Europäisches Patentamt
(19)
European Patent Office
*EP001152727B1*
Office européen des brevets
(11)
EP 1 152 727 B1
EUROPEAN PATENT SPECIFICATION
(12)
(45) Date of publication and mention
(51) Int Cl.7:
of the grant of the patent:
12.01.2005 Bulletin 2005/02
A61G 13/12, A61B 6/04
(86) International application number:
PCT/US2000/003639
(21) Application number: 00908614.1
(87) International publication number:
(22) Date of filing: 11.02.2000
WO 2000/047155 (17.08.2000 Gazette 2000/33)
(54) HINGED ADAPTOR ASSEMBLY FOR RADIOLUCENT TABLE EXTENSION
MIT SCHARNIEREN VERSEHENER ADAPTOR FÜR EINE RÖNTGENSTRAHLDURCHLÄSSIGE
TISCHVERLÄNGERUNG
ADAPTATEUR ARTICULE POUR EXTENSION DE TABLE RADIOTRANSPARENTE
(74) Representative: Schmidt, Steffen J., Dipl.-Ing.
(84) Designated Contracting States:
CH DE FR GB IT LI NL
Wuesthoff & Wuesthoff,
Patent- und Rechtsanwälte,
Schweigerstrasse 2
81541 München (DE)
(30) Priority: 11.02.1999 US 119686 P
(43) Date of publication of application:
(56) References cited:
14.11.2001 Bulletin 2001/46
(73) Proprietor: Schaerer Mayfield USA, Inc.
Cincinnati, OH 45227 (US)
WO-A-99/11176
US-A- 5 427 436
US-A- 6 003 174
US-A- 5 233 713
US-A- 5 675 851
(72) Inventor: DINKLER, Charles, E.
EP 1 152 727 B1
Cincinnati, OH 45230 (US)
Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give
notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in
a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art.
99(1) European Patent Convention).
Printed by Jouve, 75001 PARIS (FR)
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Description
Field of the Invention
[0001] This invention relates to a surgical table according to the preamble of claim 1, and more particularly, to an improved radiolucent table extension and radiolucent adaptor assembly which facilitates interoperative scanning.
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Background of the Invention
[0002] With current medical practices, it is common
for a patient to undergo a diagnostic scanning procedure, which is normally performed in a separate suite
containing the scanning machine and dedicated to
scanning procedures. The scanning machine may be a
CT, MRI, or other scanning device. Thereafter, the scan
data is utilized in a surgical planning process, which conventionally takes place at a location, for example, an office or an operating room. In some surgical procedures,
the scanning data is utilized with a system for post
processing the scan data acquired during imaging. Further, the imaging system may be located in a surgical
suite, and the surgical planning performed before and
during surgical procedure utilizing the imaging system
and scan data.
[0003] During the scanning procedure, the patient
must maintain a perfectly still and motionless posture,
and while most often, the patient simply lies on a scanning support table, in some situations, the patient may
be supported in the desired scanning position with pads,
straps or other supports. Further, the support on which
the patient rests is normally radiolucent, that is, transparent to the scanning device, so that the support does
not compromise the utility of the scanned image. Further, the patient support used for scanning normally
translates with respect to the imaging device. Translation of the patient support permits the patient to be
moved into the scanning field or zone of the scanning
machine.
[0004] After the scanning process is completed, often
the patient is then moved to an operating room which
requires either that the patient walk, or be carried, for
example, by transferring the patient from the scanning
table to an operating table. Alternatively, as illustrated
in U. S. Patent No. 5,475,884, the patient may be supported on a portable support plate, which is easily
moved between the scanning table and the operating
table. The scan data is often used in a post processing
imaging system for surgical planning purposes both prior to and during surgery. If during or after a surgical process, it is desired to scan a patient again, the patient must
be moved from the operating room to the scanning suite,
transferred to and from the operating table to the scanning table, and after scanning, transferred back to the
operating table and returned to the operating room. The
above process is cumbersome, time consuming and po-
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tentially risky for the patient.
[0005] Some newer scanning machines are substantially reduced in size. One such machine is shown in
Figs. 2 and 3 of U. S. Patent No. 5,499,415, which show
an annularshaped scanner mounted on a wheel-supported frame, to enable the scanner to be used at multiple sites. Consequently, such scanning machines do
not require their own suite or room, but instead, they
may be used within the operating suite itself. Thus, in
an operating room, the patient may be scanned ; the
surgical planning performed; an operative procedure
executed; and the patient scanned again to determine
the current status of the operative procedure. Based on
the new scanned images obtained from the one or more
"interoperative"scans, the operative procedure can be
continued and the above process repeated as necessary.
[0006] A limitation of the current state-of-the-art is that
the posture of the patient during the scanning process
is often different from the patient's posture during surgery. If a patient is positioned in one posture on a scanning table during the scanning process, and then is
moved to an operating table, that motion of the patient
may cause the position of the target to change with respect to the body surface. During surgery, this problem
is compounded by tissue shifts attendant to the opening
of body cavities, removal of body fluid or tissues and
tissue retractions. Thus, while such motion may be
small, any motion of the target will reduce or compromise the utility of the preoperative scan data.
[0007] The solution to these problems is to scan the
patient in the operating room during surgery while the
patient is maintained in the surgical posture, and further,
to make successive interoperative scans, as necessary,
while still holding the patient in the same surgical posture.
[0008] While current scanning tables are radiolucent
and provide a translation to move the patient into the
scanning machine, such scanning tables do not have
the accessories required to attach, support and stabilize
surgical instrumentation and to properly support the patient's body in the desired surgical posture. Further,
while surgical, or operating tables contain numerous accessories and couplings to which surgical instrumentation may be attached and supported, most operating tables are not compatible with scanning instrumentation.
Thus, as presently known, scanning tables cannot be
used as operating tables, and generally, operating tables are inappropriate for use as scanning tables.
[0009] In US 5,233,713 a head holder device for use
in conjunction with an imaging table is disclosed, wherein the head holder has a shape to comfortably receive
the head of a person. The head holder is attached to a
mounting panel which can be placed directly on top of
an end of the table.
[0010] US 5,675,851 describes an extension device
to be a fixed to table in a radiology laboratory to hold a
person thereon. Similarly to US 5,233,713 this exten-
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sion device is mounted on top of the table.
[0011] Furthermore US 5,427,436 describes an adjustable headrest to be mounted on an end of a table.
This headrest is not adapted to support both an upper
torso and the head of a person.
[0012] It is an object of this invention to overcome the
above-described limitations in the prior art, by facilitating the function of supporting a patient in a desired position in a manner which readily accommodates successive surgical or scanning procedures and to optimize
versatility in the supporting of a patient in a desired position which accommodates interoperative scans.
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Summary of the Invention
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[0013] This object is achieved by a surgical table extension assembly according to claim 1. The present invention provides a radiolucent table extension that connects to a surgical table and permits a patient to be positioned on the table in a posture suitable for successive
surgical or scanning procedures, the head and the upper torso of the patient supported on the table extension,
a radiolucent adaptor assembly hingedly connected to
the radiolucent table extension and a radiolucent support, of a type which holds either a radiolucent horseshoe headrest or a radiolucent skull clamp, hingedly
connected to the radiolucent adaptor assembly. The
present invention represents an improvement in versatility over the structure shown and described in U. S. Patent Application No. 08/922,969, entitled"Radiolucent
Table Extension and Method.
[0014] The radiolucent table extension is cantilevered
from one end of the surgical table and it is shaped so
that it may be moved in a relative manner into a toroidal
shaped scanning zone of an upright annular scanning
machine. This permits the patient to be scanned in the
desired surgical posture. The radiolucent table extension and the radiolucent adaptor assembly of this invention are especially useful for those procedures in which
it is desirable to maintain the patient in a desired position
during successive scanning or surgical procedures.
[0015] By operatively connecting the toroidal scanner
to an imaging system, so that the imaging system may
store data representative of scans of the patient taken
in the scanning zone, and by supporting the patient with
the extension and the hingedly connected adaptor, and
fixing the position of the patient with the horseshoe
headrest or the skull clamp hingedly connected to the
adaptor, the present invention optimizes versatility in the
positioning of a patient during successive scans, thereby assuring the accuracy of the scanned data. This
helps the surgeon to know almost immediately whether
the surgical procedure accomplished its objective, or
whether continutation of the surgical procedure may be
necessary.
[0016] According to the principles of the present invention and in accordance with the preferred embodiments, a radiolucent table extension has a first inboard
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end adapted to be attached to one end of a surgical table. The table extension includes a contoured radiolucent member designed to support an upper torso and
head of a patient with the rest of the patient's body being
further supported by an adjacently located surface of the
table. The member has a sufficiently narrow width to
permit it to be extended, in cantilever fashion, into a
scanning zone of portable CT scanning system. A second, or outboard end of the radiolucent table extension
hingedly connects to a radiolucent adaptor assembly,
which preferably comprises two spaced radiolucent
adaptor subassemblies hingedly connected along a first
connection axis to spaced collars located at the outboard end of the radiolucent member. An arcuate cutout
resides between the two spaced collars. This cutout advantageously defines an opening between the extension and the radiolucent support to accommodate surgical tubing. Likewise, a radiolucent support also has
two spaced collars aligned along a second connection
axis, and the radiolucent support hingedly connects to
the radiolucent adaptor assembly along a second connection axis. The two connection axes are parallel, and
if desired they may reside in the same vertical plane.
The radiolucent support is adapted to support at least
one cranial stabilization device, typically either a radiolucent skull clamp or a radiolucent horseshoe headrest.
[0017] The radiolucent adaptor assembly actually
comprises two spaced adaptor subassemblies. Each radiolucent adaptor subassembly includes opposing interior and exterior pieces which are tightenable, via a
threaded adjustment knob, into rigid engagement with
the spaced table extension collars and the spaced support collars. Each of the interior and exterior pieces has
locator pins in alignment with the first and second connection axes. Along each connection axis, the locator
pins extend into the respective collar with a slip fit. The
locator pins provide the hinged connection between the
radiolucent table extension and the radiolucent adaptor
along the first connection axis and the hinged connection between the radiolucent support and the radiolucent
adaptor along the second connection axis. Tightening
of the adjustment knob effectively moves the interior and
exterior pieces horizontally toward each other to engage
the outer ends of the collars, preferably via corresponding serrated, or starburst surfaces, thereby to achieve
rigid holding. Thus, even though there is hinged capability along two spaced axes, the radiolucent support is
locked in place via actuation of knobs residing on a single axis.
[0018] The hingedly connected radiolucent support is
adapted to support at least one patient stabilization device, typically either a radiolucent skull clamp or a radiolucent horseshoe headrest. When using a radiolucent
skull clamp, the radiolucent support comprises a radiolucent bracket which supports a ninety degree radiolucent intermediate connector which in turn holds the radiolucent skull clamp. The radiolucent bracket and the
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radiolucent intermediate connector connect along a
dovetail slot, to enable the radiolucent skull clamp to be
slidably located at a desired position relative to the longitudinal axis of the table extension, as may be desired
in certain situations.
[0019] When the patient stabilization device is a
horseshoe headrest, the radiolucent support is a Ushaped panel bearing an upstanding slide mount oriented transverse to the longitudinal direction of the table
extension. The radiolucent horseshoe headrest comprises two separate arcuate halves which slidably attach
to the slide mount, to form a U-shape for holding the
head of the patient.
[0020] The U-shaped panel combines with the arcuate cutout region at the outboard end of the table extension to form an enclosed oval, which is advantageous
for certain procedures wherein the patient must be positioned face down. In this arrangement the radiolucent
adaptor assembly represents, in effect, an intermediately located, double hinge for the entire support assembly
attached in cantilever fashion to the surgical table.
[0021] Because of the configuration of the radiolucent
adaptor assembly, and the configuration of the two different radiolucent supports for holding either a skull
clamp or a horseshoe headrest, the present invention
provides rigid connection of either configuration with the
same adaptor assembly. Thus, the invention greatly
simplifies and shortens the time needed for surgical attendants to interchange between a skull clamp set up
and a horseshoe headrest set up. Even with a high degree of rigidity and with this ability to easily interchange
between two different patient stabilization devices, the
present invention also achieves enhanced maneuverability of the patient stabilization device, due to the two
hinged connections. According to another aspect of the
invention, the adaptor assembly accommodates connection of a horseshoe headrest in an inboard manner,
partially surrounding an enclosed oval. The headrest is
inboard because the radiolucent plate holding the headrest represents an outermost end of the entire cantilevered structure, and the two hingeable axes reside between this outermost end and the table extension.
[0022] Thus, the double-hinged radiolucent adaptor
assembly of the present invention optimizes versatility
in supportably positioning a patient on a radiolucent table extension, via either a radiolucent skull clamp or a
radiolucent horseshoe headrest. With this inventive
structure, the patient can be supported on the radiolucent table extension in the desired posture. The patient
can then be conveniently scanned before a surgical procedure. After surgery, a subsequent scanning procedures may be performed, if necessary or if desired.
Thus, the table extension and adaptor assembly have
the advantage of not requiring that the patient be moved
with respect to the table extension between successive
scanning and surgical procedures.
[0023] Moreover, with updated scanned images readily available for viewing via the imaging system, the sur-
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geon can review the results of a surgical procedure to
determine if a particular operation has been completely
successful. For example, if the objective of the surgery
was to completely remove a hematoma from the brain,
a follow-up scan may enable the surgeon to use the imaging system to determine if the entire hematoma has
been removed. If a subsequent scan shows that some
of the "target" remains, then the surgeon can continue
the surgical procedure, using the imaging system if desired, to achieve 100% removal of the target. Thus, this
overall system facilitates successive scanning and surgical procedures, and the radiolucent table extension
and the radiolucent adaptor assembly make it possible
to use this system more effectively, by assuring accurate
and repeatable positioning of the patient.
[0024] These and other objects and advantages of the
present invention will become more readily apparent
from the following detailed description and the drawings.
Brief Description of the Drawings
[0025]
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Fig. 1 is a perspective view of a portion of a surgical
table including a radiolucent table extension assembly, in accordance with the general principles
of the invention.
Fig. 2 is a top plan view of the radiolucent table extension assembly of Fig. 1.
Fig. 3 is a side view in elevation of the radiolucent
table extension assembly of Fig. 1.
Fig. 4 is a cross-section view taken along the line
4-4 of Fig. 2.
Fig. 5 is a cross-section of view taken along the line
5-5 of Fig. 2.
Fig. 6 is a top plan view of an alternative embodiment of the radiolucent table extension assembly in
accordance with the general principles of the invention.
Fig. 7 is a perspective view of yet another alternative embodiment of a table extension assembly in
accordance with the general principles of the invention.
Fig. 8 is a top plan view of the table extension assembly shown in Fig. 7, but with additional hardware shown, namely an inboard horseshoe headrest.
Fig. 9 is a side view of the table extension of Fig. 8,
but also showing an outboard stabilization device,
in this case a skull clamp, secured to the tooling
support outboard of the edge of the table extension.
Fig. 10 is a side view, similar to Fig. 9, showing the
inboard horseshoe headrest tilted relative to the table extension assembly.
Fig. 11 is a disassembled perspective view of a radiolucent table extension and double-hinged radiolucent adaptor assembly in accordance with a preferred embodiment of the present invention, using
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a radiolucent horseshoe headrest as the patent stabilization device.
Fig. 12 is a another perspective view of a radiolucent table extension and double-hinged radiolucent
adaptor assembly, in accordance with a preferred
embodiment the present invention, with a radiolucent skull clamp serving as the patient stabilization
device.
Fig. 13 is a fragmentary view of one of the radiolucent adaptor subassemblies according to a preferred embodiment of the present invention.
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Detailed Description of the Invention
[0026] Referring to Fig. 1, a portable CT scanning system 20 is located in an operating suite with an operating
table 22. The CT scanning system may be either a mobile system such as that commercially available from
Analogic of Peabody, Massachusetts or a stationary
scanning system such as that commercially available
from General Electric Medical Systems of Milwaukee,
Wisconsin. The operating table 22 may be one of many
commercially available tables, for example, an operating table commercially available from Amsco of Erie,
Pennsylvania, MDT Diagnostic Co. ofN. Charleston,
North Carolina, or other suppliers. The operating table
has a lateral rail 23 extending along each side of the
table to which retractors, clamps and other devices may
be attached and stablely supported. A stereotactic image processing system 24, for example, the MAYFIELD-ACCISS image processing system, commercially available from Ohio Medical Instrument Company,
Inc. of Cincinnati, Ohio is operatively connected to the
scanner 20 and responsive to scan data provided by the
CT system 20, to provide selected images on a display
screen of the scan data along selected planes. Use of
an imaging system 24 of this type is described in U.S.
Patent No. 5,695,501. To facilitate the use of the operating table 22 with the CT system 20, one end of the
operating table is used to support a radiolucent table
extension 26.
[0027] Referring to Fig. 2, the table extension 26 includes a support member or plate 28 made of radiolucent material, for example, wood, carbon graphite, etc,
and the table extension 26 has a length to normally support the upper torso and head of a patient 27, the upper
torso being defined as the portion of the patient's body
above the waist including the head. As shown in Fig. 4,
the patient support member 28 has a curved cross-sectional profile and has a laminated construction with a
center layer of mahogany between two outer layers of
carbon graphite, although the invention also contemplates molding the member 26 as one integral piece.
The curve is normally a circular arc having a relatively
large radius, for example, 28 inches, to generally conform to the shape of a patient. The support member 28
may have a length up to about 52 inches, although most
procedures can be accommodated with a shorter-
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length, such as 36 inches. The outer or distal end 30 of
the support member 28 includes a horseshoe headrest
32 that is generally U-shaped and filled with a gel to
comfortably and properly support the patient's head.
The headrest 32 surrounds an opening 34 within the
support member 28. The opening 34 is sized to receive
the face of a patient lying on the support member 28 in
a prone position. The distal end 30 is narrower than the
inner or fixed end 36, and the narrow profile of the distal
end 20 of the support plate 28 facilitates positioning the
distal end 30 in scanner 20 even if the table or the scanner 20 is tilted. The support member 28, when viewed
from the top as shown in Fig. 2, has a profile that flares
outward from the distal end 30 to the fixed end 36. The
width of the support member 28 at the fixed end 36 is
generally greater than the distance between the holes
46 and is normally equal to the width of the operating
table 22.
[0028] Referring to Fig. 5, the support member 28 is
secured at its fixed end 36 within a slot 38 of an attachment base 40. Fasteners, for example, screws 42 are
used to clamp and secure the support plate 28 within
the attachment base 40. The attachment base 40 is mechanically linked to support shafts 44, which extend longitudinally from the fixed end of the support base 40 and
are sized to fit into holes 46 of the table 22. Thus, the
support plate 28 provides an extension of and is cantilevered from the end 23 of the table 22.
[0029] Referring to Figs. 1-3, an instrument or tool
support or rail 54 is attached to the periphery of the distal
end 30 of the support plate 28. The tool support 54 may
be made from a "DELRIN®" acetal polymer material, a
polyethersuylfone ("PES") material or a carbon graphite. An inner directed side 56 of the tool support 54 includes a slot 58 for receiving the portion of the periphery
60 of the support plate 28. The support plate 28 may be
secured in the slot 58 using fasteners or adhesives or
both. The slot 58 is curved with respect to a radius
sweeping a vertical plane that is generally perpendicular
to and extends across the width of the support plate 28.
An outer directed side 62 of the tool support 54 includes
a second slot 64 that is generally parallel to a longitudinal center line of the tool support 54. Thus, when viewed
from the end of the support plate 28, that is, looking to
the left in Fig. 3, the slot 64 will appear generally as a
straight slot. The slot 64 permits medical instruments,
such as stabilization devices 66, for example a skull
clamp, retractors, clamps, supports, etc., also collectively referred to as "tools" herein, to be supported, selectively moved with respect to the distal end 30 of the
support plate 28 to desired positions and locked or secured in place. In the illustrated embodiment, the slot 64
has a dovetail shape that matches a mating dovetail on
the tool to be mounted and secured to the tool support
54. For example, the tool support 54 may receive one
end 68 of a transitional element 70. The other end 72 of
the transitional element 70 is rotatably coupled to a swivel adaptor 74. The swivel adaptor, in turn, is coupled to
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a skull clamp 76. The skull clamp 76 is normally manufactured from radiolucent materials, for example, as described in U.S. Patent No. 5,276,927 issued to the assignee of the present invention.
[0030] As shown in Fig. 3, the support plate 28 is often
used in a generally horizontal position such that the top
of the operating table 22 is generally in line with the support plate 28. However, numerous surgical procedures
require that the support plate 28 be tilted or pivoted up
or down with respect to the end 25 of the table 22. The
tilting or pivoting of the support plate 28 is accomplished
by the mechanism illustrated in Fig. 5. The attachment
base 40 includes a pair of housings 86 connected to a
lower surface 41 at a location near the ends of the attachment base 40 (Fig. 4). The attachment base 40 and
housings 86 may be cast or made from aluminum. The
support shafts 44 are rigidly connected at one end to
respective cross-shafts 88 that are rotatably mounted
within the lateral side walls 90 of the housings 86. The
cross-shafts 88 extend through brass bushings (not
shown) mounted in the lateral side walls 90 and function
as pivot pin in a hinge. The support shafts 44 function
as fixed hinge members, and the housings function as
movable hinge members. A ratchet wheel 92 is fixed at
the center of each of the cross-shafts 88, and each
ratchet wheel has notches 94 between teeth 96. The
support shafts 44, cross-shafts 88, and ratchet wheels
92 are normally made from stainless steel.
[0031] Pawls 98 are shaped to mate with and fit into
the notches 94 of respective ratchet wheels 92. Each
pawl 98 is mounted on the end of a release shaft 100
that extends through a bore 102 of a respective housing
86. With the pawls 98 in the position illustrated in Fig.
5, they function to securely support their respective
housings 86 and the support plate 28 in a generally horizontal position. A spring 104 provides a bias to forcibly
maintain the pawls 98 within the slots 94. The pawls 98
and release shafts 100 are normally made of stainless
steel.
[0032] As shown in Fig. 4, a release shaft or bar 106,
normally made of aluminum or stainless steel, extends
between the shafts 100 and the housings 86. By pulling
on the bar 106, the shafts 100 move to the right as
viewed in Fig. 5; and the pawls 98 are pulled out of engagement with respective ratchet notches 94. Once the
pawls 98 is disengaged from the notches 94, the support
plate 28, attachment base 40, and housings 86 are freely rotatable relative to respective stationary ratchet
wheels 92, cross-shafts 88 and support shafts 44. Thus,
the support plate 28 may be pivoted with respect to an
axis of rotation 108 in the generally clockwise or counter-clockwise direction until the support plate 28 is at its
desired angular position as shown in phantom in Fig. 5.
Normally, the support plate 28 may be pivoted approximately 60° above and below its illustrated horizontal position. When the bar 106 is released, the springs 104
push their respective pawls 98 into the closest ratchet
notches 94, thereby securing the support plate with the
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desired angle or tilt.
[0033] In use, referring to Fig. 1, the scanning system
20 and operating table 22 are brought into a surgical
suite. The scanning system 20 has a toroid shape scanning element 110 with a central opening 112 defining an
enclosed or encircled scanning zone with which the portion of the patient to be scanned is axially aligned. The
scanning element 110 further has the capability of rotating or tilting within its base 114 with respect to a diametric horizontal axis. The distal end 30 of the support plate
28 is narrowed so that it can extend into the opening 112
without interference. If necessary, the head section (not
shown) of the table 22 is removed therefrom, and the
radiolucent table extension 26 is mounted to the table
by inserting the support bars 44 into mating bores 46 on
the end surface 47 of the table 22. The patient 116 is
then positioned on the table in a posture suitable for a
surgical procedure. The length of the support plate 28
is sized such that the patient's upper torso and head are
accessible for scanning and surgical procedures. The
portion of the patient's anatomy on which the surgical
procedure is to be performed may be stabilized by various clamps and restraining devices, for example, the
skull clamp 76. Further, the support plate 28 or the scanning element 110 may be tilted so that the desired posture and/or scanning plane is achieved.
[0034] When the desired surgical posture is achieved,
normally the patient will have already been scanned;
and the surgical planning and procedure can be performed. Thereafter, a portion of the radiolucent table extension 26 is then moved into the opening 112, for a follow-up scan. The extent to which the extension 26 is
moved into the opening 112 depends on what portion of
the head or upper torso is to be scanned. The initial
alignment of the table extension may be determined by
visual inspection; and thereafter, a scan made to determine exactly whether and to what extent the table extension may be out of alignment. Alternatively, the scanner may be equipped with LED's or other sources of light
providing beams of light with which the table extension
can be aligned. In another embodiment, the table 22
may have an alignment tab 124 (Fig. 1) which is moved
into an alignment slot 124 on the scanner 110. When
the tab 124 is properly seated in the slot 126, the table
is properly aligned with the scanner 110. The scanning
process is executed by the scanning machine moving
the scanning element 110 incrementally in an axial direction and with each increment, a scan is taken. Thereafter, the extension 26 and the patient are removed from
within the scanning element 110, either by moving the
scanning machine 20 or the operating table 22. The
scan data is then used in association with the imaging
systems 24 to plan the surgical procedure. The surgical
procedure is then performed, and thereafter, the patient
may be moved back into the scanning machine 20, and
the scanning process repeated. The scanning and imaging system may be used to gauge the effectiveness
of the surgical procedure; and if necessary, further pro-
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cedures performed. The above process may be executed any number of times with the patient remaining in the
desired position on the same patient support.
[0035] Thus, the above-described operating table and
radiolucent table extension has a significant advantage
of not only being able to support a patient during a scanning process, but also support the patient in the identical
posture during a surgical procedure. The radiolucent table extension permits an operating table that is normally
nonradiolucent and inappropriate for scanning purposes to be used with a scanning machine. Further, the table extension may be tilted to accommodate different
desired surgical postures and is sized and shaped to
readily fit within the opening of a scanning element,
whether in a horizontal or tilted position. Further, not only
does the table position permit successive scanning and
operative procedures on the upper torso and head of a
patient, but the radiolucent table extension 26 readily
supports the patient in a prone, or supine position.
[0036] Referring to Fig. 6, an alternative embodiment
of the support plate 118 has an distal end 120 that is
curved to generally follow the profile of the headrest 32.
Further a tool support 122 extends along the periphery
of the support plate 118 to a location at which the width
of the support plate 118 begins to flare outwardly toward
the width of the fixed end 32. Other than its length, the
construction and function of the tool support 122 is substantially identical to the tool support 54 described earlier.
[0037] According to a further variation of this embodiment, as shown in Figs. 7-10, a radiolucent table extension assembly 126 includes a tool support 122 removably connected to the peripheral edge at a distal end
120 of the support member 128. The support member
128 is preferably pivotal relative to a table (not shown)
to which is connected. This is done by incorporating a
pivot mechanism (not shown) into the table extension
assembly 126 or even into the table itself, as with surgical tables commercially available from Midmark of
Dayton, Ohio, which are built so as to tilt relative to horizontal. With such tube, the support member 128 is simply plugged via pins 129 into the table (not shown) which
is already oriented at a desired angle. The support member 128 may have an inner portion 128a which is contoured to the body of the patient and an outer portion
118b which is generally flat. The tool support 122 may
removably secure to the support plate 128 via a pair of
hand-tightenable knobs 124. The member 128 includes
an opening 134, and a radiolucent horseshoe headrest
32 or 132 resides inboard of, and generally in alignment
with, a portion of the opening 134 as shown in Figs. 8-10.
This configuration enables a bag-like surgical drape (not
shown) to be placed over a patient who is supported on
the support member 128 by the horseshoe 132, and in
an intubated condition, and then the tool support 122
connected to the distal end 120 to confine the drape
within the edge of the support member 128, between
the support member 128 and the tool support 122.
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Phantom line 130 in Fig. 9 illustrates an example of
where this drape would be located. The patient 27 may
be supported on the support member 128 in a face up
or face down position. In a face down position, the hole
134 may be used for routing of one or more intubation
tubes (not shown) or other medical instruments to the
patient 27.
[0038] This results in locating the tool support 122 outside the drape 130, in the surgical field. This is also true
for any other attendant hardware or assembly components 166 connected thereto, such as a skull clamp 174.
For some types of surgical procedures, this draping arrangement may be preferable during surgical or scanning procedures. At least with respect to scanning, this
configuration helps to assure that no structure will impede movement of the table extension assembly 126
into the scanning zone.
[0039] With this embodiment, i.e., the tool support 122
and the outer stabilization device 166, in this case the
skull clamp 174, connected "outboard" of the outer edge
of the support member 128, it is also possible to hold
the head of the patient with a removably connected, tiltable horseshoe 132 located inboard of the edge of the
support plate member 128 (Figs. 8, 9). Fig. 10 shows
the headrest 132 tilted relative to the support member
128. With the tiltable horseshoe headrest 132, there is
a first connection piece 132a which mounts to an inside
edge of the opening 134 and a pair of mirror image headrest pieces 132b and 132c (Fig. 8) which connect to
each other in a common plane and tilt relative to the
piece 132a. This tilting feature gives the surgeon additional versatility in positioning the patient. Both the connector piece 132a and the second headrest pieces 132b
and 132c are made of radiolucent material so as to not
create artifacts during scanning.
[0040] Figs. 8-10 show outer tooling 166, specifically
a skull clamp 174, along with an inner device such as a
horseshoe headrest 132 connected to the tool support
122. Preferably the tooling or devices 166 are radiolucent and positively hold the patient in a fixed position
relative to the support member 128, so that the patient
remains in a desired position during successive surgery
and scanning procedures. This is done with the inboard
headrest 132 and/or an outer stabilization device 166,
to affirmatively hold the patient 27 in a fixed position relative to the support plate 118. This structural capability
facilitates convenient positioning of the patient 27 during
successive scanning or surgical procedures, thereby
enabling the surgeon to conveniently and easily perform
follow-up procedures.
[0041] As will be appreciated, the horseshoe-shaped
gel filled headrest 32 illustrated and described may have
other embodiments. For example, the headrest may be
circular or another shape, may be filled with a different
material, or may be thicker so that the patient's head is
supported fully above the upper surface of the support
plate 28. The headrest 132 shown in Figs. 8-10 represents only one of these possible variations. Further, the
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EP 1 152 727 B1
opening 34 may have other configurations. For example, the opening 34 may be replaced by, or supplemented by, one or a plurality of holes of any shape for various
purposes, for example, ventilating the patient, access
for tubes and other equipment, drainage, or openings
through which the patient can see or the patient's eyes
can be seen. As will be appreciated, separate inserts or
built-in hole covers may be used to fill or cap the holes
when they are not being used.
[0042] In accordance with a preferred embodiment of
the present invention, Figs. 11-13 show a radiolucent
hinged adaptor assembly 210 and a radiolucent table
extension 228. More particularly, the radiolucent table
extension 228 is adapted to support the upper torso of
a patient, with the rest of the patient supported by a surgical table 22 of the type shown in Fig. 1. As shown in
Fig. 11, a first, or inboard, end 230 of the table extension
228 connects to the surgical table 22. Preferably this
connection at the first end 230 occurs via a pair of
spaced base mounts 232. Each of the base mounts 232
engages an inboard comer of the radiolucent table extension 228 and is shaped to receive an outwardly extending post or bar (not shown) extending from the surgical table 22. A threaded knob 234 tightens upon the
inserted post on both sides of the surgical table 22, to
securely mount the extension 228. Preferably, the extension 228 comes in two different lengths. Depending
on the length of the extension 228 and the type of table
22, the manner of mounting the extension 228 may vary.
[0043] A second or outboard end 236 of radiolucent
table extension 228 includes a pair of spaced collars 238
aligned along a first connection axis 240. The first connection axis 240 is oriented horizontally and perpendicular to the longitudinal direction of the radiolucent table
extension 228. Between the spaced collars 238, the radiolucent table extension 228 includes an arcuate cutout
region 242. The first connection axis 240 provides for
hinged, or pivotal, movement of the radiolucent adaptor
assembly 210, and everything else connected thereto,
relative to the radiolucent table extension 228 .
[0044] To provide this hinged movement about first
connection axis 240, the radiolucent adaptor assembly
210 actually comprises a pair of spaced adaptor subassemblies 250, each of the adaptor subassemblies
250 associated with one of the spaced collars 238 of the
table extension 228. Each subassembly 250 includes
an interior piece 252 and an exterior piece 254 which
are tightenable in a horizontal direction via a threaded
knob 256. The threaded knob 256 includes a screw (not
shown) which extends through an oversized central
bore (not shown) in exterior piece 254 and threads within a complementary shaped, internally threaded recess
(not shown) located within interior piece 252.
[0045] As shown in Fig. 11, the exterior piece 254 is
T-shaped, while the interior piece 252 is uniform in thickness. If desired, this arrangement can be switched
around, with the interior piece 252 being T-shaped and
the exterior piece 254 being uniformly thick, so long as
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the interior piece 252 and exterior piece 254 are tightenable together upon the respective collars 238. This
would also require switching the threaded and the
through holes.
[0046] Along first axis 240, the interior piece 252 and
the exterior piece 254 have aligned openings machined
therein which receive locator pins, via a press fit. The
locator pins are sized to extend into the collar 238 along
the connection axis 240, with a slip fit, so as to be rotatable relative to the collar 238. Together, the opposing
locator pins of the interior piece 252 and the exterior
piece 254 are held by the collar 238 along the first connection axis 240, so that upon tightening of threaded
knob 256 the inwardly directed surfaces of the interior
piece 252 and the exterior piece 254 engage the outwardly directed surfaces of the collar 238. Preferably,
the outwardly directed surfaces of the collar 238 are serrated, or have a starburst configuration, and the inwardly
directed surfaces of the interior piece 252 and the exterior piece 254 likewise have correspondingly shaped
serrations.
[0047] Thus, upon sufficient tightening of threaded
knob 256, the interior piece 252 and exterior piece 254
will move together horizontally until their respective engagement surfaces contact and engage opposing surfaces of the collar 238. This engagement force holds the
radiolucent adaptor subassembly 250 in a fixed position
relative to the radiolucent table extension 228. Upon
loosening the threaded knob 256, the subassembly 250
may be hingedly moved relative to first connection axis
240 to a different position, whereupon the threaded
knob 256 may again be tightened to form a rigid connection.
[0048] Fig. 11 also shows a radiolucent support 264
which connects to the radiolucent adaptor assembly
210. More specifically, in the arrangement shown in Fig.
11, the radiolucent support 264 is a U-shaped panel 266
which has a pair of spaced collars 268 which connect to
the spaced subassemblies 250 along the second connection axis 270. The structure and manner of connecting the radiolucent support 264 (in this case a U-shaped
panel 266) relative to the adaptor assembly 210 along
second connection axis 270 are similar to that which has
been already described with respect to the connection
of the adaptor assembly 210 to the table extension 228
along the first connection axis 240. That is, outwardly
directed surfaces of the collars 268 are serrated. Upon
tightening of knob 256 to move the interior piece 252
and the exterior piece 254 toward each other in a horizontal direction, these pieces 252 and 254 engage the
outwardly directed surfaces of the collar 268 to connect
the panel 266 to the adaptor assembly 210 in a desired
position relative to the second connection axis 270.
[0049] Preferably, the threaded knobs 256 on both
sides of the table extension 228 are tightened or loosened in unison, to facilitate orienting the radiolucent support 264 relative to the table extension 228 in a coordinated fashion. As with the connections along the first
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EP 1 152 727 B1
connection axis 240, along the second connection axis
270 each adaptor subassembly 250 includes opposing
locator pins 271 which extend along the second axis 270
and into the collars 268, to locate the interior and exterior
pieces 252 and 254 in a desired position relative to the
second axis 270.
[0050] In Fig. 11, the hinged adaptor assembly 210 of
the present invention advantageously interconnects a
horseshoe headrest 272 to the table extension 228, in
a manner such that the horseshoe headrest 272 can be
tilted relative to the table extension 228 about the first
connection axis 240, tilted about the second connection
axis 270, or both. Preferably, the horseshoe headrest
272 includes an upstanding mount 274 oriented perpendicular the longitudinal axis of the table extension 228.
This mount 274 may include a dovetail shape, or any
other desired cross-sectional shape for that matter,
which corresponds to a complementary shape formed
in a headrest portion 272a or 272b, so that the headrest
portions 272a and 272b can be slidably located on the
mount 274.
[0051] If desired, each of the horseshoe headrest portions 272a and 272b may include a base 273a and 273b
made of radiolucent material (of the type used to make
support 54), for supporting the cushion thereabove
along its curved length. The base 273a and 273b may
be made of the same material as the panel 266 and the
mount 274. With this construction, the headrest itself
272 comprises a pad or cushion secured to the base
273a and 273b.
[0052] Notably, when the adaptor assembly 210 of the
present invention is used in conjunction with the horseshoe headrest 272, the U-shaped panel 266 combines
with the arcuate cutout region 242 to form an enclosed
oval. The oval is bisected by the first connection axis
240 and by the second connection axis 270, and an outermost end of the entire assembly is now defined by the
outermost end of the U-shaped panel 266. Thus, the
headrest 272 resides inboard of the outermost end of
panel 266, and in effect, the adaptor assembly 210 provides a pair of intermediately located hinged axes 240
and 270 for locating the horseshoe headrest 272 in a
desired position relative to the table extension 228 and
the patient supported thereon.
[0053] Because of the versatile design of the radiolucent adaptor assembly 210 of the present invention, the
U-shaped panel 266 may be hinged downwardly with
respect to table extension 228 about first connection axis 240, downwardly about second connection axis 270,
or both, or upwardly relative to one or both of these
spaced parallel axes 240 and 270, or even upwardly
with respect to one of the axes 240 or 270 and downwardly with respect to the other. Moreover, this versatility is achieved via tightening and loosening of a single
pair of aligned and spaced knobs 256, preferably with
the entire cantilevered assembly held temporarily in a
desired position during the tightening or loosening. In
effect, the knobs 256 are actuator mechanisms for lock-
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ing the patient stabilization device in a desired position
relative to the table extension 228, and the actuators are
aligned along an axis which resides between the first
axis 240 and the second axis 270
[0054] Figs. 12 and 13 show the radiolucent adaptor
assembly 210 of the present invention in a configuration
wherein the radiolucent support 264 more specifically
comprises a radiolucent bracket 278 which is adapted
to hold a radiolucent skull clamp 280. As with the Ushaped panel 266, the radiolucent bracket 278 includes
a pair of spaced collars 282 which are adapted to be
connected to the spaced adaptor subassemblies 250
along the second connection axis 270. This likewise enables the skull clamp 280 to be oriented in a desired
position relative to the table extension 228, via hinged
movement about first connection axis 240, hinged
movement about second connection axis 270, or both.
[0055] Because of the versatility provided by this. radiolucent adaptor assembly 210, the structure used for
interconnecting the skull clamp 280 to the radiolucent
bracket 278 may also be simplified. More specifically,
as shown in Fig. 13, the radiolucent bracket 278 includes an internal dovetail 282 sized to receive a complementarily shaped member from an intermediate connector 286, the connector 286 being lockable to the radiolucent bracket 278 via an adjustment knob 288 and
further including an upstanding member 290 which retains another adjustment knob 292 which tightens a
starburst connection of the intermediate connector 286
to the skull clamp 280.
[0056] As with the horseshoe headrest 272, when using a radiolucent skull clamp 280 with the present invention, the radiolucent adaptor assembly 210 provides two
parallel axes of connection 240 and 270 residing between the radiolucent table extension 228 and the patient stabilization device used to hold the head of the
patient in a desired position. Thus, the present invention
increases the versatility of patient positioning relative to
a radiolucent table extension assembly, for advantageous use in interoperative scanning procedures. This
versatility is available for patient stabilization with either
a skull clamp or a horseshoe headrest. In fact, this invention makes it easy for attendants to interchange the
surgical set up, by removing one of these two different
holding devices and connecting the other. Moreover, the
present invention achieves these advantages in a manner which is user-friendly for the surgeon and operating
room attendants, because the maneuverability of the
patient stabilization device is achieved about two
spaced parallel axes 240 and 270 via adjustment of a
pair of spaced adjustment knobs 256.
[0057] The interior pieces 252, the threaded knobs
256 and the locator collars 238 and 268 along the first
connector axis 240 and the second connector axis 270
are made by Potts. Composites of Floydada, Texas out
of carbon fiber composite and epoxy resin material. The
extension 228 is made by MTD Inc. of Andover, New
Jersey out of "Delrin®" acetyl polymer material. If de-
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sired, each collar 238 and 268 may include an internal
sleeve (not shown) made of hydlar-kevlar. The exterior
pieces 254 are made out of the same material described
above with respect to support 54. However, it will be understood by those skilled in the art that these various
components may be made of any suitably rigid radiolucent material.
[0058] Also, the table extension 228 may receive a radiolucent foam pad (not shown) thereon in order to comfortably support a patient.
[0059] In another related aspect of the invention, a target holder and its attendant components and/or an articulated arm, as shown in Fig. 3 of U.S. Patent No.
5,695,501, may be removably connectable to the one
or more radiolucent patient stabilization devices and/or
the radiolucent tool support, so that the target holder and
its components and/or the articulated arm may be disconnected prior to scanning and then affirmatively reconnected in the exact same position after scanning.
This is important because the target holder and its components and/or articulated arm are typically not radiolucent. Therefore it is undesirable to keep them connected
to the rest of the structure during scanning. These components could create artifacts or impede movement of
the patient into and out of the scanning zone. Yet, it is
also important to reconnect in the same relative position.
This assures that, after scanning, the viewing probe or
the surgical device (both of which are removably held
along a line of sight by the target holder) will be aligned
and located in the same position relative to the patient
as before the scanning procedure.
[0060] Therefore, the invention in its broadest aspects
is not limited to the specific details shown and described.
The invention is as defined in the appended set of
claims.
1.
A surgical table extension assembly for use in combination with a scanning machine (20) having an enclosed scanning zone (112), comprising:
a radiolucent member (228) having an inboard
first end (230) with a patient (27) being supported by said radiolucent member (228) and by an
adjacently located surface of the table (22), the
table (22) and the radiolucent member (228)
being movable relative to the scanning machine (20) to locate the member (228) and the
head of the patient (27) within the scanning
zone (112);
a radiolucent adaptor assembly (210) hingedly
connected to an outboard second end of the
member (228) along a first connection axis
(240);
a radiolucent support (264) hingedly connected
to the radiolucent adaptor assembly (210)
along a second connection axis (270) with an
opening (242) residing between the radiolucent
support (264) and the radiolucent member
(228); and
at least one radiolucent patient stabilization device (272) supported on the radiolucent support
(264) and adapted to stabilize the head of the
patient (27), the first connection axis (240) and
the second connection axis (270) providing increased versatility in locating the patient stabilization device (272) in a desired position relative to a patient (27), the opening providing for
advantageous routing of tubing to the patient,
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characterized in that the radiolucent member
(228) is adapted to be removably attached to one
end of the table (22) to extend from the end of the
table (22) in cantilever fashion and has a rigidity sufficient to support an upper torso and the head of a
patient (27).
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2.
The surgical table extension assembly of claim 1
wherein the outboard second end of the radiolucent
member (228) includes a pair of spaced collars
(238) aligned along a first connection axis (240), the
radiolucent adaptor assembly (210) being removably connected to the radiolucent member (228) at
the spaced collars (238) and hingable about the first
connection axis (240) relative to the radiolucent
member (228).
3.
The surgical table of claim 1 or 2 wherein the outboard second end of the radiolucent member (228)
includes an arcuate central cutout region (242),
thereby defining the opening between the member
(228) and the radiolucent support (264)..
4.
The surgical table of any of claims 1 to 3 wherein
the radiolucent adaptor assembly (210) comprises
two spaced radiolucent adaptor subassemblies
(250).
5.
The surgical table of any of claims 1 to 4 wherein
the radiolucent support (264) includes a pair of
spaced support collars (268) aligned along a second connection axis (270), the radiolucent adaptor
assembly (210) being removably connected to the
radiolucent support (264) at the spaced support collars (268) and hingable about the second connection axis (270) relative to the radiolucent support
(264).
6.
The surgical table of any one of claims 1 to 5 wherein the radiolucent support (264) is a U-shaped radiolucent panel (266) and the patient stabilization device is a horseshoe-shaped radiolucent headrest
(272) mounted on the radiolucent panel (266).
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Claims
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7.
EP 1 152 727 B1
8.
9.
partially define an enclosed oval.
The surgical table of claim 6 and further comprising:
a radiolucent slide mount (274) secured to the
panel (266), the horseshoe-shaped radiolucent
headrest (272) comprising two separate radiolucent sections (272a, 272b) slidably secured
on the radiolucent slide mount (274).
The surgical table of any one of claims 1 to 5 wherein the radiolucent support is a radiolucent bracket
(278) and the patient stabilization device is a radiolucent skull clamp (280) supported by the radiolucent bracket (278).
The surgical table of claim 8 further comprising:
a radiolucent intermediate connector (286) secured to the radiolucent bracket (278), the radiolucent skull clamp (280) secured to the radiolucent intermediate connector (286).
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15. Combination of a patient table (22) having an upper
support surface and a radiolucent table extension
assembly according to one of claims 1 to 14, adapted to support a head and upper torso of a patient
(27) residing in a prone position on the upper support surface, the radiolucent table extension assembly being sized to be received within a toroidal
shaped scanning zone (112) of a scanning machine
(20), the patient table (22) and the radiolucent table
extension assembly being movable relative to the
scanning machine (20) to locate the radiolucent table extension assembly within the scanning zone
(112), and the radiolucent table extension assembly
further comprising:
a radiolucent adaptor assembly (210) hingedly
connected to an outboard second end of the
member (228) along a first connection axis
(240);
a radiolucent support (264) hingedly connected
to the radiolucent adaptor assembly (210)
along a second connection axis (270) with an
opening (242) residing between the radiolucent
support (264) and the radiolucent member
(228); and
at least one radiolucent patient stabilization device (272) supported on the radiolucent support
(264) and adapted to stabilize the head of the
patient (27), the first connection axis (240) and
the second connection axis (270) providing increased versatility in locating the patient stabilization device (272) in a desired position relative to a patient, the opening (242 providing for
advantageous routing of tubing to the patient.
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10. The surgical table extension assembly of any one
of the previous claims 1 to 9 wherein the first and
second connection axes are parallel.
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11. The surgical table extension assembly of any of
claims 1 to 10 wherein the patient stabilization device is hingably positionable relative to the radiolucent member about both the first and second connection axes and lockable into a fixed position via
actuation of at least one actuator knob (256) aligned
along an actuation axis residing between the first
connection axis and the second connection axis.
12. The surgical table extension assembly of claim 11
wherein actuation occurs via rotatable actuation of
at least two spaced knobs (256) aligned along the
actuation axis and located on opposite sides of the
opening.
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Patentansprüche
40
1.
13. A surgical table extension assembly according to
claim 1 comprising:
a radiolucent horseshoe headrest (272) supported on the radiolucent support (264) and residing inboard of an outermost end of the radiolucent support (264), the horseshoe headrest
(272) adapted to stabilize the head of the patient (27), the radiolucent horseshoe headrest
(272) being pivotal about the first connection
axis (240) and the second connection axis
(270) relative to the radiolucent member (228),
thereby to increase versatility in locating the patient stabilization device in a desired position.
Operationstisch-Verlängerungsanordnung zur Verwendung in Kombination mit einer Scannmaschine
(20) mit einer umschlossenen Scannzone (112),
umfassend:
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14. The surgical table extension assembly of claim 13
wherein the radiolucent adaptor assembly comprises a pair of spaced adaptor subassemblies which
11
ein strahlentransparentes Element (228) mit einem inneren ersten Ende (230), wobei ein Patient (27) durch das strahlentransparente Element (228) und durch eine benachbart angeordnete Fläche des Tisches (22) getragen wird,
wobei der Tisch (22) und das strahlentransparente Element (228) relativ zu der Scannmaschine (20) bewegbar sind, um das Element
(228) und den Kopf des Patienten (21) innerhalb der Scannzone (112) zu bewegen;
eine strahlentransparente Adapteranordnung
(210), die gelenkig mit einem äußeren zweiten
Ende des Elements (228) entlang einer ersten
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Verbindungsachse (240) verbunden ist;
eine strahlentransparente Stütze (264) die gelenkig mit der strahlentransparenten Adapteranordnung (210) entlang einer zweiten Verbindungsachse (270) verbunden ist, wobei sich eine Öffnung (242) zwischen der strahlentransparenten Stütze (264) und dem strahlentransparenten Element (228) befindet; und
wenigstens eine strahlentransparente Patientenstabilisiervorrichtung (272), die sich auf der
strahlentransparenten Stütze (264) abstützt
und dazu ausgelegt ist, den Kopf des Patienten
(27) zu stabilisieren, wobei die erste Verbindungsachse (240) und die zweite Verbindungsachse (270) eine erhöhte Vielseitigkeit hinsichtlich der Orientierung der Patentenstabilisiervorrichtung (272) in einer Sollposition relativ zu
einem Patienten (27) vorsieht, wobei die Öffnung vorteilhafterweise ein Hindurchführen
von Leitungen zu dem Patient vorsieht,
dadurch gekennzeichnet, dass das strahlentransparente Element (228) derart ausgelegt ist,
dass es entfernbar an einem Ende des Tisches (22)
anbringbar ist, so dass es sich von dem Ende des
Tisches (22) in freitragender Weise aus erstreckt
und eine hinreichend Steifigkeit aufweist, um einen
Oberkörper und den Kopf eines Patienten (27) zu
stützen.
umfasst, die entlang einer zweiten Verbindungsachse (270) ausgerichtet sind, wobei die strahlentransparente Adapteranordnung (210) entfernbar
mit der strahlentransparenten Stütze (264) an den
voneinander beabstandeten Ringen (268) verbunden und um die zweite Verbindungsachse (270) relativ zu der strahlentransparenten Stütze (264)
schwenkbar ist.
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6.
Operationstisch nach einem der Ansprüche 1 bis 5,
wobei die strahlentransparente Stütze (264) eine Uförmige strahlentransparente Platte (266) ist und
die Patientenstabilisiervorrichtung eine hufeisenförmige strahlentransparente Kopfstütze (272) ist,
die auf der strahlentransparenten Platte (266) angebracht ist.
7.
Operationstisch nach Anspruch 6 und ferner umfassend:
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eine strahlentransparente Schiebehalterung
(274), die an der Platte (266) befestigt ist, wobei die hufeisenförmige strahlentransparente
Kopfstütze (272) zwei separate strahlentransparente Abschnitte (272a, 272b) umfasst, die
verschiebbar an der strahlentransparenten
Schiebehalterung (274) befestigt sind.
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8.
Operationstisch nach einem der Ansprüche 1 bis 5,
wobei die strahlentransparente Stütze eine strahlentransparente Klammer (278) ist und wobei die
Patientenstabilisiervorrichtung eine strahlentransparente Schädelklemme (280) ist, die von der strahlentransparenten Klammer (278) gestützt wird.
9.
Operationstisch nach Anspruch 8, ferner umfassend:
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2.
3.
4.
Operationstisch-Verlängerungsanordnung
nach
Anspruch 1, wobei das äußere zweite Ende des
strahlentransparenten Elements (228) ein Paar
voneinander beabstandeter Ringe (238) aufweist,
die entlang einer ersten Verbindungsachse (240)
ausgerichtet sind, wobei die strahlentransparente
Adapteranordnung (210) entfernbar mit dem strahlentransparenten Element (228) an den beabstandeten Ringen (238) verbunden ist und um die erste
Verbindungsachse (240) relativ zu dem strahlentransparenten Element (228) schwenkbar ist.
Operationstisch nach Anspruch 1 oder 2, wobei das
äußere zweite Ende des strahlentransparenten
Elements (228) einen bogenförmigen ausgeschnittenen Bereich (242) umfasst, wodurch die Öffnung
zwischen dem Element (228) und der strahlentransparenten Stütze (264) begrenzt wird.
Operationstisch nach einem der Ansprüche 1 bis 3,
wobei die strahlentransparente Adapteranordnung
(210) zwei voneinander beabstandete strahlentransparente Adapterunteranordnungen (250) umfasst.
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einen strahlentransparenten Zwischenverbinder (286), der an der strahlentransparenten
Klammer (278) befestigt ist, wobei die strahlentransparente Schädelklemme (280) an dem
strahlentransparenten
Zwischenverbinder
(286) befestigt ist.
45
10. Operationstisch-Verlängerungsanordnung nach einem der vorangehenden Ansprüche 1 bis 9, wobei
die ersten und zweiten Verbindungsachsen parallel
zueinander sind.
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5.
22
Operationstisch nach einem der Ansprüche 1 bis 4,
wobei die strahlentransparente Stütze (264) ein
Paar voneinander beabstandeter Stützringe (268)
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11. Operationstisch-Verlängerungsanordnung nach einem der Ansprüche 1 bis 10, wobei die Patientenstabilisiervorrichtung gelenkig relativ zu dem strahlentransparenten Element sowohl um die erste als
auch um die zweite Verbindungsachse positionierbar und in eine feste Position über eine Betätigung
wenigstens eines Betätigungsknopfes (256) fixierbar sind, der entlang einer Betätigungsachse aus-
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Ende des Elements (228) entlang einer ersten
Verbindungsachse (240) verbunden ist;
eine strahlentransparente Stütze (264), die gelenkig mit der strahlentransparenten Adapteranordnung (210) entlang einer zweiten Verbindungsachse (270) verbunden ist, wobei sich eine Öffnung (242) zwischen der strahlentransparenten Stütze (264) und dem strahlentransparenten Element (228) befindet; und
wenigstens eine strahlentransparente Patientenstabilisiervorrichtung (272), die sich auf der
strahlentransparenten Stütze (264) abstützt
und dazu ausgelegt ist, den Kopf des Patienten
(27) zu stabilisieren, wobei die erste Verbindungsachse (240) und die zweite Verbindungsachse (270) eine verbesserte Vielseitigkeit bei
der Positionierung der Patientenstabilisierungsvorrichtung (272) in einer Sollposition relativ zu einem Patienten vorsehen, wobei die
Öffnung (242) eine vorteilhafte Hindurchführung von Leitungen zu dem Patienten bereitstellt.
gerichtet ist, welche zwischen der ersten Verbindungsachse und der zweiten Verbindungsachse
liegt.
12. Operationstisch-Verlängerungsanordnung
nach
Anspruch 11, wobei die Betätigung über eine Drehbetätigung wenigstens zweier voneinander beabstandeter Knöpfe (256) erfolgt, die entlang der Betätigungsachse ausgerichtet und auf einander entgegengesetzten Seiten der Öffnung angeordnet
sind.
13. Operationstisch-Verlängerungsanordnung
Anspruch 1, umfassend:
5
10
nach
15
eine strahlentransparente hufeisenförmige
Kopfstütze (272), die sich auf der strahlentransparenten Stütze (264) abstützt und sich innerhalb eines äußeren Endes der strahlentransparenten Stütze (264) befindet, wobei die
hufeisenförmige Kopfstütze (272) dazu ausgelegt ist, den Kopf des Patienten (27) zu stabilisieren, wobei die strahlentransparente hufeisenförmige Kopfstütze (272) um die erste Verbindungsachse (240) und um die zweite Verbindungsachse (270) relativ zu dem strahlentransparenten Element (228) schwenkbar ist,
um dadurch die Vielseitigkeit bei der Positionierung der Patientenstabilisierungsvorrichtung in
einer Sollposition zu verbessern.
14. Operationstisch-Verlängerungsanordnung
nach
Anspruch 13, wobei die strahlentransparente Adapteranordnung ein Paar voneinander beabstandeter
Adapterunteranordnungen umfasst, die teilweise
ein eingeschlossenes Oval bilden.
15. Kombination eines Patiententisches (22) mit einer
oberen Stützfläche und einer strahlentransparenten Tischverlängerungsanordnung gemäß einem
der Ansprüche 1 bis 14, die dazu ausgelegt ist, einen Kopf und einen Oberkörper eines Patienten
(27) zu stützen, der sich ausgestreckt auf der oberen Stützfläche befindet, wobei die strahlentransparente Tischverlängerungsanordnung derart dimensioniert ist, dass sie in einer toroidförmigen Scannzone (112) einer Scannmaschine (20) aufgenommen werden kann, wobei der Patiententisch (22)
und die strahlentransparente Tischverlängerungsanordnung relativ zu der Scannmaschine (20) bewegbar sind, um die strahlentransparente Tischverlängerungsanordnung innerhalb der Scannzone
(112) zu positionieren, und wobei die strahlentransparente Tischverlängerungsanordnung ferner umfasst:
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Revendications
1.
Extension de table chirurgicale à utiliser conjointement à un dispositif de balayage (20) possédant
une zone de balayage fermée (112), comprenant :
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55
eine strahlentransparente Adapteranordnung
(210), die gelenkig mit einem äußeren zweiten
13
un élément radiotransparent (228) possédant
une première extrémité intérieure (230) avec
un patient (27) étant supporté par ledit élément
radiotransparent (228) et par une surface située de manière adjacente de la table (22), la
table (22) et l'élément radiotransparent (228)
étant amovibles par rapport au dispositif de balayage (20) pour localiser l'élément (228) et la
tête du patient (27) à l'intérieur de la zone de
balayage (112) ;
un adaptateur radiotransparent (210) connecté
de manière articulée à une deuxième extrémité
extérieure de l'élément (228) le long d'un premier axe de connexion (240) ;
un support radiotransparent (264) connecté de
manière articulée à l'adaptateur radiotransparent (210) le long d'un deuxième axe de connexion (270) avec une ouverture (242) se trouvant entre le support radiotransparent (264) et
l'élément radiotransparent (228) ; et
au moins un dispositif de stabilisation radiotransparent du patient (272) supporté sur le
support radiotransparent (264) et adapté pour
stabiliser la tête du patient (27), le premier axe
de connexion (240) et le deuxième axe de connexion (270) procurant une souplesse d'utilisation accrue pour localiser le dispositif de stabilisation du patient (272) dans une position sou-
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un support coulissant radiotransparent (274)
fixé au panneau (266), l'appui-tête radiotransparent en forme de fer à cheval (272) comprenant deux sections radiotransparentes séparées (272a, 272b) fixées de manière coulissante sur le support coulissant radiotransparent
(274).
haitée par rapport à un patient (27), l'ouverture
procurant un acheminement avantageux de tubulure au patient,
caractérisé en ce que l'élément radiotransparent
(228) est adapté pour être fixé de manière amovible
à une extrémité de la table (22) pour s'étendre depuis l'extrémité de la table (22) en porte-à-faux, et
possède une rigidité suffisante pour supporter le
haut du torse et la tête d'un patient (27).
2.
3.
Extension de table chirurgicale selon la revendication 1,
dans laquelle la deuxième extrémité extérieure de
l'élément radiotransparent (228) comprend une paire de colliers espacés (238) alignés le long d'un premier axe de connexion (240), l'adaptateur radiotransparent (210) étant connecté de manière amovible à l'élément radiotransparent (228) aux colliers
espacés (238) et pouvant s'articuler autour du premier axe de connexion (240) par rapport à l'élément
radiotransparent (228).
Table chirurgicale selon la revendication 1 ou 2,
dans laquelle la deuxième extrémité extérieure de
l'élément radiotransparent (228) comprend une zone découpée centrale arquée (242), définissant ainsi l'ouverture entre l'élément (228) et le support radiotransparent (264).
5
5.
6.
7.
Table chirurgicale selon l'une quelconque des revendications 1 à 3,
dans laquelle l'adaptateur radiotransparent (210)
comprend deux sous-adaptateurs radiotransparents espacés (250).
Table chirurgicale selon l'une quelconque des revendications 1 à 4,
dans laquelle le support radiotransparent (264)
comprend une paire de colliers de support espacés
(268) alignés le long d'un deuxième axe de connexion (270), l'adaptateur radiotransparent (210)
étant connecté de manière amovible au support radiotransparent (264) aux colliers de support espacés (268) et pouvant s'articuler autour du deuxième
axe de connexion (270) par rapport au support radiotransparent (264).
Table chirurgicale selon l'une quelconque des revendications 1 à 5,
dans laquelle le support radiotransparent (264) est
un panneau radiotransparent en forme de U (266)
et le dispositif de stabilisation du patient est un appui-tête radiotransparent en forme de fer à cheval
(272) monté sur le panneau radiotransparent (266).
Table chirurgicale selon l'une quelconque des revendications 1 à 5,
dans laquelle le support radiotransparent est une
console radiotransparente (278) et le dispositif de
stabilisation du patient est un serre-crâne radiotransparent (280) supporté par la console radiotransparente (278).
9.
Table chirurgicale selon la revendication 8 comprenant en outre ;
un connecteur intermédiaire radiotransparent (286)
fixé à la console radiotransparente (278), le serrecrâne radiotransparent (280) fixé au connecteur intermédiaire radiotransparent (286).
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30
4.
8.
10
20
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26
10. Extension de table chirurgicale selon l'une quelconque des revendications précédentes 1 à 9,
dans laquelle les premier et deuxième axes de connexion sont parallèles.
11. Extension de table chirurgicale selon l'une quelconque des revendications précédentes 1 à 10,
dans laquelle le dispositif de stabilisation du patient
est positionnable de manière articulée par rapport
à l'élément radiotransparent autour des premier et
deuxième axes de connexion et verrouillable dans
une position fixée via l'actionnement d'au moins
une molette d'actionnement (256) alignée le long
d'un axe d'actionnement se trouvant entre le premier axe de connexion et le deuxième axe de connexion.
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45
12. Extension de table chirurgicale selon la revendication 11,
dans laquelle l'actionnement se produit via l'actionnement rotatif d'au moins deux molettes espacées
(256) alignées le long de l'axe d'actionnement et situées sur des côtés opposés de l'ouverture.
13. Extension de table chirurgicale selon la revendication 1 comprenant :
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55
Table chirurgicale selon la revendication 6 comprenant en outre :
14
un appui-tête radiotransparent en forme de fer
à cheval (272) supporté sur le support radiotransparent (264) et se trouvant à l'intérieur
d'une extrémité la plus extérieure du support
radiotransparent (264), l'appui-tête en forme
fer à cheval (272) adapté pour stabiliser la tête
du patient (27), l'appui-tête radiotransparent en
forme de fer à cheval (272) pouvant pivoter
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autour du premier axe de connexion (240) et
du deuxième axe de connexion (270) par rapport à l'élément radiotransparent (228), pour
ainsi augmenter la souplesse d'utilisation pour
localiser le dispositif de stabilisation du patient
dans une position souhaitée.
14. Extension de table chirurgicale selon la revendication 13,
dans laquelle l'adaptateur radiotransparent comprend une paire de sous-adaptateurs séparés qui
définissent partiellement un ovale fermé.
15. Combinaison d'une table (22) portant un patient,
possédant une surface support supérieure et une
extension de table radiotransparente selon l'une
des revendications 1 à 14, adaptée pour supporter
une tête et le haut du torse d'un patient (27) se trouvant en position couchée sur la surface support supérieure, l'extension de table radiotransparente
étant dimensionnée pour être reçue à l'intérieur
d'une zone de balayage de forme toroïdale (112)
d'un dispositif de balayage (20), la table (22) portant
un patient et l'extension de table radiotransparente
étant amovibles par rapport au dispositif de balayage (20) pour localiser l'extension de table radiotransparente à l'intérieur de la zone de balayage
(112), et l'extension de table radiotransparente
comprenant en outre :
5
10
15
20
25
30
un adaptateur radiotransparent (210) connecté
de manière articulée à une deuxième extrémité
extérieure de l'élément (228) le long d'un premier axe de connexion (240) ;
un support radiotransparent (264) connecté de
manière articulée à l'adaptateur radiotransparent (210) le long d'un deuxième axe de connexion (270) avec une ouverture (242) se trouvant entre le support radiotransparent (264) et
l'élément radiotransparent (228) ; et
au moins un dispositif de stabilisation (272) radiotransparent du patient supporté sur le support radiotransparent (264) et adapté pour stabiliser la tête du patient (27), le premier axe de
connexion (240) et le deuxième axe de connexion (270) procurant une souplesse d'utilisation accrue pour localiser le dispositif de stabilisation (272) du patient en une position souhaitée par rapport à un patient, l'ouverture (242)
procurant un acheminement avantageux de tubulure au patient.
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45
50
55
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