US 2507172 A
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M 13? 9, 195 E. A. NACLERRO 2507,12 2
SURGICAL SUPPORT FOR PATIENTS IN FACE-DOWN POSITION Filed April 15, 1948 INVENTOR.
BY W5 W 644% ATTORN Y Patented May 9, 1950 UNITED STATES PATENT OFFICE SURGICAL SUPPORT FOR PATIENTS IN FACE-DOWN POSITION This invention relates to a novel support for patients during thoracic surgical operations wherein the patient is in a face-down position and. has for its principal object the provision of an improved surgical table affording support for the chest, the head and the arms during certain types of operations such as for the removal of a lung which can be most advantageously performed while the patient is in the prone position.
In operations of this character there are a number of disadvantages in having the patient in a face-up position. In this position the incision must be made at the front where there is a much smaller exposure of the affected parts. The bronchus is most posterior and is diflicult to gain access to when the incision is at the front and to get at this structure with manipulation of the lung there is the danger of spillage of secretions into the other lung. Also, in this position administration of the anaesthesia becomes more difficult.
There are also disadvantages in the side position including that of contralateral spillage of secretions into the other lung by gravity and manipulation. This spillage is completely avoided when the patient is operated on while in facedown position, the administration of the anaesthetic is easier, there is no restriction of respiratory excursions and, above all, the bronchus and vagus are most readily accessible, which is most important in intrathoracic surgery.
An important object of the present invention is to provide an improved four-point support for the patient while comfortably resting in the facedown position, the supporting elements being arranged to allow the surgeon complete freedom of action and ready access to the back and side of the patient where the incision is made. Another object of the invention is to provide a body support of this character which permits free motion of the abdominal muscles and the lower chest cage, and allows normal activity of the diaphragm which is the most important muscle of respiration.
A further object of the invention is to provide supports for the breast, head and arms all mounted on a single pedestal which are readily demounted for transportation, which occupy a small space when not in use, and which may be used in conjunction with any conventional type of operating table, which in this instance will support the legs and pelvic regions of the patient.
In the drawing:
Fig. l is a front elevation of an apparatus embodying the present invention.
Fig. 2 is a side elevation thereof.
Fig. 3 is a top plan View thereof.
Fig. 4 is a transverse section on a vertical plane taken through the chest support.
Fig. 5 is a longitudinal section on a vertical plane taken through the head rest.
The apparatus embodying the present invention is arranged to be supported on a base I0 which rests upon the floor and is provided on its upper surface with a socket II which receives a vertical cylinder [2 within which a vertical rod l3 ismounted for vertical, sliding movement to an adjusted, fixed position.
Rod I3 is provided at its lower end with a piston (not shown) which is acted upon by fluid in the cylinder for the purpose of raising the piston and rod. A pivoted lever l4 associated with a pump acts to drive the fluid into the cylinder. The members mounted on rod l3 are shown as pipe couplings, although it will be appreciated that any other form of construction may be employed.
A T coupling l5 carries an angle 16 which supports a downwardly-extending rod 20. The arm rests 2| and 22 are adjustably supported by this rod, such arm rests being of channel shape of arcuate cross-section. Arm rest 2| is mounted at the upper end of a vertical rod 23 by means of a set screw 24. Rod 23 is connected with a horizontal rod 25 by means of a coupling 26. At its inner end rod 25 is provided with a collar 21 which is secured on vertical rod 20 in an adjusted, fixed position. A set of similar members may be employed for mounting the other arm rest 22 on rod 20.
Above T member l5, an X member 3| is mounted, the opposed horizontal terminals of which support couplings 32 upon which horizontal rods 33 are mounted. A transverse support 34 is carried on the latter rods by means of couplings 35 secured thereto by set screws 36 in order to permit movement of the transverse support 34 to an adjusted, fixed position toward or away from vertical support l3.
A vertical rod 40 is mounted on transverse support 34 and is adjustable as to height. The head support M is rigidly carried at the upper end of such rod. The head support, is of generally U shape and comprises a base plate 42 having upwardly extending flanges 43 around the edges thereof. On this base plate a plurality of layers 4-1 of resilient material, such as foam rubber, are secured and the entire head support may be enclosed in a suitable fabric covering 45.
Rods 33 may also form a support for a horizontal rod 55 upon which are mounted vertical rods 46 having horizontal extensions 41 at their upper ends to form a support for an anaesthetic tent (not shown).
The breast support 50 is mounted at the upper end of a vertical rod 5| mounted in X fitting 3!. This breast support includes a slightly concave base plate 52 generally circular in shape upon which is secured a plurality of layers 53 of the same resilient material and the entire support enclosed by a fabric cover 54.
In use the breast support 50 is first adjusted to proper height by manipulation of lever ll associated with the hydraulic lift. Next, adjustment of the arm rests 2| and 22 may be effected horizontally by moving couplings 26 along horizontal rods 25 and vertically by adjusting rods 23. Also angular adjustment of the arm rests may be effected by loosening set screws 24. Finally head rest 4! may be adjusted vertically and horizontally with respect to the breast support in the manner earlier pointed out. The conventional operating table (not shown) for supporting the legs and pelvic region may then be adjusted as to height and moved to an appropriate position in spaced relation to the breast support. The patient is now preferably lifted onto the support of the present invention and onto the operating table and the operation may proceed.
While one form or embodiment of the invention has been shown and described herein for illustrative purposes, and the construction and arrangement incidental to a specific application thereof have been disclosed and discussed in detail, it is to be understood that the invention is limited neither to the mere details or relative arrangement of parts, nor to its specific embodiment shown herein, but that extensive deviations from the illustrated form or embodiment of the invention may be made without departing from the principles thereof.
What I claim is:
1. A support for the upper section of the body in face-down surgical operations including a breast support, channelled arm rests disposed below the breast support and extending laterally therefrom, a head rest, and a unitary support for such members comprising an upright post at he upper end of which the breast support is mounted, a base for such post, and means for raising the post to an adjusted, fixed position, horizontal rods extending laterally from the post, upwardly extending rods carried adjacent the outer ends of such horizontal rods and which are movable vertically of the post to an adjusted, fixed position, the channelled arm rests being supported at the upper ends of such upwardly extending rods, a horizontal support extending longitudinally forwardly of the post, and a vertical rod carried by the horizontal support at the upper end of which the head rest is secured, and means for adjusting the latter rod vertically.
2. A support for the upper section of the body in face-down surgical operations including a breast support, channelled arm rests disposed below the breast support and extending laterally therefrom, a generally U-shaped head rest provided' With a cushioned upper surface, and a unitary support for such members comprising an upright post at the upper end of which the breast support is mounted, a base for such post, andmeans for raising the post to an adjusted, fixed position, such breast support being provided with a generally concave, cushioned upper surface, horizontal ro'ds extending laterally from the post which are movable vertically of the post to an adjusted, fixed position, the channelled arm rests being supported at the outer ends of such rods, a generally U-shaped horizontal support extending longitudinally forwardly of the post, a horizontal rod extending between the legs of such support and being movable longitudinally thereof, and a vertical rod adjustably carried on the latter horizontal rod at the upper end of which the head rest is secured.
'EMIL A. NACLERIO.
REFERENCES CITED The following references are of record in the file of this patent:
UNITED 'STATES PATENTS Number Name Date 1,148,980 Me'taxas Aug. 3,1915 1,282,580 Hosford et a1. Oct. 22,1918 1,516,795 Schwarting Nov. '25, 1924 1,582,950 Weaver et al. May 4, 1926 1,697,121 Kne'bel Jan. 1, 1929 2,054,732 Saffry Sept. 15, 1936 2,217,783 Bell Oct. 15, 1940 FOREIGN PATENTS Number Country Date 329,390 France Mar. 28, 1938