US 3197198 A
Abstract available in
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Description (OCR text may contain errors)
July 27, 1965 J. s. COLLIS 3,197,198
SURGICAL TABLE Filed Feb. 18, 1963 3 Sheets-Sheet 1 4 INVENTOR JOHN S. COLLYS ATTORNEY J. s. COLLIS SURGICAL TABLE July 27, 1965 5 Sheets-Sheet 2 Filed Feb. 18, 1963 B L L O C S N H O v ATTORNEY J. S. COLLIS SURGICAL TABLE July 27, 1965 3 Sheets-Sheet 3 Filed Feb. 18, 1963 JOHN S. COLLIS United States Patent 3,197,198 S'JRGEQAL TAELE Eohn S. Collie, Honolulu, Hawaii, assignor to Hahn V. Let/as, Lexington, Ky. Filed 18, 1%3, Ser. No. 259,169 '7 Claims. (1. 269-322) This invention relates to a surgical table and more particularly to such a table on which a patient is to be supported for spinal examination or operation.
In the treatment of patients by lumbar discography techniques the patient-supporting table may be comparatively simple in construction, as contrasted with tables used for other types of surgical work, but nevertheless, must satisfy certain essential requirements. Chief among these requirements are that while the patient is supported on the table, needles may be easily introduced into the lumbar discs, and that X-rays may be made without removing the needles from the patient and that the table construction be such that no interference is presented thereby to the prompt and effective carrying out of these steps by the operator. Concomitant with these general requirements are the specific requirements that the table provide for the patients back to be maximally fiexed and that it oifer no obstruction to the taking of both lateral and anteroposterior X-rays by means of a separate X-ray apparatus positioned adjacent the table. It is a purpose of my invention to supply a surgical table which satisfies these requirements in an improved manner.
An object of the invention is to provide an improved and simplified surgical table for use in lumbar discography examinations and operations.
Another object is to provide an improved surgical table having a structure including a rigid framework and a patient-supporting top which positions the patient at a convenient operating height and with the patients spine in maximally flexed condition.
Another object is to provide an improved surgical table having a structure including a rigid framework and patient-supporting top which permits the taking of lateral and anteroposterior X-rays of the patients spine without moving the patient.
A further object is to provide an improved surgical table having an elevator for supporting the knees of the patient and for assisting in positioning the patients body on the table top.
A still further object is to provide an improved surgical table having an elevator for supporting the knees of the patient and with an improved actuating means for the elevator.
Other objects and advantages will become apparent as the description proceeds and when considered in conjunction with the accompanying drawings in which:
FIG. 1 is a perspective view of the table showing a patient supported thereon as indicated by dotted lines.
FIG. 2 is a perspective view of the table when unoccupied, and taken from a different angle of View.
FIG. 3 is a front elevation view of the table with portions omitted and showing diagrammatically the relation of the table, the patient, and a fixed X-ray installation when an anteroposterior view of the patients spine is being taken.
FIG. 4 is a front elevation view of the table with portions omitted and showing diagrammatically the relation of the table, the patient and a fixed X-ray installation when a lateral view of the patients spine is being taken.
FIG. 5 is a sectional view to a larger scale taken on line 55 of FIG. 2 and showing the elevator carriage means, and
FIG. 6 is a sectional view to a larger scale taken on Blhllh Patented July 27, 1965 line 6-6 of FIG. 2 and showing a portion of the elevator actuating means.
Referring first to FIG. 2, my improved table includes a rigid framework which, by way of illustration and not of limitation, preferably comprises a pair of identical side frame members which conveniently may be formed of light weight tubular material such as aluminum alloy. The right hand frame member, when referred to the direction in which the patient is to be located, includes a forward leg 1%, a rearward leg 11, and an upper side rail 12 joining the upper ends of those legs and a lower side rail 13. Likewise, the left hand frame member includes similar legs and rails as seen at 14, iii, 16 and 17 respectively. The lower side rails, which are substantially horizontal, are spaced at a generous vertical distance from the upper side rails, thus, leaving a large open space in the interior of the table. These lower side rails are attached at their forward ends to the lower portions of the forward legs and support the lower ends of the rearward legs which are aflixed to those lower rails intermediate the ends of those rails. Adjacent their projecting rearward ends, the lower rails are separated by a spacer tube 1%, attached thereto, and the forward legs of the frame members are separated laterally by a similar spacer tube 19. Similar upper spacer tubes 2:) and 21 are located between the frame members and serve the additional purpose of helping to mount the table top, it being noted that the spacer tube 21 between the rearward legs is located above the path of travel of the carriage later to be described. The thus-described framework preferably, but not necessarily, is mounted upon casters as shown at 22, 23, 2.4 and 2-5.
As a feature of the invention, the rearward legs are longer than the forward legs and are forwardly inclined from their attachments to the lower side rails. These rearward legs are straight throughout the major portion of their length and merge with a smooth arcuate curve into the upper rails which are straight through a substantial portion of their length and then merge with an arcuate curve into the upper ends of the forward legs. Attached to these upper side rails and to the spacers 20 and Z1, is a table top member, formed of any suitable material having the characteristics of being pervious to X-rays, gamma rays, or the like; of being sufficiently strong to suport the weight of the patient; and of being readily cleaned and sanitary. Lucite, for example, is a suitable material for this purpose.
As will thus be noted, the table top includes a rearward skirt portion 3'3, against which the upper thighs of the patient will rest, a downwardly inclined portion 31 against which the chest or" the patient will rest, and an intermediate upwardly convex portion 32, upon which the pelvic region of the patient will rest. For the purpose of positioning the patients body into this operative position, a knee elevator having a cushion 33 detachably afi'ixed to a planar, generally rectangular, platform 34 is provided, the forward corners of this platformhaving downwardly extending guides 35, 36 attached thereto. Referring now to FlG. 5, the guide includes a central concave portion 3? adapted to hug the inner curved surface of leg 11 and with flat flanges 38 and 39 projecting from this concave portion and lying in a plane inwardly offset from the central plane of leg. ii. in order to prevent binding of the platform carriage which travels in an inclined path along the rearward legs of the framework, friction reducing rollers as, 41 and 42;, 43 are journalled in the respective flanges and are suitably spaced from each other to engage the curved sides of leg Ill and to resist the bending moment caused by the weight of the body of the patient. The guide 36 is similarly constructed and has lower rollers 44, d5 journalled in its fiat flanges 4 5, 47, as best seen in MG. 5. Completing the carriage is a horizontal rod 48 projecting through the flanges 3% and 47 of the two guides and attached thereto at its ends.
Various means for actuating the thusdescribed knee platform and its carriage may be employed without departing from the broader aspects of my invention. A preferred form, however, which is characterized by its simplicity and mechanical reliability may include a pair of elongated racks and 51 which are pivotally mounted upon rod 4-3 immediately inboard of the flanges of the guides and which extend at their lower ends through gear boxes and 53 respectively. Rigidly affixed to the lower side rails adjacent the junction of the rearward legs therewith are a pair of upstanding brackets 54 and in which the ends of drive shaft are journalled for rotation in either clockwise or counter-clockwise directions. As seen in FIG. 1, this shaft is positioned to the left of the carriage guides as they move toward their upward positions, thus providing an efficient lifting action by the racks as the weight of the patients body is moved forwardly by the travel of the knee platform in its upward direction.
Each of the gear boxes 52 and 53 is pivotally mounted upon drive shaft 56 and encloses the respective spur gears 57, 6) wlich are a tached to t tat shaft by splines and which are in mesh at all times with the respective racks. Loosely journalled upon the drive shaft adjacent its center is another gear box housing a worm wheel at attached to the shaft and which wheel is in engement at all times with a worm which in turn is affixed to the end of an elongated rotatable rod 62. This rod is journalled in a support plate 63 afiixcd to cross member (iiabove the lower side rails of the frat 1c and is manipulated by a hand wheel 65 located adjacent the plane in which the forward legs of the table are located. it will be observed that rod 62 is located at the lower region of the framework and is sufficiently far below the table top to leave a generous open space beneath that table top interiorly of the framework.
With the foregoing in mind, reference now is made to FIGS. 3 and 4 and to the position occupied by the patient during a lumbar discography examination. Normally the unconscious patient will be first supported with his knees upon cushion 33 and his body arranged as generally shown in FIG. 1. Thereafter, the surgeon with the aid of an attendant, operating hand wheel 65, will eilect the optimum positioning of the patients spine above the convex portion 32 of the table top at which time the spinal column will be maximally flexed and the patients back will generally be parallel to the floor on which the casters of the table are resting. Needles are then introduced into the lumbar discs, and the table is moved to the X-ray apparatus, which for example, may comprise a conventional generating unit and a conventional recording plate unit indicated generally by the dotted members and 67, respectively. These units may be supported from a wall by means of suitable adjustable arm linkages, or' the X-ray apparatus may itself be movable as a whole and brought to the table. In eithe" event, ample open space is provided beneath the top of the surgical table for reception and proper positioning of the X-ray member 56 which may be swung under the table top from either the right or left sides of the framework. Likewise, the patients body lies above the uppermost parts of the table and the X-ray member 6'7 may be swung into proper position above companion member 65, as when an anteroposterior view is to be recorded with the needles in place. By the same token, when a lateral view is to be taken, the table is spaced somewhat farther from wall d3 as indicated in FIG. 4 and the linkage for X-ray member all is extended beneath the table top while the linkage for member 67 is colla thus to position these mbers closely adiacent to the patients body and at the sides of the same. Any subsequent adjustment of the patients body after the X-ray apparatus has been brought into operative position, may be readily effected by raising or lowering of the knee platform and by manually assisting in bringing the patients body to the desired adjusted position.
Various other advantages of the apparatus will be apparent to those skilled in the art. For example, the knee platform has a long range of travel and is suitable for use with both adults and children; the width of the table top is ample for supporting large patients comfortably and in the event that the patients body is not centered with respect to the longitudinal center line of the table, the examination may still be conducted without lateral shifting of the body; and the arrangement by v 'hich the knee platform travels along an upwardly ing rt a useful forwardly directed component of force which urges the lower portion of the patients body into the desired position above the uppermost convex region of the table top.
While I have illustrated and described a single embodiment of my invention, it is to be understood that my invention may assume other forms and that my invention includes all variations, modifications, and equivalents coming within the scope of the appended claims.
What 1 claim as new and desire to secure by Letters Patent of the United States, is:
1. in a surgical table for use in treating the spinal column of a patient, a framework comprising a pair of side frame members, each member including a forward leg, a forwardly inclined rearward leg longer than said forward leg, an upper side rail joining the upper ends of said legs, and a lower side rail joining said legs adjacent the lower ends thereof, spacers attached to and extending between said side frame members for holding said members laterally spaced from each other and forming a reinforced rigid framework; a table top extending between and attached to said upper rails and providing a support for the prone body of a patient, said table top having a convex surface adjacent the junctions of said rearward legs and said upper rails for supporting the pelvic region of said patient in elevated position, an elevator including a platform for supporting the knees of the patient, carriage means attached to said platform and movable along said rearward legs of said framework, and means for actuating said carriage means and for efiecting Selective raising and lowering movements of said platform.
2. Apparatus as defined in claim 1 wherein said carriage means comprises a pair of downwardly extending guides attached to the forward corners of said platform, a rod extending between said guides for causing said guides to move as a unit, and rollers mounted upon the respective guides and engaging the respective rearward legs on opposite sides thereof; and said carriage actuating means includes a pair of elongated racks pivotally mounted at their upper ends upon said rod, a shaft mounted transversely of said framework and having a pair of spur gears thereon meshing with the respective racks, and means for selectively rotating said shaft in either a clockwise or counterclockwise direction.
3. Apparatus as defined in claim 2 wherein said shaft is disposed adjacent the junction of said rearward legs and said lower side rails of said framework.
Apparatus as defined in claim 2 wherein said carriage actuating means is disposed Within the boundaries of said framework established by said side frame memers thereof thereby to leave the lateral sides of said table unobstructed.
5. In a surgical table for use in treating the spinal column of a patient, a framework comprising a pair of side frame members, each member including a forward leg, a forwardly inclined rearward leg longer than said forward leg, an upper side rail joining the upper ends of said egs, and a lowerside rail joining said legs adjacent the lower ends thereof, said lower side rails being spaced from said upper side rails with a generous vertical space therebetween, spacers attached to and extending between said side frame members for holding said members laterally spaced from each other and forming a reinforced rigid framework; an X-ray pervious table top extending between and attached to said upper rails and providing a support for the prone body of a patient, said table top having a convex surface adjacent the junction of said rearward legs and said upper rails for supporting the pelvic region of said patient in elevated position above the remainder of the table and with unobstructed spaces at the sides of the pelvic region of the patient, an elevator including a platform for supporting the knees of the patient and adapted when actuated to move the patient and to position the spinal column of the patient in flexed condition above said convex surface, carriage means attached to said platform and movable along said rearward legs of said framework, and means for actuating said carriage means and for effecting selective raising and lowering movements of said platform.
6. Apparatus as defined in claim 5 wherein said table top includes a skirt portion for guiding the thighs of the patients body as the body is being elevated into position upon said table top, said skirt portion extending downwardly along said rearward legs from said convex surface and terminating above the uppermost point of movement of said carriage along said rearward legs.
7. Apparatus as defined in claim 5 wherein said table top includes a downwardly directed chest-supporting portion extending forwardly from said convex surface and terminating adjacent the junctions of said upper side rails and said forward legs of said framework.
References Cited by the Examiner UNITED STATES PATENTS ROBERT C. RIORDON, Primary Examiner.