GB2169205A - Culdoscopy operating table - Google Patents

Abstract

A culdoscopy operating table is hinged in the middle so that with the patient lying in the prone position the front portion of the table supporting the upper body is tilted downwards, the rear portion supporting the patients legs is tilted downwards and split longitudinally giving access to the operator as well as balance and stability to the patient. A removable panel beneath the abdomen allows downward bulging thus establishing the conditions for successful culdoscopy. The front and rear portions are accordingly hinged, pivoted and supported and the entire unit adjustable in height. <IMAGE>

Description

SPECIFICATION Culdoscopy operating table This invention relates to a culdoscopy operating table.

Operating tables are universally used for placing patients in order to perform different types of surgical procedures. These tables are sturdy and well supported to afford safety in use and stability under surgical conditions. They are versatile in that they can be adjusted in height, tilt, and angulation of various parts of the table.

Culdoscopy is a procedure performed on female patients by medical doctors in which a puncture deep inside the vagina enables entry into the peritoneal cavity. It is usually performed on a flat table with the patient on her knees in the genupectoral (knee-chest) positiOn.

This particular invention allows the patient to lie flat in the prone position. The culdoscopy operating table is then manipulated to bring the patient to a suitable position for culdoscopy with no effect on their part.

The essential technical features will now be explained: The table has an essentially flat, oblong upper surface, made up of four different pieces, normally in the horizontal position. These several parts are at first on the level but subsequently made to assume different positions as follows. The front portion tilts downwards carrying the head of the patient down and angling the body at the hips. Next a removable section under the abdomen is taken away leaving a space below the abdomen so that it can bulge downwards. The rear portion is divided longitudinally into two equal and separate halves.

These are pivoted outward so that their ends separate, parting the legs and leaving a space between them.

These two halves of the rear portion of the upper surface are now tilted downwards so that the feet move downwards and the legs are accordingly angled at the hips. This manipulation permits the weight of the legs to counterbalance the rest of the body, thus affording stability. The parting of the legs allows the operator to gain access in between.

Adjustment of the height of the entire table may now be made by a central pillar or support, bringing it to the proper level. In this position the operation of culdoscopy, including culdoscopic tubal ligation can easily be performed. The various parts of the table surface are held in place by suitable supports.

A specific embodiment of the invention will now be described by way of example, using details of a culdoscopy table already in present use by the inventor.

In the accompanying drawings:- Figure 1 shows the complete operating table in perpective.

Figure 2 shows the same again from a different angle.

Figure 3 illustrates the downward tilting of the front portion 1 utilizing a hinge arrangement across the middle of the table.

Figure 4 shows the removal of the removable abdominal section 2, leaving a space.

Figure 5 shows sideways separation of the end of the two halves of the rear portion 4, utilizing pivots at the centre of the table: Figure 6 illustrates downward tilting of the same ends utilizing hinge arrangements on each of the above pivots.

Figure 7 shows detail of the support for the front portion.

Figure 8 shows detail of the hinge and pivot arrangement for the rear portion.

Referring to the drawing the culdoscopy operating table has a flat upper surface which is cushioned for the patient to lie upon. The parts of the table are as follows:- (1) An essentially flat upper surface 196.5 cm long by 61 cm wide and 79 cm high from the ground. This is subdivided as explained in the following paragraphs 3 & 4 below.

(2) A central suppoff 9 to which the various parts of the table are attached. This can be built in various designs according to how the other parts of the table are to be attached. However, it basically has a floor piece to an upright pillar which may be adjusted in height.

(3) A front portion 1(196.5 cm long and 61 cm wide). This is attached directly to the central support by a hinge 3 across the centre of the table. The front end of this portion attached through an adjustable support obliquely to the lower part of the central support.

This front portion includes a removable abdominal section 2, which fits on the upper surface of the table by dowels or other arrangement, but can be lifted off and removed.

When removed there is a space below it bounded on the sides by the two edges of the frame of the front portion. This section measures 23 cm long (along the length of the table) and 61 cm wide (the same width as the table).

(4) A rear portion 4 consisting of two longitudinally divided halves. This is 100 cm long.

These are attached, at the centre of the table, to the central support by pivots and swivels as explained later. The rear ends are attached by adjustable supports to two lower frames. These frames are in turn attached to the central support by pivots and their outer ends roll outwards as castors. A V-shaped piece cut away from each side of the top at the centre of the table, allows outward opening of the two halves.

In order to describe the parts of the table more completely it is necessary to explain its use in relation to a patient lying upon it. This will give a better understanding of the various parts and their relative manipulations.

The patient is placed lying prone with her head and body on the front portion 1. Her hip joints directly overlie the hinged midline 3 and her legs on the rear portion 4, one on each side. The several parts of the upper surface of the table are shown in figures 1 and 2. The centre of gravity of the patient as well as the line of angulation of the body thru the hip joint remain at all times directly over the centre of support of the operating table. This is an important and essential feature of this particular table and is necessary for the stability of the patient and the system as a whole.

The head and the body are then tilted downwards by tilting the front portion 1 as shown in figure 3.

This is permitted by a hinge attaching the front portion to the main support 9, across its upper edge, designated by arrow 3. The front portion is also supported by struts sliding thru a hinged tubular sleeve 5. It is kept locked in a horizontal position by a locating pin passing through a hole in the sleeve as well as the strut. Removal of the pin allows the front portion to hinge downwards. Any other suitable arrangement can be utilized for this purpose, for example a screw type support turned by a handle or electric motor, or a hydraulic adjuster.

At this point the patient's shoulders are supported by shoulder rests attached to the sides of the table.

These are not shown as many of these are available and they are in common use.

The removable abdominal section is a flat cushioned surface lying on the frame of the couch and forming part of the front portion. It is located by dowels or similar arrangement. It is then lifted slightly and pulled sideways, removing it completely from beneath the patient's abdomen leaving an empty space, surrounded only by the frame of the front portion, as shown in figure 4.

The two halves of the rear portion are attached to the main support by pivots allowing them to swing sideways as shown in figure 5. The space thus produced between the patient's legs gives adequate and excellent access to the operator for performing the culdoscopic procedure.

Each pivot consists of a metal pin or shaft directed vertically downwards and snugly fitting into a tubular metal piece attached to the central support of the operating table. The centres of the pivots are 25.5 cm apart (this is an important distance as it conforms to the human body).

The above pivots are also attached by hinges to the rear portion allowing downward tilting as showr in figure 6. This angles the patient's legs downwards counterbalancing the weight of the upper half of her body, thus ensuring stability. The supports for the rear portion in this present example are as shown.

They comprise hinged legs on the rear end of the upper surface. These legs rest on a lower frame with castors to allow them to roll sideways and studs to hold them in various positions according to the angulation of the upper surface. The lower frame is attached to the central support by pivots continuous and vertically below the upper pivots already described. Any other type of support such as hydraulic, screw type, sliding sleeve or strut can be used here. The upper pivots are situated a distance of (25.5cm) apart and in practice lie directly beneath the patient's hip joints which are ball and socket in nature. Because of this movements imparted to the patient do not cause sliding of the body or shifting along the surface of the table which would happen if existing operating tables or simple modifications of these are used. Shifting or sliding are conditions which are unacceptable for the performance of this operation.

The entire operating table can be raised or lowered by attaching the central support to a central lifting post on a firm base. This is not used in the present example but is uriiversally used on operating tables and can be suitably attached along with the appropriate supports for the table upper surface.

This table can be modified by adding stirups receptacles on either side of the front portion at or near the centre of the table. This allows the use of the lithotomy position and can be used for D & C, Laparoscopy and related procedures. Upward tilting of the front and rear position can also be added giving rise to trendellenberg or reverse trendellenberg position.

Claims (6)

1. A culdoscopy operating table hinged in the middle so that the front and rear portion tilt downward from these hinges.

2. A culdoscopy operating table as claimed in claim 1 in which a removable abdominal section can be removed from the front portion leaving an empty space beneath, adjacent to the hinge at the middle of the table.

3. A culdoscopy operating table as claimed in claim 1 in which the rear portion is divided longitudinally into two equal halves.

4. A culdoscopy operating table as claimed in claim 3 in which the rear ends of the rear portion can be moved apart leaving a V shaped space between the two halves of the rear portion for the operator to gain access.

5. A culdoscopy operating table as claimed in claim 1 in which suitable supports for the various parts are so placed that adjustment is made, retaining strength and stability.

6. A culdoscopy operating table substantially as described herein with reference to figure 1 to 8 of the accompanying drawing.