operator must firmly push the hook member 15175 away from the channel 15160 and the cross-bar 15155.
- the ladder can be swung in and inwardly direction, such that the cross-bar is moved out of the channel 15160, such as is shown and described elsewhere herein.
- the spring returns the hook member 15175 to the closed position.
- Installing the ladder 100 onto the rotation block 1557 is performed in the reverse order.
- the operator must open the hook member 15175, such that the cross-bar 15155 can be swung into the channel 15160. It is noted that both of the hook members 15175 associated with a given channel 15160 must be opened simultaneously, in order for the cross-bar 15155 to be inserted into or removed from the respective channel 15160.
- This failsafe locking structure substantially prevents inappropriate or unintended detachment of the ladder from the rotation block, which could result in the patient support falling and a patient thereon being injured, as well as the patient support or the base 1310, 1410 being damaged. It is foreseen that the failsafe table
- attachment subassembly 15135 may be incorporated into this base 1410, the base 1310, or any other base known in the art that is adapted to reversibly attach to and support a patient support structure including the base 10.
- FIGS. 255a-287 illustrate yet another embodiment 1600 of a patient support structure 15 .
- the prone patient support structure 1600 is similar to the patient support structures 15 ⁇ described above. Accordingly, the numbering of components of the patient support structure 1600 will be numbered similarly to the patient support structures 15* described above .
- the patient support structure 1600 of the illustrated embodiment is a prone patient support structure 15 with a head-end 18, a foot end 19, a frame 296, left-hand and right-hand sides 298, 300, a frame head-end 302, a frame foot- end 304, a left-hand frame portion or spar 306, a right-hand frame portion 308, a head-end frame member 310 that joins the head-ends of the left- and right-hand frame portions 306, 308, a foot-end frame member 312 that joins the foot-ends of the left- and right-hand frame portions 306, 308, an attachment structure 314 for attachment of the head- or foot-ends 302, 304 of the frame 296 with a ladder 100 or 100', a translation compensation subassembly 320 (FIG.
- the patient support structure 1600 may include a lower extremity support structure 344 (FIG. 1) cooperating with the joints 326, such as is described above. It is noted that the foot-end portion of each of the left-hand and right-hand portions 306, 308 may be wider than the head-end portions thereof, such as but not limited to so as to accommodate a lower extremity support structure 344 therebetween.
- FIGS. 255a, 255b, 256 and 257 are forward top perspective views of the patient support structure 1600, including the torso support structure 1700, which may also be referred to as a chest slide or translator.
- the patient support structure 1600 is a prone patient support structure 15 for use with a base 10, such as is disclosed above, or with any other useful base, such as the bases 1310, 1340, or the like, with a pair of opposed vertical translation
- subassemblies 20 between which the patient support structure 1600 can be suspended above the floor F such as but not limited to by connection subassemblies 75 and ladders 100, 100', as described above.
- the patient support structure 1600 includes a frame 296 with a left-hand frame portion 306 and a right-hand frame portions 308.
- Each of the left-hand and right-hand frame portions 306, 308 includes a head-end member and a foot-end member joined by a joint 326.
- the head-end and foot-end members of the left-hand frame portion 306 are denoted by 306A and 306B, respectively.
- the head-end and foot-end members of the right-hand frame portion 308- are denoted by 308A and 308B, respectively.
- the left-hand frame portion 306 includes a head-end frame member 306A joined at its inboard end 306A' to the inboard end 306B' of a foot-end frame member 306B by an intervening joint 326.
- the right-hand frame portion 308 includes a head-end frame member 308A joined at its inboard end 308A' to the inboard end 308B' of a foot-end frame member 308B by another intervening joint 326.
- the outboard end 306A" of the left-hand head-end frame member 306A is joined to the outboard end 308A" of the right- hand head-end frame member 308A by the head- end frame member 310.
- the outboard end 306B" of the left-hand foot-end frame member 306B is joined to the outboard end 308B" of the right- hand foot-end frame member 308B by the foot-end frame member 312.
- the head-end frame member 310 and the foot-end frame member 312 hold the left-hand frame portion 306 and the right- hand frame portion 308 in spaced relation to one another such that they are parallel with one another and form an open frame 296.
- the joints 326 are spaced and opposed to one another such that the belly of a patient support on the patient support structure 1600 can depend or hang downwardly between the joints 326, such as but not limited to when the patient is positioned in a prone position of the patient support structure 1600, such as is described above.
- the left and right foot-end frame members 306B and 308B are spaced apart a greater distance than are the left and right head-end frame members 306A and 308A, which is more easily seen in FIGS.
- a pair of hip-thigh pads 286 are mounted on the foot end members 306b, 308b at the joints 326, such as by mounts 338, such as in the manner described above with regards to the hip-thigh pads 286.
- the hip pads 286 are contoured so as to support the patient without creating pressure points and to protect the patient from being pinched in the joints 326. Further, the hip pads 286 are spaced apart so that the patients' s belly can hand downwardly therebetween.
- the hip pads 286 can be covered with disposable drapes (not shown) .
- a sling structure (not shown) can be joined to the hip pads 286 or the hip pad mounts 338, such as to provide additional support to the patient's torso, or to accommodate a particularly small patient, such as a child, and the like. It is foreseen that in some circumstances, the separate pads 286 can be replaced with a single pad that spans the space between the joints 326, such as so as to prevent the patient's belly from hanging down between the joints 326.
- the joints 326 include a worm drive 392 with a worm 398 (FIG. 284a) and a worm gear 400, such as is described above.
- the worm 398 is covered by a shroud 349 or a frame portion 396.
- the worm 398 is operated by a drive tether subassembly 1602.
- the drive tether subassembly 1602 (FIG.
- first tether member 1604 attached to and optionally integral with, the worm 398 and a second tether member 1606.
- the first and second tether members 1604 and 1606 are joined by a tether joint 1608, such as but not limited to a universal joint structure.
- the second tether member 1606 is a shaft that extends longitudinally through the associated foot-end frame member 306B, 308B, such that the second end 1610 of the respective second tether member 1606 joins a driver or actuator, such as but not limited to a motor and associated electronics (not shown) located in the outboard ends 306B" and 308B" of the foot-end frame member 306B, 308B.
- some or all of the motor and associated electronics that actuate the second tether members 1606 are located in the translation compensation subassembly 320, located at the foot end 19 of the patient support structure 1600. Rotation of the second tether member 1606 actuates rotation of the first tether member 1604, which actuates rotation of the worm 398. Actuation of the worms 398 of the two joints 326 is synchronized so that the joints 326 move at the same rate and in the same direction. Additionally, such actuation of the joints 326 is also synchronized with movement of the translation compensation subassembly 320 and with the base 10, such as is described above.
- the left-hand and right-hand frame members 306, 308 include a rectangular cross-section and a through-channel or through-bore that extends from about the respective inboard and outboard ends, which are noted above. These through-channels enable electronics and various
- Adapting or configuring the patient support structure 1600 in this manner enables reduction in the size of the various components, such as but not limited to the joints 326, and the like.
- the spars of the frame 298 may have non- rectangular cross-sections , such as are known in the art.
- the through-channels denoted by 306C (FIG. 279a) and 308C (FIG. 257) , of the left-hand and right-hand frame portions 306, 308 respectively, also referred to as spars or beams, may have rectangular or non-rectangular cross-sections which may vary along the length of the
- the patient support structure 1600 includes a translation compensation subassembly 320 similar to that described above, with a translation compensation bar 322 that slides in and out of each of the outboard ends 306B" and 308B" of the respective foot-end members 306B, 308B.
- a portion of the translation driver 324 is associated with translation bar 322. Additional portions of the translation driver 324 are located in a housing 324B at the foot end 19 of the patient support structure 1600.
- the foot-end frame member 312 includes the housing 324B and the portions of the translation driver 342 housed therein, such as but not limited to a motor and associated electronics.
- a single motor drives the two
- each translation compensation subassembly 320 may include its own motor. Further, the two translation compensation subassemblies 320 may share a motor, some or all electronic components, and the like.
- the translation compensation subassemblies 320 are powered as described herein and are synchronized with the other components of the patient support structure 1600, such as but not limited to the joints 326.
- the translation compensation subassemblies 320 are also synchronized with the base 10, such that the patient support structure 1600 can be positioned in numerous positions for various surgical procedures, such as are described elsewhere herein.
- the patient support structure 1600 includes a torso support structure 1700, also referred to as a chest slide, a trunk translator and an upper body support and translator.
- the torso support structure 1700 is similar to the torso support structure 362 described above.
- the torso support structure 1700 of the torso support structure 1700 of the torso support structure
- illustrated embodiment includes a support body 364, a
- the support body 364 includes a pair of body slider housings 1702.
- the slider housings 1702 may be referred to as left-hand and right-hand slider housings, first and second slider housings, or as housing members.
- the terms left-hand and right-hand refer to the left-hand and right-hand sides of the torso support structure 1700 and correspond to the left and right sides of a patient supported on the torso support structure 1700.
- Each slider housing 1702 includes a forward end 1704 and a rear end 1706.
- the forward end 1704 may be referred to as a first end or an outboard end.
- the rear end 1706 may be referred to as a second end or an inboard end.
- the slider housings 1702 are rectangular in cross-section. Accordingly, each slider housing 1702 also includes inner and outer sides, 1708 and 1710 respectively, and upper and lower sides, 1712 and 1714 respectively. However, it is foreseen that the slider housings 1702 may have a non-rectangular cross-section.
- the slider housings 1702 each include a through- channel 1716, or through-bore, extending from a first opening 1718 located at the forward end 1704 to a second opening 1720 at the rear end 1706.
- the through channel 1716 is sized and shaped to slidingly receive a respective left-hand or right- hand head-end member 306A or 308A therethrough, as is
- the through- channel 1716 is also rectangular in cross-section, with an inner side surface 1722, and outer side surface 1724, and upper side surface 1726 and an outer side surface 1728.
- each through-channel 1716 includes at least three slider mechanisms 1730.
- the through- channel 1716 includes one, two or four slider mechanisms 1730.
- the slider mechanisms 1730 are located between, or sandwiched between, the head-end member 306A or 308A and a respective side surface of the through-channel 1716.
- a slider mechanism 1730 is sandwiched between the head-end member 306A, 308A and each of the inner, outer and upper side surfaces 1722, 1724 and 1726 of a respective through-channel 1716.
- a fourth slider mechanism 1730 is
- the slider mechanisms 1730 extend along the length of the respective inner, outer, upper and lower side surfaces 1722, 1724, 1726 and 1728, and are adapted to enable the torso support structure 1700 to slide along a length of the head-end members 306A, 308A.
- the slider mechanisms 1730 are adapted enable the slider housing 1702 to slide or glide along a length of the respective head-end member 306A, 308A, whereby the torso support structure 1700 is slidingly moved along a length of the frame 296 of the patient support structure 1600.
- the torso support structure 1700 also includes a translation mechanism, generally 1732, associated with each of the slider housings 1702. Each translation mechanism 1732 is linked, attached to or associated with the head-end frame member 310 of the frame 296. In the illustrated embodiment, as is most easily seen in FIG. 269a, the translation
- the translation mechanisms 1732 are located on the lower or bottom sides of the respective head-end member 306A, 308A and linked to the lower side 1714 of the respective slider housing 1702 by a tether 1734 described below. It is foreseen that at least a portion of the translation mechanism 1732 may be located elsewhere in or on the torso support structure 1700 or on the patient support structure 1600.
- the translation mechanism 1732 includes a driver (not shown) for actuating movement of the torso support structure 1700.
- a tether 1734 links the driver of the translation mechanism 1732 with the slider housing 1702.
- the driver drives movement of the tether 1734 in and out of the translation mechanism housing 1736, such as forward and backward, so as to actuate movement of the attached slider housing 1702 along a length of the respective head-end member 306A, 308A.
- Actuation of the driver, or movement of the tethers 1734 is synchronized with movements of other portions of the patient support structure 1600, such as but not limited to the joints 326. This synchronization is adapted to
- Each body slider housing 1702 includes a manual adjustment structure, generally 1742, for manually adjusting the distance D2 between the chest pad 368 and the hip- thigh pads 286.
- the manual adjustment structure generally 1742, for manually adjusting the distance D2 between the chest pad 368 and the hip- thigh pads 286.
- the manual adjustment structure generally 1742, for manually adjusting the distance D2 between the chest pad 368 and the hip- thigh pads 286.
- adjustment structure 1741 includes an adjustment track 1744, or strip, with a series of sequential or incremental selection portions 1744, or openings or through-bores, which is attached to the lower side 1714 of the slider housing 1702.
- the headend of the adjustment track 1744 is attached, joined or linked with the tether 1734.
- the foot-end of the adjustment track 1744 is associated with the slider housing 1702.
- the slider housing 1702 is linked to or engaged with the adjustment track 1744 by a selection member 1748, such as a spring-laded pin or handle, that is received through one of the incremental selection portions 1746, such as is most easily seen in FIG. 279a.
- the selection member 1748 is pulled out of the respective engaged selection portion 1746, the slider housings 1702 are moved forward or rearward along the head-end members 306, 308 until the desired distance D2 is achieved or reached, and then the selection member 1748 is re-engaged in a new incremental selection portion 1746 that is substantially aligned
- the position of the torso support structure 1700 can be incrementally manually adjusted along a length of the frame 296, so as to provide optimal support to a patient's upper body and so as to substantially maintain the distance D2 between the first pitch axis PI and the torso support structure 1700.
- structures 1742 are forseen.
- the driver of the translation mechanism 1732 includes a motor, such as but not limited to a servo motor, or any other suitably sized and powerful motor known in the art. It is foreseen that the translation
- mechanism 1732 may include alternative tethers 1734 than are depicted in the figures, such as but not limited to a chain driver structure or a worm drive structure.
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Neurosurgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
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Abstract
Description
Claims
Applications Claiming Priority (6)
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US201261743240P | 2012-08-29 | 2012-08-29 | |
US201261795649P | 2012-10-22 | 2012-10-22 | |
US201361849016P | 2013-01-17 | 2013-01-17 | |
US201361849035P | 2013-01-17 | 2013-01-17 | |
US201361852199P | 2013-03-15 | 2013-03-15 | |
PCT/US2013/000199 WO2014035460A1 (en) | 2012-08-29 | 2013-08-28 | Patient positioning support apparatus with virtual pivot-shift pelvic pads, upper body stabilization and fail-safe table attachment mechanism |
Publications (3)
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EP2890351A1 true EP2890351A1 (en) | 2015-07-08 |
EP2890351A4 EP2890351A4 (en) | 2016-05-18 |
EP2890351B1 EP2890351B1 (en) | 2019-01-16 |
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EP13833588.0A Active EP2890351B1 (en) | 2012-08-29 | 2013-08-28 | Patient positioning support apparatus with virtual pivot-shift pelvic pads, upper body stabilization and fail-safe table attachment mechanism |
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EP (1) | EP2890351B1 (en) |
WO (1) | WO2014035460A1 (en) |
Families Citing this family (4)
Publication number | Priority date | Publication date | Assignee | Title |
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CN105212951B (en) * | 2015-10-15 | 2017-10-20 | 中国人民解放军第二军医大学 | Backbone is in body biomechanical measurement device |
CN108187174A (en) * | 2018-03-09 | 2018-06-22 | 无锡市人民医院 | A kind of pediatric surgical operation wound care rinsing table |
CN114533478B (en) * | 2022-03-01 | 2023-01-24 | 南华大学附属第一医院 | Intelligent posture correction equipment for preoperative examination of hepatobiliary surgery |
CN114795726B (en) * | 2022-04-20 | 2023-05-23 | 苏爱峰 | Body position adjusting device for patient with severe respiratory disease |
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GB810956A (en) * | 1956-04-13 | 1959-03-25 | Allen & Hanburys Ltd | Improvements relating to surgical operation tables |
US20110107517A1 (en) * | 2007-10-22 | 2011-05-12 | Steve Lamb | Surgery table apparatus |
US20110107516A1 (en) * | 2005-02-22 | 2011-05-12 | Jackson Roger P | Patient positioning support structure with trunk translator |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040133983A1 (en) * | 2003-01-13 | 2004-07-15 | Newkirk David C. | Surgical table |
-
2013
- 2013-08-28 EP EP13833588.0A patent/EP2890351B1/en active Active
- 2013-08-28 WO PCT/US2013/000199 patent/WO2014035460A1/en active Application Filing
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
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GB810956A (en) * | 1956-04-13 | 1959-03-25 | Allen & Hanburys Ltd | Improvements relating to surgical operation tables |
US20110107516A1 (en) * | 2005-02-22 | 2011-05-12 | Jackson Roger P | Patient positioning support structure with trunk translator |
US20110107517A1 (en) * | 2007-10-22 | 2011-05-12 | Steve Lamb | Surgery table apparatus |
Non-Patent Citations (2)
Title |
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See also references of WO2014035460A1 * |
Also Published As
Publication number | Publication date |
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EP2890351A4 (en) | 2016-05-18 |
WO2014035460A1 (en) | 2014-03-06 |
EP2890351B1 (en) | 2019-01-16 |
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