WO1999025303A1

WO1999025303A1 - Multifunctional operating table

Info

Publication number: WO1999025303A1
Application number: PCT/IB1998/001801
Authority: WO
Inventors: Aldo Cristofolini
Original assignee: Officina Di Protesi Trento S.P.A.
Priority date: 1997-11-19
Filing date: 1998-11-12
Publication date: 1999-05-27
Also published as: EP1032350A1; DE69803876T2; EP1032350B1; DE69803876D1; ITVI970203A1; IT1296688B1

Abstract

A multifunctional operating table comprises a column (2) with a ground support platform (2'), a plane member (3) apt to support the patient to be operated and means for removable connection between the column (2) and the plane member (3), in which the column defines a symmetrical longitudinal plane (K). The removable connection means is comprised of mechanical coupling means (29, 30, 33, 34), of the kind having corresponding complementarily shaped profiles tapered towards the top, electronic means (37, 38, 39, 40) for transmitting information and electrical means for transmitting power.

Description

MULTIFUNCTIONAL OPERATING TABLE

Technical field

The present invention relates to operating tables of universal use, especially adapted for different types of surgery.

Background art

Surgical operations are commonly made on operating tables which essentially comprise a support column with a base platform laid on the ground and supporting an operating plane member on which the patient to be operated lies.

During surgical operations it is necessary to position the patient, and more particularly his/her body part on which the operation is to be performed, in the most comfortable position for the surgeons and their assistants to operate. For this reason the table must be provided with a surface supporting the patient, said surface being adaptable to all body sizes, usable for al! types of surgery and, overall, being displaceable by the operator without effort and without hindering the action field of operators and surgeons.

The known operating tables available nowadays on the market endeavour to meet these needs, but suffer from several drawbacks that are listed hereafter.

The removal of the plane members from the column or from the plane/column system can be performed from one side or from both, e.g. along the direction head to feet or laterally.

The speeds of the movement of the plane member are fixed. A consequence is that moving it can be either too slow or too quick depending on the type of surgery.

It is not possible to bring the table with patient to a very high or very low position, with high inclination toward the head or feet side with the consequence that the patient cannot be positioned in the so-called extreme positions.

In case of manoeuvring errors or breakdown, surgeons are obliged to read the instructions for use from the user's manual. For this reason the signals are often incomplete, distorted or even mistaken.

Information is often visualised by means of notices written in languages unknown to operators, which render the information useless.

For positioning or repositioning the plane member to the standard positions it is necessary to use series of manual commands by means of trial and thus in a wholly empirical manner.

Operating tables of the known type are not provided with memory apt to deliver statistical data concerning the use of the table, manoeuvring errors that occurred in a certain period of time, the quantity of operations, alarms, breakdowns and similar events.

If digital displays are associated to the operating table, display leds are not easily visible either because they are often covered by bed sheets or because they are out of sight of the surgeons or assistants.

Mechanical or electrical-electronic transmission systems available on the operating table of the known types do not allow to arrange the plane member on the column in a position inverted of 1 80° in a manner that the head side is in a position inverted with the feet side.

Supports that hold the patient's feet are not transparent to radio signals even if they are can be displaced by translating motion and spread for giving an easier access to users. On the contrary if they are transparent to radio signals, they cannot be translated and spread.

When the operating plane is put on the trolley to be removed from the column, it cannot be moved to allow cleaning or positioning of patients.

The protection elongating bellows, being rich in folds where dust and dirt easily accumulate, make difficult cleaning and sterilisation of said table.

In order to allow high performances, the tables of the known types are provided with joints and linkages. They produce clearances that can give place origin to dangerous oscillations of the table.

Description of the invention

The main purpose of the present invention is to eliminate the above mentioned disadvantages by means of an operating table allowing patients to be placed on a stretcher from all four sides.

Another purpose of the invention is to provide an operating table with variable velocity apt to produce more or less rapid movements depending on the type of surgery to be carried out.

Another purpose of the invention is to provide an operating table allowing positioning of patients in extreme positions, e.g. in very high or very low positions or with very high inclinations of head or feet side.

Another purpose of the invention is to provide an operating table having a diagnostic system allowing to give information to users on the state of the system, so as to help said users to correct the possible manoeuvre errors.

Another purpose of the invention is to provide an operating table allowing the display of multilingual messages, easily accessible to operators.

Another purpose of the invention is to provide an operating table allowing storage in memory of the most recurrent positions so as to be able to call them back at any moment and rapidly.

Another purpose of the invention is to provide an operating table that can provide statistical data on its state of usage and reliability.

Another purpose of the invention is to provide an operating table that can give operators information not visible on digital displays.

Another purpose of the invention is to provide an operating table where the connection between table and supporting column allows power supply.

? Another purpose of the invention is to provide an operating table allowing spreading and widening of the feet supporting sections in a way totally transparent to radio signals.

Another purpose of the invention is to provide an operating table allowing movements of the plane also when the latter is separated from the column and placed on the trolley. Another purpose of the invention is to provide an operating table allowing simplification of the rubber bellow structure and facilitating cleaning and sterilising.

Yet another important purpose of the invention is to provide an operating table with high stiffness and stability.

The above mentioned purposes and others, which will be better clarified hereafter are provided for by means of an operating table, in accordance with the main claim, comprising a support column with a support ground platform, an operating plane member adapted to support the patient to be operated and means for removably connecting said column to said plane member, wherein said column defines a longitudinal symmetry plane, characterised in that said removable connection means comprise mechanical coupling means with complementarily shaped profiles tapered towards the upper side thereof, to which electronic means for the transmission of information and electrical means for power transmission are associated.

Contrarily to known tables, in the operating table according to the invention the mechanical coupling means connecting the plane member to the column can advantageously transmit both power supply and information, independently from the position or inclination of the operating plane member, without any danger of multifunctioning interference due to dirt penetration.

Moreover, in comparison with the know tables, the table according to the invention allows advantageously more flexibility for the users, for the following reasons:

- it provides the possibility of interchanging operating planes among different operating rooms, - it is no more necessary to check in advance the operating rooms to determine the loading side of the patient,

- it provides the user with a greater freedom to vary the speed of table movements in accordance with the type of surgery to be performed, - it is possible to perform surgical operations with the patient placed in extreme positions,

- users have at their disposal statistical information useful both for use and maintenance of the operating table,

- users receive information both by reading displays and hearing synthetised messages,

- the problems caused by the interpretation of different languages are avoided,

- maintenance and searches for failures origin are simplified.

Yet another advantage is provided by the lack of joints and linkages which allows operating tables according to the invention to reach higher performances, compared to operating tables of the known kind, by avoiding mechanical clearances.

Brief description of the drawings

Further advantages and aspects of the invention will become more evident from the detailed description of a preferred, non limitative, embodiment of a table according to the invention hereafter shown by way of non-limitative example by means of the accompanying drawings, in which: Fig. 1 shows an axonometric view of the table;

Fig. 2 shows an axonometric view of the support column of the table of Fig. 1 ;

Fig. 3 shows a partial cross-sectional view of a particular of the table of Fig. 1 ; Fig. 4 shows a side view of a particular of Fig. 3; Fig.5 shows a side view of the particular of Fig. 3;

Fig 6 shows a side view of a particular of Fig. 5;

Fig 7 shows a top view of a particular of the surface;

Fig 8 shows an exploded front view of some details of the table;

Fig 9 shows a side view of some detail elements of the table;

Fig 1 0 shows a top view of some fork-shaped trolleys interacting with the table;

Fig 1 1 shows a top view partial section of the column of the table of Fig. 1 .

Description of an embodiment

With reference to the figures, the operating table according to the invention, generally identified with reference number 1 , is made of two main parts: the column 2 and the operating plane member 3 which define a longitudinal symmetry plane K.

Column 2 forms the lower part of table 1 and supports plane member 3, said table comprising ground support platform 2'. Plane member 3 is usually covered with cushions on which the patient is laid.

The operating table system is comprised also of a trolley 4, adapted to remove either plane member 3 from column 2 or both. Column 2 is of telescopic type and, by means of it, it is possible to modify the height, longitudinal and lateral inclinations of the plane member 3.

Column 2 is externally provided with a telescopic protection M, solidarily moving with it during height variations, which protection being composed by several panels siidably coupled to each other to protect elements arranged inside column 2. In the internal side of column 2 there is arranged a lower telescopic section 5 comprising a first tubular element 6 fixed to the column structure and a second tubular element 7 adapted to slide with respect to the first one by means of a screw jack 8. The upper part 10 of the second tubular element 7 is connected to the head 1 1 of the column to which the plane is connected. The head of the column is a monolithic block with an approximately wedge shaped external profile, with a rounded upper portion, whereby the longitudinal surfaces are substantially perpendicular to the longitudinal symmetry plane K.

Head 1 1 is connected to the telescopic protection M by means of bellow S, having longitudinal and transversal bends apt to allow its folding and to protect the column head activating organs. These organs comprise a motor reduction gear 1 2 with a pinion 1 3 coupled to a chain 14 by means of which it transmits rotatory movement to another pinion 1 5 fixed on the screw extremity 9 to provoke vertical movement of the lower telescopic section 5, along two directions 1 6, with consequent raising and lowering of the column head 1 1 .

A couple of jacks 1 7 and 1 8, for example of the type with ball-recirculating screw, are hingedly fixed on the respective stirrups 1 7', 1 8' to the second tubular element 7 of the lower telescopic section 5, said jacks are connected in their upper section to the head 1 1 .

Jacks 1 7 and 1 8 are activated by distinct motor reduction gears, respectively referred as 1 9 and 20, by means of transmissions of the known type, which allow raising and lowering of the column head 1 1 in the rotation direction shown by arrow 21 , thus allowing the head to tilt laterally around the rotation axis Y which is substantially parallel to the operating table longitudinal symmetry plane K.

A splined telescopic shaft 22, operated by a motor reduction gear 23 which transmits the rotatory movement by means of a transmission of the known type, is connected by means of a universal joint to a reduction worm gear 24. The reduction gear 24 is provided with two shaft juts 25, 26, each driving into rotary motion the respective epicycloidal reduction gears 27, 28 around their rotation axis X transversal to the longitudinal symmetry plane. Each of the epicycloidal reduction gears provides the head 1 1 with the longitudinal inclination (Trendelenburg) and is coupled to the respective coupling projections 29, 30, provided for in the head 1 1 and adapted to be connected to the plane member 3. The coupling projections 29 and 30 respectively belong to the said mechanical coupling means 31 , 32, which comprise respective complementarily shaped coupling seatings 33, 34 both arranged in the operating plane member 3. Each coupling projection 29, 30 and corresponding coupling seatings 33, 34 have on their complementarily shaped coupling surfaces respective contacts 35, 36 for electrical power supply, an electronic device 37,38 for data transmission and a sensor 39, 40 for recognition of operating plane member 3 presence and position. As each couple of electronic devices must be active whenever the system is in use, the electronic devices of each couple belong to the same board 41 , 42 respectively situated in each coupling projections 29, 30 and in each coupling seating 33, 34 so as to form in each mechanical coupling means a dual data detection and transmission system.

More particularly, the contact pair 35, 36 for transmitting power supply is supplied with direct current whose polarity depends on the orientation of the operating plane in relation to column 2. Thus, plane member 3 receives always the right polarity on its contacts without any need for correction. The power supply for the operating plane is deactivated whenever not mounted on the column 2 by means of said coupling seatings 33, 34 coupled on the coupling projections 29,30 of column 2.

As to the transmitting means 37, 38 they are preferably of the infrared type and have a unique integrated circuit that allows signal transmission and detection for information exchange between said column 2 and said operating plane member 3. As to the recognition means for the plane, which are formed by the electronic means 39, 40, they can detect the presence and orientation of the operating plane member 3. Without this information it is not possible to put the column in motion which remains thus blocked.

Operating plane member 3 comprises a seat 43 that can be coupled to the column head 1 1 by means of the mechanical coupling means 31 , 32 described above. Particularly, the operating plane member 3 comprised of a body back section 44 comprising two arms 45, 46 pivotally mounted at the respective hinges 47, 48, 49, 50 by means of the respective motor reduction gears 51 , 52 longitudinally accommodated in the arms.

Moreover, the operating plane comprises also a feet section 53 formed by a pair of supports 54, 56 arranged on the prolongation of the body back section to which they are hingedly connected by means of joints 56, 57. A pair of motor reduction gears 58, 59 longitudinally arranged near the seat section 43 and internally to the arms 45, 46 of the body back section 44 allows both simultaneous and independent movements of the leg supports 55,54.

Joints 56, 57 are formed by a pair of rods 58, 59 connected to the seat 43 at one end by means of pins 60,62 and to the leg supports at the other end by means of pins 62, 63. The blocking handles 64, 65 are provided to allow locking and unlocking of the oscillating rods 58, 59 to permit their lateral translation through a compass-like rotation of the leg supports 54, 55. This avoids covering of the user's working field which thus remains unshielded to radio signals.

Each single leg support 54, 55 may be provided with one or more articulations for partial lowering of the legs or for placing them in a bridge position. Moreover a pair of motor reduction gears 66, 67 are arranged in the seat 43 of the plane member 3 and the reduction means allow the translation of both leg supports 54, 55 in the directions F. The fixing of the plane member 3 to the column head 1 1 takes place when projections 29, 30 of the column are coupled in the corresponding seatings 33, 34 of the seat 43. After coupling of the two parts, the stability of the coupling is guaranteed by docking means 68, available in every seating 33, 34, being received in the corresponding recesses 69 available in each jut 29, 30.

Each docking element 68 can be manoeuvred from outside by means of a lever 70 that engages in appropriate seatings 71 provided in the fork 72 of the trolley 4. The trolley 4 can be used to remove the operating plane member 3 by a translation movement either along the direction P from the feet side or along the direction T from the head side.

A different trolley 4' allows the plane member 3 to be taken away along the lateral direction L perpendicular to the former, which trolley 4' being provided with different seatings 73, each apt to actuate said same undocking lever 70 to undock the operating plane.

As to the control system of the table, it is preferably arranged in the inner side of the column 2 and comprises a central processing unit (CPU), the main control and steering circuits and the power supply and battery charger, not shown in the drawings. The CPU of the column, which is provided with a microprocessor, controls both manual and automatic movements, moreover:

- it receives control signals from the keyboard via cable connection or via infrared rays, - it controls in the right sequence the motors necessary to generate the movements,

- it controls the "travel end" software by means of computing and saving in the electronic memory the motor circuits impulses,

- it controls the "travel end" security hardware, - it records the positions of the single motors of the column,

- it provides the operator with the necessary information by means of multilingual systems and voice synthesisers,

- it communicates with the operating plane by transmitting commands for carrying out the movements to the electronic means of the same plane and by receiving information and data to be visualised on the display,

- it activates or deactivates the power supply of the plane,

- it recognises what plane is mounted on the column and what is the orientation side of the patient's head for inverting, if necessary, the motion of the motors actuating the longitudinal inclination, in the respect of the symbols on the keyboard.

The software of the electronic part is designed to control hardware and stops operating of the system in case of malfunction:

- activation of the brushless motors produces redundant signals that are received at the CPU which in turn controls that the functioning motor is the right one,

- the infrared transmission system IrDA is controlled by the two microprocessors that transmit and receive signals to verify that transmission is exact, - by means of its interface the CPU controls the correct functioning of the Driver and Mos Power sections,

- the CPU checks and corrects the computing errors in the memory,

- the CPU manages and shows on the display possible failures, alarm signals or warnings to the operators.

The whole electronic system is realised in a manner not to generate sparks that might ignite inflammable and/or explosive mixtures.

The use of an actuating brushless motor system guarantees that the motor does not generates sparks, and additionally gives the possibility to control speed and number of revolutions without the need to add other components like encoders or tachometric dynamos.

The system is provided with a self-diagnostic system with an external information display for the users in the form of a multilingual display, relative to table state information, warning or failure messages. Said self-diagnostic system has the possibility of remotely repeating on a display system of the assistance centre all the operating table system functions and information on its working state, engine position and system state for quick client assistance in the whole world, thus avoiding understanding problems due to different languages. The telecommunication is made by means of a telephone modem or similar communication system connected to the interface normally used for the cable keyboard.

The display allows the user to access without errors the programme menu which allows him /her:

- to store in the electronic memory a number of recurring positions for the operating table that can be recalled at any moment. The system must thus know in every moment its position and confront it with the one to be reached in order to command the servomotors correctly, - the possibility of choosing the language, among a list of languages, in which the information is displayed and given by the voice synthesiser,

- the possibility of varying engine speed to best adapt it to user's need,

- the possibility of extrapolating statistics on movements and alarms that occurred.

The search for the horizontal level position of the system, for repositioning the operating plane member at the end of the operating session and for transferring the patient with the trolley o by means of automatic transfer, can be performed with high security through checks in real time of the present and final positions, of all motorised segments at the same time, in order to avoid interference with the floor, which can be dangerous for the patient. The user has still the possibility of halting at any moment the system automatic search of the horizontal position to leave some of the sections of the operating plane member in the final post-operating state or in any other position decided by the user.

The system must also avoid possible excessively tilted positions and interference with the floor to guarantee the patient's security.

The invention can be subject to numerous modifications and variations, without thereby departing from the scope of the invention as defined in the following claims.

Claims

1 . A multi functional operating table, comprising a support column (2) with a platform (2') for ground support, a plane member (3) adapted to support the patient to be operated with a support ground platform (2'), and means (31 , 32) for removably connecting said column (2) and said plane member (3), wherein said column (2) defines a longitudinal symmetry plane (K), characterised in that said removable connection means comprise mechanical coupling means (29, 30, 33, 34) with complementarily shaped profiles tapered towards the top of the table which are associated with electronic means (37, 38, 39, 40) for the transmission of information and electrical means (35, 36) for power transmission.

2. Operating table according to claim 1 , characterised in that said column (2) is provided in the upper side with a head ( 1 1 ) adapted to cooperate with the operating plane member (3).

3. Operating table according to claim 2 characterised in that said mechanical coupling means comprises at least a pair of projections (29, 30) associated to said head (1 1 ) and respective seatings (33,34) associated to said operating plane member .

4. Operating table according to claim 3 characterised in that said conjugated profile of said projections (29,30) and said seatings (33,34) is substantially of truncated trapezoidal shape.

5. Operating table according to claim 3 characterised in that said electronic transmission means comprise at least an electronic device (37,38) for signal transmission/reception, said electronic device being arranged on the complementarily shaped profiles of said mechanical coupling devices.

6. Operating table according to claim 3 characterised in that said electronic transmission means comprise a sensor (39,40) for the recognition of the presence and orientation of said operating plane member (3).

7. Operating table according to claim 6 characterised in that said at least one electronic transmitting- receiving device (37,38) is of the infrared rays type (IrDA) or similar.

8. Operating table according to claim 2 characterised in that said head (1 1 ) is provided with translation means in a substantially vertical direction (Z).

9. Operating table according to claim 3 characterised in that said head ( 1 1 ) is provided with first oscillating means to allow oscillation in a substantially vertical plane around a rotation axis (X) substantially horizontal which extends transversally to said longitudinal symmetry plane (K).

10. Operating table according to claim 9 characterised in that said juts (29,30) are provided with second oscillation means that allow oscillation with respect to said head (1 1 ) around a second rotation axis (Y) substantially horizontal and perpendicular to said first axis (X).

1 1 . Operating table according to claim 8 characterised in that translation means comprise at least one screw jack (8,9) with ball-recirculating screw acting between a non movable portion of said column (2) and a mobile telescopic element (7) solidarily fixed to the head ( 1 1 ).

1 2. Operating table according to claim 9 characterised in that said first oscillation means comprise at least a pair of jacks ( 1 7, 1 8) of the type with ball-recirculating screw interacting between said mobile telescopic element (7) and said head ( 1 1 ).

1 3. Operating table according to claim 9 characterised in that said second oscillation means comprise a kinematic chain formed by a splined shaft coupling (22), an universal joint (23'), a worm gear (24) and at least one pair of epicycloidal reduction gears (27,28) connected to said juts (29,30).

1 4. Operating table according to claim 2 characterised in that a flexible bellow (S) is provided with transversal and longitudinal folds for protection of the connecting space between said head (1 1 ) and said column (2).

1 5. Operating table according to claim 1 characterised in that said operating plane member (3) comprises a seat section (43), that can be coupled to said head (1 1 ) and provided with said seatings (33,34).

1 6. Operating table according to claim 1 5 characterised in that said seat (43) is connected in the longitudinal direction with a section (44) apt to hold the body back at one end and to a feet section (53) at the other end.

1 7. Operating table according to claim 1 6 characterised in that said feet section (53) comprises a pair of lateral supports (54,55) fixed to said seat section (43) by means of respective rods (58,59) oscillating in a substantially horizontal plane and provided with blocking means (64,65) for allowing lateral regulation of feet support (54,55), to guarantee the transparency to radio signals in that part of the table.

1 8. Operating table according to claim 1 6 characterised in that said body back section (44) comprises a pair of hinged arms (45,46) connected by means of respective joints (47-50) and movable by means of motor reduction gears (51 ,52) arranged inside said arms (45,46).

1 9. Operating table according to claim 1 characterised in that electronic control means (CPU) are provided which comprise information means in the form of digital display, vocal and telecommunication means.

20. Operating table according to claim 19 characterised in that said electronic control means are arranged inside said column (2) .

21 . Operating table according to claim 1 , apt to cooperate with a trolley (4, 4') for lifting and transporting said operating plane member, characterised in that it comprises uncoupling means (70) associated with said operating plane member apt to cooperate with respective seatings (71 ,73) provided in the forks (72) of the trolley (4,4').