WO2000048526A1

WO2000048526A1 - Mat for retaining surgical instruments

Info

Publication number: WO2000048526A1
Application number: PCT/GB2000/000540
Authority: WO
Inventors: Richard Malcolm Hall; Michael Karol
Original assignee: Technovent Ltd.
Priority date: 1999-02-18
Filing date: 2000-02-18
Publication date: 2000-08-24
Also published as: AU2679400A; GB9903647D0

Abstract

A mat for supporting and retaining surgical instruments is described and is constructed of silicone rubber or other flexible autoclavable and sterilisable material. The mat is provided with a plurality of magnets encapsulated within the material from which it is made such that the mat is entirely free from cracks, recesses, pits and the like in which dirt and other contaminants can become lodged, and which would render the mat non-sterile. The instruments ideally have at least a shaft portion of a ferromagnetic material or provided with such material and said shafts are generally of a sufficient length to ensure that said instrument is retained on the mat by at least two separate magnets, although a single magnet may provide enough magnetic attraction to retain the instrument on the mat. Additionally, the mat is provided with a lip around the periphery of the upper surface and a plurality of apertures through the mat and within the boundary defined by said lip. The apertures allow for drainage and gas flow therethrough during sterilisation.

Description

MAT FOR RETAINING SURGICAL INSTRUMENTS

This invention relates to a mat on which tools, apparatus and instruments may be placed, and particularly to a mat for use in surgical operations on which surgical and medical instruments may be placed.

Although the following description relates exclusively to mats used alone or in trays for retaining surgical instruments thereon, and accordingly to surgical procedures, the present invention is not to be considered limited only to such procedures, and may be used to retain a wide variety of instruments where such may be repeatedly used and replaced by a user and subsequently replaced for later use. A typical example may include a mat for retaining drawing instruments, or tools having at least a longitudinal shaft portion such as spanners, wrenches and the like. Further examples of tools which could be held on such a mat include dental and veterinary instruments and woodworking tools .

In current surgical procedure and when operating on an animal or human, a surgeon either requests instruments from an assistant who duly passes the required instrument to the surgeon, or alternatively an upright table may be provided adjacent the operating table on which a tray of required instruments is placed. In the latter case, the instruments are chosen as required from the tray by the surgeon and replaced after use. The repetitiveness of the selection and replacement of the various and numerous instruments which may be used by a surgeon during a particular operation is time-consuming when it is considered that the said surgeon is required to turn away from the particular area of an animal or human on which he is operating to select or replace an instrument. In many surgical procedures, many of the required instruments appear similar and many different instruments may be used, and it is therefore desirable to position the tray as closely as possible to the surgeon to facilitate and simplify his selection of an instrument therefrom.

More recently surgical mats of a silicone rubber construction have been introduced which are adapted to be rested on the human or animal and proximate an area thereof on which the surgical procedure is being conducted. The silicone rubber used in the construction of the mats is sufficiently flexible and drapable to conform to the shape of the human or animal on which it is placed, and furthermore the upper surface of such mats is typically provided with a plurality of deformable resilient protrusions which are either of a sufficient height and proximally spaced such that a shaft of an instrument may be depressed between said protrusions to elastically deform same and thus retained thereby, or are provided in suitable numbers and stand proud of the surface of the mat only slightly to provide the said upper surface of the mat with a sufficient coefficient of friction to prevent significant slip of the instruments thereacross.

Such mats are disadvantaged in different respects . Mats of the former type are disliked by surgeons on account of their tendency to retain the instruments too effectively with the result that a surgeon attempting to remove an instrument from between the protrusions not only raises the instruments but also the entire mat and other instruments thereon. In the latter case, the frictional surface of the mat provides insufficient retention of the instruments, especially where the instruments are generally cylindrical in cross-section, and slippage and/or rolling of the instruments across the upper surface of the mat and in some cases completely off the mat is a pervasive problem.

Many types of mat have been considered but the particular means of retaining the instruments thereon is limited by the mandatory requirement of the sterility of the mat, and also by the fact that such mats, not being generally regarded as disposable items, must be capable of being completely sterilised, usually in an autoclave. The environment within an autoclave is particularly hostile, temperatures of between 125°-134°C combined with pressures of the order of 2-3 atmospheres pressure not being uncommon conditions, and therefore it has heretofore been concluded that each mat must be formed from a simple silicone mould and furthermore be free of recesses, pits and the like which could serve to collect dirt and other contaminants.

It is an object of this invention to provide an instrument mat which overcomes or at least mitigates the abovementioned disadvantages .

It is a yet further object of the invention to provide a mat which effectively retains instruments having at least a longitudinal shaftlike portion with present significant resistance to a surgeon wishing to lift the instrument from the surface of the mat.

It is a further object of the invention to provide an ergonomically designed mat having suitable instrument retention characteristics which can be deposited in autoclavable trays, thus providing an improved means for transporting clinically sterilised instruments.

It is a yet further object of the invention to provide a mat with additional functionality over existing mats.

Accordingly there is provided a mat constructed of a silicone rubber type or other flexible autoclavable and sterilisable material adapted for retention of instruments having at least a shaft portion of a ferromagnetic material or provided with such material, characterised in that a plurality of spaced magnetic means are provided in the said mat which magnetically attract the shaft portion over a portion of its length, said magnetic means being autoclavable and/or resistant to standard sterilisation procedures and having their polarities orientated in the same direction the upper and lower surfaces of the mat.

Preferably the upper surface of the mat is provided with a plurality of spaced protrusions which increase the effective coefficient of friction of the mat to instruments placed thereon.

Preferably the magnetic means are of an autoclavable metallic compound.

Preferably the magnetic means are chemically bonded to or encapsulated within the silicone rubber of the mat.

Preferably the said mat is flexible so as to be drapable over and conform to the profile of the human or animal body portion on which it may be placed.

Preferably, at least a pair of spaced magnetic means are provided in the mat such that the shaft portion of an instrument placed thereon is magnetically attracted to the mat in at least two location along the shaft portion thereof. Alternately, instruments may be retained by only a single magnet.

It is yet further preferable that the protrusions are of a sufficient number and height to prevent the shaft portion of an instrument from coming into contact with the magnetic means, the magnetic effect of which is accordingly reduced but remains sufficient to retain the instrument on the said mat.

It is alternately preferable that the magnetic means are encapsulated within the mat in such a manner to define raised bulges on the upper surface of the mat in the region of said magnetic means such that utensils can be supported thereon with the majority of their bodies raised above the surface of the mat.

Preferably, the magnetic means are provided internally of the mat and sealed therein such that ingress of dirt and other contaminants is completely precluded. Alternatively, the magnetic means may be recessed in one surface of the mat, which may or may not be provided with protrusions, the depth of the recess being sufficient to prevent direct contact of the magnetic means and the shaft portion of the instrument, thus reducing the magnetic attraction therebetween to a degree which nevertheless provides sufficient retention of the instrument on said surface.

In a further alternative embodiment, the mat may be provided with protrusions, and the magnetic means may be set flushly with of the surface of the mat from which the protrusions protrude.

It is preferably that the mat be provided with apertures which allow a gaseous flow therethrough during the autoclaving/sterilisation process.

Preferably the mat is removably disposed in a tray of plastics material or metal, a variety of instruments being provided on said mat within the tray which may be sealed as a package.

It is still further preferable that the mat is provided with interengaging or interlocking means along at least one edge thereof to allow for interengagement or interlock with corresponding means provided on an adjacent mat. It is also preferable that the mat be provided with at least a pair of upwardly projecting lips along at least a portion of a pair of edges, and preferably around the entire periphery of the mat.

Preferably the mat is provided with a plurality of apertures around the periphery immediately adjacent said upwardly projecting lips to allow for drainage of water from the upper surface of the mat.

Preferably the mat is additionally provided on its lower surface with protrusions which increase the resistance of the mat to slippage across the surface of the human or animal, or other surface on which the mat is placed.

Preferably the mats are specifically designed with regard to a particular set of surgical instruments and are accordingly shaped.

It should be mentioned that during a surgical procedure, the accepted method for removing and lifting an instrument from a tray, mat, or the like is to first tilt the instrument shaft upwardly away from the surface which supports the instrument, whereafter the instrument is drawn away at an angle from the mat. The mat of the present invention is adapted to retain instruments thereon and does so in a manner which is especially advantageous if the instruments are removed in this preferred manner. In particular, the magnetic attraction of both of the spaced magnetic means on the two areas of the shaft is sufficient to retain the instrument on the mat in general use, but when the instrument shaft is tilted to such an extent that one of the magnetic means no longer exerts its magnetic effect on the shaft portion, the said instrument is effectively released from the mat.

The mat described above can be used in a wide variety of surgical procedures, including ophthalmic and ocular procedures, dentistry, neurosurgery, ENT (Ear, Nose, and Throat) , craniofacial, maxillofacial, chest and breast surgery, and veterinary procedures. The drapability of the mat allows the mat to conform instantly to the contour of the chest, torso or abdomen, or even the limbs of a human or animal on which a procedure is being effected, and tests have shown that even when the mat is draped over a limb such that its edge regions are disposed almost vertically around said limb, utensils may still be retained safely by said mat. The mat can also be draped over endo-tracheal general anaesthetic intubations without any loss of functionality. The surgeon can simply place instruments on either of the sides of the mat draped over the tube entering the patients mouth.

Further possible uses for the mat include washing and sterilising procedures where aggressive cleaning environments often damage sensitive and delicate utensils. The mat may be used effectively to secure same within washing apparatus.

The mat may be stamped to punch out larger apertures to render the mat less bulky and to increase the surface area of instruments placed on said mat free from contact of said mat. Such apertures have a further advantage when the mat is used for retaining instruments thereon during cleaning, as the powerful water jets which spray the utensils can then pass through the larger apertures without rebounding to any significant extent to dislodges instruments thereon. It is believed by the applicant that the resilience of the mat prevents instruments from being damaged during the cleaning procedure, and furthermore the facility of the instruments to be jostled and wobbled by the water jets without becoming dislodged from the magnets in the mat which hold them in place renders the mat an extremely useful device. The slight bulging of the magnets in the upper surface of the mat enhances this effect. The mat is also ideal for the retention of needles during suturing procedures.

A further considered use for a mat according to the invention is as a baby play mat. The encapsulation of the magnets and the silicone construction render the mat entirely safe for play, and the magnetic aspect may amuse the child.

Additionally, the magnetic means within the mat are ideally disposed in cups of a diamagnetic material to reduce the intensity of the magnetic flux directed away from the magnet in the lower surface of the mat which is nearest the skin of the human or animal by which the mat is supported. In this manner, patients having magnetically sensitive apparatus, such as a pacemaker, within their bodies are not affected by said magnetic flux. Ideally, the cup has a small protrusion in its base on which the magnet rests to define an air gap between the base and the lower surface of said magnet.

A specific embodiment of the invention is now described by way of example with reference to the accompanying drawings wherein:

Figure 1 shows a perspective view of a mat according to the invention,

Figures 1A, IB, 1 C show respectively a plan view of a mat from above and from underneath, and of a mat having larger apertures in its surface.

Figures 2a, b, c show a perspective view, a plan view an a further perspective view of different configurations of mat according to the invention, Figure 3a is a schematic representation of how adjacent mats may be interlocked together,

Figure 3b shows a perspective view of a tray containing a mat according to the invention,

Figure 3c shows a plan view of a mat according to an alternative embodiment of the invention,

Figures 4a, b, c, d, show alternative embodiments of the invention,

Figures 5a, b, c show yet further alternative embodiments of the invention,

Figures 6a, b, c show still further alternative embodiments of the invention, and

Figures 7a, b, c, show still yet further alternative embodiments of the invention.

Referring firstly to Figure 1 , there is shown a silicone rubber mat 2 provided with a plurality of protrusions 4 provided in its upper surface 6 which are ideally integrally formed with the mat during the moulding thereof. The mat is shown having a curved profile such as that it might adopt when draped over, for example the chest of a patient on whom an operation is being conducted. The mat could obviously be draped anywhere on the patient as desired by the surgeon which provides sufficient support for the mat to prevent its slipping off said patient. Additional protrusions (not shown) may be provided on the under surface of the mat to increase its frictional resistance to such slip. A plurality of autoclavable metallic magnets 8 are also provided within the structure of the mat, and may either be recessed beneath the upper surface 6, being flush therewith or stand proud thereof, but in any event, it is desirable that a surgical instrument 10 having a working portion 12 and a shaft portion 14 rests on the mat 2 or on the protrusions 4 in such a manner as to prevent direct contact between the magnets 8 and either the working portion 12 or the shaft portion 14. In this manner the magnetic attraction of the magnets 8 is sufficient to stably retain the instrument on the mat 2 without providing to great a resistance to the removal of said instrument. When one or other end of the shaft is tilted upwardly of the surface of the mat to remove the instrument from the mat as desired in preferred surgical practice, the magnetic force on that particular end is reduced rapidly as the particular end is moved away, and thus the instrument may be easily removed.

Figures 1A, I B show a mat 100 having an upper surface 102 and a lower surface 104, the latter being supported on a human or animal on which an operation is to be carried out, but ideally separated therefrom with a surgical sheet to avoid any contact of the mat with the skin of said animal or human. The mat 100 is provided with a lip 106 around its entire periphery which is broader along one edge of the mat shown at 108 to allow either for connection of a further mat as hereinafter described, or to allow for branding and other information to be provided thereon. Within the boundary defined by said lip 106 are provided a plurality of apertures 110 proximate said lip which allow for drainage of fluids from the mat. Centrally disposed apertures 1 12 are also provided for the same purpose. Ideally the upper surface of the mat is formed with a slightly convex profile such that when the mat is supported on a horizontal surface such as the tray of an autoclave, steam condensing on the mat can run off towards the edges and through said apertures 110. A plurality of ideally uniformly spaced protrusions 1 16 in rows is provided on said surface which act as stops for any instruments which become dislodged and begin to roll over the surface of the mat when in use.

A plurality of magnets 1 18 is also provided, each of said magnets shown in dotted in Figure 1A as said magnets are encapsulated within the silicone rubber behind the upper surface 102 of said mat. The encapsulation of said magnets within the mat can be seen more clearly in Figure 1A where a plurality of feet 120 indicate the regions where magnets have been encapsulated within the mat. These feet also serve to interrupt the smooth lower surface 104 of the mat and thus increase its overall coefficient of friction. In use, the mat rarely moves or slides over any surface due to the combination of the rubbery silicone material and said feet.

The mat shown in Figures 1 , 1A, I B can be rolled up and deposited in autoclaves or for storage purposes, and are generally similar to a bath mat in flexibility.

Figure 1 C shows a mat of similar construction to those of Figures 1A, I B, but provided with large apertures 122 punched through the mat to allow for water jets to pass therethrough when the mat is disposed in an aggressive cleaning environment. The apertures are shown in no particular pattern in Figure 1 C, but they may be patterned to improve aesthetic appeal.

Figure 2a shows a tray 16 provided internally with a mat 18 having ridges 20 along which magnets 22 are provided. Protrusions 24 are provided in the trough portions of the mat defined by the ridges . In Figure 2b, a plan view of a tray of alternative shape is shown in which a mat 26 provided with magnets 28 and protrusions 30 is disposed.

Figure 2c shows a further alternative tray 31 provided with a mat 32 having protrusions 34 and magnets 36 disposed therein. The mat 32 is additionally provided with steam slots 38 which allow gaseous flow therethrough, for example a steam sterilisation procedure such as autoclaving. Said steam slots allow a tray such as 31 with mat and surgical instruments (not shown) deposited therein to be placed as an entire package in an autoclave unit for sterilisation. Such practice has heretofore been precluded because the mats have tended to be integrally provided with the trays.

Figure 3a shows a possible interlocking arrangement 40 between adjacent mats 42, 44. As the mats in general are manufactured from a silicone rubber material which is resilient and flexible, tongue 46 and groove 48 formation may be provided to allow the mats to be pushed together resiliently interlocking same as shown in the figure.

Figure 3b shows a yet further embodiment of tray 50 and mat 52 disposed therein.

In Figure 3c, there is shown a tray 54 with a mat 56 having ridges 58 integrally formed therewith, as opposed to the protrusions shown in the mats of previous embodiments. The ridges are adapted to support the shaft portions of various lengths of instruments (not shown) which are stably retained thereon as a result of magnets 60 set within the trough portions of the mat defined by said ridges .

Figure 4a shows a further alternative embodiment of tray 62 with mat 64 disposed therein, the profile of the under surface of the tray 62 varying to increase the resistance of the tray to slippage between the patient or other surface on which said tray may be rested. Figure 4b shows an alternative configuration of mat 66 having differently shaped protrusions 68 over its surface, whereas Figures 4c and 4d show possible different configurations of tray suitable for being placed over particular portions of a human or animal on which an operation is being conducted.

Figures 5a, b, c show further alternative configurations and shapes of mats and accompanying trays, as do Figures 6a, b, c, and 7a, b, c. In Figure 6a the magnets 68 are shown recessed in the upper surface 70 of the mat 72. In Figure 6c, a mat 74 is shown disposed in a tray 76 and provided with ridges 78 which define troughs in which are situated linear magnetic strips 80, which may optionally be encapsulated with the thickness of the silicone rubber mat. It is to be mentioned that the idea of thus encapsulating the magnets may be applied to any of the embodiments of mat discussed. Ergonomically designed trays 82, 84, 86 and with corresponding mats 88, 90, 92 are shown in Figures 7a, b, c respectively, and again in the mat 92 randomly disposed ridges 94 are provided between which magnets 96 are disposed.

In all the embodiments discussed above, it is to be mentioned that the tray and mat may be integrally formed in silicone rubber as a single item, which will therefore be resilient and flexible, rims being provided around the edges of the mats thus formed to retain instruments deposited therein when the magnetic attraction between the magnet and the instrument is insufficient to hold same in place, for example when the mat assumes a severely inclined attitude when draped over an animal or human.

Claims

1. A mat constructed of a silicone rubber type or other flexible autoclavable and sterilisable material adapted for retention of instruments having at least a shaft portion of a ferromagnetic material or provided with such material, characterised in that a plurality of spaced magnetic means are provided in the said mat which magnetically attract the shaft portion over a portion of its length, said magnetic means being autoclavable and/or resistant to standard sterilisation procedures and being orientated within said mat such that the magnetic polarity is uniform over upper and lower surfaces of said mat.

2. A mat according to claim 1 characterised in that the upper surface of the mat is provided with a plurality of spaced protrusions which increase the effective coefficient of friction of the mat to instruments placed thereon.

3. A mat according to any preceding claim wherein the magnetic means are of an autoclavable metallic compound.

4. A mat according to any preceding claim wherein the magnetic means are encapsulated within the silicone rubber of the mat.

5. A mat according to any preceding claim wherein the said mat is flexible so as to be drapable over and conform to the profile of the human or animal body portion on which it may be placed.

6. A mat according to any preceding claim wherein at least a pair of spaced magnetic means are provided in the mat such that the shaft portion of an instrument placed thereon is magnetically attracted to the mat in at least two location along the shaft portion thereof.

7. A mat according to any of claims 2-6 wherein that the protrusions are of a sufficient number and height to prevent the shaft portion of an instrument from coming into contact with the magnetic means, the magnetic effect of which is accordingly reduced but remains sufficient to retain the instrument on the said mat.

8. A mat according to any preceding claim wherein the magnetic means are encapsulated within the mat in such a manner to define raised bulges on the upper surface of the mat in the region of said magnetic means such that utensils can be supported thereon with the majority of their bodies raised above the surface of the mat.

9. A mat according to any of claims 1 -3, or 5-8 when not dependent on claim 4 wherein the magnetic means may be recessed in one surface of the mat, the depth of the recess being sufficient to prevent direct contact of the magnetic means and the shaft portion of the instrument.

10. A mat according to any of claims 1 -3, or 5-8 when not dependent on claim 4 wherein the mat is provided with protrusions, and the magnetic means are set flushly with of the surface of the mat from which the protrusions protrude.

1 1. A mat according to any preceding claim wherein the mat is provided with apertures which allow a gaseous flow therethrough during the autoclaving/ sterilisation process and drainage of condensate and other fluids from the upper surface thereof either when said mat is being sterilised or in use.

12. A mat according to any preceding claim wherein said mat is removably disposed in a tray of plastics material or metal, a variety of instruments is provided on said mat on said tray, the arrangement being provided in a sealed, sterilised package.

13. A mat according to any preceding claim wherein an edge of the mat is provided with interengaging or interlocking means to allow for connection with corresponding means provided on an edge of an adjacent mat.

14. A mat according to any preceding claim wherein the mat is provided with at least a pair of upwardly projecting lips along at least a portion of a pair of edges.

15. A mat according to claim 14 wherein a lip is provided around the entire periphery of the mat.

16. A mat according to any preceding claim wherein a lower supporting surface of said mat is provided with protrusions which increase the resistance of the mat to slippage across the surface of the human or animal, or other surface on which the mat is placed.