CN101257878B - 手术室工作台的重新设计 - Google Patents

手术室工作台的重新设计 Download PDF

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CN101257878B
CN101257878B CN2006800323834A CN200680032383A CN101257878B CN 101257878 B CN101257878 B CN 101257878B CN 2006800323834 A CN2006800323834 A CN 2006800323834A CN 200680032383 A CN200680032383 A CN 200680032383A CN 101257878 B CN101257878 B CN 101257878B
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约翰·R·曼杰尔迪
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    • B65F—GATHERING OR REMOVAL OF DOMESTIC OR LIKE REFUSE
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    • B—PERFORMING OPERATIONS; TRANSPORTING
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    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B2050/005—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover
    • A—HUMAN NECESSITIES
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    • H01—ELECTRIC ELEMENTS
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    • H01R13/00—Details of coupling devices of the kinds covered by groups H01R12/70 or H01R24/00 - H01R33/00
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    • H01R27/00—Coupling parts adapted for co-operation with two or more dissimilar counterparts
    • H01R27/02—Coupling parts adapted for co-operation with two or more dissimilar counterparts for simultaneous co-operation with two or more dissimilar counterparts

Abstract

描述了一种患者工作台，其用固定基座设计进行改进，从而便于重患者使用、提供倾斜和向外伸展能力、工作台顶部的延伸(即提供从头到脚的覆盖)以及总体稳定性。手术室工作台的重新设计包括将设施源结合到工作台的体系结构中，以便诸如配线、真空和气体软管等设施从工作台本身引出。工作台的所有设施源(与从工作台发出的设施源不同)可来自于地下连接。进一步，此工作台可与为特定手术定制的工作台互换。

Description

手术室工作台的重新设计
相关申请的交叉参考
本申请要求由本发明人于2005年7月20日递交的美国临时专利申请序列号NO.60/701,106的利益。美国序列号NO.60/701,106的内容在此以引用方式明确地并入本文。
下列参考以引用方式特此明确地并入本文：
■美国专利NO.4,101,120
■美国专利NO.5,048,071
■美国专利NO.5,231,719
■美国专利NO.6,170,102
■随本发明人的本申请于本日一同递交的为以下标题的申请：
●IN-CEILING FOCUS LOCATED SURGICAL LIGHTING
●HOSPITAL OPERATING ROOM RE-DESIGN
●AMBIENT LIGHTING IN HOSPITAL SURGICALENVIRONMENTS
●USE OF ULTRAVIOLET GERMICIDAL IRRADIATION INHEALTH CARE ENVIRONMENTS
●IN-WALL WASTE RECEPTACLES FOR HOSPITAL ANDLAB ORATORY ENVIRONMENTS
●ROB OTIC FLOOR CLEANING WITH STERILE，DISPOSABLE CARTRIDGES
●MULTIFUNCTIONAL FLOOR PODS
技术领域
本发明通常涉及一种用于在医疗程序中支撑患者的装置，更具体地说，涉及为例如气体、电力和液体等设施(utility)提供改进的进入通道的外科手术工作台。
背景技术
常规的外科手术工作台通常包括一扁平的患者支撑件(flat patientsupport)和用于将患者支撑件保持在距离地面预定高度的下端基座。常规的外科手术工作台的基座通常包含用于在一定方位范围内使扁平的患者支撑件倾斜的控制装置以便于某些外科手术的实施。因此，很明显手术室工作台必须提供许多功能，其必须允许进入患者身上进行外科手术程序的部位。众所周知，虽然外科手术工作台可提供动力或手动驱动装置以用于旋转患者支撑平台，或甚至使平台倾斜且使平台向外伸展，但是某些医疗程序的紧急性可能要求支撑平台本身为要进行的程序做独特的定制。旋转、倾斜和其他平移移动的能力不足以在所有情况下提供必要的外科手术入路。例如，产科工作台(obstrometric table)具有区别于用在关节内视镜外科手术中的工作台的独特的设计布局。结果，现代手术室使用很多外科手术工作台；然而，手术室的地面空间总是很稀缺的。因而不利于提供多种手术室工作台，而每个设置成用于特定类型的程序。
Schnelle的美国专利NO.5,231,719“具有可拆卸的患者支撑表面装置的手术工作台”(Operating Table with Removable Patient Support SurfaceMeans)的已有技术中所显示的一项改进描述了一种手术工作台，其中患者支撑装置可被拆下，脱离支撑柱，以便于对支撑柱重新定位。此技术中没有描述为具体外科手术程序而定制的一套可互换工作台的使用。而且，尽管所描述的工作台可定位，但必须手动驱动。由于手动定位耗费时间，所以当医疗程序的紧急性可能需要快速接近特殊部位时是危险的。
现代外科手术工作台中另一缺陷是缺乏外科手术程序所需要的设施的方便的进入通道。例如，在典型的程序中，外科医生可能需要换气连接(scavenging connection)例如以提供抽吸，或者可能需要气体线路例如以提供氧气。由于需要许多设施，所以众多电缆、软管和线的存在会带来相关的安全问题。被电缆绊倒的外科医生或助理员会伤害外科医生和患者。进一步，当电缆、线和软管对外科医生重新定位患者的能力强加限制时，允许定位以提供患者入路的手术台在手术中的进一步调整受到严格限制。
由于已有技术中的这些缺陷，因此允许对患者支撑装置进行动力重新定位同时连接到从工作台本身引出的众多设施连接的手术室工作台和支撑柱的组合将会是有益的。进一步，手术室工作台和支撑柱的组合中手术室工作台可拆卸且允许连接定制的患者支持装置将会更加有益。
发明内容
描述了一种患者工作台，其用固定基座设计进行改进，从而便于较重的患者使用、更大的倾斜和向外伸展能力、更大的工作台顶部延伸(即提供从头到脚的覆盖)以及总体稳定性。手术室工作台的重新设计包括将设施源(utility source)结合到工作台的体系结构中，以便诸如配线、真空和气体软管等设施可从工作台本身引出，而不会拖在手术室的地面上。工作台的所有设施源(与从工作台发出的设施源不同)可来自于地下连接。进一步，此工作台可与为具体程序定制的工作台互换。
在典型应用中，患者工作台设置在邻近支撑臂的位置并由穿过支撑臂锚(support arm anchor)和患者工作台上的锚插入的杆或由其他装置固定到适当位置。在一个实施方案中，杆可用螺栓连接。可供选择地，患者工作台也可放在支撑臂或柱上的支撑结构的顶部上。通过放置在支撑结构上，锁被驱动，将工作台牢固地固定在适当位置。当采用以上方法中任一种或由本发明所设想的其它互锁装置时，设施线路也将连接在支撑臂与工作台之间。可使用简单的插座提供连接器接口，或设施线路可通过在连接工作台与支撑结构即支撑臂、柱或表面时对接工作台来进行连接。之后，工作台可由使用已有技术中已知结构的动力装置来定位。例如，连接到由枢轴连接的臂的铰链由致动器(actuator)驱动，之后提供定位工作台的能力。另外，支撑结构的基座，即低于上部支撑柱筒或臂的区域能够沿垂直轴旋转，优选地在任一方向旋转180度，从而提供360度的运动范围。优选地，旋转由液压动力装置提供，例如通过将支撑结构放置到本身搁置在衬套上的旋转底座上来提供。整个结构锚定在地面中，优选地锚定在沿下层地板延伸且锚定在下层地板材料中的钢板中。所有设施连接将从下层地板延伸入支撑结构并最终进入到工作台面。
随着手术室手术程序的改变，如果备用工作台适合于与支撑结构和支撑结构设施对接，那么工作台就可与备用工作台互换。该工作台进一步适合于在沿工作台的各个点处提供设施连接，从而允许重要设施容易地、无障碍地进入。
与本发明一致，本发明的目的是提供一种手术室工作台和支撑柱，允许将患者支撑装置从支撑柱分离出来，并可用适合于将要进行的外科手术程序的备选患者支撑装置来替换。
本发明的目的是支撑柱适合于允许工作台进行定位。因此，例如支撑柱可包含连接在枢轴处并由动力撑条移动以提供对工作台的定位的臂。而且，支撑柱的基座是可旋转的。
本发明的又一目的是提供一种手术室工作台和支撑柱，其中上述患者支撑装置进一步适合于为用在医疗程序中的各种设施提供插座和连接器，使所述设施穿过支撑柱从工作台内引出且之后源自外部源。
本发明的另一个目的是提供一种能够支撑重患者与附属器材的手术室工作台和支撑柱。
本发明全部或部分地实现了上述目的中的至少一个目的。考虑以下描述和权利要求之后，进一步的目的是显而易见的。
附图说明
联系附图可更好地理解本发明。应注意，本发明不限于附图中所显示的确定的实施方案，其中：
图1是依据本发明的患者工作台的侧视图。
图2是一种可能的患者工作台、支撑柱接口连接装置(support-columninterfacing means)的侧视图。
图3是支撑柱接口插座(support-column interface receptacle)的详细视图。
图4是本发明另一实施方案的截面侧视图，显示了具有可替换支撑装置的工作台。
参考数字的简要描述
100外科手术工作台和支撑柱；102外科手术床和垫；104顶部框架；106出口/入口；108设施连接；110设施连接；112升高位置；114降低位置；116枢轴；118上部支撑肋；120臂；122枢轴；124地板；126枢轴；128撑条；130臂；132撑条；134设施线路；136套(housing)；138旋转基座；140支撑锚；150患者支撑装置；152铰接件(hinge)、插销(latch)；154设施盒；156设施进入点；158下部支撑柱；160上部支撑柱；162致动器、活塞；164转盘、衬套；166支撑块；168地板；170设施线、电缆、软管；172锚；200设施接合(utility Junction)；202设施接合装置；204支撑柱接合支撑件、背栅板(back-grid)；206支撑柱接合支撑件、前栅板(front-grid)；208凹陷的槽口；210设施插座；212杆套(rod housing)；214锚；216工作台接合支撑件、栅板；218连接器主体；220设施连接器/适配器；222设施电缆；224螺栓和杆组件、支撑柱；226螺栓和杆组件、工作台；228锚定板、支撑柱；230锚定板、工作台；232支撑结构；240螺纹杆
具体实施方式
图1是在手术室地板124之上处于升高位置112或处于降低位置114的外科手术工作台100的侧视图。为外科手术工作台100提供了套136。外科手术床102牢固地连接到一坚固的基底例如钢板140，此钢板140可用螺栓连接到或以其它方式连接到例如由混凝土制成的下层地板(124之下)中。动力撑条128和132借助于搭在枢轴116、122和126上的臂120和130用来升高和降低带有垫102的顶部框架104。被加强地制造以支撑重患者例如550磅的患者，工作台100具有上部支撑肋118；且工作台100的台面可向外伸展、旋转和滑动。所有设施例如功率、真空、电气和气体等穿过套136进行供应，如由线路134所展示的。这些线路的头端或尾端被传送到出口/入口106。必要时，设施出口/入口106备有设施连接108和110，并可在工作台100的任意一端使用。外科手术工作台100可围绕套136内的旋转基座138旋转360度。
在图2中，显示了一种可能的装置，用于允许患者支撑工作台相互交换，同时为从支撑柱中引出的设施提供连接。结构200包括了具有杆套212(虚线箭头显示了杆240(未显示)的路径)的一对支撑板或栅板204和206。杆套可车螺纹以与螺纹杆相结合，从而提供额外的稳定性。插座/适配器212也显示在凹陷的槽口208中，从而允许连接缩进槽口208内，并因此与210连接。套212允许杆240(未显示)进入并用支撑柱上的锚定装置锚定。连接到杆240或锚定到杆240的可以是用于插座210和患者工作台100的连接器。这可在图3中更清楚地看到。
在图3中，显示了带有工作台锚230的支撑柱/患者工作台接合装置202，栅板/板216夹在支撑锚214和本身提供适配器/连接器220的连接器套218之间，并被插入到已经在224处固定到支撑柱锚228上的杆上。穿过栅板/板204、206和216插入的杆例如杆240在支撑柱与工作台之间提供稳定的连接。如图中所看到的，杆可用螺栓连接如在杆/螺栓224处和画虚线的杆/螺栓226处。从支撑柱引出的设施可由电缆线路222送入到插座。进一步的支撑可由额外的结构例如232来提供。
图4显示了图1中所显示的外科手术工作台4的备选实施方案。在工作台100的这种构想中，患者工作台支撑装置150铰接在点152处，从而允许工作台倾斜。设施盒154(其可单独设置或与其他盒一起设置在工作台150的任意处)提供插座/连接156。所有设施线路、连接、线、电缆170都从支撑装置150、支撑柱158和160以及下面地板168内传送到盒154。工作台可通过由致动器/活塞组合162移动柱160越过158进行垂直位移。支撑柱由162支撑，并放置在安装在块166内的衬套/转盘164上，从而允许工作台旋转。整个工作台、柱组合由锚172稳定地锚定，而锚172固定到地板168下的材料中。可在铰接点或另外地在其它连接到支撑柱的部位处移开患者工作台支撑装置150，从而允许重新连接为特定的外科手术程序而具体设置的类似的患者工作台支撑装置。该患者工作台支撑装置同样具有带有内部设施源的设施盒154的特点。
在前面的描述中，确定的术语和直观描绘用来展示优选的实施方案。然而，所用术语或所描述的图示不应解释为超出了已有技术中所显示的不必要的限制，因为，术语和图示仅是示范性的且并不表示限制了本发明的范围。进一步认识到，可对本发明做出其它修改，而不偏离如附加权利要求中所提到的本发明的范围。

Claims (8)

1.一种医疗程序手术工作台，其包括
支撑所连接的患者支撑表面的支撑柱，所述支撑柱适合于允许定位所连接的患者支撑表面；
所述患者支撑表面可松脱地安装在所述支撑柱上，且所述患者支撑表面适合于提供从所述患者支撑表面内导出的设施；其中，
所述设施从地板下出来，通过所述支撑柱进入所述患者支撑表面，并且，
所述支撑柱包括安装在枢轴上并由动力撑条驱动的臂，所述动力撑条借助于搭在所述枢轴上的所述臂用来升高和降低所述患者支撑表面。
2.如权利要求1所述的工作台，其中所述动力撑条由电动机、电动机械发生器、电动液压泵、或电动气动泵驱动。
3.如权利要求1所述的工作台，其中所述设施由插座、连接器、或插座和连接器的组合提供。
4.如权利要求3所述的工作台，其中所述设施是气体或换气设施，所述气体或换气设施是借助于通用适配器的连接来提供的。
5.如权利要求1或权利要求4中任一项所述的工作台，其中所述患者支撑表面对接到所述支撑柱之内或之上，从而来自所述支撑柱的所述设施被引入到所述患者支撑表面中。
6.如权利要求5所述的工作台，其中所述支撑柱通过锚定到所述地板而永久地安装到所述地板内。
7.如权利要求1所述的工作台，其中所述定位通过旋转、通过从所述地板垂直位移、以及通过相对于所述地板向外伸展而进行。
8.如权利要求1所述的工作台，其中所述支撑柱通过锚定到所述地板而永久地安装到所述地板内。
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