Beds – Invalid bed or surgical support – Adapted for imaging
Reexamination Certificate
2000-03-03
2001-03-13
Melius, Terry Lee (Department: 3628)
Beds
Invalid bed or surgical support
Adapted for imaging
C005S622000, C005S632000, C005S638000
Reexamination Certificate
active
06199233
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to beds and more particularly, to an improved surgical operating table.
BACKGROUND OF THE INVENTION
With current medical practices, it is common for a patient to undergo a diagnostic scanning procedure, which is normally performed in a separate suite containing the scanning machine and dedicated to scanning procedures. The scanning machine may be a CT, MRI, or other scanning device. Thereafter, the scan data is utilized in a surgical planning process, which conventionally takes place at a location, for example, an office or an operating room. In some surgical procedures, the scanning data is utilized with a system for post processing the scan data acquired during imaging. Further, the imaging system may be located in a surgical suite, and the surgical planning performed before and during surgical procedure utilizing the imaging system and scan data.
During the scanning procedure, the patient must maintain a perfectly still and motionless posture, and while most often, the patient simply lies on a scanning support table, in some situations, the patient may be supported in the desired scanning position with pads, straps or other supports. Further, the support on which the patient rests is normally radiolucent, that is, transparent to the scanning device, so that the support does not compromise the utility of the scanned image. Further, the patient support used for scanning normally translates with respect to the imaging device. Translation of the patient support permits the patient to be moved into the scanning field or zone of the scanning machine.
After the scanning process is completed, often the patient is then moved to an operating room which requires either that the patient walk, or be carried, for example, by transferring the patient from the scanning table to an operating table. Alternatively, as illustrated in U.S. Pat. No. 5,475,884, the patient may be supported on a portable support plate, which is easily moved between the scanning table and the operating table. The scan data is often used in a post processing imaging system for surgical planning purposes both prior to and during surgery. If during or after a surgical process, it is desired to scan a patient again, the patient must be moved from the operating room to the scanning suite, transferred to and from the operating table to the scanning table, and after scanning, transferred back to the operating table and returned to the operating room. The above process is cumbersome, time consuming and potentially risky for the patient.
Some newer scanning machines are substantially reduced in size. One such machine is shown in
FIGS. 2 and 3
of U.S. Pat. No. 5,499,415, which show an annular-shaped scanner mounted on a wheel-supported frame, to enable the scanner to be used at multiple sites. Consequently, such scanning machines do not require their own suite or room, but instead, they may be used within the operating suite itself. Thus, in an operating room, the patient may be scanned; the surgical planning performed; an operative procedure executed; and the patient scanned again to determine the current status of the operative procedure. Based on the new scanned images, the operative procedure can be continued and the above process repeated as necessary.
A limitation of the current state-of-the-art is that the posture of the patient during the scanning process is often different from the patient's posture during surgery. If a patient is positioned in one posture on a scanning table during the scanning process, and then is moved to an operating table, that motion of the patient may cause the position of the target to change with respect to the body surface. During surgery, this problem is compounded by tissue shifts attendant to the opening of body cavities, removal of body fluid or tissues and tissue retractions. Thus, while such motion may be small, any motion of the target will reduce or compromise the utility of the preoperative scan data.
The solution to these problems is to scan the patient in the operating room during surgery while the patient is maintained in the surgical posture.
While current scanning tables are radiolucent and provide a translation to move the patient into the scanning machine, such scanning tables do not have the accessories required to attach, support and stabilize surgical instrumentation and to properly support the patient's body in the desired surgical posture. Further, while operating tables contain numerous accessories and couplings to which surgical instrumentation may be attached and supported, most operating tables are not compatible with scanning instrumentation. Thus, as presently known, scanning tables cannot be used as operating tables, and generally, operating tables are inappropriate for use as scanning tables.
It is an object of this invention to overcome the above-described limitations in the prior art, by facilitating the function of supporting a patient in a desired position in a manner which readily accommodates successive surgical or scanning procedures.
SUMMARY OF THE INVENTION
The present invention achieves the above-stated objective with a radiolucent table extension that connects to a surgical table and permits a patient to be positioned on the table in a posture suitable for successive surgical or scanning procedures, with the head and the upper torso of the patient supported on the table extension and the radiolucent table extension including additional cooperative components such as a radiolucent horseshoe headrest and a radiolucent skull clamp to positively hold the patient relative to extension. The radiolucent table extension is cantilevered from one end of the surgical table and it is shaped so that it may be moved in a relative manner into a toroidal shaped scanning zone of an upright annular scanning machine. This permits the patient to be scanned in the desired surgical posture. This radiolucent table extension is especially useful for those procedures in which it is desirable to maintain the patient in a desired position during successive scanning or surgical procedures.
By operatively connecting the toroidal scanner to an imaging system, so that the imaging system may store data representative of scans of the patient taken in the scanning zone, and by supporting the patient with the extension and fixing the position of the patient with the horseshoe headrest and the skull clamp, this invention facilitates the positioning of the patient during successive scans, thereby assuring the accuracy of the scanned data. This helps the surgeon to know almost immediately whether the surgical procedure accomplished its objective, or whether a subsequent surgical procedure may be necessary.
According to the principles of the present invention and in accordance with the preferred embodiments, a radiolucent table extension has a first end adapted to be attached to one end of a table. The table extension includes a contoured radiolucent member designed to support an upper torso and head of a patient with the rest of the patient's body being further supported by an adjacently located surface of the table. The member has a sufficiently narrow width to permit it to be extended, in cantilever fashion, into a scanning zone of portable CT scanning system. A tool support extends along a periphery of the member and is designed to receive and support at least one outboard stabilization device, such as a skull clamp, to positively hold the patient in a fixed position relative to the member. The extension also includes at least one inboard stabilization device. More specifically, inboard of the periphery a radiolucent horseshoe headrest also provides stabilized support for the patient. Therefore, the patient can be supported on the radiolucent table extension in the desired posture. The patient can then be conveniently scanned before a surgical procedure. After surgery, a subsequent scanning procedures may be performed if necessary or desired. Thus, the table extension has the advantage of not requiring that the patient be
Dinkler Charles E.
Kantrowitz Allen
Mun In Ki
Melius Terry Lee
Santos Robert G.
Wood Herron & Evans L.L.P.
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