US20230240927A1 - Systems and methods for supporting and stabilizing a patient during hip distraction - Google Patents
Systems and methods for supporting and stabilizing a patient during hip distraction Download PDFInfo
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- US20230240927A1 US20230240927A1 US18/161,851 US202318161851A US2023240927A1 US 20230240927 A1 US20230240927 A1 US 20230240927A1 US 202318161851 A US202318161851 A US 202318161851A US 2023240927 A1 US2023240927 A1 US 2023240927A1
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- 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
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- A61G13/04—Adjustable operating tables; Controls therefor tiltable around transverse or longitudinal axis
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- 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
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- 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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- A61G13/00—Operating tables; Auxiliary appliances therefor
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- A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
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- A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
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- A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
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- A61G7/1025—Lateral movement of patients, e.g. horizontal transfer
- A61G7/1032—Endless belts
Definitions
- applying the distraction force may include setting a position of a distractor that applies the distraction force, and wherein the position of the distractor may be maintained while the tilt of the surgical table is reduced.
- the patient is positioned with the patient's hips and torso supported by the surgical table.
- the slide-resisting pad may be sized so that the patient's buttocks and shoulders are in contact with the slide-resisting pad.
- the patient's hips may be supported by the distal portion 120 of the surgical table 104 , which may be made of radiolucent materials (e.g., a carbon fiber composite) such that X-ray and/or CT imaging may be performed on the hip while the patient is positioned on the surgical table.
- the patient may be strapped to surgical table and/or to the slide-resisting pad.
- the slide-resisting pad is strapped to the surgical table.
- the patient is not strapped to the surgical table and/or is not strapped to the slide-resisting pad.
- the body of patient pad 5 comprises one or more sheets of material (e.g., a foam sheet, a plastic sheet, a textile sheet, etc., including any of the materials described above) which is strong enough to support the weight of the patient;
- top surface 10 of patient pad 5 comprises an atraumatic material which provides resistance to a patient sliding thereon (e.g., high friction foam);
- first region 40 (having a higher coefficient of friction) comprises a layer of material (e.g., foam, suction cups, etc.) disposed on bottom surface 15 of patient pad 5 ;
- second region 45 (having a lower coefficient of friction) comprises a layer of material (e.g., low friction foam, a polymer sheet, a woven sheet, rollers, etc.) disposed on bottom surface 15 of patient pad 5 .
- stiffener 75 preferably comprises a layer of material disposed between top surface 10 and bottom surface 15 of patient pad 5 , although the layer of material could also be disposed alongside top surface 10 and/or bottom surface 15 .
- stiffener 75 comprises one or more semi-rigid materials, e.g., plastic sheets.
- the desired stiffened effect may be achievable with selective stacking of the layers
- the patient pad When the patient needs to be stabilized on the surgical table during a surgical procedure, the patient pad is not lifted along two or more of its edges so that the first region (having a higher coefficient of friction) engages the support structure and the second region (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all), whereby to stabilize the patient on the surgical table by preventing sliding of the patient pad (carrying the patient) along the surgical table.
- a patient pad includes: a top element for supporting a patient; and a bottom element for engaging a support structure; wherein the bottom element comprises at least two handles; wherein the top element comprises at least two openings for passing the at least two handles therethrough; wherein the top element can be disposed atop the bottom element with the at least two handles extending through the at least two openings, whereby the patient pad can be lifted as a unit by pulling upward on the two handles.
Abstract
A method for hip distraction includes positioning a patient on a patient pad placed on a surgical table; and applying a distraction force to a leg of the patient that is sufficient to distract a hip joint of the patient, wherein the distraction force is opposed by a slide-resisting friction force provided by the patient pad and the patient pad is sufficiently stiff to resist bunching while providing the slide-resisting friction force.
Description
- This application is a continuation of U.S. patent application Ser. No. 17/488,213, filed Sep. 28, 2021, which claims the benefit of U.S. Provisional Application No. 63/084,494, filed Sep. 28, 2020 and U.S. Provisional Application No. 63/148,597, filed Feb. 11, 2021, the entire contents of each of which are hereby incorporated by reference herein.
- This disclosure relates to hip distraction in general, and more particularly to supporting and stabilizing a patient during hip distraction.
- When performing surgical procedures on the hip joint, it is common to distract the hip joint prior to the surgery in order to provide additional room within the hip joint during the surgery and in order to better present selected anatomy to the surgeon during the surgery. Hip distraction is commonly achieved by applying a distraction force to the distal end of the leg of the patient. Generally, a surgical boot is placed on the foot and lower leg of the patient, the surgical boot is connected to a distraction frame, and the distraction frame is used to apply a distraction force to the surgical boot, whereby to apply a distraction force to the leg of the patient.
- With conventional hip distraction, it is common to provide a padded post (often referred to as a perineal post) between the legs of the patient. This padded post provides a counterforce to the anatomy when the distraction force is applied to the surgical boot. However, the use of a padded post can create complications, since the padded post can press against the pudendal nerve of the patient, and/or the sciatic nerve of the patient, during distraction. Additionally, the padded post can exert pressure on the blood vessels in the leg of the patient during distraction. Thus, it would be desirable to minimize or eliminate the use of the padded post if other means could be used to provide a counterforce to the anatomy when the distraction force is applied to the surgical boot.
- With some surgeries, it can be desirable to position the patient in the so-called “Trendelenburg position”, e.g., during abdominal surgery. When disposed in the Trendelenburg position, the patient lies on the surgical table “flat on their back”, with their feet higher than their head, e.g., by approximately 15-30 degrees. In order to facilitate this arrangement, the surgical table is typically tilted so that the patient's head is angled downward and the patient's feet are angled upward.
- In the case of hip arthroscopy, it has been recognized that positioning the patient in this manner can facilitate distraction of the hip joint without a perineal post; that is, the gravitational weight of the patient inclined in the Trendelenburg position counteracts the distraction force in lieu of the perineal post. The frictional forces of the patient on the surgical table also contribute to counteract the distraction force. This approach has sometimes been referred to as “post-less” or “post-free” hip arthroscopy.
- There are a number of benefits of post-less hip distraction, including eliminating the risk of damage caused by pressure against the pudendal nerve, the sciatic nerve, and/or the blood vessels of the patient during distraction. Another benefit is that no force is transferred to the non-operative leg, which can eliminate risks associated with forces being applied to the non-operative leg (such as neurovascular damage). Yet another benefit of post-less hip distraction is that a post-less procedure results in less pelvic tilt than conventional distraction using a post.
- According to some embodiments, a method for performing a surgical procedure on a hip of a patient includes positioning the patient on a slide-resisting pad on a surgical table, tilting the surgical table so that the patient is in a Trendelenburg position, applying a distraction force to achieve at least a desired amount of distraction of the hip without a perineal post, and reducing a degree of tilt of the surgical table after the degree of distraction has been achieved. At least a portion of the surgical procedure is then performed on the patient with the surgical table in the reduced degree of tilt. The desired amount of hip distraction is maintained despite the reduced degree of tilt due to a reduction in the required distraction force attributable to relaxation of tissue of the joint and due to the slide-resisting pad providing slide-resisting force sufficient to maintain the position of the patient. Through this method, the surgeon can perform at least a portion of the surgery with the patient in a more natural position similar to that achieved when using a perineal post while benefiting from the advantages of a post-less procedure.
- According to various embodiments, a method for hip distraction includes positioning a patient on a slide-resisting pad placed on a surgical table; tilting the surgical table so that the patient is in a first degree of inclination; applying a distraction force to a leg of the patient while the patient is in the first degree of inclination so that a hip joint of the patient is distracted, wherein the distraction force is opposed by a combination of a slide-resisting friction force provided by the slide-resisting pad and a gravitational force attributable to the first degree of inclination; reducing the tilt of the surgical table in accordance with a reduction of the distraction force over time so that the patient is in a second degree of inclination; and performing at least a portion of a surgical procedure on the distracted hip joint while the patient is in the second degree of inclination.
- In any of these embodiments, the second degree of inclination may be zero so that the patient is in a horizontal position and the at least a portion of the surgical procedure is performed on the distracted hip joint while the patient is in the horizontal position.
- In any of these embodiments, the combination of a slide-resisting friction force provided by the slide-resisting pad and the gravitational force attributable to the first degree of inclination of the patient may be sufficient to oppose the distraction force so that the patient does not slide in a direction of the distraction force.
- In any of these embodiments, applying the distraction force may include setting a position of a distractor that applies the distraction force, and wherein the position of the distractor may be maintained while the tilt of the surgical table is reduced.
- In any of these embodiments, the inclined first position may be at most 20 degrees from horizontal.
- In any of these embodiments, the surgical table may be free of a perineal post.
- In any of these embodiments, skin of the patient may be in direct contact with the slide-resisting pad.
- In any of these embodiments, the slide-resisting pad may be placed on one or more table top pads of the surgical table.
- In any of these embodiments, the slide-resisting pad may extend at least beneath shoulders and buttocks of the patient.
- In any of these embodiments, the slide-resisting pad may be strapped to the surgical table.
- In any of these embodiments, the slide-resisting pad may be a disposable pad.
- In any of these embodiments, the slide-resisting pad may include a foam material.
- In any of these embodiments, the slide-resisting pad may include at least one higher friction layer.
- In any of these embodiments, the slide-resisting pad may be a single layer of the foam material.
- In any of these embodiments, the slide-resisting pad may be less than five inches thick.
- In any of these embodiments, the slide-resisting pad may include one or more thickness changes for enhancing patient-to-pad friction.
- In any of these embodiments, the one or more thickness changes may include a corrugated shape.
- In any of these embodiments, the one or more thickness changes may include a thickened area in a location that corresponds to a location of buttocks of the patient.
- In any of these embodiments, the thickened area may form a wedge shape.
- In any of these embodiments, the slide-resisting pad may include at least one visual indicator for indicating at least one of how to position the slide-resisting pad on the surgical table and how to position the patient on the slide-resisting pad.
- In any of these embodiments, the at least one visual indicator may include at least one cut-out.
- In any of these embodiments, the patient may not be strapped to the surgical table.
- In any of these embodiments, the distraction force may be applied by moving a boot of a distractor away from the surgical table.
- The invention will now be described, by way of example only, with reference to the accompanying drawings, in which:
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FIG. 1 is a schematic diagram illustrating asystem 100 for supporting and stabilizing a patient for hip distraction for performing a surgical procedure on the hip, according to various embodiments; -
FIG. 2 is a block diagram illustrating amethod 200 for performing surgery on a hip of a patient, according to various embodiments; -
FIG. 3A is a schematic diagram illustrating a patient positioned on a slide-resisting pad on a surgical table that is in a horizontal position, according to various embodiments; -
FIG. 3B illustrates the tilting of the patient ofFIG. 3A , according to various embodiments -
FIG. 3C illustrates a reduced degree of tilt of the patient ofFIG. 3A , according to various embodiments; -
FIG. 4 illustrates a portion of a distraction assembly that includes a force gauge, according to various embodiments; -
FIG. 5 is a schematic diagram illustrating a slide-resisting pad, according to various embodiments; -
FIGS. 6A-6C illustrate slide-resisting pad configurations, according to various embodiments; and -
FIGS. 7A and 7B illustrate various slide-resisting pads that can include location indicators and straps, according to various embodiments. -
FIGS. 8-10B, 11A-11J and 12-24 are schematic views showing a patient pad comprising at least one first region having a higher coefficient of friction and at least one second region having a lower coefficient of friction, according to various embodiments; -
FIGS. 25-27 are schematic views showing a patient pad comprising a stiffener to resist bunching when the patient pad is subject to a sliding force, according to various embodiments; -
FIG. 28 is a schematic view showing a patient pad comprising a first region having at least one opening communicating with a source of at least one of suction and air pressure, according to various embodiments; -
FIGS. 29 and 30 are schematic views showing a patient pad comprising a bottom element comprising at least two handles and a top element comprising at least two openings for passing the at least two handles therethrough, according to various embodiments; and -
FIG. 31 andFIG. 32 are schematic views showing a patient support comprising a conveyor belt, according to various embodiments. - Reference will now be made in detail to implementations and embodiments of various aspects and variations of systems and methods described herein. Although several exemplary variations of the systems and methods are described herein, other variations of the systems and methods may include aspects of the systems and methods described herein combined in any suitable manner having combinations of all or some of the aspects described.
- According to various embodiments, described herein are systems and methods for performing a surgical procedure via post-free hip distraction in which a degree of incline of the patient used to counteract the distraction force is decreased for at least a portion of the surgical procedure while maintaining a desired amount of distraction. According to various embodiments, a patient is placed on a slide-resisting pad on a surgical table and placed in a first degree of inclination (a Trendelenburg position). A distraction force is applied to the patient to achieve a desired amount of distraction of the patient's hip joint) with the distraction force being countered by the frictional force provided by the slide-resisting pad and the gravitational force on the patient acting along the incline. The inventors discovered that the distraction force can decrease over time due to relaxing of the soft tissue of the patient and, therefore, that the degree of incline of the patient can be reduced. Thus, according to various embodiments, the degree of incline of the patient is reduced and at least a portion of the surgical procedure is performed with the patient in the reduced degree of incline, enabling the surgeon to perform the surgical procedure in a more natural position akin to a surgical procedure performed with a perineal post and without the risks to the patient posed by the use of a perineal post.
- In the following description of the various embodiments, reference is made to the accompanying drawings, in which are shown, by way of illustration, specific embodiments that can be practiced. It is to be understood that other embodiments and examples can be practiced, and changes can be made without departing from the scope of the disclosure.
- In addition, it is also to be understood that the singular forms “a,” “an,” and “the” used in the following description are intended to include the plural forms as well, unless the context clearly indicates otherwise. It is also to be understood that the term “and/or” as used herein refers to and encompasses any and all possible combinations of one or more of the associated listed items. It is further to be understood that the terms “includes, “including,” “comprises,” and/or “comprising,” when used herein, specify the presence of stated features, integers, steps, operations, elements, components, and/or units but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, units, and/or groups thereof.
-
FIG. 1 is a schematic diagram illustrating asystem 100 for supporting and stabilizing a patient for hip distraction for performing a surgical procedure on the hip, according to various embodiments. Thepatient 102 is supported by a tiltable surgical table 104. Surgical table 104 can be any suitable surgical table that is tiltable for placing the patent in a Trendelenburg position. The surgical table 104 generally comprises abase 106 for contacting the operating room floor, apedestal 108 rising frombase 106, and aplatform 110 for supporting the patient. Acushion 112 is generally disposed on thetop surface 114 ofplatform 110. - According to some embodiments, the surgical table 104 comprises a
distal portion 120 that may be made of radiolucent materials (e.g., a carbon fiber composite) such that X-ray and/or CT imaging may be performed on the anatomy residing on thedistal portion 120, such as via C-arm X-ray system 150. In some embodiments, thedistal portion 120 is a removable extension mounted onto an end of the surgical table 104, such as disclosed in U.S. non-provisional patent application Ser. No. 15/890,047, filed on Feb. 6, 2018 and titled “Method and apparatus for supporting and stabilizing a patient during hip distraction,” the entire contents of which are hereby incorporated by reference. Thedistal portion 120 may include acushion 122. - The surgical table 104 is configured to tilt the
platform 110 to position thepatient 102 in an inclined position. A degree of inclination can be indicated on aninclinometer 124, which can be located on theplatform 110 or on thedistal portion 120. The surgical table 104 may be a post-less surgical table—i.e., the surgical table 104 does not have a perineal post. - According to various embodiments, the
system 100 include atraction system 130 that includes one or more leg supports 131 for supporting and/or applying traction to theleg 190 of thepatient 102. The one or more leg supports 131 can be mounted (e.g., removable mounted) to the surgical table 104, such as to thebase 106 of the surgical table 104 or to theplatform 110 of the surgical table 104, or can be a free-standing assembly. According to various embodiments, aleg support 131 generally includes aboot 132 for holding thefoot 192 of thepatient 102 and a support structure (generally indicated by reference numeral 134) for altering a position of theboot 132 and, thereby, theleg 190 of thepatient 102. Thesupport structure 134 may be adjustable relative to the surgical table 104, such as via one ormore user controls 135, for positioning the leg in the desired position for a surgical procedure and/or for applying a distraction force to the leg. According to various embodiments, the distraction force is applied to theboot 132 through amechanism 136 to which theboot 132 is mounted. Themechanism 136 may include a user control 138 (e.g., handle, knob, lever, switch, etc.) for making at least some adjustment to an amount of distraction travel of theboot 132 and/or an amount of distraction force applied through theboot 132. Themechanism 136 may include a force gauge, such asforce gauge 400 illustrated inFIG. 4 , for indicating an amount of traction force applied to theleg 190 through themechanism 136. - According to various embodiments, a slide-resisting
pad 142 is positioned on the top surface of the surgical table 104 (which, according to various embodiments, can include the top portion of the distal portion 120) and is configured to increase the friction between the patient and surgical table 104. The friction provided by the slide-resisting pad, both friction with the surgical table 104 (e.g., between the slide-resistingpad 142 and thecushions 112 and 122) and friction with the patient, can resist at least a portion of the distraction force applied to one or more legs of thepatient 102 to reduce the possibility of thepatient 102 inadvertently sliding on surgical table 104, particularly during hip distraction and/or leg manipulation and/or during tilting of thepatient 102. -
FIG. 2 is a block diagram illustrating amethod 200 for performing surgery on a hip of a patient, according to various embodiments. Atstep 202, a patient is positioned on a slide-resisting pad on a surgical table. For example, the patient may be positioned on slide-resistingpad 142 positioned on surgical table 104 ofsystem 100. According to various embodiments, the slide-resisting pad may be positioned on the surgical table and the patient may be lifted onto the slide-resisting pad or the slide-resisting pad with the patient thereon may be lifted together onto the table. According to various embodiments, the surgical table may be in a horizontal position (i.e., 0 degrees of tilt) when the patient is positioned on the surgical table.FIG. 3A is a schematic diagram illustrating apatient 302 positioned on a slide-resistingpad 306 on a surgical table 304 that is in a horizontal position, according to various embodiments. - According to various embodiments, the patient is positioned with the patient's hips and torso supported by the surgical table. According to various embodiments, the slide-resisting pad may be sized so that the patient's buttocks and shoulders are in contact with the slide-resisting pad. According to various embodiments and referring to
system 100 ofFIG. 1 , the patient's hips may be supported by thedistal portion 120 of the surgical table 104, which may be made of radiolucent materials (e.g., a carbon fiber composite) such that X-ray and/or CT imaging may be performed on the hip while the patient is positioned on the surgical table. According to various embodiments, the patient may be strapped to surgical table and/or to the slide-resisting pad. In some embodiments, the slide-resisting pad is strapped to the surgical table. In some embodiments, the patient is not strapped to the surgical table and/or is not strapped to the slide-resisting pad. - According to various embodiments, the patient's skin is in direct contact with the slide-resisting pad to ensure a maximum frictional force between the patient and the slide-resisting pad. In other embodiments, a sheet or patient gown is disposed between the patient and the slide-resisting pad.
- According to various embodiments, the patient's leg or legs may be fastened into one or more leg supports that will be used to apply traction to the patient's leg during the surgical procedure, such as one or more leg supports 131 of
system 100. - At
step 204, the surgical table is tilted so that the patient is in a first degree of inclination, with the patient's head positioned lower than the patient's legs—i.e., positioning the patient in a Trendelenburg position.FIG. 3B illustrates the tilting of the patient, according to various embodiments. The surgical table 304 is titled by an initial angle of θi from horizontal. According to various embodiments, θi is 30 degrees or less, preferably 20 degrees or less, more preferably 15 degrees or less, more preferably 10 degrees or less, or more preferably 5 degrees or less. - Generally, the surgical table is tilted by an amount at least sufficient in combination with the friction force provided by the slide-resisting pad to ensure that a sufficient traction force can be applied to the leg(s) of the patient. In some embodiments, a default amount of tilt is used regardless of the characteristics of the patient and/or the procedure type. In other embodiments, the amount of tilt of the surgical table is tailored to patient characteristics and/or procedure type. For example, the weight of the patient may affect the amount of tilt, with heaver patients generally tilted less than lighter patients. Different procedure types may require different amounts of distraction and, thus, different degrees of tilt. Patients with greater muscle mass may require higher distraction forces, and thus greater degree of tilting, than similar patients with less muscle mass.
- At
step 206, a distraction force is applied to at least one leg of the patient while the patient is in the first degree of inclination. The applied distraction force is sufficient to distract the hip joint of the patient by a desired amount. Distraction forces can be, for example, up to 150 pounds. The distraction force is illustrated by vector Fi inFIG. 3B . The distraction force can be applied according to well-known techniques and based on the experience of the surgeon and the configuration of the traction system. According to various embodiments, the distraction force is applied by setting a position of a distractor of the traction system of the surgical table. For example, insystem 100 ofFIG. 1 , the distraction force may be applied by moving theboot 132 away from the surgical table 104, such as by moving thesupport structure 134 via theuser control 135 and/or by adjustments to themechanism 136 via theuser control 138. Alternatively, distraction force may be applied by move the surgical table away from the patient's feet. Alternatively, distraction force may be applied by tilting the table in Trendelenburg method. - According to various embodiments, the distraction force Fi and the degree of tilt θi are achieved in an iterative manner, such as by first setting a degree of inclination, applying an amount of distraction force, increasing the degree of tilt should the applied distraction force cause patient sliding, and then increasing the distraction force further. Thus, steps 204 and 208 may be performed at least partially in parallel.
- According to various embodiments, an amount of distraction of the hip joint is verified via imaging, such as via display of one or more images generated by C-
arm X-ray system 150 ondisplay 152 ofsystem 100. According to various embodiments, the distraction force may be applied in an incremental fashion with the surgeon checking the amount of distraction of the patient's hip after each incremental increase in the distraction force, such as via X-ray imaging. - The distraction force applied to the leg of the patient is generally countered by the frictional force provided by the slide-resisting pad and a component of the patient's weight that acts along the incline. According to various embodiments, additional patient holding force may be provided by one or more straps that strap the patient to the surgical table and/or the slide-resisting pad. According to various embodiments, a fluid (e.g., air, saline) could be injected into the joint to decrease the force required for traction by breaking the suction seal between the labrum and femoral head. This could be done prior to applying a traction force or while a traction force is applied.
- The surgical procedure on the hip could be performed by the surgeon with the patient in the θi inclined position. However, performing the surgical procedure with the patient in a less inclined position may be more desirable for the surgeon, such as because the surgeon may be more experienced performing the surgery with the patient in a horizontal position using a perineal post, the surgical site may be more accessible with less tilt, and/or imaging may be more intuitive with the patient in a horizontal position. The inventors discovered that the amount of distraction force required to maintain a desired amount of distraction can decrease over time, at least in part due to relaxation of the soft tissue of the patient and, thus, that the amount of tilt can be reduced over time in accordance with the reduction in the distraction force.
- Accordingly, at
step 208 ofmethod 200, the tilt of the surgical table is reduced to a second degree of inclination that is less than the first degree of inclination provided instep 204 in accordance with a reduction of the distraction force over time. A reduced degree of tilt according to various embodiments is illustrated inFIG. 3C in which the degree of tilt, as indicated by θn, is less than the degree of tilt inFIG. 3B . At least some distraction force remains and is sufficient to keep the hip joint distracted by the desired amount, which is shown inFIG. 3C by force vector Fn. At least a portion of the surgical procedure is then performed atstep 210 with the patient positioned in the second degree of inclination and with the hip joint distracted by the desired amount. The second degree of inclination can be any degree of inclination that is less than the first, including 0 degrees of inclination—i.e., horizontal. - According to various embodiments, the tilt of the surgical table can be reduced in
step 208 after a predetermined amount of time has elapsed since the hip joint reached the desired amount of distraction. The predetermined amount of time can be, for example, 2, 5, 10, 15, or 20 minutes. The predetermined amount of time may be based on the sex of the patient. In some embodiments, the tilt of the surgical table is reduced in accordance with an observed reduction in the distraction force. For example, the traction system may include a force gauge that indicates an amount of distraction force applied to the patient, such asforce gauge 400 ofFIG. 4 , and the surgeon may reduce the tilt of the surgical table once the force gauge indicates a distraction force that is sufficiently reduced. - According to various embodiments, the position of the distractor that applies the distraction force to the leg of the patient is maintained as the tilt of the surgical table is reduced. In some embodiments, the traction system remains stationary as the surgical table tilt adjustment is made and the position of the traction system is adjusted after the surgical table tilt adjustment is made. In some embodiments, this can include increasing or decreasing the distraction force to the extent the distraction force may have reduced as a result of the change of the tilt of the surgical table.
- According to various embodiments, the required amount of distraction and, therefore, the distraction force may change over time during the surgical procedure and the distraction force may be adjusted accordingly. In some embodiments, the degree of tilt of the surgical table may be adjusted in a corresponding manner. For example, a first portion of a surgical procedure may be performed with a first amount of distraction of the hip joint, requiring a first amount of distraction force and a corresponding degree of tilting (Fn, θn), and a second portion of the surgical procedure may be performed with a second amount of distraction of the hip joint that is less than the first amount of distraction, such that a lower level of distraction force and corresponding degree of tilting (Fn+1<Fn, θn+1<θn) is used for the second portion of the surgical procedure. The reverse may be true as well—the distraction force and corresponding tilting may be increased during the surgical procedure.
- According to various embodiments, frictional force provided by the slide-resisting pad (due to the patient's weight alone or in combination with one or more straps) may be sufficient to resist the distraction force required for achieved the desired amount of distraction such that the patient need not be placed in the Trendelenburg position. Accordingly, the distraction force may be applied while the surgical table remains horizontal and at least a portion of the surgical procedure may be performed while the hip is distracted and the surgical table is in the horizontal position. Thus, the patient may be initially positioned at 0 degrees of tilt, traction may be applied while the patient is horizontal, the joint may be sufficiently distracted without tilting the patient, and at least a portion of the surgery may be performed while the patient is in the non-tilted position. According to various embodiments, a surgeon may determine whether to place a patient in an inclined position for applying a traction force based on one or more properties of the patient, such as the patient's weight, age, gender, muscularity, etc. In some embodiments, a surgeon may use a Beighton score, which is related to the patient's laxity, to determine how much traction force may be needed, and therefore, whether and how much incline may be needed.
- According to various embodiments, the surgical procedure or at least a portion of the surgical procedure comprises a minimally invasive procedure. According to various embodiments, the surgical procedure is or includes hip arthroscopy, hip arthroplasty, femoral neck fracture repair, femoral shaft fracture repair, tibial shaft fracture repair, periacetabular osteotomy, or de-rotational femoral osteotomy. This is merely an exemplary list of surgical procedures and is not intended to be limiting.
- According to various embodiments, the slide-resisting pad, such as slide-resisting
pad 142 ofsystem 100, is configured to provide high frictional force between the patient and the pad and between the pad and the surgical table (e.g., the cushions of the surgical table) to enable post-free hip distraction with or without positioning the patient in the Trendelenburg position. Examples of suitable slide-resisting pads, according to various embodiments, include any of the stabilizing pads described in U.S. non-provisional patent application Ser. No. 15/890,047, filed on Feb. 6, 2018 and titled “Method and apparatus for supporting and stabilizing a patient during hip distraction.” Suitable slide-resisting pads, according to various embodiments, also include any of the pad embodiments described in U.S. provisional patent application No. 62/954,888, filed Dec. 30, 2019, and titled Apparatus and Method for Patient Positioning, the entire contents of which are hereby incorporated by reference. -
FIG. 5 is a schematic diagram illustrating a slide-resistingpad 500 according to various embodiments. Slide-resistingpad 500 includes atop surface 502 for contacting a patient and abottom surface 504 for contacting the surgical table (e.g., the cushions of the surgical table). Thetop surface 502 preferably comprises a high friction material for preventing a patient from sliding relative to thepad 500. Thetop surface 502 is made of a material which is suitable for contacting the skin of a patient, with respect to both patient compatibility and comfort, while also increasing friction with the patient. According to various embodiments, thepad 500 includesstraps 506 for strapping thepad 500 to the surgical table and/or to the patient. According to various embodiments, thepad 500 is a disposable pad. - According to various embodiments, the
pad 500 is formed of a single material, such as a closed or open cell foam material. The material may have a “tacky” surface to provide high coefficients of friction with the patient and/or table. The foam material may be compliant so as to conform to the patient. A suitable foam material is a polyether polyurethane blend. According to various embodiments, the coefficient of friction of thepad 500 against bare skin is sufficient to enable a traction force to be applied to the patient to achieve a desired amount of traction while the surgical table and patient remain in a horizontal position, which in some embodiments is at least 0.85, at least 0.90, at least 0.95, at least 1.00, at least 1.05, at least 1.10, or at least 1.15, per ASTM D1894. According to various embodiments, these coefficients friction may be achieved with a polyurethane foam pad that provides 12-22 lbs. of force at 25% Indentation Force Deflection per ASTM D3574. - According to various embodiments, the
pad 500 is formed of layers of different material. In some embodiments, a high friction material forms the top and/orbottom surfaces pad 500. For example, aTricot 100% Polyester (0.035″ thick) may be laminated on to a foam middle layer, such as a urethane foam middle layer. The suede may be coated with SEBS (styrene-ethylene-butadiene-styrene) hot melt adhesive such that the coated suede has a coefficient of friction between 1.0-3.0 per ASTM D1894. - The
pad 500 may be any suitable thickness. In some embodiments, thepad 500 is a minimum of 0.5 inches, which may be a minimum thickness to prevent ripping or tearing during a surgical procedure. In some embodiments, thepad 500 is less than 5 inches thick, preferably a maximum of 3 inches, which provides maximum performance while not being too cumbersome for shipping, storage, and/or handling. - According to various embodiments, the
pad 500 includes one or more features cut or formed into a foam material. For example, thepad 500 may have a thickened region intended to be positioned adjacent to a patient's buttocks or shoulders to resist lateral movement of the buttocks or shoulders. Anexemplary pad 600 with a thickenedregion 602 is illustrated inFIG. 6A . In some embodiments, thepad 500 includes a corrugated or serrated shape, such asregion 604 ofpad 600 inFIG. 6A . A pad can include convolutions, such as shown inFIG. 6B . In some embodiments, the pad includes a wedge-shaped region, such as shown inFIG. 6C , which can be positioned adjacent the buttocks of the patient to provide further resistance to sliding. - According to various embodiments, the slide-resisting pad includes indicators for indicating proper patient positioning and proper equipment positioning, which may include indicating that there is no metal in the imaging field if anatomy being imaged is arranged in a predetermined manner with respect to the indicators. For example, the
pad 700 inFIG. 7 includes twoindicators 702 in the form of cutouts, and thepad 700 can be placed on the surgical table such that the cutouts are arranged with respect to a portion of the surgical table that suitable for imaging, such as adjacent the proximal end of thedistal portion 120 ofsystem 100. With thepad 700 properly placed on the surgical table, theindicators 702 indicate to the surgical personnel where the patients' hip should be located to enable imaging. The surgical personnel can position patient on pad/table so that patient anatomy that needs to be imaged (x-ray) can be clearly seen without excessive or extra shadowing from the table or mounting brackets. According to various embodiments, thepad 700 includes at least two sets ofstraps pad 700 to the surgical table and/or to the patient. The first set ofstraps 704 may be located at aproximal end 708 of thepad 700 at or near the location where the patient's shoulders are positioned. The second set ofstraps 706 may be located at adistal end 710 of thepad 700 at or near the location where the patient's buttocks are positioned. By locating thestraps pad 700 that correspond to the patient's shoulders and buttock, respectively, the locations of thepad 700 that receive the greatest pressure from the patient can be strapped to the surgical table. - In some embodiments, the pad may include more than two sets of straps. For example, in
FIG. 7B ,pad 750 includes a third set ofstraps 712 that is located between the first and second sets ofstraps straps 712 may be located at the portion of thepad 750 that corresponds to the small of the back of the patient. The typical curvature of a patient's back may result in the patient's body applying the least amount of pressure to the pad at the location that corresponds to the small of the back of the patient. This may lead to bunching of the pad in this location when the patient is inclined. Locating a third set of straps at the small of the back, therefore, can help prevent bunching of the pad and increase the resistance of the pad to movement of the patient. - In some embodiments, straps 704 attach to the surgical table (e.g. the side rails). In some embodiments, straps 706 attach to the
distal portion 120; in this embodiment, straps 706 may attach to cutouts in the distal portion. In some embodiments, straps 712 may attach to thedistal portion 120, theplatform 110 or the connection between thedistal portion 120 and theplatform 110. -
FIGS. 8-10B, 11A-11J and 12 illustrate various embodiments of a slide-resisting pad configured in particular for facilitating transferring a patient from a gurney to a surgical table, transporting the patient along the surgical table, stabilizing the patient on the surgical table during a surgical procedure, and/or transporting the patient off the surgical table and back onto a gurney at the conclusion of the surgical procedure.Patient pad 5 comprising atop surface 10 for supporting a patient, and abottom surface 15 for engaging a support structure.Patient pad 5 further comprises (when seen from the perspective of an observer) aright side edge 20, aleft side edge 25, atop edge 30 and abottom edge 35.Bottom surface 15 comprises at least onefirst region 40 having a higher coefficient of friction, and at least onesecond region 45 having a lower coefficient of friction. During transport of the patient from a gurney to the surgical table, transport of the patient along the surgical table, and transport of the patient from the surgical table back onto a gurney, second region 45 (having a lower coefficient of friction) engages the support structure (e.g., the gurney or the surgical table) and first region 40 (having a higher coefficient of friction) does not engage the support structure, whereby to facilitate transport of the patient by sliding patient pad 5 (carrying the patient) along the support structure; and during stabilizing of the patient on the surgical table during a surgical procedure, first region 40 (having a higher coefficient of friction) engages the support structure and second region 45 (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all), whereby to facilitate stabilizing the patient on the surgical table by preventing sliding of patient pad 5 (carrying the patient) along the surgical table. - By way of example but not limitation, when the patient needs to be transported from a gurney to the surgical table, transported along the surgical table, and transported from the surgical table back onto a gurney,
patient pad 5 is gripped alongside two or more of its edges and lifted so that second region 45 (having a lower coefficient of friction) engages the support structure (e.g., the gurney or the surgical table) and first region 40 (having a higher coefficient of friction) does not engage the support structure. Patient pad 5 (carrying the patient) is then slid along the support structure so as to facilitate transport of the patient. When the patient needs to be stabilized on the surgical table during a surgical procedure,patient pad 5 is not lifted along two or more of its edges so that first region 40 (having a higher coefficient of friction) engages the support structure and second region 45 (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all), whereby to stabilize the patient on the surgical table by preventing sliding of patient pad 5 (carrying the patient) along the surgical table. - In some embodiments, the body of
patient pad 5 comprises one or more sheets of material (e.g., a foam sheet, a plastic sheet, a textile sheet, etc., including any of the materials described above) which is strong enough to support the weight of the patient;top surface 10 ofpatient pad 5 comprises an atraumatic material which provides resistance to a patient sliding thereon (e.g., high friction foam); first region 40 (having a higher coefficient of friction) comprises a layer of material (e.g., foam, suction cups, etc.) disposed onbottom surface 15 ofpatient pad 5; and second region 45 (having a lower coefficient of friction) comprises a layer of material (e.g., low friction foam, a polymer sheet, a woven sheet, rollers, etc.) disposed onbottom surface 15 ofpatient pad 5. - By way of example but not limitation, and looking now at
FIG. 11A ,patient pad 5 may comprise asheet 1200 formed out of a material having a higher coefficient of friction, such that one or more portions of thebottom surface 15 ofsheet 1200 constitute one or more first regions 40 (having a higher coefficient of friction). One ormore sheets 1205 formed out of a material having a lower coefficient of friction may be mounted to the bottom ofsheet 1200, such that one or more second regions 45 (having a lower coefficient of friction) are provided on the bottom ofpatient pad 5.FIG. 11B shows a construction similar to that ofFIG. 11A , except that the one ormore sheets 1205 are received in one or more recesses formed insheet 1200.FIGS. 11C and 11D show constructions which are similar toFIGS. 11A and 11B , respectively, except that asheet 1210 is mounted abovesheet 1200. In some embodiments,sheet 1210 may be optimized to provide atraumatic contact with the patient while providing resistance to patient sliding thereon. -
FIG. 11E shows another construction in which asheet 1205, formed out of a material having a lower coefficient of friction, has one ormore sheets 1200, formed out of a material having a higher coefficient of friction, mounted belowsheet 1205, and in which asheet 1210 is mounted abovesheet 1205.FIG. 11F shows a construction similar to that ofFIG. 11E , except that the one ormore sheets 1200 are received in one or more recesses formed insheet 1205.FIGS. 11G and 11H are similar toFIGS. 11C and 11D , respectively, except that one or moreintermediate sheets 1215 are interposed betweensheets Sheet 1215 may be optimized for various functionality, e.g., strength.FIGS. 11I and 11J are similar toFIGS. 11E and 11F , respectively, except that one or moreintermediate sheets 1215 are interposed betweensheets - According to various embodiments, a
first region 40 is disposed beneath at least one of a hip/buttocks and a shoulder of the patient, inasmuch as the hips/buttocks and shoulders of the patient tend to be weight concentrators, as described above with respect toFIGS. 7A and 7B . According to various embodiments, afirst region 40 is disposed beneath a hip/buttocks of the patient and anotherfirst region 40 is disposed beneath a shoulder of the patient. According to various embodiments, asecond region 45 is disposed between two adjacentfirst regions 40. According to various embodiments, afirst region 40 is disposed beneath each hip/buttocks and shoulder of the patient. According to various embodiments, a differentfirst region 40 is disposed beneath each hip/buttock and shoulder of the patient. In some embodiments, if desired, asecond region 45 may be disposed between two adjacentfirst regions 40. According to various embodiments, afirst region 40 is disposed beneath the two hips/buttocks of the patient and anotherfirst region 40 is disposed beneath the two shoulders of the patient. In some embodiments, if desired, asecond region 45 may be disposed between two adjacentfirst regions 40. - According to various embodiments, and looking now at
FIGS. 12-15 and 18-22 ,patient pad 5 comprises a central longitudinal axis 50, and asecond region 45 is disposed along central longitudinal axis 50, afirst region 40 is disposed on one side of the second region and anotherfirst region 40 is disposed on the other side of the second region. In some embodiments, if desired, onefirst region 40 may be disposed beneath one hip of the patient and anotherfirst region 40 may be disposed beneath the other hip of the patient, and thesecond region 45 may be disposed between the twofirst regions 40. In some embodiments, if desired, onefirst region 40 may be disposed beneath one shoulder of the patient and anotherfirst region 40 may be disposed beneath the other shoulder of the patient, and thesecond region 45 may be disposed between the twofirst regions 40. In some embodiments, if desired, onefirst region 40 may be disposed beneath one hip of the patient, anotherfirst region 40 may be disposed beneath the other hip of the patient, afirst region 40 may be disposed beneath one shoulder of the patient, anotherfirst region 40 may be disposed beneath the other shoulder of the patient, and adjacentfirst regions 40 may be separated from one another bysecond regions 45. According to various embodiments,patient pad 5 may be configured to change its points of contact with the support structure by changing the configuration of itsbottom surface 15. According to various embodiments,patient pad 5 is configured to change the configuration ofbottom surface 15 by lifting ofpatient pad 5. - According to various embodiments,
patient pad 5 may comprise central longitudinal axis 50,right side edge 20 on one side of central longitudinal axis 50,left side edge 25 on the other side of central longitudinal axis 50, a right side handle 55 adjacentright side edge 20 and a left side handle 60 adjacentleft hand edge 25, such that upon lifting the two handles, the right and left side edges sit further from the support structure than central longitudinal axis 50. As a result, second region 45 (having a lower coefficient of friction) engages the support structure and first regions 40 (having a higher coefficient of friction) are disengaged from the support structure, thereby enabling patient pad 5 (carrying the patient) to be slid along the support structure. According to various embodiments,second region 45 is aligned with central longitudinal axis 50 andfirst region 40 is laterally offset from central longitudinal axis 50. - According to various embodiments, and looking now at
FIGS. 17-20 , astrap 65 extends between the twohandles 55, 60. According to various embodiments, a right side shoulder handle 55A is disposed adjacentright side edge 20 in the vicinity of a shoulder of the patient, a rightside hip handle 55B is disposed adjacentright side edge 20 in the vicinity of a hip of the patient, a left side shoulder handle 60A is disposed adjacentleft side edge 25 in the vicinity of a shoulder of the patient, and a leftside hip handle 60B is disposed adjacentleft side edge 25 in the vicinity of a hip of the patient. According to various embodiments, astrap 65 extends between right side shoulder handle 55A and left side shoulder handle 60A, and anotherstrap 65 extends between right side hip handle 55B and leftside hip handle 60B. According to various embodiments, astrap 65 extends between right side shoulder handle 55A and leftside hip handle 60B, and anotherstrap 65 extends between left side shoulder handle 60A and rightside hip handle 55B. - According to various embodiments, and looking now at
FIGS. 21-24 ,patient pad 5 comprises a contouredbottom surface 15 wherein second region 45 (having a lower coefficient of friction) normally resides further away from the support structure (e.g., the gurney or the surgical table) than first region 40 (having a higher coefficient of friction).Patient pad 5 also comprises aninflatable chamber 70 for selectively movingfirst region 40 further away from the support structure thansecond region 45. As a result, wheninflatable chamber 70 is inflated, second region 45 (having a lower coefficient of friction) engages the support structure and first region 40 (having a higher coefficient of friction) is disengaged from the support structure, thereby enabling patient pad 5 (carrying the patient) to be slid along the support structure. Wheninflatable chamber 70 is deflated, second region 45 (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all) and first region 40 (having a higher coefficient of friction) engages the support structure, whereby to stabilize the patient on the surgical table by preventing sliding of patient pad 5 (carrying the patient) along the surgical table. In some embodiments,inflatable chamber 70 is aligned withsecond region 45. - According to various embodiments, and looking now at
FIGS. 25-27 ,patient pad 5 further comprises astiffener 75 to resist bunching whenpatient pad 5 is subjected to a sliding force. In some embodiments,stiffener 75 preferably comprises a layer of material disposed betweentop surface 10 andbottom surface 15 ofpatient pad 5, although the layer of material could also be disposed alongsidetop surface 10 and/orbottom surface 15. In one preferred form of the invention,stiffener 75 comprises one or more semi-rigid materials, e.g., plastic sheets. Alternatively, where the patient pad is a composite comprising multiple layers, the desired stiffened effect may be achievable with selective stacking of the layers. - It should be appreciated that, if desired,
patient pad 5 may be provided withstiffener 75, with or without providing at least onefirst region 40 having a higher coefficient of friction and at least onesecond region 45 have a higher coefficient of friction. More particularly, In some embodiments,patient pad 5 comprisestop surface 10 for supporting a patient, andbottom surface 15 for engaging a support structure, whereintop surface 10 comprises foam, whereinbottom surface 15 comprises at least one of foam, a polymer sheet and a woven sheet, and further whereinpatient pad 5 comprisesstiffener 75 to resist bunching whenpatient pad 5 is subjected to a sliding force. In some embodiments,stiffener 75 preferably comprises a layer of material disposed betweentop surface 10 andbottom surface 15 ofpatient pad 5, although the layer of material could also be disposed alongsidetop surface 10 and/orbottom surface 15. In one preferred form of the invention,stiffener 75 comprises one or more semi-rigid materials, e.g., plastic sheets. Alternatively, where the patient pad is a composite comprising multiple layers, the desired stiffened effect may be achievable with selective stacking of the layers - According to various embodiments, and looking now at
FIG. 28 ,patient pad 5 comprisestop surface 10 for supporting a patient, andbottom surface 15 for engaging a support structure, whereinbottom surface 15 comprises afirst region 80 having at least one opening 85 communicating with a source 90 of at least one of suction and air pressure. During transport of the patient from a gurney to the surgical table, transport of the patient along the surgical table, and transport of the patient from the surgical table back onto a gurney, the at least one opening 85 offirst region 80 communicates with a source 90 of air pressure so as to create an air cushion beneathbottom surface 15 ofpatient pad 5 and thereby facilitates transport of patient pad 5 (carrying the patient) along the support structure; and during stabilizing of the patient on the surgical table during a surgical procedure, the at least one opening 85 offirst region 80 communicates with a source 90 of suction, so as to create an air grip beneathbottom surface 15 ofpatient pad 5 and thereby facilitate stabilizing patient pad 5 (carrying the patient) on the surgical table. - By way of example but not limitation, when the patient needs to be transported from a gurney to the surgical table, transported along the surgical table, and transported from the surgical table back onto a gurney, at least one opening 85 of
first region 80 communicates with a source 90 of air pressure so as to create an air cushion beneathbottom surface 15 ofpatient pad 5, and thereby facilitates transport of 15 patient pad 5 (carrying the patient) along the support structure. Patient pad 5 (carrying the patient) is then slid along the support structure so as to facilitate transport of the patient. When the patient needs to be stabilized on the surgical table during a surgical procedure, at least one opening 85 offirst region 80 communicates with a source 90 of suction, so as to create an air grip beneathbottom surface 15 ofpatient pad 5 and thereby facilitates stabilizing patient pad 5 (carrying the patient) on the surgical table. - According to various embodiments, and looking now at
FIGS. 29 and 30 , apatient pad 5 comprises atop element 1105 for supporting a patient, and abottom element 1110 for engaging a support structure, whereinbottom element 1110 comprises at least twohandles 1115, whereintop element 1105 comprises at least twoopenings 1120 for passing the at least twohandles 1115 therethrough, whereintop element 1105 can be disposed atopbottom element 1110 with the at least twohandles 1115 extending through the at least twoopenings 1120, wherebypatient pad 5 can be lifted as a unit by pulling upward on the two handles 1115. - According to various embodiments, and looking now at
FIGS. 31 and 32 , apatient support 1125 comprises aconveyor belt 1130 for receiving a patient thereon and for moving the patient by rotation ofconveyor belt 1130. - According to various embodiments, systems and methods include transporting a patient from a gurney to a surgical table, transporting the patient along the surgical table, stabilizing the patient on the surgical table during a surgical procedure, and transporting the patient off the surgical table and back onto a gurney at the conclusion of the surgical procedure. According to various embodiments, these systems and methods can use any of the slide-resisting pads described herein and can include a pad that includes a top surface for supporting a patient; and a bottom surface for engaging a support structure; wherein the bottom surface comprises: at least one first region having a higher coefficient of friction; and at least one second region having a lower coefficient of friction.
- During transport of the patient from a gurney to the surgical table, transport of the patient along the surgical table, and transport of the patient from the surgical table back onto a gurney, the second region (having a lower coefficient of friction) engages the support structure (e.g., the gurney or the surgical table) and the first region (having a higher coefficient of friction) does not engage the support structure, whereby to facilitate transport of the patient by sliding the patient pad (carrying the patient) along the support structure; and during stabilizing of the patient on the surgical table during a surgical procedure, the first region (having a higher coefficient of friction) engages the support structure and the second region (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all), whereby to facilitate stabilizing the patient on the surgical table by preventing sliding of the patient pad (carrying the patient) along the surgical table.
- By way of example but not limitation, when the patient needs to be transported from a gurney to the surgical table, transported along the surgical table, and transported from the surgical table back onto a gurney, the patient pad is gripped alongside two or more of its edges and lifted so that the second region (having a lower coefficient of friction) engages the support structure (e.g., the gurney or the surgical table) and the first region (having a higher coefficient of friction) does not engage the support structure. The patient pad (carrying the patient) is then slid along the support structure so as to facilitate transport of the patient.
- When the patient needs to be stabilized on the surgical table during a surgical procedure, the patient pad is not lifted along two or more of its edges so that the first region (having a higher coefficient of friction) engages the support structure and the second region (having a lower coefficient of friction) may or may not engage the support structure (either fully or partially or not at all), whereby to stabilize the patient on the surgical table by preventing sliding of the patient pad (carrying the patient) along the surgical table.
- According to some embodiments, a patient pad includes: a top surface for supporting a patient; and a bottom surface for engaging a support structure; wherein the top surface comprises foam; wherein the bottom surface comprises at least one of foam, a polymer sheet and a woven sheet; and further wherein the patient pad comprises a stiffener to resist bunching when the patient pad is subjected to a sliding force.
- According to some embodiments, a patient pad includes: a top surface for supporting a patient; and a bottom surface for engaging a support structure; wherein the bottom surface comprises: a first region having at least one opening communicating with a source of at least one of suction and air pressure. During transport of the patient from a gurney to the surgical table, transport of the patient along the surgical table, and transport of the patient from the surgical table back onto a gurney, the at least one opening of the first region communicates with a source of air pressure so as to create an air cushion beneath the bottom surface of the patient pad and thereby facilitate transport of the patient pad (carrying the patient) along the support structure; and during stabilizing of the patient on the surgical table during a surgical procedure, the at least one opening of the first region communicates with a source of suction, so as to create an air grip beneath the bottom surface of the patient pad and thereby facilitate stabilizing the patient pad (carrying the patient) on the surgical table.
- By way of example but not limitation, when the patient needs to be transported from a gurney to the surgical table, transported along the surgical table, and transported from the surgical table back onto a gurney, the at least one opening of the first region communicates with a source of air pressure so as to create an air cushion beneath the bottom surface of the patient pad, and thereby facilitates transport of the patient pad (carrying the patient) along the support structure. The patient pad (carrying the patient) is then slid along the support structure so as to facilitate transport of the patient. When the patient needs to be stabilized on the surgical table during a surgical procedure, the at least one opening of the first region communicates with a source of suction, so as to create an air grip beneath the bottom surface of the patient pad and thereby facilitates stabilizing the patient pad (carrying the patient) on the surgical table.
- According to some embodiments, a patient pad includes: a top element for supporting a patient; and a bottom element for engaging a support structure; wherein the bottom element comprises at least two handles; wherein the top element comprises at least two openings for passing the at least two handles therethrough; wherein the top element can be disposed atop the bottom element with the at least two handles extending through the at least two openings, whereby the patient pad can be lifted as a unit by pulling upward on the two handles.
- According to some embodiments, a patient support includes: a conveyor belt for receiving a patient thereon and for moving the patient by rotation of the conveyor belt.
- The foregoing description, for the purpose of explanation, has been described with reference to specific embodiments. However, the illustrative discussions above are not intended to be exhaustive or to limit the invention to the precise forms disclosed. Many modifications and variations are possible in view of the above teachings. The embodiments were chosen and described in order to best explain the principles of the techniques and their practical applications. Others skilled in the art are thereby enabled to best utilize the techniques and various embodiments with various modifications as are suited to the particular use contemplated.
- Although the disclosure and examples have been fully described with reference to the accompanying figures, it is to be noted that various changes and modifications will become apparent to those skilled in the art. Such changes and modifications are to be understood as being included within the scope of the disclosure and examples as defined by the claims. Finally, the entire disclosure of the patents and publications referred to in this application are hereby incorporated herein by reference.
Claims (30)
1. (canceled)
2. A method for hip distraction, the method comprising:
positioning a patient on a patient pad placed on a surgical table; and
applying a distraction force to a leg of the patient that is sufficient to distract a hip joint of the patient, wherein the distraction force is opposed by a slide-resisting friction force provided by the patient pad and the patient pad is sufficiently stiff to resist bunching while providing the slide-resisting friction force.
3. The method of claim 2 , wherein applying the distraction force comprises setting a position of a distractor that applies the distraction force.
4. The method of claim 3 , wherein applying the distraction force comprises moving a boot of the distractor away from the surgical table.
5. The method of claim 2 , wherein the distraction force is opposed entirely by the slide-resisting friction force provided by the patient pad.
6. The method of claim 2 , comprising strapping the patient pad to the surgical table.
7. The method of claim 2 , wherein positioning the patient on the patient pad comprises positioning the patient such that the patient pad extends beneath shoulders and buttocks of the patient.
8. The method of claim 7 , wherein a first set of straps are located proximate to where shoulders of the patient are positioned and a second set of straps are located proximate to where buttocks of the patient are positioned.
9. The method of claim 2 , wherein the patient pad comprises a stiffener configured to resist bunching when the patient pad is subjected to a sliding force.
10. The method of claim 9 , wherein the stiffener comprises one or more plastic sheets.
11. The method of claim 9 , wherein the stiffener comprises a layer of material disposed on at least one of a top surface and a bottom surface of the patient pad.
12. The method of claim 2 , wherein the patient pad resists bunching based on a layered structure.
13. The method of claim 2 , wherein the patient pad comprises a foam material.
14. The method of claim 13 , wherein the foam material comprises a polyether polyurethane blend.
15. The method of claim 13 , wherein the patient pad comprises a single layer of the foam material.
16. The method of claim 2 , wherein a coefficient of friction provided by the patient pad is at least 0.85.
17. The method of claim 2 , wherein the patient pad is a disposable pad.
18. The method of claim 2 , wherein the patient pad comprises at least one visual indicator for indicating how to position the patient pad on the surgical table and/or how to position the patient on the patient pad.
19. The method of claim 18 , wherein the at least one visual indicator comprises at least one cut-out.
20. A patient pad comprising:
a top surface for supporting a patient; and
a bottom surface for engaging a support structure;
wherein the top surface comprises foam;
wherein the bottom surface comprises at least one of foam, a polymer sheet and a woven sheet; and
further wherein the patient pad comprises a stiffener to resist bunching when the patient pad is subjected to a sliding force.
21. The patient pad of claim 20 , wherein the stiffener comprises a layer of material disposed between the top surface and the bottom surface.
22. The patient pad of claim 20 , wherein the stiffener comprises a layer of material disposed alongside the top surface and/or the bottom surface.
23. The patient pad of claim 20 , wherein the stiffener comprises one or more plastic sheets.
24. The patient pad of claim 20 , comprising a first set of straps located proximate to where shoulders of the patient are positioned and a second set of straps located proximate to where buttocks of the patient are positioned.
25. The patient pad of claim 20 , wherein the foam of the top surface and/or the bottom surface comprises a polyether polyurethane blend.
26. The patient pad of claim 20 , wherein a coefficient of friction provided by the patient pad is at least 0.85.
27. The patient pad of claim 20 , wherein the patient pad is a disposable pad.
28. The patient pad of claim 20 , comprising at least one visual indicator for indicating how to position the patient pad on the support structure and/or how to position the patient on the patient pad.
29. The patient pad of claim 28 , wherein the at least one visual indicator comprises at least one cut-out.
30. A method for patient positioning, the method comprising:
providing a patient pad comprising:
a top surface for supporting a patient; and
a bottom surface for engaging a support structure;
wherein the top surface comprises foam;
wherein the bottom surface comprises at least one of foam, a polymer sheet and a woven sheet; and
further wherein the patient pad comprises a stiffener to resist bunching when the patient pad is subjected to a sliding force; and
positioning a patient so that the patient is supported by the top surface of the patient pad.
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EP3576687A4 (en) | 2017-02-06 | 2021-03-10 | Stryker Corp. | Method and apparatus for supporting and stabilizing a patient during hip distraction |
EP3576684A4 (en) | 2017-02-06 | 2020-12-02 | Stryker Corp. | Distraction frame for effecting hip distraction |
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