Note: Descriptions are shown in the official language in which they were submitted.
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OPERATING SUPPORT FOR SURGEONS
FIELD
The present disclosure concerns embodiments of an operating support for a
surgeon performing a medical procedure (e.g., surgery) on a patient.
BACKGROUND
During laparoscopic surgery, the surgeon typically stands to one side of the
operating table while manipulating relatively long instruments and while
viewing
the procedure on a video monitor. Unfortunately, the surgeon has little
opportunity
to move the body and change posture, which often leads to fatigue and pain.
Thus,
there is a strong need for an apparatus to support the surgeon during such
procedures
in a manner that reduces the stress and strain on the surgeon's body.
SUMMARY
The present disclosure concerns embodiments of an operating support that
supports a surgeon in a sitting position straddling a patient. By straddling
the
patient, the surgeon is ideally positioned to perform certain types of
laparoscopic
surgery, such as pelvic surgery, which requires the use of relatively long
surgical
instruments. The operating support places the surgeon in a more ergonomically
correct position that reduces the stress and strain on the surgeon's body as
compared
to the conventional technique of performing laparoscopic surgery in a standing
position at one side of the operating table. The position of the surgeon
relative to the
patient also provides other doctors or nurses access to the patient during the
procedure, for example if the anesthesiologist must attend to the patient.
The operating support in disclosed embodiments includes a frame structure
that supports a seat such that an end portion of an operating table can be
positioned
directly underneath the seat to allow the surgeon to straddle a patient
positioned on
(e.g., lying down) the operating table. The seat can be vertically adjustable
relative
to the frame structure to allow the seat to be positioned at a desired height
relative to
the patient. The operating support also can include foot supports for
supporting the
surgeon's feet, a chest support for supporting the surgeon's chest, and arm
supports
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for supporting the surgeon's arms. The foot supports, the chest support, and
the arm
supports also can be vertically adjustable to suit the individual needs of the
surgeon.
The frame structure desirably has light-weight construction so that the
operating support can be easily positioned for use and transported between
operating
theaters. In certain embodiments, the frame structure can be constructed from
tubular frame members and desirably is made from a light-weight material such
as
steel, aluminum or any of various other suitable metals, alloys, polymers, or
composite materials. This provides a light-weight construction allowing for
easy
positioning and transporting of the operating support. If it becomes necessary
during surgery to provide additional access to the patient, for example if the
anesthesiologist requires additional access to the patient, the surgeon can
quickly
dismount the operating support. The operating support then can be easily moved
away from the patient to provide other doctors or nurses additional access the
patient.
In one representative embodiment, an operating support for a surgeon
performing a medical procedure on a patient positioned on an operating table
comprises a seat adapted to support the buttocks of the surgeon and a frame
structure
supporting the seat. The frame structure is configured to be positioned
relative to
the operating table such that the seat is positioned over the operating table
and the
surgeon, while sitting in the seat, can straddle the patient.
In another representative embodiment, an operating support for a surgeon
performing a medical procedure on a patient positioned on an operating table
comprises a frame structure comprising first and second laterally spaced,
vertically
extending support members, and a seat supported between the first and second
support members. The support members are spaced from each other such that an
end portion of the operating table can be positioned between the support
members
and beneath the seat to allow the surgeon to straddle the patient at a
position above
and over the patient.
In another representative embodiment, a surgical system comprises an
operating table for supporting a patient, and a support apparatus for a
surgeon
performing a medical procedure on the patient. The support apparatus comprises
a
seat adapted to support the buttocks of the surgeon, and means for supporting
the
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seat at a position over and above an end portion of the operating table such
that the
surgeon, while sitting in the seat, can straddle the patient.
In another representative embodiment, a method of performing a medical
procedure on a patient positioned on an operating table is provided. The
method
comprises sitting on an operating support at a position above and over the
patient
while straddling the patient, and performing a surgical procedure on the
patient.
The foregoing and other features and advantages of the invention will
become more apparent from the following detailed description, which proceeds
with
reference to the accompanying figures.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side view of an operating support for a surgeon, according to one
embodiment.
FIG. 2 is a front view of the operating support shown in FIG. 1.
FIG. 3 is a perspective view of the operating support shown in FIG. 1.
FIG. 4 is a top plan view of the operating support shown in FIG. 1.
FIGS. 5 and 6 are side views showing how the seat can be removed from the
operating support.
FIG. 7 is a perspective view of the arm support assembly of the operating
support shown partially in section.
FIG. 8 is an elevation view of the lower end portion of one of the arm
supports and one end portion of the shaft of the arm support assembly.
FIG. 9 is a perspective view of the lower end portion of one of the arm
supports and one end of the bracket assembly that supports the arm support
assembly on the operating support.
FIG. 10 is a perspective view of the bracket assembly for the arm support
assembly.
FIG. 11 is a perspective view of the lower end portion of one of the arm
supports and one end portion of the shaft of the arm support assembly shown
with
the bearing housing removed for purposes of illustration.
FIG. 12 is an enlarged side view showing one of the brackets of the bracket
assembly mounted on horizontal rungs of the operating support.
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FIG. 13 is a side view of the operating support of FIG. 1 being used to
support a surgeon in a position straddling a patient lying on an operating
table.
FIG. 14 is a perspective view of the operating support and operating table
shown in FIG. 13.
DETAILED DESCRIPTION
As used herein, the singular forms "a," "an," and "the" refer to one or more
than one, unless the context clearly dictates otherwise.
As used herein, the term "includes" means "comprises." For example, a
device that includes or comprises A and B contains A and B but may optionally
contain C or other components other than A and B. A device that includes or
comprises A or B may contain A or B or A and B, and optionally one or more
other
components such as C.
Referring first to FIGS. 1-4, there is shown one embodiment of an operating
support, or saddle, indicated generally at 10, that supports a surgeon in an
ergonomically correct position for performing certain types of medical
procedures,
and in particular surgical procedures. The operating support 10 can be used
while
performing surgery on a patient positioned on (e.g., lying down) an operating
table
(e.g., the operating table 12 shown in FIGS. 13 and 14) or on a patient chair
that can
recline (e.g., a dentist chair) to position the patient in a lying-down or
near lying-
down position. The operating support 10 can be used to support the surgeon in
a
seated position straddling the patient to reduce stress and strain on the
surgeon's
body while performing certain types of surgery, especially laparoscopic
surgery
(e.g., pelvic surgery). The support can used for performing various other
types of
procedures, including, without limitation, interventional radiology
procedures,
maxillo-facial surgery, abdominal surgery, cardiac surgery, thoracic surgery,
dental
procedures, neurosurgical procedures, and orthopedics, to name a few.
The operating support 10 in the illustrated embodiment includes a seat 14
adapted to support the buttocks of the surgeon and a frame structure 16 that
supports
the seat 14. The frame structure 16 is configured to be positioned relative to
the
operating table 12 such that the seat 14 can be positioned above and over an
end
portion of the table 12 as illustrated in FIGS. 13 and 14.
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As best shown in FIGS. 1-4, the frame structure 16 in particular
embodiments includes first and second main support members 18a, 18b,
respectively, positioned on opposite sides of the seat 14. The support members
18a,
l 8b can be connected to each other by a cross member 20 at the top of the
frame
structure and can extend downwardly and forwardly from the cross member 20. As
best shown in FIG. 4, the support members 18a, l 8b also can extend laterally
outwardly away from the seat moving in a direction toward the floor to provide
a
larger footprint at the base of the frame structure for better stability. The
support
members 18a, l8b are laterally spaced from each other on opposite sides of the
seat
a distance sufficient to allow an end portion of the operating table 12 to be
positioned between the support members and underneath the seat 14. This allows
the surgeon to be supported in a seated position straddling the patient, as
depicted in
FIGS. 13 and 14.
As shown in FIG. 3, the frame structure 16 additionally can include rear
support members 22a, 22b having upper ends connected to the support members
18a, l8b and lower ends supported on the floor. The lower ends of the rear
support
members 22a, 22b can be connected to each other by a lower cross member 50.
One
or more cross members 24 can extend between the main support member 18a and
the rear support member 22a and between the main support member l8b and the
rear
support member 22b.
The lower ends of the support members 18a, l 8b can have support pads 52a,
52b, respectively, contacting the floor (FIG. 2). The support pads 52a, 52b
can be
made of a low-friction material, for example a low-friction polymer such as
high
density polyethylene or Delron , so that the support 10 can be easily moved in
the
operating theater. In alternative embodiments, the lower ends of the support
members 18a, l8b and/or the lower ends of the rear support members 22a, 22b
can
include wheels to facilitate positioning and transporting the support 10. Such
wheels can be provided with locks to prevent the wheels from the moving during
surgery.
As best shown in FIGS. 2 and 3, the frame structure 16 in particular
embodiments can also include a support frame assembly 26 (also referred to
herein
as a seat support member), which can have an upper end connected to the cross
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member 20 and a lower end connected to a cross member 28 extending between and
connected to the rear support members 22a, 22b. The support frame assembly 26
in
the illustrated embodiment includes elongated vertical posts 30 extending
vertically
between cross members 20 and 28 and a plurality of vertically spaced,
horizontally
disposed rungs, or bars, 32 extending between and connected to the vertical
posts
30.
The seat 14 can include a seat cushion 34 and a seat frame 36 supporting the
seat cushion. The seat frame 36 desirably is vertically adjustable to adjust
the height
of the seat along the support frame assembly 26. For example, the seat frame
36 can
include a rear portion 38 (FIG. 1) that is configured to be removably mounted
to the
rungs 32. The seat can be easily adjusted to a desired height by removing the
seat
frame 36 from support frame assembly 26 and placing the seat frame 36 on rungs
32
at a desired height.
FIG. 5 is an enlarged view of the rear end portion 38 of the seat frame 36,
according to one embodiment. The rear end portion 38 can be formed from two
laterally spaced side plates 104, each of which is positioned adjacent a
respective
post 30 of the support frame assembly 26. As shown, each side plate 104 can be
formed with an upwardly curved protrusion, or hook portion, 106 that extends
between two adjacent rungs 32. Each side plate 104 can also be formed with
another protrusion 108 that extends between two adjacent rungs 32 below
protrusion
106. By virtue of the engagement of the protrusions 106, 108 with the rungs
32, the
seat 14 is retained in a horizontal position against the weight of the user.
As shown in FIG. 6, the seat 14 can be removed from the support frame
assembly 26 by lifting the front end of the seat upwardly until the lower
protrusion
108 clears the corresponding rungs 32, and then sliding the seat downwardly to
remove the upper protrusion 106 from the corresponding rungs 32. Other
techniques
or mechanisms can be used to permit the seat 14 to be vertically adjustable.
For
example, the seat can be mounted on a vertical screw mechanism that is
operable to
adjust the height of the seat.
Referring again to FIG. 1, the operating support 10 can include a chest
support 54 adapted to support the chest of the surgeon during use. The chest
support
desirably is adjustable in the forward and rearward directions (as indicated
by
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double-headed arrow 56 in FIG. 1) as well as upwardly and downwardly (as
indicated by double-headed arrow 58 in FIG. 1) to satisfy the individual needs
and
preferences of the surgeon. In the illustrated embodiment, for example, the
chest
support 54 includes a chest support pad 60 that is supported on and adjustable
relative to a chest-support frame 62. The frame 62 in the illustrated form
includes a
horizontal lower portion 64 extending from and connected to the seat frame 36
and a
vertical upper portion 66 extending upwardly from the forward end of the lower
portion 64. The lower portion 64 and the upper portion 66 can be formed from
two
parallel, elongate frame members 68, as best shown in FIG. 2. The chest pad 60
can
be adjustably mounted to the frame 62 by an adjustment knob 70 that has a
threaded
shaft that extends through the frame members 68 and into a threaded opening in
the
chest pad. The chest pad 60 can be adjusted to a desired height along the
frame
members 68 by loosening the knob 70, sliding the chest pad 60 to the desired
height,
and then tightening the knob 70 to secure the chest pad in place against the
frame
members 68.
The chest support 54 can be similarly adjusted in the fore-aft direction
(toward and away from the front of the seat). For example, as shown in FIG. 2,
the
chest-support frame 62 can be secured to the lower surface of the seat frame
36 by
an adjustment knob 74 having a threaded shaft 76 that extends through frame
members 68 and into a threaded opening in the lower surface of the seat frame
36.
The knob 74 can be loosened to permit fore-aft adjustment of the chest-support
frame 62 relative to the seat frame. Tightening the knob 74 secures the chest-
support frame 62 to the seat frame at the desired fore-aft position.
Furthermore, in certain embodiments, the angle of the chest support 54
relative to a vertical plane can be adjusted to allow the user to lean closer
to or
farther away from the patient. For example, the upwardly extending frame
portion
that supports the chest support (e.g., upper portion 66) can be pivotably
mounted at
its lower end portion to permit pivoting of the frame portion and the chest
support
54 relative to a vertical plane. Any suitable techniques or mechanisms can be
used
to permit pivoting of the frame portion to a desired angle relative to the
vertical
plane and to lock the frame portion at the desired position. In one
implementation, a
push button, lever, or similar control mechanism can be used such that
activation of
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the control mechanism is effective to allow pivoting of the chest support to a
desired
position and release of the control mechanism retains the chest support at the
desired
position, similar to the controls used to adjust the position of a seat in an
automobile.
The operating support 10 can include first and second foot supports 76a, 76b
adapted to the support the right and left feet, respectively, of the surgeon.
The foot
supports 76a, 76b desirably are vertically adjustable to satisfy the
particular needs of
the user. For example, in the illustrated embodiment, the foot supports 76a,
76b are
mountable to and adjustable along the length of the support members 18a, 18b.
As
best shown in FIG. 1, each foot support 76a, 76b can include a horizontally
disposed
foot pad 78, a bracket 80 and an extension arm 82 extending between and
connecting the foot pad to the bracket. To permit vertical adjustment of the
foot
supports, each bracket 80 can be formed with a plurality of pins or prongs
(not
shown) that can be inserted into apertures 86 formed along the length of the
respective support member 18a, 18b. Other techniques or mechanisms also can be
used to mount foot supports 76a, 76b to the support members 18a, 18b. For
example, the brackets 80 can be secured to support members 18a, l 8b with
bolts,
screws, or other types of fasteners.
The operating support can further include an arm support assembly 42
coupled to and supported by the frame structure 16. The arm support assembly
42
can include first and second arm supports 88a, 88b for supporting the arms of
the
surgeon. Each arm support 88a, 88b can include an arm rest 90 mounted on the
forward end of a support arm 92. As best shown in FIG. 2, the support arm 92
of
each support 88a, 88b extends downwardly from the respective arm rest 90 and
rearwardly toward the seat support member 26. The lower end portion of each
support arm 92 can be connected to a respective pivot mechanism 94. The pivot
mechanisms 94 are connected to opposite ends of a shaft 96 (FIG. 7), which in
turn
can be removably mounted to the support frame assembly 26.
Each pivot mechanism 94 can be configured to permit pivoting movement of
the respective arm support 88a, 88b about two separate pivot axes. For
example, in
the illustrated embodiment, each pivot mechanism 94 allows for pivoting
movement
of the respective arm support about a vertical pivot axis and a horizontal
pivot axis.
This allows each arm support to be pivoted upwardly and downwardly about a
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horizontal pivot axis between a lowered position (shown in solid lines in FIG.
1)
adjacent the surgeon and a raised position away from surgeon (shown in dashed
lines in FIG. 1), in the directions indicated by double-headed arrow 98 in
FIG. 1.
Each arm support also can be pivoted about a respective vertical axis between
a
forward position (shown in solid lines in FIG. 4) adjacent the surgeon and a
rearward position (shown in dashed lines in FIG. 4) away from surgeon,
independent
of pivoting movement about its horizontal axis, as indicated by double-headed
arrow
100.
As best shown in FIG. 7, each pivot mechanism 94 in the illustrated
embodiment comprises a bearing housing 110 that receives the lower end portion
of
a respective support arm 92. The pivot mechanism 94 can include an upper
bearing
112 and a lower bearing 114 retained between the housing 110 and the lower
portion
of the support arm 92. The housing 110 and the bearings 112, 114 can be
retained
on the lower end portion of the support arm 92 by a tapered lock nut assembly.
The lock nut assembly in the illustrated embodiment comprises a cap portion
116 having an enlarged head portion 118 and an extension portion 120 that
extends
into the lower portion of the support arm 92. A screw 122 extends through a
threaded opening in the cap portion 116 and a corresponding threaded opening
in a
tapered nut 124. The nut 124 has an angled lower surface that bears against an
angled upper surface of the extension portion 120. When the screw 122 is
tightened,
the nut 124 rotates relative to the cap portion 116. By virtue of the angled
surfaces
of the nut 124 and the extension portion 120, the nut 124 is urged against the
inner
surface of the support arm 92, securing the lock nut assembly at the lower end
of the
support arm 92. The lock nut assembly retains the bearings and the bearing
housing
in place between the head portion 118 and a flange member 126 of the support
arm
92 while allowing pivoting movement of the support arm 92 relative to the
bearing
housing about a vertical pivot axis V (FIG. 8).
As best shown in FIG. 11, the lower end portion of the support arm 92 can be
formed with an elongated opening 128 that receives the adjacent end portion
130 of
the shaft 96. The arc length of the opening 130 defines the angle through
which the
support arm 92 can pivot about its vertical axis V. The shaft end portion 130
serves
as a stop that limits pivoting movement of the support arm 92 about its
vertical pivot
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axis. Thus, as the support arm is pivoted about its vertical axis, the shaft
end portion
130 can contact the opposing sides of the opening 130 to limit pivoting of the
support arm 92 between the forward and rear positions shown in FIG. 1.
Referring again to FIG. 7, the bearing housing 110 in the illustrated
configuration can include a horizontally extending, shaft-receiving portion
132 that
houses an adjacent portion of the shaft 96. As best shown in FIG. 9, the shaft
96 can
be fixedly secured to the bearing housing 110 by a screw 134 that extends
through
the shaft-receiving portion 132 and is tightened into a threaded opening in
the shaft
96. In this manner, both support arms 92 pivot together about the horizontal
axis
defined by the shaft 96. In alternative embodiments, the support arms 92 can
be
configured to pivot independently of each other about the horizontal pivot
axis.
As best shown in FIGS. 7 and 10, a bracket assembly 136 can be mounted on
the shaft 96 between the pivot mechanisms 94. The bracket assembly 136 in the
illustrated configuration is configured to allow the arm support assembly 42
to be
removed from and placed on any of the rungs 32 (FIG. 3) to adjust the vertical
position of the assembly 42.
The bracket assembly 136 in certain embodiments includes first and second
spaced-apart brackets 138 secured to the ends of an elongated tubular cross
member
140 that houses a central portion of the shaft 96. A bearing 142 can be
disposed on
the shaft 96 adjacent each bracket 138. As best shown in FIG. 12, each bracket
138
can be formed with curved hook portions 144 and 146 configured to be placed
around horizontal rungs 32 for supporting the arm support assembly 42 on the
frame
structure 16. To remove or adjust the height of the arm support assembly 42,
the
assembly 42 is lifted up until the hook portions clear the rungs, and then
moved
rearwardly away from the rungs. The arm support assembly 42 can be supported
on
any two rungs to suit the needs of the user.
Upward and downward pivoting movement of the support arms 92 can be
limited by a stop member 148 extending from each housing portion 132 into a
curved opening or slot 150 formed in the adjacent bracket 138 (FIGS. 8 and 9).
In
use, the support arms 92 and the bearing housings 110 can be pivoted upwardly
and
downwardly about the horizontal pivot axis, with such motion being limited by
the
arc length of the slot 150. In alternative embodiments, only one stop member
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and corresponding slot 150 can be provided since the support arms 92 in the
illustrated embodiment are interconnected by shaft 96 to pivot together about
the
horizontal pivot axis.
In alternative embodiments, the arm supports 88a, 88b can be mounted for
pivotal movement about respective vertical axes V but are prevented from
pivoting
upwardly and downwardly about a horizontal axis. In still other embodiments,
the
arm supports 88a, 88b can pivot about a horizontal axis but are prevented from
pivoting about respective vertical axes.
The frame structure desirably has light-weight construction so that the
operating support can be easily positioned for use and transported between
operating
theaters. As shown in the illustrated embodiment, the frame structure 16 can
be
constructed from tubular frame members desirably made from a light-weight
material such as steel, aluminum or any of various suitable alloys. This
provides a
light-weight construction allowing for easy positioning and transporting of
the
operating support. In alternative embodiments, the frame structure can have a
different construction that does not utilize tubular frame members.
FIGS. 13 and 14 illustrate the use of the operating support 10 for performing
laparoscopic surgery, and in particular laparoscopic pelvic surgery, on a
patient
positioned on an operating table 12. As shown, the operating support 10 is
positioned such that the front end portion of the operating table 12 extends
beneath
the seat 14. This allows the surgeon to sit at a position straddling the upper
body of
the patient. In this position, the surgeon can more easily manipulate the
relatively
long instruments used in laparoscopic surgery with less stress and strain on
the
surgeon's body. The position of the surgeon relative to the patient also
provides
other doctors or nurses access to the patient during the procedure, for
example if the
anesthesiologist must attend to the patient. If it becomes necessary during
surgery to
provide additional access to the upper body of the patient, for example if the
anesthesiologist requires additional access to the patient, the surgeon can
quickly
move one of the arm supports 88a, 88b to its rearward and/or raised position
to
permit the surgeon to dismount the operating support. The operating support
then
can be easily moved away from the patient to provide other doctors or nurses
additional access the patient.
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In use, portions of the operating support 10 and/or the surgeon can be
covered with a disposable, sterile drape to reduce the risk of contamination.
For
example, as shown in FIG. 2, separate drapes 160 can be provided to cover the
arm
supports 88a, 88b or portions thereof and a drape 162 can be provided to cover
the
chest support 54 or portions thereof. As shown in FIG. 13, another drape 164
can be
provided to cover the patient and the legs of the surgeon. The drape 164 in
the
illustrated example has an opening and two side portions that extend around
the
waist of the surgeon and are tied off or otherwise connected to each other at
the back
of the surgeon, as indicated at 166. The size and shape of the drape 164 can
be
altered to suit the particular procedure being performed. Although not shown
in
FIG. 13, in a specific implementation, the drapes 160, 162 are used together
with the
drape 164. Following the medical procedure, the used drapes can be disposed of
and
replaced with new drapes.
The drapes can be made from any of various materials that are used for
making commercially available surgical drapes, such as fabrics, polymeric
materials,
paper, or combinations thereof.
In view of the many possible embodiments to which the principles of the
disclosed invention may be applied, it should be recognized that the
illustrated
embodiments are only preferred examples of the invention and should not be
taken
as limiting the scope of the invention. Rather, the scope of the invention is
defined
by the following claims. We therefore claim as our invention all that comes
within
the scope and spirit of these claims.
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