EP1702535A1 - Treatment table with knee support - Google Patents

Abstract

The couch has a plate (1) with an area for supporting an upper body part of patients. A base is provided for supporting the plate, where the plate has a knee support (51). The knee support has a thigh section (52) that is bent opposite to the upper body part area. The support is adjustable in height and is movable relative to the upper body part area in a longitudinal direction of the couch. An independent claim is also included for a method of supporting of patients with a treatment couch.

Description

The present invention relates to a treatment table for the storage of patients, specifically on a treatment table with a knee support for more comfortable storage of the legs of the patient.

Treatment couches for patient storage basically have a couch plate for the patient and a base supporting the couch panel on a floor, such as in a treatment room. Of course, the deck plate can be upholstered, so it does not necessarily have to be a rigid plate in the narrower sense. The deck plate may also be multi-part, composed of various plate-like elements.

Knee braces are also known in the dental treatment tables. They have a thigh portion for supporting the thighs of the patient, which is angled relative to a torso portion of the couch. The patient is therefore not forced to lie flat while lying in the dental treatment, but can adopt a more comfortable posture in which his legs are supported by a knee brace so high that the thighs are slightly angled relative to the torso. By the term "knee brace" is here thus meant a shaping of the platform in such a way that the knees are slightly "raised" stored.

The invention is based on the technical problem of specifying a treatment couch for the storage of patients with an improved knee brace.

The invention is directed to a treatment couch for supporting a patient with a patient support plate having a torso portion for supporting the upper body of the patient and a base for supporting the support plate on a floor, the support plate having a knee brace facing one The thigh section, which is angled over the upper body region of the lying platform characterized in that the knee support is displaceable relative to the upper body region in the longitudinal direction of the treatment couch.

In addition, the invention is also directed to a medical device with such a treatment table and to a corresponding method for storage of a patient.

Preferred embodiments of the invention are specified in the dependent claims. The following disclosure relates both to the device aspect and to the method aspect of the invention, without any explicit distinction between them.

The treatment couch according to the invention has a knee brace with a thigh portion angled relative to the upper body area of the bed plate. According to the invention, this knee brace is displaceable relative to the upper body region in the longitudinal direction of the treatment couch, ie in the direction pointing from the foot to the head of the patient or vice versa. This adjustability is conceptually distinguishable from the already known from dental treatment tables Verkippbarkeit the upper body portion of a treatment couch against the thigh portion of the knee brace. Rather, this invention is initially concerned with an at least substantially translatory displacement, ie with the distance between a point fixed on the upper body section, for example the upper end of the upper body section, and the hip-side beginning of the thigh section, at which the upper leg section is closest to the upper body region comes, is changed.

In this way, the treatment table can be set particularly favorable to different body sizes of the patient. In medical treatments of body parts in the area of the upper body, head or upper limbs, it is possible, in particular, to prevent the location of the area to be treated from becoming very different for patients of different sizes. By adjusting the longitudinal position of the knee brace, for example, it can be ensured, for example, that the head of the patient lies substantially at the same longitudinal position when the head is to be examined or treated.

In particular, the possibilities of the invention thus go beyond a longitudinally adjustable separate headrest, because the adjustment range of such a headrest is naturally limited, if not to be taken in large patients gaps between the headrest and upper body area of the platform.

In a preferred embodiment of the invention, the knee brace is additionally "height adjustable", d. H. that the knee-side end of the thigh section can be raised. This can be done in a translatory manner, but preferably the thigh section is tiltable relative to the upper body region of the deck plate.

Preferably, in addition to the thigh portion, the knee brace also has a lower leg portion which is angled relative to the thigh portion so as to provide a convex curvature or a convex curvature when viewed from the side of the knee of the patient. In a preferred embodiment, the lower leg portion is constructed such that it is entrained in the above-mentioned lifting of the knee-side end of the thigh portion with its knee-side end and thereby the foot-side end of the lower leg portion approximately at the same height, in particular approximately in the region of escape of the upper body portion of the deck plate , remains. This adjusts the height of the convex curvature or the convex curvature, without affecting the height of the patient's foot position. For the sake of illustration, reference is made to the exemplary embodiment.

A favorable possibility for implementing the described adjustability of the knee brace is that the thigh portion is hinged at its hip-side end to another component, in particular a bearing plate, which in turn is displaceable in the longitudinal direction. At the same time, the knee-side end of the thigh section is articulated via a lever to a further, ie second component, which is displaceable independently of the first component in the longitudinal direction. Also, the second component may be a bearing plate. The lever is thus hinged on the one hand to the second bearing plate and on the other hand to the knee-side end of the thigh portion. A common longitudinal displacement the two components thus displaces the thigh portion in the longitudinal direction and, when the lower leg portion is taken with its foot-side end of the second bearing plate, with the entire knee brace. However, a relative movement between the two bearing plates changes the distance between the bearing plate side hinge axis of the lever and the hinge axis between the hip-side end of the thigh section and the first bearing plate, so that the lever is raised or lowered and thus the Anwinkelung the thigh section is changed. For purposes of illustration, reference is again made to the exemplary embodiment.

In the context of the invention, it is basically preferable to implement the displaceability according to the invention in the longitudinal direction via longitudinal rails. In connection with the embodiment explained above, the first and the second bearing plate or, more generally speaking, the first and the second component can each be displaceable via longitudinal rails and, in a particularly preferred embodiment, can be driven and thus adjustable by means of locking bars integrated with the longitudinal rails. In principle, a single longitudinal rail would be sufficient, but a plurality of longitudinal rails, in particular two longitudinal rails are preferred, in each case in the region of the lateral edge of the deck plate.

The integrated spindle drive can be configured such that, on the one hand, guides of the displaceable components can slide over smooth areas of the guide rails, while, on the other hand, at least one guide element provided with an internal thread, which serves as a nut, is driven on a threaded section on the respective guide rod. In particular, one of two laterally mounted guide rods can be provided in each case for driving one of the displaceable components. In favor of a jam-free good guidance, at least two non-driven guides per displaceable component which extend beyond the guide provided with the nut are preferably provided, of which at least one runs on the respective other guide rail. This too is illustrated in the exemplary embodiment.

Preferably, the treatment couch according to the invention is adjustable not only in terms of the described adjustment of the knee brace, but also in others Respect. In particular, the deck plate should preferably be adjustable relative to the base along at least two mutually substantially perpendicular directions in order to adjust the position of the patient, moreover, for example, to be able to make a fine positioning of the head relative to a medical technical device. In this case, the bed plate may be pivotable in the adjustment about a rotational axis lying perpendicular to its longitudinal direction.

This embodiment is thus characterized by the fact that at least one of said adjustment options should be solved by a pivoting movement mechanism with a rotation axis. In this case, the axis of rotation is perpendicular to the longitudinal direction, the so-called. "Y-direction", so that in a pivoting movement about a vertical "Z-axis" parallel axis of rotation a horizontal "X-adjustment" and at one to the horizontal "X-direction" parallel axis of rotation results in a "Z-adjustment".

It has been shown that the conventional linear guides at two, esp. In accordance with the invention preferred three adjustment axes lead to a considerable technical effort and thus relatively expensive constructions. I. d. R. are used for the X and the Z-adjustment directions each have multiple drives. In contrast, the X-adjustment and the Z-adjustment can be accomplished relatively easily by a pivoting movement about said axes. In particular, drives can be saved, ie in the case of a manual adjustment corresponding drives with manual operation or otherwise motor drives. It is even possible, though not absolutely necessary, to provide only a single drive for the pivotal movement about a rotation axis. In the case of the invention, by the way, with respect to all axes of rotation, preferably motor drives are preferably included, but treatment couches with hand-operated adjustment possibilities or those with partly motorized and partly manually operated adjustment options are also included.

Preferably, both the X-adjustment and the Z-adjustment via a pivoting movement mechanism are solved, however, significant advantages of the invention are already achieved when only one of the two adjustment is carried out in this way.

A positioning of the axis of rotation for the Z-adjustment (ie the X-parallel axis of rotation) in the area of the foot end of the deck plate and also a positioning of the axis of rotation for the X-adjustment (ie the Z-parallel axis of rotation) from the middle of the bed has proven particularly useful on the side of the foot end, with respect to the Y longitudinal direction. Thus, in the adjustment already in the middle of the body and even more at the head end as a result of pivotal movement about the axis of rotation reaches considerable lifting heights. Concretely, this means that the X-parallel pivot axis is approximately within 10% of the longitudinal extent with respect to the longitudinal extent of the deck plate from the foot end, the reference amounting to 100% of the total length of the deck plate without the optional optional headrest. In the same sense, the Z-parallel pivot axis is preferably within 30% of the longitudinal extent seen from the foot end, more preferably within 25% and in the best case within 20%.

In a preferred embodiment, the motor adjustment drive for the Z adjustment can be a motor, for example an electric motor, with a coupling wheel provided on an output shaft and a coupling belt driven by the coupling wheel. The coupling wheel and coupling belt may be, for example, a gear / toothed belt or gear / chain combination. The coupling band carries a driver, which either entrains the adjustable part of the treatment couch or is coupled to the part of the treatment couch which is not moved during the Z adjustment. In the former case, the motor is stationary with respect to the part of the treatment couch which is fixed during the Z-adjustment, in the second-mentioned case it is stationary with respect to the part of the treatment couch covered by the Z-adjustment. In this way, the arcuate adjustment can be realized by a simple rotary drive. For the sake of illustration, reference is made to the exemplary embodiment.

A preferred embodiment of the X-adjustment can be a per se conventional linear drive, such as a Spindelhubtrieb or rack and pinion, which is articulated at its two ends, ie at a respect. The linear movement and an end moved by the linear movement end. Due to the articulated mounting of the linear linear actuator can be used in the actually arcuate pivoting movement about the rotation axis according to the invention.

Preferably, the treatment table on a headrest for supporting the patient's head, which is adjustable relative to the deck plate. This adjustability may be of interest in addition to the already described adjustability of the platform for treatments on the head. However, in the context of this invention is particularly interested in a headrest, which is adjustable in a substantially vertical Z-direction relative to the deck plate, in which a drive for the Z-adjustment of the headrest is installed in the headrest and the headrest together with the drive as a module is detachable from the treatment couch.

The drive of this headrest, whether it is a manual drive, such as a hand crank or an adjustment, or a motor, esp. Electric motor, is to be part of the headrest. This means that the headrest is mounted as an independent unit to the treatment table and removable without the drive itself would have to be separated from the headrest. The drive should therefore at most be coupled via signal lines or supply lines to the other treatment couch, for example because it is supplied together with local motors or is controlled by a common control. The connection between the headrest and the treatment bed is therefore limited to static releasable fasteners and lines.

The prior art has instead installed the drive in the treatment couch, for example, as an electric motor which drives a push rod via a spindle gear, which transmits the adjustment movement to the headrest. This has the disadvantage that in the production no separately pre-assembled headrest module can be used, which only needs to be connected by some mounting screws or the like with the treatment table. Furthermore, one can achieve advantages with the solution according to the invention in the maintenance or retrofitting of a treatment table by the headrest can be removed as a complete functional unit and can exchange for another need for repair or updating or modification request against another headrest.

Preferably, the vertical Z-adjustability of the headrest is realized by a pivoting movement, to which only a single drive is required. Esp. may be substantially perpendicular to the vertical Z-direction and further substantially perpendicular to the longitudinal extent of the treatment couch extending pivot axis may be provided on the side facing the treatment couch or in articulation points on the treatment couch.

Also preferred is a rack and pinion drive, in particular in conjunction with the described pivoting movement. For the sake of illustration, reference is made to the exemplary embodiment. A rack and pinion drive is i. d. R. easier and less problematic than, for example, a driven spindle gear or a linear motor. Preferably, the rack drive has a guide for the rack itself, which in turn is rotatable to compensate for the tilt of the rack during the pivotal movement of the headrest. The rack is also preferably hollow and may then serve to guide conduits between the headrest and the treatment couch in a protected manner.

Basically, motor drives of the Z-adjustment of the headrest are preferred in this invention. This applies esp. For electric motor drives. In a further preferred embodiment, these are controlled in a manner adapted to Verstettbewegungen the treatment couch, so that esp. An automatic tilt compensation of the headrest can be done when the treatment table or its deck plate is tilted. This tilting movement of the deck plate can u. a. occur because a vertical Z-adjustment of the deck plate by a pivoting movement thereof takes place and the associated pivot axis is remote from the headrest. The automatic tilt compensation then makes it possible to keep constant the angular orientation of the headrest, i. for example, a consistently horizontal position of the headrest. This is particularly advantageous in treatments of the patient's head.

In a further preferred embodiment, the headrest further comprises an X-adjustment relative to the deck plate, and preferably also by a pivoting movement about a now lying parallel to the Z-direction of rotation axis. This adjustment is preferably motorized. Again, it is preferred that the X-adjustment can be done in a (mechanically or motorized) adapted to an X-adjustment of the deck plate manner, in order to pivot-X adjustments of the deck plate a corresponding angle compensation in the headrest to obtain. Then namely the patient's head can be moved in the X direction, without causing an angle error occurs in the region of lying on the headrest patient head. However, if this option is omitted, the angle errors that occur are not so great that this would lead to a problem in all applications.

For the technical implementation of the X-adjustment of the headrest by a pivoting motion apply mutatis mutandis to the versions of the Z-adjustment.

If a headrest according to the invention mounted in a modular manner on the treatment couch is adjusted, a risk of jamming can occur. This applies esp. For a pivoting of the distal end of the headrest relative to the treatment table, wherein the upper bed surface of the headrest is moved to the treatment couch. The invention provides in this case to leave sufficient distances, so that esp. The treatment personnel is not subject to any risk of jamming. On the other hand, since an at least substantially continuous lying surface is to be created for the patient, it is preferable to extend an already favorable cushion on the headrest beyond its fixed parts, so that such safety gaps are covered. As an additional measure can be provided to hold the pad on the headrest only via a hook and loop fastener and possibly further detachable by direct removal fasteners, such as centering pins o. Ä. Should a cushioning effect from the pad, this can easily be released from the hook and loop fastener and the possible other fastening means, whereby greater clamping forces can be avoided.

It has already been stated that in the invention preferably the Z-adjustment and the X-adjustment take place via the described pivoting movements. On the other hand, it is preferred according to the invention, the Y-adjustment, so the adjustment in the longitudinal direction, continue to make in a conventional manner via a linear guide. Since the Y-adjustment is not carried out gravitationally parallel, it may be sufficient here to use a single linear drive, such as a spindle drive, and to store the deck plate, moreover, displaceably in the Y direction. Incidentally, in the invention, it is preferable that the Y-displacement move from the fixed base, and further that the X-displacement be the Z-displacement mechanism "entrains", so to speak, between the Y-adjustment and the Z-adjustment is interposed. As a result, the X-adjustment of gravity influences remain free and can limit the Z-adjustment to the movement of relatively smaller components of the entire treatment couch.

The treatment couch may comprise a support leg, which is entrained in the X-adjustment and is mounted on a with respect to the X-adjustment rotary axis remote part of the treatment table, preferably in the vicinity of the shoulder or head region of the patient. As a result, an improved overall stability can be achieved when extending the X-movement as a result of the support foot.

A preferred field of application for the treatment couch according to the invention lies in components of medical devices for the treatment of the head and in particular of the eye. Furthermore, the invention preferably relates to devices for the treatment of the human body, but can also be used in treatment beds for animals. A particularly preferred area is the laser surgery on the human eye, in which the treated eye can be brought into the correct position for the laser surgery by the treatment couch according to the invention.

Finally, the invention also relates to a method for storing a patient using the described treatment couch. The foregoing and following description of the treatment couch in its device details is to be understood as a disclosure of said method.

Figur 1

zeigt eine Seitenansicht einer erfindungsgemäßen Behandlungsliege, wobei jedoch keine Kniestütze dargestellt ist.

Figur 2

zeigt die Behandlungsliege aus Figur 1 mit veränderten Verstellpositionen.

Figur 3

zeigt eine Draufsicht auf die Behandlungsliege aus den Figur 1 und 2.

Figur 4

zeigt eine Draufsicht entsprechend Figur 3 mit verschiedenen Verstellpositionen der Liegeplatte.

Figur 5

zeigt eine Schnittdarstellung durch eine Kopfstütze der Behandlungsliege gemäß den Figur 1 - 4.

Figur 6

zeigt eine Figur 5 entsprechende Darstellung eines anderen Ausführungsbeispiels für die Kopfstütze.

Figur 7

zeigt die Kopfstütze aus Figur 6 in Explosionsdarstellung.

Figur 8

zeigt die Kopfstütze aus Figur 5 in Explosionsdarstellung.

Figur 9

zeigt die Kopfstütze aus den Figur 6 und 7 in Seitenansicht mit zwei verschiedenen Verstellpositionen.

Figur 10

zeigt eine perspektivische Ansicht der Kopfstütze aus den Figur 6 bis 8.

Figur 11

zeigt eine schematisierte Draufsicht auf ein weiteres Ausführungsbeispiel für eine erfindungsgemäße Behandlungsliege mit einer X-verstellbaren Kopfstütze.

Figur 12

zeigt eine schematisierte perspektivische Ansicht noch eines weiteren Ausführungsbeispiels für eine erfindungsgemäße Behandlungsliege mit einem Stützfuß.

Figur 13

zeigt eine Seitenansicht einer Liegeplatte zu den Behandlungsliegen, die in den Figuren 1 bis 12 im Einzelnen dargestellt sind, wobei eine Kniestütze eingezeichnet ist.

Figur 14

zeigt eine Seitenansicht gemäß Figur 13 mit einer veränderten Position der Kniestütze.

Figur 15

zeigt eine Seitenansicht einer Liegeplatte zu den Behandlungsliegen, die in den Figuren 1 bis 12 im Einzelnen dargestellt sind, wobei eine Kniestütze eingezeichnet ist.

Figur 16

zeigt eine Seitenansicht gemäß Figur 15 mit einer veränderten Position der Kniestütze.

Figur 17

entspricht der Seitendarstellung in Figur 14, wobei eine Seitenverkleidung weggelassen ist.

Figur 18

ist eine perspektivische Darstellung mit abgesenkter Position der Kniestütze, wobei einige Teile weggelassen sind.

Figur 19

ist eine perspektivische Darstellung entsprechend Figur 18 mit angehobener Position der Kniestütze.

Figur 20

ist eine perspektivische Darstellung entsprechend Figur 19 aus anderer Blickrichtung.

Figur 21

ist eine perspektivische Darstellung entsprechend Figur 19 aus anderer Blickrichtung.

Figur 22

ist eine Unteransicht der Liegeplatte mit der Kniestütze entsprechend den Figuren 13 bis 21.

In the following an embodiment of the invention will be described in further detail, wherein the disclosed individual features may be essential to the invention in other combinations.

FIG. 1

shows a side view of a treatment couch according to the invention, but no knee brace is shown.

FIG. 2

shows the treatment table of Figure 1 with changed adjustment positions.

FIG. 3

shows a plan view of the treatment couch of Figures 1 and 2.

FIG. 4

shows a plan view corresponding to Figure 3 with different adjustment positions of the deck plate.

FIG. 5

shows a sectional view through a headrest of the treatment table according to the figures 1-4.

FIG. 6

a figure 5 corresponding representation of another embodiment of the headrest.

FIG. 7

shows the headrest of Figure 6 in an exploded view.

FIG. 8

shows the headrest of Figure 5 in an exploded view.

FIG. 9

shows the headrest of Figures 6 and 7 in side view with two different adjustment positions.

FIG. 10

shows a perspective view of the headrest of the figure 6 to 8.

FIG. 11

shows a schematic plan view of another embodiment of a treatment couch according to the invention with an X-adjustable headrest.

FIG. 12

shows a schematic perspective view of yet another embodiment of a treatment couch according to the invention with a support foot.

FIG. 13

shows a side view of a deck plate to the treatment couches, which are shown in detail in Figures 1 to 12, wherein a knee brace is located.

FIG. 14

shows a side view of Figure 13 with an altered position of the knee brace.

FIG. 15

shows a side view of a deck plate to the treatment couches, which are shown in detail in Figures 1 to 12, wherein a knee brace is located.

FIG. 16

shows a side view of Figure 15 with an altered position of the knee brace.

FIG. 17

corresponds to the side view in Figure 14, wherein a side panel is omitted.

FIG. 18

is a perspective view with lowered position of the knee brace, with some parts are omitted.

FIG. 19

is a perspective view corresponding to Figure 18 with the raised position of the knee brace.

FIG. 20

is a perspective view corresponding to Figure 19 from another direction.

FIG. 21

is a perspective view corresponding to Figure 19 from another direction.

FIG. 22

is a bottom view of the deck plate with the knee support according to the figures 13 to 21.

Figure 1 shows the side view of a treatment table according to the invention, wherein some interesting technical details are shown, which would not be visible from the outside when the housing is closed. In Figure 1, 1 denotes a deck plate on which a mattress 2 is located and at its right end to a vertical end of the deck plate 1, a headrest 3 is mounted. However, FIG. 1 shows no knee support for reasons of clarity. Figures 13 to 22 describe the construction of the deck plate with a knee brace in detail.

The deck plate 1 is mounted in a manner to be explained in more detail on a base 4, which rests on Verstellfüße 5 on a floor 6.

In the base 4 a linear drive with an electric motor 7 and a driven by this spindle lifting rod 8 is fixedly mounted. The spindle lifting rod 8 is mounted on a bracket 9, via which the electric motor 7 and the spindle lifting rod 8 can move a first intermediate plate 10. The first intermediate plate 10 is slidably mounted on a rail 11 running linear guides 12 in horizontal direction in Figure 1 and thus in the longitudinal direction of the deck plate 1. This direction thus corresponds to the Y direction.

The first intermediate plate 10 carries at about 17% - 18% of the longitudinal extent on the side of the foot (drawing not to scale) a bearing 13 with in Figure 1 vertical axis of rotation. About this bearing 13, a second intermediate plate 14 is rotatably supported relative to the first intermediate plate 10 about the vertical axis through the bearing 13. In this case, the second intermediate plate 14 is supported on a running surface 16 of the first intermediate plate 10 via a roller designated 15 and on the other hand connected to a driver 17 which is driven by a toothed belt described in more detail below. The toothed belt runs in a designated 18 in Figure 1 housing. Thus, the second intermediate plate 14 can be pivoted about the vertical axis passing through the bearing 13, which in the Y-direction spaced from the bearing 13 areas, ie in particular in the headrest 3, an adjustment in a direction perpendicular to the plane, namely the X-direction, corresponds.

At the second intermediate plate 14 is in the footer (about 7% - 8% of the longitudinal extent, drawing not to scale), a pivot bearing 19 is provided, on which the deck plate 1 is articulated. In the head area, the deck plate 1 is pivotally connected to a Spindelhubstange 20 which is linearly driven by an electric motor 21, which in turn is hinged to a mounting platform of the second intermediate plate 14.

FIG. 2 shows the side view according to FIG. 1 with some deviations with respect to the adjustment positions. The comparison of FIGS. 1 and 2 shows, on the one hand, that by exiting the spindle lifting rod 20 from the electric motor 21, the deck plate 1 can be pivoted about the rotation axis 19 and thus raised in the head region in the vertical direction, ie in the Z direction.

Furthermore, the comparison of Figures 1 and 2, that by moving the spindle lifting rod 8, here retraction into the electric motor 7, the first intermediate plate 10 and thus also the second intermediate plate 14 and the deck plate 1 can be moved in the Y direction.

Figure 3 shows a plan view of the treatment couch of Figures 1 and 2, wherein in particular the mechanism for driving the driver 17 is shown in more detail. An electric motor 22 with lying in the Z direction of rotation axis drives a toothed belt 23, which is guided over four pulleys 24 and is secured to the driver 17. A rotation of the output shaft of the electric motor 22 thus moves the driver 17 in the X direction and thus moves the second intermediate plate 14 relative to the first intermediate plate 10 in the X direction. This movement is illustrated in Figure 4, wherein in solid lines one with the head end according to FIG 4 down adjustment in the X direction and in dashed lines a taken in the opposite direction X-adjustment is located. For the sake of clarity, the reference numerals have been omitted in FIG. The rotation takes place about the axis through the bearing 13. The roller 15, which lies approximately centrally with respect to the X direction under the second intermediate plate 14, remains within the adjustment range shown in Figure 4 on the over the entire X-width of the first intermediate plate 10 continuous track 16.

The figures also show that the headrest 3 is attached via two levers 25 hinged to the deck plate 1. Figure 1 and Figure 2 also show that in the Z direction under the levers 25, a further Spindelhubstange 26 is provided with an electric motor 27. The electric motor 27 is hinged to the headrest 3. Furthermore, the spindle lifting rod 26 is hinged to the deck plate 1. The comparison of Figure 1 and 2 shows that by retraction and extension of the screw jack 26 in and out of the motor 27, a tilting movement of the headrest 3 about the hinge axis of the lever 25 on the deck plate 1, with which in particular an automatic tilt compensation at Z -Verstellung the deck plate 1 can accomplish. This inclination compensation is clearly visible in FIG. In addition, the headrest 3 can of course be tilted in other ways, if desired. The automatic tilt compensation is done by appropriate tuning of the control of the motor 27 to the drive of the motor 21st

Figure 5 shows the headrest of the treatment bed in detail, in a sectional view seen in the X direction.

The headrest 3 has a holding plate 28, the exact structure of which is even clearer from the following figures and which can be fastened by fastening screws 29 on the treatment couch itself. The retaining plate 28 is already shown symbolically in FIGS. 1-4, but not numbered.

The fastening screws engage in a metal plate 30 with corresponding threads to relieve the otherwise made of plastic retaining plate 28. They also hold in the retaining plate 28 a hinge box 31 in which the already mentioned with reference to Figure 1 - 4 and shown there rack 26 is articulated.

As the following figures illustrate in more detail, the actual head shell 32 of the headrest 3 is hinged to the support plate 28 via two joint boxes lying above or below the plane of the drawing with corresponding rocker arms. This head shell 32 consists of an anatomically shaped upper part 33 and an attached housing part 34, in which the already mentioned rack 26 protrudes. In the housing part 34 is arranged below the plane of the electric motor 27, which is already shown in Figure 1, installed with a well recognizable in Figure 5 output pinion. Further, a guide 35 is provided which holds and guides the rack 26, but in which it is displaceable. The guide 35 can be pivoted about the axis of the output pinion of the electric motor 27 and thus follow in the movement of the headrest 3 a pivotal movement of the rack 26 about the articulated attachment in the hinge box 31.

The headrest 33 consists essentially of a soft foam pad 36, which is attached via a hook and loop fastener 37 to an upper plate of the housing part 34. To facilitate insertion of this pad 36, not shown centering pins may additionally be provided here.

This plate is, as Figure 5 shows in the horizontal position of the head rest 33 is slightly spaced from the holding plate 28, so in the direction of the holding plate 28 facing direction does not protrude far beyond the remaining housing part 34. Therefore arises at this point a slot between the housing part 34 and the holding plate 28, which is surmounted by the pad 36. A risk of jamming is not given because this slot is sized so large that operators can not easily pinch their fingers. Further, the pad 36, which can approach in a downward movement quite stronger to the support plate 28 as shown in Figure 5, dodge upwards. This follows, on the one hand, from a certain deformability and, on the other hand, is an advantage of the Velcro fastener 37.

FIG. 6 shows an alternative embodiment to FIG. 5, which can be attached in the same way to a treatment couch according to FIGS. 1-4. In the following, only the differences from FIG. 5 will be discussed. On the one hand, a centering pin 38 is shown in Figure 6, the pad 36 on the upper plate of the housing part 34 of the headrest 32 holds. On the other hand, the electric motor 27 is here replaced by a hand crank drive 39 with a worm gear 40, 41. The gear 41 of the worm gear is located on a common axis with a pinion 27 corresponding to the output gear of Figure 5 corresponding pinion for driving the rack 26th

The hand crank 39 has a fold-out pin for ease of cranking, indicated at 42. It can be seen that the manual drive in the same way is part of the headrest 3, as is true for the electric motor 27 with the associated drive parts in Figure 5. Incidentally, there are no fundamental differences from FIG. 5.

Figure 7 illustrates the headrest 3 of Figure 6 in an exploded view. It can be seen that the pad 36 has a somewhat semicircular shape and the housing part 34 of the headrest 32 is adapted to this semi-circular shape and holds the pad 36 from the outside. It also recognizes the over the housing part 34 protruding part of the pad 36 and an associated semicircular recess in the holding plate 28, in this. Projecting supernatant. In addition to the joint box 31, FIG. 7 shows two further gel kit boxes, designated 43, which are held by screws 44. These joint boxes 43 carry hinge pins, which are attached to the housing part 34 of the headrest 32 and on the other hand inserted into the recognizable receiving holes of the holding plate 28 and screwed with the screws 44. Incidentally, the fastening screws 29 and 44 also serve for fastening the retaining plate 28 to the rest of the treatment couch in a manner not shown in detail. They are screwed through a plate of the treatment couch through the support plate 28 with the hinge boxes 31 and 43.

Furthermore, FIG. 7 shows in perspective the guide 35 for the toothed rack 26 and the worm gear 40, 41 from FIG. 6.

Finally, it can be seen that the rack 26 is designed as a hollow tube. In a manner not shown 26 electrical lines can be laid in the rack, such as when instead of the manual drive 39 - 42, an electric motor drive 27 is used.

Figure 8 shows an analogous representation to Figure 7, but to the embodiment of Figure 5. Further, in the illustration of Figure 8 for illustration, the pad 36 is omitted, the Figure 7 shows. Incidentally, reference is made to the explanations to the figures 5-7.

Figures 9 and 10 show a side view of the headrest 3 of Figures 6 and 7 with a lower and an upper adjustment position and a perspective view of the headrest 3 for a better understanding of Figure 7. Here, no reference numerals are drawn to improve the pictorial representation ,

In Figure 9 can be seen in particular that an adjustment with the manual drive 39 - 42 causes the head rest 32 relative to the support plate 28 moves upward and thereby supported on the rack 26 and the hinge box 31. The same applies vice versa for an adjustment down. This can be done in the context of a motorized embodiment adapted to a Z-adjustment of the deck plate 2 of the treatment couch to ensure a constant, for example, horizontal holding the patient's head. This is esp. For the application of the treatment couch according to the following explanations of importance.

It can be seen that the rack 26 or, more generally, the length adjustment element of the drive is arranged below the hinges forming the pivot axis. This is advantageous because then smaller changes in length due to a headrest adjustment on the level of the patient's head (in the Y direction) occur and the drive is thus better accessible from below for operation or for removal and installation.

Figure 11 shows a schematic plan view of another embodiment to illustrate the optional feature of an X-adjustment of the headrest 3. On the deck plate 1 with the Z-parallel axis of rotation 13 for the X-adjustment of the aforementioned holding plate 28 in this case via a motor driven rack 46 with motor 45 on one outer side (seen in the X direction) and mounted via a pivot 47 on the opposite outer side. In order to the holding plate 28 can be adjusted relative to the deck plate 1 about the axis of rotation 47, so that angular errors due to X-adjustments of the deck plate 1 can be compensated for the rotation axis 13. The Y errors occurring in this example - the axis of rotation 47 is not centered - can in turn be taken into account by an automatic consideration in the Y-adjustment of the deck plate 1, if desired. Incidentally, the X-adjustability of the headrest 3 can of course be beneficial for other reasons.

FIG. 12, in turn, shows a further optional embodiment in which the X-adjustable part of the treatment bed is intercepted on the floor via an adjustable support foot 48. This support leg 48 is shown here only symbolically and can be driven in practice to stand out during adjustment movements from the ground and set up after adjustment for stabilization. Alternatively, the lower end of the support leg 48 may also be provided with a roll rolling on the ground or a sliding surface. The support leg 48 is attached to an end plate, which in turn is connected to the aforementioned intermediate plate 14, which in turn can be pivoted about the axis 13 relative to the base 4.

The illustrated treatment couch is an integral part of a laser surgical unit, not shown in further detail and known per se, for the treatment of ametropia in the human eye. Above the headrest 3, the head of this device is mounted and directs a Z-directional laser beam into the eye, which must be brought to the treatment couch in the appropriate position. X-adjustment allows switching between the two eyes of the patient. The optical adjustment options of the laser device itself must therefore cover only the fine movements of the laser beam in the actual treatment. The positioning of the patient takes place independently of this via the treatment couch. In particular, the X-adjustment can also be used to facilitate the patient's entry.

Figure 13 shows the deck plate 1 of the mattress 2 from the previous figures in more detail, the headrest 3 and the other parts of the treatment table for the sake of clarity are omitted. You have to get the deck plate 1 of Figure 13 and the following figures instead of the previously only schematically indicated deck plate 1 in the figures described so far.

The deck plate 1 carries a multipart mattress 2 with a shown in the right part and in relation to the deck plate 1 fixed mattress part and other shown in the left part of three mattress parts corresponding to the described in more detail below and summarily denoted by 51 knee brace. The knee brace 51 has a thigh portion 52 and a lower leg portion 53. The comparison of FIGS. 13 and 14 shows that the height of the knee brace 51 can be adjusted in the transition from the thigh section 52 to the lower leg section 53 by an adjusting mechanism which will be described below.

FIGS. 15 and 16 correspond to FIGS. 13 and 14, with the difference that there the knee brace 51 is displaced in the direction to the right, that is to say in the longitudinal direction of the lying plate 1 towards the headrest.

The introduction to the description has already explained that the adjustment possibilities of the knee brace 51 according to the invention can take place via longitudinal displacements on longitudinal rails. FIG. 17 shows a view corresponding to FIG. 14, wherein a lateral cover on the deck plate 1 has been omitted in the lower area, so that a front longitudinal rail 54 is visible. Figures 18 and 19 correspond to Figures 13 and 14, but show the deck plate without the stationary part of the mattress 2 and without the panel around the longitudinal rail 54 shown in Figure 17 and a parallel thereto further longitudinal rail 55 in perspective. FIG. 21 corresponds to FIG. 18, but is a perspective bottom view, whereas FIG. 20 corresponds to FIG. 19 and is not seen in perspective from the foot end but from the head end. FIG. 22, in turn, shows the deck plate 1 in a bottom view.

In particular, in Figures 13, 14 and 19 it can be seen that a lever 56 for the adjustment of the knee brace 51 by lifting the knee-side ends of the thigh portion 52 and the lower leg portion 53 is responsible. The hip-side end of the thigh section 52, as shown in particular in FIGS. 18, 19 and 20, is articulated on a first bearing plate 57. The lever 56 in turn is hinged at its lower end to a second bearing plate 58, as shown in particular Figure 19.

Figure 21 shows particularly clearly that the bearing plates 57 and 58 are mounted on the guide rails 54 and 55 via three guides 59-64. The guides 61 and 62 each contain an internal thread, ie a nut, and are guided on a section of the respective guide rail 54 or 55 provided with an external thread. The threaded portion on the guide rail 54 extends from the right end of the guide rail 54 on the guide 61 also to the left to the mark recognizable in Figures 18 - 22. The threaded portion of the guide rail 55, in turn, extends from the left end of the guide rail beyond the guide 62 to the mark visible in FIGS. 21 and 22. Incidentally, the guide rails 54 and 55 are smooth on the outside. They are driven by electromotive drives not shown in detail, cf. the reference numerals 65 and 66 in FIGS. 21 and 22.

FIGS. 17 to 22 illustrate how the adjustment movements illustrated in FIGS. 13 to 16 can be carried out. When driving the integrated spindle bar for the nut-provided guide 62, guide rail 55 is driven, the second support plate 58 moves toward the headrest or in the opposite direction. As long as doing the also a spindle rod for the nut provided with guide 61 performing guide rail 54 is stationary, the guide 59 slides over the guide rail 54 and the first bearing plate 57 remains unmoved. This results in an adjustment of Figure 13 of Figure 14 or vice versa, by the lower hinge axis of the lever 56 is displaced and due to the fixed length of the thigh portion 52 and the rest position of the hinge axis with which the thigh portion 52 is articulated on the first bearing plate 57 , the position of the knee brace 51, on which the lever 56 is articulated, is displaced upwards or downwards. The knee brace 51 thus bulges or lowers.

But if at the same time the guide rail 54 is moved in the same direction, the relative position of the bearing plates 57 and 58 remains unchanged with respect to each other and shifts the entire knee brace from a position shown in Figure 13 in one Position according to Figure 15 or vice versa or from a position according to Figure 14 in a position according to Figure 16 or vice versa. It is clear that due to different speeds or opposing speeds corresponding superimpositions of these movements can be achieved.

In all these movements, the position of the upper body region, that is, the upper body portion 67 relative to the deck plate 1 remains unchanged. The same applies, at least for the longitudinal direction Y, for the headrest, not shown here. The knee-rest adjusters illustrated with reference to FIGS. 13 to 22 thus take place relative to the deck plate 1, which in turn can be adjusted in various ways as explained in the preceding description of FIGS. 1 to 12.

Finally, FIGS. 13 to 17 and also in particular show that a substantially cylindrical sliding body 68 is mounted at the foot-side end of the lower leg section 53, with which the lower leg section 53 slides during the adjusting movements on the horizontal horizontal bearing plate 58 underneath. Thus, the foot-side end of the lower leg portion 53 remains substantially at the same height as the upper body portion 67 and thus in its flight.

Claims (14)

Treatment couch for storing a patient with
a patient slab (1) having a torso area (67) for supporting the upper body of the patient,
and a base (4) for supporting the deck plate (1) on a floor (6),
the lying plate (1) having a knee support (51),
which has a thigh section (52) which is angled in relation to the upper body region (67) of the lying surface (1),
characterized in that the knee brace (51) is slidable relative to the upper body region (67) in the longitudinal direction (Y) of the treatment couch. Treatment couch according to claim 1, wherein the thigh portion (52) of the knee brace (51) is adjustable by lifting at least one knee-side end relative to the upper body portion (67) of the deck plate (1). A treatment couch as claimed in claim 2, wherein the knee support (51) has a lower leg portion (53) angled with respect to the thigh portion (52),
and the foot-side end of the lower leg portion (53) upon lifting the knee-side end of the thigh portion (52) and associated lifting of the knee-side end of the lower leg portion (53) remains approximately in alignment with the upper body portion (67) of the deck plate (1). A treatment couch as claimed in any one of the preceding claims, wherein the thigh portion (52) of the knee brace (51) is hinged at its hip end to a longitudinally displaceable first member (57) and at its knee - side end via a lever (56) independent from the first component (57) in the longitudinal direction displaceable second component (58) is articulated. Treatment couch according to claim 4, in which the first and the second component (57, 58) are displaceable by means of longitudinal rails (54, 55) and can be adjusted by means of locking bars (54, 55) integrated with the longitudinal rails (54, 55). A treatment couch as claimed in any one of the preceding claims, wherein the deck plate (1) is adjustable relative to the base (4) to adjust the patient's positional position,
and the deck plate (1) is pivotable about a first rotation axis (19) parallel to a direction (X) perpendicular to the longitudinal direction (Y) in these displacements, the pivotal movement corresponding to a vertical displacement (Z), and a second rotation axis (13) which is parallel to a direction (Z) perpendicular to the longitudinal direction (Y), said pivoting movement corresponding to a horizontal (X) and perpendicular to the longitudinal direction (Y) adjustment. A treatment couch according to claim 6, wherein the bed plate (1) is also adjustable relative to the base (4) along a direction (Y) parallel to its longitudinal direction, the knee support (51) being movable in the longitudinal direction (Y) relative to the bed plate (1 ) is adjustable. Treatment table according to one of the preceding claims, comprising a headrest (3) attached to the decking plate (1), the knee support (51) being adjustable in the longitudinal direction (Y) relative to the headrest (3). A treatment couch according to claim 8, wherein the headrest (3) is tiltable with respect to the decking plate (1) about a horizontal axis of rotation (X) perpendicular to the longitudinal direction (Y), with an automatic Z-tilt compensation device being provided during a corresponding movement Adjustment of the deck plate (1) by the adjustability of the headrest (3), an automatic tilt compensation of the headrest (3) can be done. Treatment couch according to claim 8 or 9, wherein the headrest (3) relative to the deck plate (1) about a perpendicular to the longitudinal direction (Y) lying vertical axis of rotation (Z) is tiltable, wherein an automatic X-tilt compensation device is provided with which during a corresponding adjustment of the deck plate (1) by the adjustability of the headrest (3), an automatic tilt compensation of the headrest (3) can be done. Medical device for treatment in the head area with a treatment table according to one of the preceding claims. Apparatus according to claim 11 for the treatment of the eyes. Apparatus according to claim 11 or 12 with a laser surgical device. Method for supporting a patient with a treatment couch according to one of the preceding claims 1 - 10, wherein the patient is placed on the treatment couch in a suitable treatment position and the knee support (51) is adjusted in the longitudinal direction (Y) to the treatment couch on to adjust the size of the patient.

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