EP1785121A2 - Surgical table - Google Patents

Abstract

The table has a column (10) with a base (14) and a head (16), and a patient accommodating area (12), which is connected with the head. The area is swivelable relative to the column around an axis, which is parallel to the accommodating area plane. A curved guide way (42), which is continuous around a curved axis, is provided at the head. A saddle coupled with the area is supported on the guide way so that saddle is adjustable along the guide way by a drive.

Description

The invention relates to an operating table comprising a table column with a pedestal and with a column head and a connectable to the column head patient bearing surface which is pivotable about at least one axis parallel to the bearing surface plane relative to the table column.

Surgical tables of the aforementioned type are generally mounted pivotably on the column head both about an axis directed transversely to the longitudinal direction of the patient support surface (inclination axis) and about an axis (tilt axis) directed parallel to the longitudinal direction of the patient support surface.

The bearing surface must have a relatively large distance to its pivot axes, so that they can perform a sufficiently large pivoting movement in the direction of inclination or inclination before it abuts the column head. If the pivot axes are arranged above the lifting guide in order to achieve sufficient free positioning for the pivoting movements in the direction of tilting and inclining, a lowering of the operating table to a low level is severely limited. On the other hand, the pivot axes are arranged so that they penetrate the lifting guide, this has strong restrictions at least one pivoting movement. This arises from the situation that with the pivoting the bearing surface around the first, mounted on the column head pivot axis, the bearing of the second pivot axis is mitverschwenkt. This then collides quickly with the lifting guide.

The invention has for its object to provide an operating table of the type mentioned, which allows a greater latitude in the adjustment of the bearing surface about its inclination axis and / or tilt axis and in the vertical direction.

To achieve this object, the invention proposes that in an operating table of the type mentioned on the column head a continuously curved around a curvature axis guideway is provided on which a coupled with the bearing surface saddle is mounted so that it is adjustable by means of a saddle drive along the guideway is. Preferably, the axis of curvature of the guideway lies within the column of the table, so that therefore the guideway is curved convexly upwards.

Due to the fact that the saddle, which is coupled to the patient support surface, slides on the outside of the curved guideway, there is no need for a mounting of the pivot axis penetrating the column head. As a result, space is created within the column head, which is available for the height adjustment and allows a larger stroke of the height drive. In particular, this design also allows a stronger lowering of the column head with the patient support surface. Because the saddle can be driven to the end of the respective guideway, at least in the case of a convexly curved guideway, the angle of inclination of the patient support surface can also be made very large in accordance with the curvature of the guideway, without the patient support surface abutting the pillar head.

Preferably, the guide track is arranged on a head frame, which is pivotable relative to the table column by means of a pivot drive about a pivot axis perpendicular to the axis of curvature of the guide track. The storage of this pivot axis can be arranged in front of and / or behind, ie laterally of the lifting guide be, so that the space for this pivotal movement does not limit the lifting movement. In this way, the patient support surface can be pivoted in two directions.

Preferably, the saddle drive has at least one at least in one direction flexible pushing and / or pulling element, which is guided displaceably along the guide track and connected on the one hand with the saddle and on the other hand with an actuator. This can create a saddle drive, on the one hand can develop a high power and on the other hand takes up little space. Preferably, the actuator is a linear drive, for example, a pressure-medium-actuated cylinder. A particularly space-saving and yet reliable design of the saddle drive can be achieved in that the push and / or pull element is a back-rigid chain that can turn in one direction only. Such a chain can be connected directly to the piston of the fluid-operated cylinder and forms a stiff but one-way bendable, i. deflectable piston rod. In this way, a linear drive can be created, whose stroke corresponds approximately to its length and in which no additional space for the extension of the piston rod is needed.

In the above-described type, in which the back-rigid chain is directly connected to the piston and thus enters into the cylinder during retraction of the piston in this, it is expedient if the piston is acted upon only in the extension direction with pressure medium. In order to adjust the saddle in this case in both directions, it is expedient if the saddle drive comprises two each connected to an actuator push or pull elements which are arranged and designed so that they work in push-pull.

In an alternative embodiment of the saddle drive, the latter can comprise at least one seat-side drive element which can be driven by a motor and which engages with a gear element arranged on the head frame. Appropriately, the saddle-side gear element is a worm, which is in engagement with a sprocket mounted on the head frame.

For pivoting the head frame about its pivot axis is proposed that the pivot drive comprises two pressure medium actuated pivot cylinder, which are arranged within the column and on the one hand supported on the column head and on the other hand engage the head frame on both sides of the pivot axis. In this way, the necessary force for pivoting the patient support surface can be conveniently applied. Another possibility provides that the pivot drive comprises at least one with the head frame rotatably connected and coaxial with the pivot axis arranged worm wheel and a motor driven by the worm wheel in engagement worm.

It is conceivable that the bearing surface is coupled to the saddle so that its longitudinal direction is parallel to the axis of curvature of the guideway. In this case, the Kantungsachse is parallel to the axis of curvature of the guideway. In a preferred embodiment, the bearing surface can be coupled to the saddle such that the longitudinal direction of the bearing surface is perpendicular to the axis of curvature of the guideway. In this case, the axis of curvature of the guideway is equal to the pitch axis.

Thus, the bearing surface can be releasably connected in a conventional manner with the column head, the invention proposes that the bearing surface is arranged on a connecting frame, which has coupling elements which are intended to engage with arranged on the saddle counter coupling elements. Preferably, the bearing surface is pivotally mounted on the connecting frame about a pivot axis directed transversely to its longitudinal direction, wherein the pivoting can be effected by means of a bearing surface actuator. In a preferred embodiment, the bearing surface actuator comprises at least one drive unit having at least one servomotor attached to the connection frame or the bearing surface portion connected thereto and engaging a driven member connected to the other portion (bearing surface portion or connection frame).

In the preferred embodiment, in which the axis of curvature of the guideway is equal to the axis of inclination, results from the pivoting of the patient support surface Another advantage in combination with the sliding of the saddle on the guideway around its pivot axis. If the saddle is displaced from one end of the guideway to the other end of the guideway, it can always be held in a horizontal position by a simultaneous pivoting of the patient support surface in the opposite direction. In the end, there is a horizontal displacement of the patient support surface relative to the support column, without the need for a separate guide or a separate drive would be required. In addition, in this case results in the position of the saddle at the end of the guideway, an additional lowering of the patient support surface relative to the center position of the saddle, ie the highest point of the track, without requiring a height adjustment of the column head would be required. If the saddle is moved to one end, and the patient support surface is pivoted in the same direction, the tilt angle add up to a very large achievable angle of inclination.

In general, the patient support surface is divided into individual segments which are adjustable relative to each other. A high degree of flexibility in the adjustment of the patient support surface into different positions suitable for different interventions results when the bearing surface comprises at least two bearing surface segments which are hinged together about a joint axis coaxial to the bearing surface pivot axis, wherein the bearing surface actuator is formed so that the two bearing surface segments together or individually individually or individually individually adjustable. For this purpose, the servomotor of the bearing surface actuator can each be in driving connection via a coupling with one of the bearing surface segments. When both clutches are actuated, both bearing surface segments are simultaneously pivoted, i. the patient support surface is pivoted as a whole. If only one of the clutches is engaged, the bearing surface is bent in the region of the bearing surface pivot axis.

Fig. 1

eine teilweise schematische Seitenansicht eines erfindungsgemäβen Operationstisches,

Fig. 2

eine schematische Teildarstellung des Säulenkopfes und der Höhenverstelleinrichtung der Operationstisch-Säule,

Fig. 3

eine teilweise schematische Teil-Seitenansicht eines an dem Säulenkopf schwenkbar gelagerten Kopfrahmens, an dem die Führungsbahn für den Sattel ausgebildet ist,

Fig. 4

eine vergrößerte Darstellung des mit A bezeichneten Details aus Figur 3,

Fig. 5

eine schematische Teildarstellung eines mit einer Lagerfläche verbundenen Verbindungsrahmens und eines Sattels, mit dem der Verbindungsrahmen koppelbar ist,

Fig. 6

eine teilweise schematische und teilweise geschnittene Darstellung des Lagerflächenstellantriebes zum Verschwenken der Lagerfläche relativ zu dem Verbindungsrahmen,

Fig. 7

eine teilweise schematische perspektivische Darstellung zweier mit zwei gegeneinander verschwenkbaren Lagerflächensegmenten verbundenen Antriebselemente, die in Eingriff mit Antriebsrädern des in Figur 6 dargestellten Lagerflächenstellantriebes stehen,

Fig. 8

eine perspektivische Ansicht der in Figur 7 dargestellten Teile in Richtung des Pfeiles A in Figur 7,

Fig. 9

eine schematische Darstellung des Säulenkopfes mit dem Kopfrahmen, dem an dem Kopfrahmen geführten Sattel und einer mit dem Sattel gekoppelten Lagerfläche gemäß einer ersten Ausführungsform der Erfindung und

Fig. 10 bis 15

der Figur 9 entsprechende Darstellungen einer zweiten Ausführungsform der Erfindung in verschiedenen Stellungen des Sattels und des Kopfrahmens.

Further features and advantages of the invention will become apparent from the following description, which explains the invention with reference to embodiments in conjunction with the accompanying drawings. Show it:

Fig. 1

a partial schematic side view of an inventive operating table,

Fig. 2

a schematic partial view of the column head and the height adjustment of the operating table pillar,

Fig. 3

a partially schematic partial side view of a pivotally mounted on the column head head frame on which the track for the saddle is formed,

Fig. 4

an enlarged view of the designated A detail of Figure 3,

Fig. 5

a schematic partial view of a connected to a bearing surface connecting frame and a saddle to which the connection frame is coupled,

Fig. 6

a partially schematic and partially sectional view of the bearing surface actuator for pivoting the bearing surface relative to the connecting frame,

Fig. 7

a partially schematic perspective view of two connected to two mutually pivotable bearing surface segments drive elements which are in engagement with drive wheels of the bearing surface actuator shown in Figure 6,

Fig. 8

7 is a perspective view of the parts shown in FIG. 7 in the direction of the arrow A in FIG. 7;

Fig. 9

a schematic representation of the column head with the head frame, the guided on the head frame saddle and with the saddle coupled storage area according to a first embodiment of the invention and

10 to 15

9 shows corresponding representations of a second embodiment of the invention in different positions of the saddle and the head frame.

The operating table illustrated in FIG. 1 comprises an operating table column generally designated 10 and a patient support surface 12 arranged thereon. The table column or support column has a pedestal 14 and a column head 16. Only one of the column section lying between the pedestal and the column head can be seen in FIG the supporting elements and the height adjustment covering covering 18, which consists of a plurality of ring-like elements in the height adjustment of the column, ie when lowering and raising the column head 16 are telescopically displaced relative to each other.

Figure 2 shows a part of the internal structure of the support column 10. On a vertical guide 20, a head portion 22 by means of a guide portion 24 is guided vertically displaceable. The displacement of the head part 22 takes place by means of a pressure-medium-actuated cylinder, of which only the piston rod 26 can be seen in FIG. 2, which acts on the inner upper end of a bell-shaped bearing section 28 of the head part 22. The vertical guide 20 can be made in several parts in a conventional manner, so that the guide sections telescopically with the help of several cylinders can be pushed into each other to achieve a large stroke of the height adjustment.

In the bearing section 28, a head frame 30, shown only partially in FIG. 2 and shown in side view in FIG. 3, is pivotably mounted about a pivot axis 32 (FIGS. 2 and 3). The pivotal movement of the head frame in the bearing portion 28 by means of two working cylinders 34 which are supported on the one hand on the guide portion 24 of the head portion 22 and on the other hand engage cylinder tubes 36 which the bearing portions 38 of the head frame together connect and their other function will be explained in more detail later.

The head frame 30 further comprises two the two bearing sections 38 interconnecting arcuately curved bracket 40, which form a convex curved guide rail 42 for a saddle 44 shown schematically in Figure 5 and Figures 9 to 15, with the patient support surface 12 can be coupled.

The saddle 44 is adjustable along the guideway 42 by means of a saddle drive. This saddle drive comprises two actuators in the form of pressure-actuated piston cylinder assemblies 46, consisting of the above-mentioned cylinder tubes 36 and one in each of these displaceable piston 48. The piston 48 is directly connected to a back-rigid push chain 50 and can on its side facing away from the push chain with pressurized fluid be charged. The back-rigid push chain 50 can only turn in one direction and is coupled at its end facing away from the piston 52 with the saddle 44. The thrust chain 50 is guided outside the cylinder tube 36 in each case in a guide slot 54 extending within the bearing section 38 or the bracket 40. The two actuators 46 with their thrust chains 50 are arranged opposite to each other and can be operated in push-pull, so that each actuator 46 forcibly moves the saddle 44 only when pushing out the chain from the cylinder tube 36. The pistons 48 of the actuators 46 are thus acted upon in one direction only with pressure medium. This eliminates the need for a seal of the cylinder tubes 36 at the outlet of the push chains. On the other hand, the hydraulic control is simplified, since in the push-pull operation of the actuators always only as much pressure fluid flows out of the one cylinder, as flows into the other.

The bearing surface 12 may be connected directly to the saddle 44. In a preferred embodiment, the bearing surface 12 can be coupled to the saddle 44 via a connecting frame 56 (FIG. 5).

In one embodiment, a segment of the bearing surface may be connected directly to the saddle 44 and the connecting frame 56, respectively. In this case, the inclination of the bearing surface 12 is determined solely by the movement of the saddle on the guide track 42. If the saddle is at its highest point on the guideway 42, the bearing surface 12 assumes a horizontal position, as shown in the schematic representation of FIG. If the saddle 44 moves from this position towards one of the ends of the guide track 42, then the bearing surface 12 is inclined accordingly.

Preferably, the saddle 44 and the connecting frame 56 carries a bearing 60, in which at least one bearing surface segment is rotatably mounted. Preferably, two bearing surface segments 66 are disposed on either side of the bearing 60, the left and right side rails 78 of the bearing surface segments 66 may be interconnected by a shaft 62 and a coaxial hollow shaft. The segments 66 can be pivoted depending on and / or independently of each other, as will be explained later.

First, only so much held that the entire bearing surface 12 about the axis of the shaft 62 relative to the connecting frame 56 and thus also relative to the saddle 44 is pivotable.

The connecting frame 56 also has two from its central plate 58 downwardly projecting side walls 68, of which in Figure 5 only one is shown. On the inside of each side wall 68 is a dashed line in Figure 5 coupling element 70 which is intended to engage in a receiving pocket 72 which is formed on the outside of a side part 74 of the saddle 44, as seen in Figure 5. In this way, the connecting frame 56 and thus the bearing surface 12 can be coupled to the saddle 44 in a detachable manner, with the exact nature of the coupling will not be discussed here. On the outside, each side wall 68 of the connecting frame 56 carries a drive device, generally designated 76, shown in FIG. 6, which is used to adjust the segments 66 of the central portion 64 of the bearing surface 12 is used and will be explained in more detail below with reference to Figures 6 to 8.

Figures 7 and 8 each show a side rail 78 of a segment 66, wherein a segment 66 consists of two such side rails on which a cushion 80 (Figure 1) can be arranged. Each side rail 78 is connected on its underside with a sector disk 82 which carries at its lower arcuately curved edge a sprocket portion 84 with internal teeth. In this case, as shown in Figures 7 and 8, the arrangement is such that the lower edge of a sector disc surrounds the lower edge of the other sector disc, so that the sprocket portions 84 of both sector discs in the axial direction of the shaft 62 are adjacent. The sprocket portions 84 are each intended for engagement with a drive gear 86 which is part of the drive device 76 shown in FIG.

The drive gears 86 are rotatably mounted on the side wall 68 of the connecting frame 56 and are each rotatably connected to a worm wheel 88. Each worm wheel 88 is driven via a worm gear 90, which is rotatably mounted in a bearing 92 on the side wall 68 and is connected via a switchable clutch 94 and a gear 96 with two electric motors 98 in drive connection. Instead of the two motors 98, a single motor could be provided to drive the worm wheels 90. The transmission 96 causes always both motors 98 are in driving connection with both clutches 94. When both clutches 94 are engaged, both drive gears 86 are driven in the same direction. As a result, the entire central portion 64 is pivoted about the axis of the shaft 62 like a rigid plate. On the other hand, if only one of the clutches 94 is engaged, only one of the segments 66 is adjusted so that the segments 66 form an angle with each other (FIG. 13).

The bearing 92 of the worm gears 90 is axially displaceable against the biasing force of springs 100 (Figure 6). Further, the bearing 92 is associated with a limit switch 102, which by an axial displacement of the bearing 92 via a plunger 104th is operable. Should a pivoting of one of the segments 66 down this or its associated plate portion of the bearing surface 12 encounter an obstacle so that further movement is blocked, the reaction force causes an axial displacement of the worm gear 90 and its bearing 92, whereby the plunger 104 of the limit switch 102 is actuated. The actuation of the limit switch, the electric motors 98 can be switched off, so that damage to the operating table, the drive device 76 or a risk to the patient and the operator can be avoided.

The various adjustment possibilities of the patient support surface 12 on the support column 10 will now be explained in more detail with reference to FIGS. 10 to 15, wherein in the embodiment according to FIGS. 10 to 15 the bearing surface 12 is connected to the saddle 44 via the connection frame 56. As far as only the movement of the saddle 44 and the head frame 30 is described, the corresponding embodiments of course also apply to the embodiment of Figure 9, in which the bearing plate 12 is connected directly to the saddle 44.

Figure 10 shows the saddle at the highest point of the guideway 42, i. in the middle between their ends. The bearing surface 12 is adjusted horizontally relative to the connecting frame 56.

FIG. 11 shows a displacement of the saddle 44 towards one of the ends of the guide track 42. At the same time the bearing surface 12 is adjusted relative to the connecting frame 56 so that it in turn assumes a horizontal position. It can be seen that this ultimately corresponds to the position in FIG. 10 of a longitudinal displacement of the bearing surface 12 and a lowering of the bearing surface 12, without the head frame 30 or the entire column head being adjusted in height. By a displacement of the saddle 44 from one end of the guide track 42 to its other end with simultaneous pivoting of the bearing surface 12 relative to the connecting frame 56 can thus be achieved as a result, a horizontal displacement of the bearing surface 12.

Figure 12 shows the saddle 44 at the end of the guideway 42 with simultaneous inclination of the bearing surface 12 relative to the connecting frame 56. It can be seen that the angle of inclination of the bearing surface can be made very large, without the bearing surface abuts the column head.

Figure 13 shows the saddle 44 in the same position as in Figure 12, but with the segments 66 pivoted about the axis of the shaft 62 against each other. This makes it possible to adjust the patient support surface without major changes so that patients for rectal procedures can be stored in a suitable manner.

Figure 14 shows the head frame after pivotal movement about the axis 32, i. 15, the tilting movement is combined by a pivoting of the head frame with a tilting movement by moving the saddle on the guide track.

The above explanations show that the solution according to the invention considerably expands the adjustment range of the bearing surface 12 both in the height direction as well as about the inclination axis and the tilting axis. At the same time allows the principle of sliding on the track saddle without further aids a horizontal displacement of the bearing surface 12th

In the illustrated embodiments, the bearing surface is coupled to the saddle, that the bearing surface longitudinal direction is directed parallel to the displacement direction of the saddle on the guideway or perpendicular to the axis of curvature of the guideway. The bearing surface 12 thus performs during the displacement of the saddle on the guideway movement about the inclination axis. However, it is also possible to couple the bearing surface rotated by 90 ° with the saddle in such a way that, when the saddle is displaced on the guide track, the bearing surface moves about the axis of the fold, i. around an axis extending parallel to its longitudinal axis.

Claims (26)

An operating table comprising a table column (10) with a pedestal (14) and a column head (16) and a patient bearing surface (12) connectable to the column head (16) which is pivotable about at least one axis parallel to the bearing surface plane relative to the table column (10) , characterized in that on the column head (16) there is provided a guide track (42) continuously curved around a curvature axis, on which a saddle (44) which can be coupled with the bearing surface (12) is mounted such that it can be moved by means of a saddle drive (46, 50) along the guide track (42) is adjustable. Operating table according to claim 1, characterized in that the axis of curvature of the guide track (42) lies within the table column (10). Operating table according to claim 1 or 2, characterized in that the guide track (42) on a head frame (30) is arranged, by means of a pivot drive (34) about a to the axis of curvature of the guide track (42) perpendicular pivot axis relative to the table column (10) pivotable is. Operating table according to one of claims 1 to 3, characterized in that the saddle drive has at least one at least in one direction flexible push and / or pull element (50), along the guide track (42) slidably guided and on the one hand with the saddle (44) and on the other hand connected to an actuator (46). Operating table according to claim 4, characterized in that the actuator (46) is a linear drive. Operating table according to claim 5, characterized in that the linear drive is a pressure-medium-actuated cylinder (36, 48). Operating table according to one of claims 4 to 6, characterized in that the thrust element is a back-rigid chain (50). Operating table according to claim 6 and 7, characterized in that the chain (50) is directly connected to the piston (48) of the pressure-medium-actuated cylinder (36, 48). Operating table according to one of claims 4 to 8, characterized in that the saddle drive comprises two each with an actuator (46) connected push or pull elements (50) which are arranged and connected so that they work in push-pull. Operating table according to one of claims 1 to 3, characterized in that the saddle drive comprises at least one saddle-side driven by a motor gear element, which is in engagement with a arranged on the head frame (30) gear member. An operating table according to claim 10, characterized in that the saddle-side gear element is a worm and the gear frame attached to the head frame is a sprocket. Operating table according to one of claims 1 to 11, characterized in that the pivot drive comprises two pressure-medium-actuated pivot cylinder (34) which are arranged within the column (10) and on the one hand on the column head (22, 24) supported and on the other hand on the head frame (30 ) on both sides of the pivot axis (32) attack. Operating table according to one of claims 1 to 11, characterized in that the pivot drive comprises at least one rotatably connected to the head frame and arranged coaxially to the pivot axis worm wheel and a motor driven by the worm wheel in engagement worm. Operating table according to one of claims 1 to 13, characterized in that the column head (16) relative to the pedestal (14) by means of a vertical drive (26) is adjustable. Operating table according to claim 14, characterized in that the height drive comprises a telescopic vertical guide (20) and a linear drive (26). Operating table according to one of claims 1 to 15, characterized in that the bearing surface is arranged on a connecting frame (56) having coupling elements (70), which are intended for engagement with the saddle (44) arranged counter coupling elements (72). Operating table according to one of claims 1 to 16, characterized in that the bearing surface (12) on the saddle (44) or the connecting frame (56) about a transversely directed to its longitudinal direction pivot axis (62) is pivotally mounted. Operating table according to claim 17, characterized in that the bearing surface (12) by means of a bearing surface actuator (76) relative to the saddle (44) or connecting frame (56) is pivotable. Operating table according to claim 18, characterized in that the bearing surface actuator comprises at least one drive unit with at least one servo motor (98) which is fixed to the connecting frame (56) or the bearing surface portion (66) connected to it and with one with the other part ( Bearing surface portion 66 or connecting frame 56) engaged driving element (82, 84) is engaged. An operating table according to claim 18 or 19, characterized in that the bearing surface (12) comprises at least two bearing surface segments (66), which are hinged together about a pivot axis coaxial to the bearing surface pivot axis, and that the bearing surface actuator (76) is formed so that the two bearing surface segments (66) together or individually individually adjustable. An operating table according to claim 20, characterized in that the servomotor (98) of the bearing surface actuator (76) in each case via a coupling (94) with one of the bearing surface segments (66) is in drive connection. An operating table according to claim 21, characterized in that the servomotor drives in each case a toothed wheel (86) which engages with a toothed rim (84) on the respective bearing surface segment (66). Operating table according to one of claims 19 to 22, characterized in that the servomotor (98) is coupled to the gear (86) via a gear screw (90), which is mounted axially displaceable, that the gear screw (90) in a first axial end position is biased and that the worm gear (90) is assigned a power supply of the servomotor (98) controlling limit switch (102) such that it can be actuated in axial displacement of the worm (90) in its second axial end position. Operating table according to one of claims 19 to 23, characterized in that - with respect to the bearing surface pivot axis - on both sides of the connecting frame (56), a drive unit (76) is provided. Operating table according to one of claims 1 to 24, characterized in that the bearing surface (12) with the saddle (44) is coupled such that the longitudinal direction of the bearing surface (12) is perpendicular to the axis of curvature of the guide track (42). Operating table according to one of claims 1 to 24, characterized in that the bearing surface (12) with the saddle (44) is coupled such that the longitudinal direction of the bearing surface (12) is directed parallel to the axis of curvature of the guide track (42).

Images