DE69803876T2 - MULTIFUNCTIONAL OPERATING TABLE - Google Patents

Description

Technical area

The present invention relates to an operating table for general use, which is particularly adapted for different types of surgery.

State of the art

Surgical procedures are generally performed on operating tables, which essentially consist of a supporting column with a plate for supporting the floor and for supporting an operating plate element on which the patient to be operated on lies.

During surgical interventions, it is necessary to position the patient, and in particular his/her body on which the operation is to be performed, in the most comfortable position for the operating surgeon and his/her assistants. For this reason, the table must be equipped with a surface that supports the patient, which surface must be adaptable to all body sizes, usable for all types of surgery and, above all, adjustable without effort or impeding the range of action of the operating surgeons and surgeons.

The well-known operating tables available on the market today attempt to meet these requirements, but have various disadvantages, which are listed below.

The removal of the plate elements from the column or from the plane/column system can be done from one or both sides, e.g. along the direction from head to feet or sideways.

The speeds of movement of the plate elements are fixed. One consequence is that their movement can be either too slow or too fast, depending on the type of intervention.

It is not possible to place the table with the patient in a very high or very low position, with a high inclination of the head or foot side, with the result that the patient cannot be placed in the so-called extreme positions.

In case of movement errors or failures, the surgeons are obliged to read the instructions for use in the user manual. For this reason, the signals are often incomplete, distorted or even wrong.

Clues are often conveyed using statements written in languages unknown to the operators, rendering the clues useless.

To position or reposition the plate element into the standard positions it is necessary to use a series of manual inputs by means of trials and thus in an overall empirical manner.

Operating tables of the known type are not equipped with memories suitable for providing statistical data regarding the use of the table, handling errors, that occurred in a certain period of time, the number of operations, alarms, failures and similar events.

When digital displays are provided on the operating table, the LED displays are not easily visible either because they are often covered by bedsheets or because they are out of the field of view of the surgeons or assistants.

Mechanical or electrical-electronic transmission systems available on operating tables of the known type do not allow the plate elements on the column to be placed in a position rotated by 180º in such a way that the head side is in an inverted position with the foot side.

Cradles that hold patients' feet are not transparent to radio signals, and even if they are, they cannot be moved or spread to allow users easier access. On the contrary, if they are transparent to radio signals, they cannot be translated and spread.

When the operating table is placed on the chassis to be removed from the column, it cannot be moved to allow cleaning or positioning of the patient.

The protective bellows, which have many folds where dust and dirt can easily accumulate, make cleaning and sterilizing these tables difficult.

In order to enable high performance, the tables of the known type are equipped with joints and connections. These create openings that can cause dangerous vibrations in the table.

US-A 5 659 909 discloses a multifunctional operating table with a column mounted on a plate for support on the floor, a plate element designed to support the patient, and means for releasably connecting this column to the plate element. This connecting means is provided with mechanical coupling means with complementarily shaped profiles which are connected to electronic means for transmitting information and electrical means for transmitting power.

US-A 4 101 120 relates to a multifunctional operating table with all the features of the preamble of the main claim 1. However, the plate element of such a known operating table is not provided with attachment devices that allow a chassis to be coupled or detached from all four sides of the table.

Description of the invention

The main aim of the present invention is to eliminate the above-mentioned disadvantages with an operating table that allows patients to be placed on an area from all four sides.

Another aim of the invention is to provide an operating table with different speeds, which is suitable for generating more or less rapid movements depending on the type of procedure to be performed.

Another aim of the invention is to create an operating table that allows patients to be arranged in extreme positions, e.g. in very high or very low positions or with high inclinations of the head or foot side.

Another aim of the invention is to create an operating table with a diagnostic system that makes it possible to provide information to users about the status of the system, in order to help these users to correct possible handling errors.

Another object of the invention is to provide an operating table that enables the display of multilingual messages that are easily accessible to the surgeons.

A further aim of the invention is to create an operating table that allows the most frequently set positions to be stored in a memory so that they can be recalled quickly at any time.

Another aim of the invention is to create an operating table that can provide statistical data about its condition and reliability.

Another object of the invention is to provide an operating table that provides information to surgeons that is not visible on displays.

A further aim of the invention is to create an operating table whose connection between the table and the supporting column enables a power supply.

Another object of the invention is to provide an operating table that allows the expansion and widening of the supporting sections for the feet in a manner that is completely transparent to radio signals.

Another aim of the invention is to provide an operating table that allows movements of the plane even when the latter is separated from the column and arranged on the chassis.

Another aim of the invention is to provide an operating table that allows simplification of the structure of the rubber bellows and facilitates cleaning and sterilization.

Yet another important aim of the invention is to provide an operating table with high rigidity and stability. The above aims and others which will be better clarified hereinafter are provided with an operating table in accordance with the main claim with a supporting column with a plate for support on the floor, a plate element with a longitudinal axis designed to support the patient to be operated on, and means for releasably connecting this column to the plate element, this column forming a vertical plane of symmetry passing through this longitudinal axis of the plate element, this releasable connecting means being provided with mechanical coupling means with complementary shaped profiles tapering towards the upper part of the table and connected to electronic means for the transmission of information and electrical means for the transmission of power, connection means for releasably connecting said plate element to the column by means of a lifting and transferring vehicle, characterized in that said connection means comprise a pair of actuating elements arranged on each side of said plate element and adapted to cooperate with the vehicle along both longitudinal and transverse directions so that said plate element can be removed from all four sides thereof.

In contrast to known tables, in the operating table according to the invention the mechanical coupling devices connecting the column to the plate element can preferably transmit both power supply and information, regardless of the position or inclination of the operating plate element, without any risk of overlapping functions due to the ingress of dirt.

In comparison with the known tables, the table according to the invention allows the user more flexibility for the following reasons:

- it provides the possibility of exchanging operating levels between different operating rooms,

- it is no longer necessary to check the operating rooms beforehand to determine the patient's loading side,

- it gives the user greater freedom to control the speed of table movements in in accordance with the type of intervention to be performed,

- it is possible to perform surgical procedures in which the patient is in extreme positions,

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

- Users receive information both by reading displays and listening to artificial messages,

- the problems caused by interpreting different languages are avoided,

- Maintenance and troubleshooting are simplified.

Yet another advantage is provided by the absence of joints and connections, which enables the operating tables according to the invention to achieve higher performances than operating tables of the known type by avoiding mechanical openings.

Short description of the drawings

Further advantages and characteristics of the invention will become clearer from the detailed description of a preferred but non-limiting embodiment of a table according to the invention, which is illustrated below by way of a non-limiting example with the accompanying figures, of which:

Fig. 1 shows an axonometric view of the table;

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

Fig. 3 shows a partial sectional view of a detail of the table of Fig. 1;

Fig. 4 shows a side view of a detail of Fig. 3 ;

Fig. 5 shows a side view of the detail of Fig. 3 ;

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

Fig. 7 shows a top view of a detail of the surface;

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

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

Fig. 7 shows a top view of a detail of the surface;

Fig. 10 shows a top view of some forked chassis interacting with the table;

Fig. 11 shows a partial top view of the column of the table of Fig. 1.

Description of a design

With reference to the figures, the operating table according to the invention, generally designated by the reference numeral 1, is made up of two main parts: the column 2 and the plate element 3, which define a longitudinal plane of symmetry K.

Column 2 forms the lower section of the table 1 and carries the plate element 3, whereby this table forms the supporting plane 2' on the floor. Plate element 3 is normally covered with cushions on which the patient is laid.

The operating table system also includes a chassis 4 designed to remove either plate element 3 from column 2 or both. Column 2 is of the type of a telescope and by means of it it is possible to change the height, the longitudinal and the lateral inclinations of the plate element 3.

Column 2 is provided on the outside with a protection M for the telescope, which moves together with it during changes in altitude, this protection being composed of several covers which are slidably connected to one another in order to protect the elements arranged in column 2.

On the inside of the column 2, a lower telescopic section 5 is arranged, 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 by means of a screw jack 8. The upper part 10 of the second tubular element 7 is connected to the head 11 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 section, the longitudinal surfaces being substantially perpendicular to the longitudinal plane of symmetry K.

Head 11 is connected to the telescopic protection device M by means of bellows S with longitudinal and transverse bends to allow its folding and to supply the means for the head of the column. These means comprise a motor-reduction gear 12 with a gear 13 connected to a chain 14 by means of which rotary motion is transmitted to another gear 15 fixed on the screw end 9 to produce vertical movement of the lower telescopic section 5 along two directions 16 with consequent raising and lowering of the head 11 of the column.

Two lifters 17 and 18, e.g. of the ball recirculating screw type, are pivotally attached to the respective brackets 17', 18' with the second tubular element 7 of the second lower telescopic section 5, the lifters being connected in their upper section to the head 11.

The two jacks 17 and 18 are actuated by separate motor-reduction gears, designated 19 and 20 respectively, by means of transmission elements of known type, which enable the head 11 of the column to be raised and lowered in the direction of rotation indicated by the arrow 21, thus allowing the head to tilt laterally about the axis of rotation Y, which is substantially parallel to the longitudinal plane of symmetry K of the operating table.

A smooth telescopic shaft 22, driven by the motor-reduction gear 23, which transmits the rotary motion by means of transmission elements of 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 projections 25, 26, which set each of the respective epicycloidal reduction gears 27, 28 in rotary motion about its axis of rotation X, which is transverse to the longitudinal plane of symmetry. Each of the epicycloidal Reduction gear applies the longitudinal inclination (Trendelenburg) to the head 11 and is coupled to the respective abutment projections 29, 30 provided on the head 11 and designed to be connected to the plate element 3. The abutment projections 29 and 30 each belong to the mechanical coupling devices 31, 31, which each comprise complementarily shaped coupling seats 33, 34, both of which are arranged in the operating plate element 3. Each landing projection 29, 30 and corresponding coupling seats 33, 34 have on their complementary shaped coupling surfaces, respectively, contacts 35, 36 for electrical power supply, an electronic device 37, 38 for data transmission and a sensor 39, 40 for detecting the presence and position of the operating plate element 3. Since each pair of electronic devices must be active when the system is in operation, the electronic devices belong on the same board 41, 42, respectively arranged on each landing projection 29, 30 and in each coupling seat 33, 34, so as to form a dual data acquisition and transmission system in each mechanical coupling device.

In particular, the contact pair 35, 36 for transmitting the power supply is supplied with direct current, the polarity of which depends on the orientation of the operating plane with respect to the column 2. Thus, the plate element 3 always receives the correct polarity at its contacts without any need for correction. The power supply for the operating plane is switched off when not mounted on the column 2 by means of the coupling seats 33, 34 which are connected to the contact projections 29, 30 of the column 2.

The transmission means 37, 38 are preferably of the infrared type and have a single integrated circuit that enables the signal transmission and the detection for the exchange of information between the column 2 and the operating plate element 3. The plate detection means, formed by the electronic devices 39, can detect the presence and the orientation of the operating plate element 3. Without this information, it is not possible to set the column in motion, which then remains locked.

Operating plate element 3 comprises a seat 43 which can be connected to the head 11 of the column with the mechanical coupling devices 31, 32 described above. In particular, operating plate element 3 comprises a rear portion 44 of the body with two arms 45, 46 which are pivotally mounted on respective hinges 47, 48, 49, 50 by means of respective motor reduction gears 51, 52 housed longitudinally in the arms.

The operating tables also include a foot section 53 formed of a pair of supports 54, 56 mounted on the extension of the rear portion of the body to which they are pivotally attached by means of joints 56, 57. A pair of motor-reduction gears 58, 59 mounted longitudinally near the seat section 43 and inboard of the arms 45, 46 of the rear portion of the body allow both simultaneous and independent movements of the leg supports 55, 54.

Joints 56, 57 are formed by a pair of connecting rods 58, 59 which are 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 locking elements 64, 65 are provided to allow the closing and opening of the oscillating connecting rods 58, 59 to permit their lateral transmission by a compass-like rotation of the leg supports 54, 55. This avoids covering the user's working field, which thus remains unshielded from radio signals.

Each individual leg support 54, 55 can be provided with one or more joints for partially lowering the legs or for bringing them into a bridge position. Furthermore, a pair of motor-reduction gears 66, 67 can be arranged in the seat 43 of the plate element 3 and the reduction devices allow the transfer of the two leg supports 54, 55 in the directions F. The fastening of the plate elements 35 to the head 11 of the column takes place when the projections 29, 30 of the column are connected to the corresponding seats 33, 34 of the seat 43. After connecting the two parts, the stability of the connection is ensured by the engaging devices 68 available in each seat 33, 34, which are received in the corresponding recesses present in each projection 29, 30.

Each attachment element 68 can be manipulated from the outside by means of a lever 70 engaging in suitable seats 71 provided in the fork 72 of the chassis 4. The chassis 4 can be used to move the operating plate element 3 by a translational movement either along the direction P from the foot side or along the direction T from the head side.

Another chassis 4' allows the plate element 3 to be removed along the lateral direction L, which is perpendicular to the previous one, this chassis 4' is provided with different seats 73, each of which is suitable for actuating the same release lever 70 in order to release the operating plate.

5 The control system for the table is preferably arranged on the inner side of the column 2 and comprises a central processing unit (CPU), the main controller and control circuits and the power supply and battery chargers (not shown).

The column's CPU, which is equipped with a microprocessor, controls both manual and automatic movements and also:

- it receives control signals from the input via cable connection or via infrared radiation,

- it controls the correct sequence of the necessary motors to generate the movements,

- it controls the "travel end" software via computer and stores the impulses of the motor circuit in the electronic memory,

- it controls the "travel end" security hardware,

- it records the positions of the individual motors of the column,

- it provides the operator with the necessary information using multilingual systems and speech synthesis,

- it communicates with the operating board by transmitting instructions for carrying out the movements to the electronic devices of the same board and by receiving information and data that are made visible on the display,

- it activates and deactivates the power supply for the disk,

- it recognizes which plate is mounted on the column and which is the orientation side of the patient's head in order to reverse, if necessary, the movement of the motor that adjusts the longitudinal inclination with reference to the symbols on the input.

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

- Activating the brushless motor generates redundant signals that are received by the CPU, which in turn controls the correct operation of the motor;

- the infrared transmission system IrDA is controlled by two microprocessors that transmit and receive signals to check that the transmission is accurate,

- through its interface, the CPU controls the correct operation of the drivers and Mos power sections,

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

- the CPU manages and displays possible errors, alarm signals or warnings to the operator.

The entire electronic system is designed in such a way that no sparks are generated that could ignite flammable and/or explosive mixtures.

The use of a brushless motor system ensures that the motor does not generate sparks and also gives the Ability to control speed and rpm without the need to add additional components such as encoders or tachometric dynamos.

The system is provided with a self-diagnosis system with an external information display for the user in the form of a multilingual display with reference to information about the table's status, warning or error messages. The self-diagnosis system has the possibility of repeating by remote control on a display system of the assistance center all the functions and information of the operating table system about its operational status, machine position and system status for quick customer service all over the world, thus avoiding understanding problems due to different languages. The telecommunication is connected by means of a telephone modem or similar communication systems to the interface normally used for cable input.

The display allows the user to access the program menu without errors, which enables him/her to:

- to store in the electronic memory a number of repeated positions of the operating table that can be recalled at any time. The system must therefore know its position at any time and compare it with the one that must be reached in order to control the servomotors correctly

- the possibility of choosing the language from a list of languages in which the information will be displayed and output by the speech synthesis,

- the possibility of varying the engine speed in order to best adapt it to the needs of the user,

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

The search for the horizontal lever position of the system for repositioning the surgical panel at the end of the operation and for transferring the patient with the trolley by means of automatic transfer can be carried out with high safety by checking in real time the current and final positions of all the motorized segments at the same time in order to avoid contact with the floor, which can be dangerous for the patient. The user also has the possibility to stop the system at any time, automatically searching for the horizontal position in order to leave some of the sections of the surgical panel in the final post-operation state or in any other position decided by the user.

The system must also avoid possible excessive tilted positions and contact with the ground to ensure the safety of the patient.

The invention is susceptible to numerous changes and variations without departing from the scope of the invention as defined in the following claims.

Claims (20)

1. Multifunctional operating table with a supporting column (2) with a plate (2') for support on the floor, a plate element (3) with a longitudinal axis (Y) designed to support the patient to be operated on, and means (31, 32) for releasably connecting this column (2) to the plate element (3), this column (2) forming a vertical plane of symmetry (K) that runs through this longitudinal axis (Y) of the plate element (3), this releasable connecting means being provided with mechanical coupling means (29, 30, 33, 34) with complementarily shaped profiles that taper towards the upper part of the table and are connected to electronic means (37, 38, 39, 40) for the transmission of information and electrical means (35, 36) for the transmission of power, connection means (68) for releasably connecting said plate element (3) to the column (2) by means of a lifting and transferring vehicle, characterized in that these connection means comprise a pair of actuating elements (70) arranged on each side of said plate element (3) and adapted to cooperate with the vehicle (4) along both longitudinal and transverse directions, so that this plate element (3) can be removed from all four sides thereof. 2. Operating table according to claim 1, characterized in that the actuating means (70) are levers designed to engage with respective seats (71, 73) provided in the forks of the vehicles (4, 4'). 3. Operating table according to claim 1, characterized in that the column (2) is provided on its upper side with a head (11) which is designed to cooperate with the plate element (3) in operation. 4. Operating table according to claim 3, characterized in that the mechanical coupling means comprise at least a pair of projections (29, 30) associated with the head (11) and respective complementary shaped seats (33, 34) associated with the plate element in operation. 5. Operating table according to claim 4, characterized in that the complementarily shaped projections (29, 30) and seats (33, 34) have a substantially truncated, trapezoidal profile. 6. Operating table according to claim 4, characterized in that the electronic means for transmission comprise at least one electronic device (37, 38) for signal transmission/reception, the electronic device being arranged on the complementarily shaped profiles of the mechanical coupling devices. 7. Operating table according to claim 4, characterized in that the electronic means for transmission comprise a sensor (39, 40) for detecting the presence and orientation of the plate element (3) in operation. 8. Operating table according to claim 6, characterized in that the at least one electronic transmission/reception device (37, 38) is of the infrared radiation type (rDA) or similar. 9. Operating table according to claim 3, characterized in that the head (11) is provided with translation means in a substantially vertical direction (Z). 10. Operating table according to claim 3, characterized in that the head (11) is provided with first oscillating means so that oscillation is possible in a substantially vertical plane about a substantially horizontal axis of rotation (X) extending transversely to the longitudinal plane of symmetry (K). 11. Operating table according to claim 9, characterized in that the projections (29, 30) are provided with second oscillating means so that oscillation is possible with respect to the head (11) about a second axis of rotation (Y) which extends substantially horizontally and perpendicular to the first axis (X). 12. Operating table according to claim 9, characterized in that the translation means comprise at least one vice (8, 9) with ball-return screw acting between a stationary portion of the column (2) and a mobile telescopic element (7) solidly fixed to the head (11). 13. Operating table according to claim 10, characterized in that the first oscillating means comprise at least a pair of vices (17, 18) of the ball-return screw type acting between the mobile telescopic element (7) and the head (11). 14. Operating table according to claim 10, characterized in that the second oscillating means form a kinematic chain consisting of an elongated coupling shaft (22), a universal joint (23'), a worm gear (24) and at least one pair of epicyclic reduction stages (27, 28) connected to the projections (29, 30). 15. Operating table according to claim 3, characterized in that a flexible fan (S) is provided with transverse and longitudinal folds to protect the connecting space between the head (11) and the column (2). 16. Operating table according to claim 1, characterized in that the operating plate element (3) has a seat section (43) which can be connected to the head (11) and is provided with the seats (33, 34). 17. Operating table according to claim 16, characterized in that the seat portion (43) is connected in the longitudinal direction to a portion (44) suitable for holding back the body at one end and to a foot portion (53) at the other end. 18. Operating table according to claim 17, characterized in that the foot section (53) comprises a pair of lateral supports (54, 55) which are fixed to the seat section (43) by means of respective rods (58, 59) oscillating in a substantially horizontal plane and provided with locking means (64, 65) so that lateral adjustment of the foot supports (54, 55) is possible and permeability for radio signals in the part of the table. 19. Operating table according to claim 18, characterized in that the body supporting portion (44) comprises a pair of pivotable arms (45, 46) connected by respective joints (47-50) and movable by means of motor reduction gears (51, 52) arranged inside the arms (45, 46). 20. Operating table according to claim 1, characterized in that electronic control devices (CPU) are provided within the column (2), which include information devices in the form of digital displays, sound and telecommunication devices.