GB2573216A

GB2573216A - Seating device for a patient positioning device and patient positioning device with a seating device

Info

Publication number: GB2573216A
Application number: GB1908321.1A
Authority: GB
Inventors: Wassim Bouraoui Mohamed; Buck Matthias
Original assignee: Bec GmbH
Current assignee: Bec GmbH
Priority date: 2016-12-24
Filing date: 2017-12-21
Publication date: 2019-10-30
Anticipated expiration: 2037-12-21
Also published as: WO2018115265A1; GB2573216B; GB201908321D0; DE102016015530A1

Abstract

The invention relates to a seating device (18) for a patient positioning device (1) having a first section (19) and a second section (20), which are aligned at an angle with respect to each other in at least one configuration of the seating device (18). One of the sections (19, 20) forms a backrest (25) and the other section (19, 20) forms a seating surface (24). A securing device for fixing to a positioning unit of the patient positioning device (1) is arranged on the first section (19). The seating device (18) is designed to be mounted in a first position (22) and a second position (23). In the first position (22), the first section (19) forms the seating surface (24), and in the second position (23) the second section (20) forms the seating surface (24). A patient positioning device (1) comprises a positioning unit which maintains the seating device (18) in the securing device. The positioning unit is designed to position the seating device (18) in the at least one first position (22) and the at least one second position (23).

Description

Seating device for a patient positioning system and patient positioning system with a seating device

The invention relates to a seating device for a patient positioning system of the species disclosed in the pre-characterising clause of claim 1 and to a patient positioning system with a seating device. A patient positioning system with a seating device is known from DE 10 2005 041 606 A1. The seating device takes the form of a chair with a back, a seat and a foot affixed to the seat. The foot is fixed to a base plate that is connected to the positioning unit of the patient positioning system.

In the patient positioning system shown in DE 10 2005 041 606 A1, parts of the chair, the base plate and/or the positioning unit are located in the beam path in many treatment beam to patient alignments. During imaging, in particular, it is desirable for no parts of the positioning unit of the patient positioning system to be located in the beam path. At the same time, it should advantageously be possible to take images from all spatial directions so as to be able to image as many regions of the body as possible in the views and sectional planes desired.

The object of the invention is to produce a seating device of the generic type that permits versatile patient positioning and with which the patient positioning system can be arranged outside the beam path of a beam of an imaging system or an irradiation unit. A further object of the invention is to specify a patient positioning system with a seating device that permits versatile patient positioning and at the same time the arrangement of the positioning unit outside the beam path of a beam.

This object is achieved in respect of the seating device by a seating device with the features of claim 1. As regards the patient positioning system, the object is achieved by means of a patient positioning system with the features of claim 13.

The seating device has two sections that are connected to one another at a connecting region and aligned at an angle to one another in at least one configuration of the seating device. In this arrangement the two sections can be connected permanently together. The two sections can, however, also be connected adjustably together such that the incline of the back of the seating device, for example, can be adjusted. The two sections can also be arranged in a common plane such that in at least one configuration the seating device forms a patient bed. In this context, a configuration of the seating device refers to an arrangement of the individual elements of the seating device.

The seating device can be moved into different positions by means of the patient positioning system. For example, the entire seating device can be tilted, pivoted or moved in a translational movement or a combined translational and rotational movement. The seating device is designed such that it can be arranged in a first position in which the first section, on which is arranged the mounting device for fixing it to the positioning unit, forms the seat. The seating device can also be arranged in a second position in which the second section forms the seat. In this arrangement, the first section and/or the second section can form other regions of the seating device in addition to the seat. The seating device is thus designed so that in a first position the first section forms the seat and the second section forms the back. When the seat is in a horizontal position, for example, forces exerted by the patient are thereby transferred in the vertical direction via the first section to the positioning unit. When the seating device is in the second position, the first section forms the back and the second section forms the seat. In the second position the seating device is thus fixed to the back so that, when the back is aligned vertically, for example, the forces are transferred via a lateral link to the positioning unit.

In the first position the upper body of the patient is accessible for an imaging unit or an irradiation unit. The patient positioning unit is not arranged in the region of the back. When the seating device is in the second position, the legs of the patient are available for an imaging unit or an irradiation unit since the positioning unit engages with the first unit, i.e. in this position with the back. As a result the seating device can be used in a number of different configurations and a very wide range of regions of the patient can be imaged with only one single seating device without the positioning unit being located in the beam path.

The first and second sections are each advantageously formed of at least two subsections that are connected to one another by means of a fixable pivot joint.

In this context a fixable pivot joint means a pivot joint that can be fixed in various different pivoting positions and that, when released, allows the two subsections to pivot in relation to one another. This makes it possible to set the two subsections in a desired position relation to one another. Here the two subsections are advantageously dimensioned such that in at least one position of the seating device the first subsection forms the seat and the second subsection forms a lower-leg support. The length of the first subsection thus corresponds to the depth of the seat. In a particularly preferred design the first part subsection of the first section and the first subsection of the second section are of equal length, thereby producing the same seat depth in both the first and second positions.

The connecting region advantageously comprises a fixable pivot joint via which it is possible to set an angle between the first section and the second section. The angle between seat and back can be set by means of the adjustable pivot joint. The mounting device is advantageously designed as a mounting flange. In a preferred design the mounting flange can be a plate that is provided to connect it to the positioning unit. The connection to the positioning unit can preferably take the form of bolts that are held in the holes provided in the mounting flange. The seating device has a transverse direction in which the connecting region extends. The transverse direction is oriented in the lateral direction of the patient. In particular, the transverse direction lies parallel to the line of intersection of the extensions of the seat and the back. The seating device advantageously has at least one column that forms a supporting structure of the seating device. To permit imaging of all regions of the patient and at the same time to achieve a comparatively small width of the seating device, the column can advantageously be moved in the transverse direction in relation to the seat. As a result the column can be arranged in a region of the patient that is not to be imaged or radiated, i.e. outside the beam path. A continuous column that forms a supporting structure for both the back and the seat is advantageously provided. The fact that separate columns are not provided for back and seat results in a simple construction.

Mounting the column on the mounting flange such that it is able to move along a guide produces a simple design. A fixing device for fixing the column in relation to the guide in a plurality of positions is preferably provided. The guide can advantageously take the form of a rail and a carriage mounted on the rail such that it is able to slide along it. The fixing device is advantageously designed for one-handed operation so that the operator can hold the column with one hand and fix the column in the desired position with the other. A simple design of fixing device for fixing the column is achieved if the fixing device comprises an engaging element that is mounted on the mounting flange or column such that it is able to rotate about a pivot axis. The pivot axis is preferably aligned parallel to the longitudinal direction of the guide, in particular in the transverse direction. The engaging element advantageously has an engaging contour. A mating contour is advantageously formed on the other component of the mounting flange or column, in a first rotational position of the engaging element the engaging contour of the engaging element engaging in this mating contour and thereby fixing the engaging contour and the mating contour in relation to one another in the direction of the pivot axis, and in a second rotational position of the engaging element, the engaging contour being pivoted out of the region of the of the mating contour such that it is possible to move the column and rail against one another in the direction of the pivot axis. Fixation is effected simply by rotating the engaging element about its pivot axis between a first and a second rotational position. The two rotational positions can, for example, be positions of the engaging element rotated by 90° or 180° in relation to one another. The engaging contour and the mating contour are advantageously contours that engage with one another such as toothed contours, for example. This permits a form-fit fixation of the rail and the column in relation to one another in a simple manner.

In a preferred design the engaging element is arranged on the column and the mating contour is arranged on the rail. If the seating device has a plurality of columns, they can be fixed to a common mating contour. The fact that only the engaging element of the column to be adjusted, and not the mating contour, has to be released means that the position of the columns can be adjusted independently of one another. However, an arrangement of the engaging element on the mounting flange can also be advantageous. It can, however, also be advantageous for the engaging element to be arranged on the rail and the mating contour on the column.

Advantageously at least one cover to form the seat and/or the back is held on the column such that it can be released. The seat and/or the back are advantageously modular in design and can take the form of a plurality of covers fixed individually to the column. As a result, individual, desired covers can be removed depending on the region to be imaged in order to make the desired region of the patient freely accessible. In a preferred design a fixing device is provided for fixing the cover to the column. In a particularly preferred design the fixing device for fixing the cover is formed on the column corresponding to the fixing device for fixing the column to the mounting flange. In this arrangement the engaging element is preferably held on the cover. Arranging the column in a central region of the mounting flange also achieves good accessibility of an operating element for pivoting the engaging element. It is also, however, possible for the engaging element to be held on the column and the mating element to be held on the cover.

In a particularly preferred design the seating device as at least two columns that are held on the mounting flange such that they can move along the seating device in the transverse direction. In this arrangement the two columns are preferably held on common guides to ensure a simple construction. At least two guides are preferably provided to guide the columns on the mounting flange. Adequate stability of the seating device is achieved by at least two columns. As they can be moved, the two columns can be set so as to make a central region of the patient freely accessible. It is also preferably possible to move the columns to one or other side of the seating device so that lateral regions of the patient can be imaged in their entirety. Each column preferably has at least one pivot joint.

To achieve multiple adjustability and adaptation to the desired position of the patient, it is preferably possible for the pivot joints of the columns to be adjusted independently of one another. This means, for example, that the legs of the patient can be moved into various positions. This is possible over the entire length of the legs if the second section forms the seat and the first section, on which the mounting device is arranged, forms the back.

In a preferred design the seating device has at least one receiver for the detachable mounting of attachment devices. A plurality of receivers is preferably provided for the detachable mounting of attachment devices. The receivers are particularly provided on the side of the columns facing away from the seat or back and/or on the free ends of the columns. Possible attachment devices include arm supports and foot supports, for example.

For a patient positioning system with a positioning unit that holds the seating device to the mounting device it is advantageous for the positioning unit to be designed to position the seating device formed in the at least one first position and in the at least one second position. As a result the positioning unit has a sufficient degree of freedom to set the seating device to the first position or the second position. In the at least one first position, the first section is advantageously inclined at less than 30° to the horizontal, in particular in the horizontal direction. In the at least one second position, the second section is advantageously inclined at less than 30° to the horizontal, in particular in the horizontal direction. As a result the seating device is designed as a chair with a seat inclined at less than 30° to the horizontal, in particular with a horizontal seat, in both the first and second positions.

An embodiment of the invention is explained below with reference to the drawings.

Fig. 1 shows a side view of a patient positioning system in a first position.

Fig. 2 shows a side view of the patient positioning system from Fig. 1 in a second position.

Fig. 3 shows a perspective view of the seating device of the patient positioning system from Figs. 1 and 2 occupied by a schematically illustrated patient.

Figs. 4 and 5 show side views of the seating device from Fig. 3.

Fig. 6 shows a top view of the seating device from Fig. 3.

Fig. 7 shows a perspective view of the seating device from the preceding figures with no patient on the seating device.

Fig. 8 shows a side view of the seating device from Fig. 7.

Fig. 9 shows a perspective view of the seating device in the same position as shown in the perspective view in Figs. 7 and 8 but in another configuration.

Fig. 10 shows a side view of the seating device in the position and configuration from Fig. 9.

Fig. 11 shows a side view of the seating device in a second position.

Fig. 12 shows a perspective view of the seating device in the position shown in Fig. 11, but in another configuration.

Fig. 13 shows a side view of the seating device in the position and configuration shown in Fig. 12.

Fig. 14 shows the seating device from the preceding figures in the position shown in Figs. 3 to 8 with some of the covers removed.

Figs. 15 and 16 show side views of the seating device from Fig. 14.

Fig. 17 shows a perspective view of the seating device in another configuration with a cover removed.

Figs. 18 and 19 show side views of the seating device in the configuration from Fig. 17.

Fig. 20 shows a perspective view of a further configuration of the seating device.

Figs. 21 and 22 show side views of the seating device in the configuration from Fig. 20.

Fig. 23 shows a perspective view of the mounting flange and two sections of a column of the seating device on which a cover is arranged with the fixing device fixed.

Fig. 24 shows a side view of the arrangement from Fig. 23.

Fig. 25 shows a section along the line XXV-XXV in Fig. 24.

Fig. 26 shows a perspective view of according to Fig. 23 with the fixing device open.

Fig. 27 shows a side view of he arrangement from Fig. 26.

Fig. 28 shows a section along the line XXVIIl-XXVIlI in Fig. 27.

Fig. 29 shows a section along the line XXVII l-XXVIl I in Fig. 27 through a fixing device of a cover.

Fig. 30 shows a perspective view of the arrangement from Fig. 26 with the fixing device of the cover open.

Fig. 31 shows a side view of the arrangement from Fig. 30.

Fig. 32 shows a section along the line XXXII-XXXII in Fig. 31.

Fig. 1 shows a side view of a patient positioning system 1. The patient positioning system 1 serves to position a patient 17 (shown schematically) in a room in relation to a radiation source 15 (also shown schematically) that generates a beam 16. The radiation source 15 can be provided for radiotherapy or imaging purposes. The radiation source 15 can generate a beam 16 comprising protons, neutrons or ions, preferably heavy ions. The beam 16 can be generated by a cyclotron, for example. However, the radiation source 15 can also generate a beam 16 comprising photons, for example an X-ray or gamma beam. Provision can also be made for other types of beam. It is desirable to expose only that region of the patent 17 to be irradiated to the beam 16.

To enable the alignment of the patient in the desired position relative to the radiation source 15 and to the beam 16, it is known to arrange the patient in the room on a chair or bed of the patient positioning system 1 by means of a positioning unit. According to the invention, a seat device 18 is provided to receive the patient. In the embodiment a robotic arm 2 is provided as the positioning unit. However, another type of positioning unit can also be advantageous.

In the embodiment the robotic arm 2 is a six-axis robot that permits movements in all three spatial directions and about all three spatial axes. The robotic arm 2 has a base frame 3 on which a carousel 4 is mounted such that it is are able to rotate about a first axis of rotational movement 8. In the embodiment the base frame 3 is provided for fixation to the ceiling of the room and the first axis of rotational movement 8 is aligned vertically. However, it may also be advantageous to arrange the base frame 3 on the floor or on a wall of the room. A swing arm 5 is mounted on the carousel 4 such that it is able to pivot about a second axis of rotational movement 9. The second axis of rotational movement 9 is aligned vertically in relation to the first axis of rotational movement 8 and in the embodiment is arranged horizontally. An arm 6 is mounted on the swing arm 5 such that it is able to pivot about a third axis of rotational movement 10. In the embodiment the third axis of rotational movement 10 is aligned parallel to the second axis of rotational movement 9. Arranged on the arm 6 is a hand section 7 which allows rotational movements about a fourth axis of rotational movement 11, a fifth axis of rotational movement 12 and a sixth axis of rotational movement 13. The robotic arm 2 can also be provided with further axes of rotational movement to increase the degree of freedom of movement. The seating device 18 is arranged on the hand section 7. To this end the seating device 18 has a mounting device, in the example a mounting flange 14. The mounting flange 14 is preferably fixed to the hand section 7 by means of bolts. Another type of fixing may, however, also be advantageous.

The seating device 18 has a first section 19, to which the mounting flange 14 is fixed, and a second section 20. The two sections 19 and 20 are connected to one another at a connecting region 21. In the configuration shown in Fig. 1, two arm rests 26 and 27, on which the lower arms of the patient 17 rest, are fixed to the second section 20.

Fig. 1 shows the seating device 18 in a first position 22 in which the first section 19 forms a seat 24 of the seating device 18 and the second section 20 forms a back of the seating device 18. In the first position 22 shown in Fig. 1 the seat 24 is aligned horizontally. In this position the mounting flange 14 is located beneath the seat 24. The weight force of the patient 17 and the seating device 18 is thus transferred horizontally downwards to the hand section 7 of the robotic arm 2.

The fact that the mounting flange 14 is located under the seat and the upper legs of the patient 17 enables the region of the upper body and head of the patient 7 to be brought into the beam path of the beam 16 without the mounting flange 14 entering the beam path. This requires a sufficient distance between the central axis of the beam 16 and the mounting flange 14, particularly with widely scattered beams 16. If individual regions of the back 25 are removed, the seating device 18 can be configured such that only the patient 17 and none of the parts of the seating device 18 or the robotic arm 2 are located in the beam path. This is particularly advantageous for imaging processes as the imaging of the patient is not distorted by parts of the seating device 18. It can also be advantageous in the case of irradiation, however, as the beams 16 used for radiotherapy place considerable stress on the material of the seating device 18. The service life of the seating device 18 can be significantly increased if none of the parts of the seating device 18 are located in the beam path.

In the position 22 of the seating device 18 shown in Fig. 1, the fifth axis of rotational movement 12 of the hand section 12 is horizontally and the sixth axis of rotational movement 13 of the hand section 7 vertically aligned. In Fig. 1 the beam 16 is indicated horizontally by way of example. Depending on the region of the patient 17 to be irradiated, the beam can be aligned in any other position in relation to the patient 17. The radiation source 15 can be provided on a gantry, for example, to allow for the adjustment of the beam 16.

Fig. 2 shows the patient positioning system 1 in a second position 23 of the seating device 18. In the second position 23 the second section 20 forms the seat 24 and the first section 19 forms the back 25. In the position 23 shown in Fig. 2, the second section 20 is aligned horizontally and the first section 19 is aligned vertically. As a result the mounting flange 14 is aligned vertically. In position 23 as shown here, the fifth axis of rotational movement 12 is horizontal and the sixth axis of rotational movement 13 is also horizontal. The weight force of the patient 17 and the seating device 18 is transferred in the horizontal direction to the hand section 7 of the robotic arm 2. The mounting flange 14 is now arranged adjacent to rather than beneath the patient 17. As a result it is possible to image or irradiate the upper legs and legs of the patient 17 without regions of the robotic arm 2 or the mounting flange 14 being in the beam path. As described in greater detail below, the seating device 18 is advantageously also configured such that no parts of the seating device 18 are located in the beam path of the beam 16.

The suitability of the seating device 18 for positioning the patient 17 in the first position 22 and the second position 23 is advantageously achieved by designing the regions of both sections 19 and 20 that support the patient 17 such that they are identical to one another. This permits sections 19 and 20 to be used both as seats 24 and as backs 25. As shown in Figs. 1 and 2, in each of these cases only part of sections 19 and 20 forms the seat while the back 25 can be formed by all of section 19 or 20.

Figs. 3 to 8 show the seating device 18 in the first position 22. As shown in Fig. 3, provided in the connecting region 21 is a pivot joint 48 that permits the two sections 19 and 20 to pivot about a pivot axis 33 in relation to one another. By this means it is possible to adjust the incline of the back 25 in relation to the seat 24. The pivot joint 38 is advantageously designed such that the sections 19 and 20 can be aligned at least at an angle of 180° in relation to one another, i.e. in one plane. This also allows the seating device 18 to be used as a bed. In this arrangement the angle between the sections 18 and 19 is measured on the side facing the patient 17.

The first section 19 has a pivot joint 41 that permits a pivoting movement about a pivot axis 34. The second section 20 also has a pivot joint 41 that permits a pivoting movement about a pivot axis 35. The pivot axes 33, 34, and 35 run parallel to one another. The pivot axes 33, 34, and 35 extend in a transverse direction 90 of the seating device 18. Here the transverse direction 90 is the direction in which the connecting region 21 extends. The transverse direction 90 is aligned in the lateral direction of the patient 17. As shown in Fig. 3, the first section 19 forms a lower-leg support 29 as well as seat 24. Arranged on the region forming the lower-leg support 29 are foot supports 28 on which the feet of the patient 17 can be positioned. As also shown in Fig. 3, the seat 24, the lower-leg support 29 and the back 25 take the form of covers, which are described in greater detail below.

Fig. 4 also shows the orientation of the pivot axes 34 and 35 in the transverse direction 90. As Fig. 4 also shows, in the region of the pivot joint 41 the covers 30 have recesses 40 to ensure that the covers 30 do not impede pivoting about the pivot axes 34 and 35 and are easily accessible for an operator.

As shown in Figs. 4 and 5, two columns 31 and 32 are provided on the side of the covers 30 facing away from the patient 17. The columns 31 and 32 form the supporting structure of the seating device 18. The columns 31 and 32 are fixed to the mounting flange 14 and hold the covers 30. To be able to adjust the seating device 18 flexibly to each individual application the seating device 18 is modular in design. The two columns 31 and 32 are designed to be completely separate from one another. Each column 31, 32 has pivot joints 41 and 48 that can be adjusted independently of one another for the two columns 31 and 32. A plurality of covers 30 is provided, designed separately from one another and fixed separately to the columns 31 and 32. To this end rails 64, which are described in greater detail below, are provided on the covers 30. Another type of fixation can also be advantageous.

On the side facing away from the patient 17 the columns 31 and 32 have a plurality of receivers 42, which in the embodiment are designed as carriages to receive a rail. Another design of the receivers 42 can also be advantageous. The arm rests 26 and 27 with mounting sections 43 are fixed in the receivers 42. As shown in Fig. 5, the mounting sections 43 extend from transverse sides 101 and 102 of the seating device 18 to approximately a centre plane 45. The transverse sides 101 and 102 are the longitudinal sides of the seating device 18 that run to the right and left in the region of the sides of the patient. In the embodiment, transverse side 101 is the left-hand side of the seating device 18 in relation to the patient 17 and transverse side 102 is the right-hand side of the seating device 18. A centre plane 45 of the seating device 18 lies centrally between transverse sides 101 and 102 and is also vertically aligned when the upper body of the patient 17 is vertically aligned.

The arrangement of the mounting sections 43 on the columns 31 and 32 is also shown in Fig. 6. In the first position 22 and the configuration of the seating device 18 shown in Figs. 3 to 6, column 31 is arranged to the left of the patient 17 and column 32 to the right of the patient 17, both behind the back of the patient.

Fig. 7 shows the design of the two sections 19 and 20 in detail. The first section 19 has two subsections 36 and 37 that are connected to one another via the pivot joint 41 and can be pivoted in relation to one another about the pivot axis 34. The first subsection 36 is connected to a first subsection 38 of the second section 20 at the connecting region 21. The first subsection 38 is connected to a second subsection 39 of the second section 20 via the pivot joint 41. In the first position 22 of the seating device 18 shown in Fig. 7, the first subsection 36 forms the seat 24, the second subjection 37 forms the lower-leg support 29 and subsections 38 and 39 form the back 25. In this arrangement the first subsection 38 is arranged in the region of the lower back and the second subsection 39 is arranged in the region of the upper back of a patient 17 sitting on the seating device 18 (Fig. 4).

Figs. 7 and 8 also show the fixing of the columns 31 and 2 to the mounting flange 14. As shown in Fig. 7, the column 31 is held onto the mounting flange 14 by guides 46 and 47. The column 32 is held onto the mounting flange 14 in a corresponding manner, as shown in Fig. 8.

Fig. 8 shows the design of the guides 46 and 47 in detail. In the first position 21 a first rail 66 is arranged on the mounting flange 14 below the connecting region 21. A second rail 67 is arranged at the end of the first subsection 36 facing away from the connecting region 21. Both rails 66 and 67 extend parallel to the pivot axes 33, 34 and 35. Arranged on the first subsection 36 are two carriages 53 that are guided along the rails 66 and 67 and form guides 46 and 47 with them.

As shown in Fig. 8, the subsections 36 and 38 have a length a. The length a is measured from the pivot axis 33 to the other pivot axis 34, 35 of subsections 36, 38 respectively. The length a of the subsections 36 and 38 determines the seat depth if the subsection 36, 38 forms the seat 24. The length a is advantageously adapted to a centre length of the supper leg of the patient 17. The second subsections 37, 39 each have a length b that is measured from the pivot axis 34, 35 of the associated pivot joint 41 to the free end of subsections 37 and 39. Arranged at the free end of each of them is a receiver 52. The length b is advantageously adapted to a standard length of the lower leg of a patient 17 to the foot so that the patient can rest his/her feet in comfort when a footrest is fixed in the receiver 52 (Fig. 7).

As also shown in Fig. 8, in the configuration illustrated the top of subsection 36 forming the seat 24 forms an angle a, which is 90° in the configuration shown, with the top of subsection 38 forming in the back. The pivot joint 48 preferably permits an angle a, which is 90° in the configuration shown, forming the back 25 form of at least 90° to 120°, in particular at least 90° to 180°. Angles a of less than 90° can also be advantageous. The top of subsection 36 forming the seat 24 forms an angle β, which is 270° in the configuration shown, with the top of subsection 37 forming the lower-leg support 29. The seat 24 and the lower-leg support 29 are thus aligned vertically in relation to one another. Angles β of at least 180° to 270° advantageously be set. The tops of subsections 38 and 39 of the second section 20, which form the back 25, are arranged in one plane.

Fig. 8 also shows the arrangement of the receivers 42 on the back of the seating device 18 facing away from the patient 17. Receivers 42 are arranged on the halves of subsections 37 and 39 distant from the pivot joints 41. Subsection 38 has a receiver 42 adjacent to the pivot joint 41 in the half distant from pivot joint 48. In this arrangement the receivers 42 are advantageously provided on each column 31 and 32, as shown in Fig. 5.

As also shown in Fig. 8, the receivers 52 are arranged on the ends of the sections 19 and 20 facing away from the connecting region 21. In the embodiment the receivers 52 are designed as cylindrical openings and serve to receive the footrests 28 (Fig. 7). Other attachments can also be arranged on the receivers 52. As shown in Fig. 9, each column 31, 32 has a receiver 52 at each end. In addition to the receivers 42 and 52, further receivers for attachments such as armrests 26 and 27 and footrests 28 can also be provided on the seating device 18.

The pivot joints 41 and 48 are designed as fixable joints. Operating levers 49, 50 are provided to fix and release them. The pivot joints 41 have operating levers 49 and the pivot joint 48 has an operating lever 50. The operating levers 49 and 50 are advantageously designed as quick-release devices in the form of toggles that release or lock the corresponding actuating contour of the pivot joints 41 and 48 in a known manner. The fixing can, for example, be effected by means of toothed sections that engage with one another or by means of a pin that engages in both parts of the pivot joint and is moved by the actuating lever. Other, known designs of fixable pivot joints can also be provided.

As shown in Fig. 8, operating levers 58, which serve to release or fix a given cover 30 on the associated column 31 or 32, are provided on the covers 30. They are described in greater detail below.

Fig. 9 shows the seating device 18 in another configuration. The position of the seating device 18 corresponds to the position 22 as shown in the previous figures, i.e. the first section 19 forms the seat 24 and the mounting flange 14 is arranged below the seat 24. The two columns run parallel to one another in subsections 36, 38, 39. In subsection 37 the columns 31 and 32 are aligned at different angles to subsection 36. Column 31 forms a subsection 37a that forms a smaller angle with the seat 24 than a subsection 37b formed by the second column 32 and the covers 30 arranged on it. Due to the fact that the covers 30 only extend to the centre plane 45, the columns 31 and 32 can be aligned at different angles with the covers 30 arranged on them.

As shown in Fig. 10, the lower-leg support 29a formed by subsection 37a is aligned at an angle β of less than 270° to the seat 24. The configuration of the seating device 18 shown in Figs. 9 and 10 exhibits an angle β of approx. 210° to 220°. Subsection 37b forms a lower-leg support 29b that forms an angle β’ with the seat 24 that is greater than the angle β. In the configuration shown, the angle β’ is 240° to 260°. Advantageously it is also possible to set a plurality of other angled positions of subsections 37a and 37b between 180° and 270°.

Figs. 9 and 10 also show the design of the armrests 26 and 27. The armrests 26 and 27 are preferably of identical design and can be adjusted flexibly. In the embodiment, starting from the mounting section 41, a first length adjustment device 92, a first pivot device 91, a second length adjustment device 94, a second pivot device 93 and a third length adjustment device 96 are provided to adjust the lower-arm supports 26 and 27. After them is arranged a lower-arm rest 95. The length adjustment devices 92, 94 and 96 and the pivot devices 91 and 93 are advantageously designed such that the lower-arm rests 95 can be arranged in any desired position and can be adjusted to the size of the patient 17. Advantageously the pivot devices 91, 93 and the length adjustment devices 92, 94 and 96 can be released and fixed tool-free, in the embodiment by means of a control wheel 97. In the configuration shown in Figs. 9 and 10, subsections 36 and 38 form an angle a that is greater than 90° such that the patient 17 can be positioned reclining.

Fig. 11 shows the seating device 18 in the second position 23 in which the first section 19 forms the back 25 and the second section 20 forms the seat 24. The mounting flange 14 is fixed to the back 25 and arranged behind the patient 17 (Fig. 2). At the connecting region 21 sections 19 and 20 form an angle a that is measured between the seat 24 and the back 25 and is 90° in the configuration shown. However, an angle a greater than 90° can also be advantageous. If the patient is arranged in a position in which the back 25 is inclined, the mounting flange 14 is also angled accordingly. In the second position 23 shown in Fig. 11, the weight force of the patient 17 is absorbed by the second section 20 and transferred via the pivot joint 48 to the first section 19 and from there to the mounting flange 14. Subsections 38 and 39 of the second section 20 are positioned at an angle in relation to one another. At the side facing the patient 17 the two subsections form an angle γ, which is 270° in the configuration shown. Advantageously it is possible to set an angle γ of between 180° and 270°. The first subsection 38 forms the seat 24 and the second subsection 39 forms the lower-leg support 29. Subsections 36 and 37 of the first section 19 are aligned parallel to one another and form an angle β of 180°.

Fig. 12 shows the seating device 28 in the second position 23 in a further configuration of the seating device 18. The mounting flange 14 is still aligned vertically and the second section 20 forms the seat. However, the columns 31 and 32 are positioned completely separate from one another in the second section 20 and pivoted in relation to one another such that there is no continuous seat 24. A first subsection 24a of the seat 24 is formed by a subsection 38a of the second section 20, which is formed by the column 31 and covers arranged on the column 32. A second section 24b of the seat 24 is formed by the first subsection 38b of the second column 32. Owing to the fact that subsections 38a and 38b are pivoted in relation to one another, pivot axes 35a, 35b also cease to coincide between subsections 38a/39a and 38b/39b. Subsection 39a can be pivoted at the pivot axis 35a in relation to subsection 38a and subsection 38a can be pivoted at the pivot axis 35b in relation to subsection 38b. Pivot axes 35a and 35b are a certain distance from one another. As shown in Fig. 13, subsection 38a forms an angle a of 90° with subsection 36. Subsection 38b forms an angle a’ with subsection 36 that is greater than angle a. In the configuration shown the angle a’ is 110° to 130°. As is also shown in Fig. 13, in the second position 23 as illustrated the first column 31 is arranged horizontally in subsections 38a and 39a, while the second column 32 is inclined downwards from the connecting region 21 in subsections 38b and 39b. In this arrangement the second column 32 is angled at the pivot joint 41. Subsection 38b forms an angle γ with subsection 39b that is greater than 180°. Here the angle γ is measured between subsection 24b of the seat 24 and the lower-leg support 29b on the side facing the patient 17. In the configuration shown the angle γ is between 220° and 230°. Other angles γ are also possible and can be set by adjusting the pivot joint 41 to another position.

Fig. 14 shows the seating device 18 in the first position 22 and the arrangement of sections 19 and 20 in relation to one another described with reference to Figs. 3 to 8. The configuration illustrated in Figs. 14 to 16 differs from the configuration already described in that a cover 30 has been removed from each of the columns 31 and 32. This creates a free region 89 between the columns 31 and 32 in which the patient 17 is not supported by the seating device 18. If a beam 16 is directed at the patient 17 (Fig. 1) in this region, the beam 16 does not hit any of the parts of the patient positioning system 1. This avoids both any distortion of the images generated by the beam 16 in the case of an imaging process and any weakening of material by the beam 16, in particular where the beam 16 is used for radiation therapy. In the configuration shown in Figs. 14 to 16, covers 30 on the subsection 39 of columns 31 and 31 have been removed. Specifically, the covers 30 adjacent to subsection 38 have been removed to produce an opening in the back 25. Since the covers 30 are fixed to the columns 31 and 32 individually and separately from one another, it is also possible to remove the covers at the regions of the patient 17 to be irradiated independently of one another, making a variety of configurations and arrangements of the covers 30, which can be adjusted to any specific case, possible. Visible at sections 39 of the columns 31 and 32 in the region of the removed covers are carriages 65 that serve to receive the rails 64 of the covers 30. The carriages 65 with the rails 64 form guide 54 for the covers 30 along which the columns 31 and 32 and the covers 30 can be moved in relation to one another and be fixed in different positions to one another. Also visible in Fig. 14 are operating levers 72 of the individual fixing devices of the covers 30. In the embodiment there is provided on each operating lever 72 a fixing pin 76 that secures the operating lever 72 in its position and has to be pulled sideways from its allocated receiver in order to adjust the operating lever 72. Other securing devices for the operating lever 72 can also be advantageous.

As shown in Figs. 14 to 16, it is possible to arrange up to two covers 30 on each column 31 and 31 in each subsection 36, 37, 38 and 39. Thus it is possible to arrange in each subsection 36 to 39 four covers 30 that are fixed individually to the allocated column 31 or 32 and thus can also be removed individually. As also shown in Figs. 14 to 16, the covers 30 that border the connecting region 21 are shorter in design and do not project into the connecting region 21 so as not to restrict the pivoting of sections 19 and 20 in relation to one another. The further covers are designed mirror symmetrically to one another and each project into the region of the pivot joints 41 and the receivers 52. The recesses 40 are provided in the region of the pivot joints 41 and the receivers 52. Here the cover 30 of subsection 37 on column 31, which is arranged adjacent to pivot joint 41, is of identical design to the cover of subsection 37 on column 32, which is arranged adjacent to the receiver 52. The cover 30 of subsection 37 on column 32, which is arranged adjacent to pivot joint 41, is designed mirror symmetrically to the cover arranged on the opposite side of the centre plane 45, The other covers 30, with the exception the covers 30 arranged in the connecting region 21, are of identical design to these two constructions of cover 30. Accordingly three differently designed types of cover 30 are sufficient for the entire seating device 18.

As shown in Fig. 15, the covers 30 have a plurality of mounting openings 69 that are advantageously arranged in a grid pattern. The mounting openings 69 can serve to mount fixing devices for the patient such as support plates, rails, hook-and-loop fastener strips and self-adhesive bandages. This enables the patient 17 to be properly secured during irradiation or an imaging process. Fig. 15 also shows the section of a fixing device 70 for fixing the covers to the columns 31,21 arranged on each column 31, 32. The fixing devices 70 have the carriages 65 for receiving the rails 64 of the covers 30 (Fig. 5). The rails 64 are also shown in Fig. 16. As also shown in Fig. 16, the covers 30 have an engaging element 73 that extends over the entire width of a cover 30 and has an engagement contour 74 that is described in greater detail below.

To simplify the adjustment of sections 19 and 20 in relation to one another at the pivot joint 48 and permit it to be carried out with little force, there are provided on the second section 20 spring elements 80, gas pressure springs in the embodiment, that hold the sections 19 and 20 at least partially together even when the pivot joint 48 is released.

In order to be able to image lateral regions of the patient without any interference from the seating device 18 the columns 31 and 32 are positioned on the mounting flange 14 such that they can be adjusted in the transverse direction 90. As shown in Fig. 16, a toothed rod 56, which extends in the transverse direction 90 and can be fixed to the two columns 31 and 32 in the transverse direction 90, is arranged on the mounting flange 14. Here the position of the columns 31 and 32 on the toothed rod 56 is freely selectable. For example, both columns 31 and 32 can be adjusted to the left-hand side of the seating device 18 in relation to the patient 17 or to the right-hand side of the seating device 18 in relation to the patient 17 such that both columns 31, 32 are located on one side of the centre plane 45. A plurality of intermediate positions for the columns 31 and 32 is also possible.

Figs. 17 to 19 show a configuration of the seating device 18 in which the column 32 is located almost on the centre plane. The columns 31 and 32 are arranged on the left-hand side of the covers 30 in relation to the patient 17 sitting on the seating device 18. In the configuration shown one of the covers 30 of subsection 39 has been removed from the column 32. As a result the outer region of the upper back of the right-hand side of the patient 17 is arranged in a free region 89. Any other cover 30 can also be removed individually in order to increase the free region 89, for example.

Figs. 20 to 22 show a configuration of the seating device 18 in which a larger free region 89 is created. To this end both columns 31 and 32 are arranged on the same side of the centre plane 45. To support the patient 17 on his/her right-hand side covers 30’, which extend over the entire width c of the seat 24, are provided. The width c of the seat 24 is indicated in Fig. 20. The width c of the seat 24 is measured in the transverse direction 90.

The covers 30 and the covers 30’ are formed by a lateral section 81 that features the operating lever 72 (Fig. 22). The lateral section 81 is advantageously made of metal. Held on the lateral sections 81 are plates 83, 83’ of different length. The plates 30 and 30’ advantageously consist of carbon-fibre-reinforced plastic and are therefore radiolucent. In the embodiment the lateral sections 81 are not provided as part of the seat 24.

As shown in Fig. 21, the covers 30 with the plates 83 have a width d measured in the transverse direction 90. Owing to the width of the lateral section 31 the width d is somewhat greater than half the width c of the sat 24, namely greater by the width of the lateral section 81. The covers 30 and 30’ can be arranged so as to create a desired free region 89. Only the region of the mounting flange 14 should advantageously be covered by covers 30’ so that in the arrangement of the column 32 shown the patient 17 cannot come into contact with the mounting flange 14 and the rails 66 and 67.

As shown in Fig. 22, the columns 31 and 32 are fixed to the toothed rod 56 by means of fixing devices 55. The fixing devices 55 have a very small design height. The two fixing devices 55 are designed mirror symmetrically to one another and engage in the common toothed rod 56. As a result, only the construction of a fixing device 55 is described. As shown in Fig. 23, the toothed rod 56 is arranged separately from the rails 66 and 67 on the side of rail 66 facing away from rail 67. To fix and release the fixing device 55 an operating lever 57 is provided on each column 31, 32, as is also shown in Fig. 22. The arrangement of the fixing devices 55 on the outside of the mounting flange 14 results in good accessibility of the outside of the columns 31 and 32 that face away from the other column 31, 32.

As shown in Fig. 24 the operating lever 57 is mounted on the first subsection 36 of the relevant column 31, 32 such that it can be pivoted about a pivot axis 26. The operating lever 57 is connected such that it is unable to rotate to an engaging element 57, which is shown in the sectional view in Fig. 25.The operating lever 57 with the engaging element 58 is able to pivot about the pivot axis 62. In the embodiment the engaging element 58 is designed as a shaft that extends over a large part of the width of subsection 36. The engaging element 58 has an engaging contour 59 that engages in a mating contour 60 when the fixing device 55 is in the fixed position shown in Figs. 24 and 25. The mating contour 60 is formed on the toothed rod 56. In the embodiment the engaging contour 59 and the mating contour 60 are designed as toothed contours. However, any other contour suitable for fixing in the transverse direction 90 can also be provided. The pitch of the teeth determines the grid dimension of the possible positions of the columns 31 and 32.

Fig. 26 shows the operating lever 57 in the released, outward pivoted position. In the embodiment the operating lever 57 and so the engaging element 59 can be pivoted by 90° between the two positions. As is also shown in Fig. 26, there is provided on the operating lever 57 a fixing pin 61 that projects into a fixing opening 79 on the first subsection 36 when the fixing device 55 is in the fixed state and thereby secures the operating lever 57 against any unintentional release. The fixing pin 61 is advantageously spring-mounted in a known manner.

As shown in the sectional view in Fig. 28, in the released position the engaging element 58 does not engage in the mating contour 60. In the peripheral region facing the mating contour in this rotational position the engaging element 58 takes the form of a subarea of a cylinder that ends above the mating contour and does not engage in it. The radius of the engaging element 58 is therefore smaller in this peripheral region than in the peripheral region in which the engaging contour 50 (Fig. 25) is arranged. As a result, it is possible to move subsection 36 and so the entire column 31 in the transverse direction 90 in relation to the toothed rod 56 and so in relation to the mounting flange 14. To fix the subsection 36 and so the entire column 31 in a desired position, the operating lever 57 is pivoted back to the position shown in Figs. 23 to 25. In so doing the engaging contour 59 is pivoted into the region of the mating contour 60. The engaging contour 59 is preferably provided with lead-in chamfers in the peripheral direction to achieve simple pivoting and self-centring of the engaging contour 50 in relation to the mating contour 60. Owing to the design of the fixing device 55 shown with an engaging element 58 able to rotate about its longitudinal axis it is possible to achieve a secure and stable fixation. The fixing device is small in size and suitable for transferring large forces. It is possible to release and fix it simply and safety using one only hand. A fixing device 70 that works in the same manner is advantageously provided for the covers 30. The fixing devices 70 of all the covers 30, 30’ are advantageously of identical design. Fig. 29 shows the fixing device 70 in detail. The engaging element 73 is mounted in the rail 64 of the cover 30 such that it is able to rotate about a pivot axis 77. In the embodiment the engaging element 73 is designed as a shaft that extends in the transverse direction 90 (Fig. 26). The engaging element 73 is connected to the operating lever 57 such that it is able to rotate. The engaging contour 74, which extends over a partial region of the periphery of the engaging element 73 and is designed in the embodiment as a toothed contour, is formed on the engaging element 73.

Fixed to the base of the rail 64 (Fig. 27) is a toothed rod 71 that has the mating contour 75, i.e. a toothed contour. As shown in Fig. 27, the mating contour 75 projects into the free space surrounded by the rail 64. As also shown in Fig. 27, the lateral section 81 of the cover 30 has a recess 82 in which the operating lever 57 of the fixing device 70 is arranged.

In the fixed position shown in Fig. 29, the engaging contour 74 engages in the mating contour 75 and thus fixes the cover 30 to the relevant column 31 or 31 (in the view shown to subsection 36 of column 31) in the direction of the pivot axis 77 of the engaging element 73, i.e. in the transverse direction 90 (Fig. 26).

Figs. 30 to 32 show the fixing device 70 in the released position. As shown in Fig. 31, the operating lever 72 is pivoted by 90° in relation to the fixed position and projects downwards out of the recess 82. Arranged in the region of the mating contour 75 in this position is a cylinder subarea 78 of the engaging element 73, which is a short distance from the mating contour 75 and does not engage in it, as shown in Fig. 32. In this region the radius of the engaging element 73 is smaller than the distance between the pivot axis 77 and the mating contour 75.

As a result, in this position the column 31 or 32 can be moved in the transverse direction 90 in relation to the cover 30. The engaging contour 74 advantageously has a lead-in chamfer in the peripheral direction, thus guaranteeing simple fixing.

As shown by a comparison of Figs. 28 and 29, fixing devices 55 and 70 are based on the same principle as in each case an engaging contour 59, 74 is rotated into a mating contour 60, 75. In the case of fixing device 55, however, the engaging element 58 is clearly shorter in design than the mating contour 60.

Here the column 31, 32 moves in relation to the toothed rod 56 and the operating lever 57 is provided on the column. In fixing device 71 the engaging element 73 is clearly longer in design than the toothed rod 71 with the mating contour 75. Here the mating contour 75 moves in relation to the cover 30 on the column 31, 32. The operating lever 57 is held on the cover 30, i.e. on the non-moving part.

In an alternative design of the seating device 18 the engaging contour 59 of the fixing device 55 is arranged on the mounting flange 14. To this end an engaging element 59 is advantageously mounted on the mounting flange 14 such that it is able to pivot and advantageously extends over the entire width of the mounting flange 14. As a result both columns 31, 32 can be released and fixed by operating only one operating lever 57. A mating contour 60 is advantageously arranged on each column 31, 32. A further alternative design of the seating device 18 provides for the arrangement of engaging elements 73 with engaging contours 74 of fixing devices 79 on the columns 31 and 32 and for the covers 30, 30’ to have mating contours 75. Here the mating contours 75 advantageously extend over approximately the entire width of the covers 30 and approximately over half the width of the covers 30’.

The individual embodiments can be combined in any manner to obtain advantageous designs of seating devices 18.

Claims

1. A seating device for a patient positioning system, the seating device having a first section (19) and a second section (20) that are connected to one another at a connecting region (21), the two sections (19, 20) being aligned at an angle to one another in at least one configuration of the seating device (18) and one of the sections (19, 20) forming a back (25) and the other section (19, 20) forming a seat (24), there being arranged on the first section (19) a mounting device for fixing to a positioning unit of the patient positioning system (1), it being possible to arrange the seating device (18) in at least one first position (22) and in at least one second position (23), characterised in that in the first position (22) of the seating device (18) the first section (19) forms the seat (24) and that in the second position (23) of the seating device (18) the second section (20) forms the seat (24).

2. A seating device according to claim 1, characterised in that the first section (19) and the second section (20) are each formed of at least two subsections (36, 37, 38, 39) that are connected to one another via a fixable pivot joint (41), the first subsection (36, 38) forming the seat (24) and the second subsection (37, 39) forming a lower-leg support (29) in at least one position (22, 23) of the seating device (18).

3. A seating device according to claim 1 or 2, characterised in that the connecting region (21) comprises a fixable pivot joint (48) by means of which it is possible to set an angle (a) between the first section (19) and the second section (20).

4. A seating device according to any of claims 1 to 3, characterised in that the mounting device is a mounting flange (14), that the seating device (18) has a transverse direction (90) in which the connecting region (21) extends and that the seating device (18) has at least one column (31, 32) that forms a supporting structure of the seating device (18) and can be moved in the transverse direction (90) in relation to the seat (24).

5. A seating device according to claim 4, characterised in that the column (31, 32) is mounted on the mounting flange (14) such that it is able to slide along a guide (46, 47) and that a fixing device (55) for fixing the column (31, 32) in relation to the guide (46, 47) is provided in a plurality of positions.

6. A seating device according to claim 5, characterised in that the fixing device (55) for fixing the column (31, 32) comprises an engaging element (58) that is mounted on the mounting flange (14) or the column (31, 32) such that it is able to rotate about a pivot axis (62), the engaging element (58) having an engaging contour (59), there being formed on the other component of the mounting flange (14) and the column (31, 32) a mating contour (60), the engaging contour (59) of the engaging element (58) engaging in the mating contour (60) in a first rotational position of the engaging element (58) and thereby fixing the engaging contour (59) and the mating contour (60) to one another in the direction of the pivot axis (62) and the engaging contour (59) being pivoted out of the region of the mating contour (60) in a second rotational position of the engaging element (58) so as to permit a movement of the column (31, 32) and the rail (64) in relation to one another in the direction of the pivot axis (62).

7. A seating device according to any of claims 4 to 6, characterised in that held on the column (31, 32) such that it can be detached is at least one cover (30, 30j to form the seat (24) and/or the back (25).

8. A seating device according to claim 7, characterised in that a fixing device (70) is provided for fixing the cover (30, 30') to the column (31, 32).

9. A seating device according to claim 8, characterised in that the fixing device (70) for fixing the cover (30, 30’) comprises an engaging element (73) that is mounted on the cover (30, 30j or the column (31, 32) such that it is able to rotate about a pivot axis (77), the engaging element (73) having an engaging contour (74), there being formed on the other component of the cover (30, 30') and the column (31, 32) a mating contour (75), the engaging contour (74) of the engaging element (73) engaging in the mating contour (75) engaging in a first rotational position of the engaging element (73) and thereby fixing the engaging contour (74) and the mating contour (75) to one another in the direction of the pivot axis (77) and the engaging contour (74) being pivoted out of the region of the mating contour (73) in a second rotational position of the engaging element (73) such that the column (31, 32) is able to move in relation to the cover (30, 30') in the direction of the pivot axis (77)

10. A seating device according to any of claims 4 to 9, characterised in that the seating device (18) has at least two columns (31, 32) that are held on the mounting flange (14) such that they are able to move in the transverse direction (90) of the seating device (18).

11. A seating device according to claim 10, characterised in that each column (31, 32) has at least one pivot joint (41, 48) and that the pivot joints (41, 48) of the columns (31, 32) can be adjusted independently of one another.

12. A seating device according to any of claims 1 to 11, characterised in that the seating device (18) has at least one receiver (42, 52) for the detachable mounting of attachment devices.

13. A patient positioning system with a seating device according to any of claims 1 to 12, the patient positioning system (1) having a positioning unit that holds the seating device (18) to the mounting device, the positioning unit being designed to position the seating device (18) in the at least one first position (22) and in the at least one second position (23).

14. A patient positioning system according to claim 13, characterised in that the first section (19) is inclined by less than 30° to the horizontal in at least one first position (22) and that the second section (20) is inclined by less than 30° to the horizontal in at least one second position (23).