Abstract:
A cradle for supporting a patient during a surgical procedure includes a supporting base adapted to rest upon a supporting surface and a cradle body for embracing and supporting a patient in proper posture to undergo performance of a surgical procedure. A cradle body support structure supports the cradle body above the supporting base in such a manner that the cradle body may rotate about a horizontal, longitudinal cradle body rotational axis to change the position of the patient while the cradle body maintains the patient in proper surgical posture.

Description:
TECHNICAL FIELD  
       [0001]     The present invention relates to devices for the physical support of patients during surgical procedures. More particularly, the present invention relates to devices for the support of patients during endoscopic surgical procedures. Most particularly, the present invention relates to devices for the support of patients during the performance of laparoscopic assisted OHE (ovarian hysterectomy) veterinary procedures performed on dogs.  
       BACKGROUND OF THE INVENTION  
       [0002]     Endoscopic procedures have replaced many more traditional invasive surgical procedures in contemporary human and veterinary medical practices, and the development of new endoscopic, trauma-minimizing procedures in both human and veterinary medicine is continuing at a steady pace.  
         [0003]     Many endoscopic procedures require that patients be placed and maintained in a favorable posture and/or position to facilitate manipulation of endoscopic and surgical instruments and equipment. In the course of performing many of these procedures it is necessary to change the patient&#39;s posture and/or position as the various elements of the protocol of the procedure are performed. Particularly during procedures involving exploration or the performance of surgery upon organs at disparate locations in a body cavity, it may be advantageous to change the patient&#39;s body orientation to allow gravity to act upon organs and body tissues to facilitate viewing of and access to various organs and other physiological elements.  
         [0004]     Patient physical support devices utilized in the surgical arts of the past have allowed the posture and position of patients to be manipulated during surgical and endoscopic procedures. Some have provided adjustable panels and other restraint and support devices to maintain the patient in a fixed position or posture. However, these tables have generally required manipulation of the patient by hand to achieve adjustment of the patient&#39;s posture or position during the course of a surgical procedure, introducing risks associated with displacement of anesthesia and surgical equipment elements and the failure to maintain an aseptic environment.  
       DISCLOSURE OF THE INVENTION  
       [0005]     It is an object of the present invention to provide an operating table which will facilitate changing the position of a surgery patient during the course of a surgical procedure.  
         [0006]     It is a further object of the present invention to provide an operating table which will allow a patient to be rotated about a horizontal, lateral axis to utilize gravity to assist in displacement of organs and body tissues in body cavities while maintaining the patient in a constant, fixed posture during endoscope assisted medical procedures.  
         [0007]     It is yet another object of the present invention to facilitate such rotation of a patient from a position of dorsal recumbency to positions of right or left lateral recumbency during a veterinary, laparoscopic assisted spay procedure while maintaining an aseptic surgical field.  
         [0008]     In keeping with the above objectives, a surgical cradle comprising a preferred embodiment of the present invention includes a cradle body and cradle support base. The cradle body has walls which are joined at about 90 degrees to form a trough. The cradle body is provided with a narrow longitudinal flat base and is supported above the support base to allow it to rotationally tilt about a longitudinal axis beneath the cradle base. The cradle body may be locked in an upright position by passing a locking pin through a locking pin hole in an end panel of the support base and into one of the cradle body side walls.  
         [0009]     The cradle support base has an upper support surface central portion and raised upper surface side portions running along its longitudinal edges. With the locking pin removed the cradle body may be tilted left or right to bring the exterior surface of a cradle body side wall to a condition of repose, resting upon the upper support surface of the support base. In this position, the distal edge of the cradle body side wall lies immediately adjacent to the inner edge of raised upper cradle support base surface and the inner surface of the side wall and the adjacent raised surface portion align to provide a generally continuous, planar work surface.  
         [0010]     An animal may be anithised, placed in the cradle body in dorsal recumbent position, and taped or strapped in proper posture for performance of an endoscopic procedure. In the course of the procedure, the animal may readily be moved from a dorsal recumbent to a right or left side lateral recumbent position while maintaining the animals posture and the aseptic surgical field.  
         [0011]     Other objects, advantages and aspects of the invention will become apparent upon perusal of the following detailed description and claims and upon reference to the accompanying drawings. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0012]      FIG. 1  is an isometric view of a surgical cradle comprising a preferred embodiment of the present invention positioned for dorsal recumbency.  
         [0013]      FIG. 2  is an isometric view of a surgical cradle comprising a preferred embodiment of the present invention positioned for right lateral recumbency.  
         [0014]      FIG. 3  is an isometric view of a surgical cradle comprising a preferred embodiment of the present invention positioned for left lateral recumbency.  
         [0015]      FIG. 4  is an end view of the surgical cradle in the configuration of  FIG. 1 .  
         [0016]      FIG. 5  is a side view of the surgical cradle in the configuration of  FIG. 1 .  
         [0017]      FIG. 6  is an end view of the surgical cradle in the configuration of  FIG. 3 . 
     
    
     DETAILED DESCRIPTION  
       [0018]     Surgical cradle  100  comprising a preferred embodiment of the present invention is shown in  FIGS. 1 through 6 , and includes cradle body  110  and cradle support base  120 . Cradle body  110  includes cradle body walls  112  and  114 , which are joined to form an angle of about 90 degrees beneath cradle body base  116 . Cradle body  110  of the preferred embodiment of  FIG. 1  is supported, in a manner to allow it to rotationally tilt about longitudinal axis A-B, by cradle body support pins  132  passing through cradle support pillar  130 , as may be seen in  FIGS. 1, 2  and  3 , and cradle support base end panel  128 , as may be seen in  FIGS. 4 and 6 . As may be seen in  FIGS. 4, 5  and  6 , cradle body  110  may be locked in the upright configuration of  FIG. 1  by passing locking pin  140  through end panel locking pin hole  142  and into cradle body locking pin hole  144  in cradle body side wall  114 .  
         [0019]     Cradle support base  126  has upper support surface  122  over its central portion and raised upper surface portions  124  and  126  running along its longitudinal edges. With locking pin  140  removed from locking pin holes  142  and  144 , cradle body  110  may be tilted to bring the exterior surface of cradle body side wall  114  to a condition of repose, resting upon upper support surface  122  of cradle support base  120 , as shown in  FIG. 2 . With cradle body  110  in this position, the distal edge of cradle body side wall  114  lies immediately adjacent to the inner edge of raised upper cradle support base surface  124  and the inner surface of side wall  114  and surface  124  align to provide a generally continuous, planar work surface. Also, with locking pin  140  removed, cradle body  110  may be tilted to bring the exterior surface of cradle body side wall  112  to rest upon upper support surface  122  of cradle support base  120 , as shown in  FIG. 3 . With cradle body  110  in this position, the distal edge of cradle body side wall  112  lies immediately adjacent to the inner edge of raised upper cradle support base surface  126  and the inner surface of side wall  112  and surface  126  align to provide a generally continuous, planar work surface.  
         [0020]     When the surgical cradle of the present invention is to be utilized to perform a veterinary laparoscopic assisted two portal OHE procedure, the cradle support base of the exemplary embodiment is placed on the surface of a standard veterinary surgical table. The animal upon which the spay procedure is to be performed is then placed in a position of dorsal recumbence in the cradle body such that cradle body sides  112  and  114  retain the animal in a centered position with cradle base  116  supporting the center of the animals back with its head toward support base end panel  128 . The animal&#39;s posture and position within cradle body  110  may be fixed by taping its legs and body to cradle walls  112  and  114  with an appropriate surgical tape. The cradle may also be provided with retention straps equipped with buckles, press type or other suitable fasteners, and attached to the edges of cradle walls  112  and  114  to facilitate securing the animal in proper posture and position in the cradle. While the animal is in dorsal recumbence, with locking pin  140  engaged in end panel lock pin hole  142  and side wall lock pin hole  144 , a pneumoperitoneum is raised to a suitable pressure in a standard manner. A cannula is established at the level of the umbilicus, and this first portal is used to insert the laparoscope.  
         [0021]     Locking pin  140  is then removed from locking pin holes  144  and  142  and cradle body  110  is rotated about rotational axis A-B to bring cradle body side  114  to rest upon support surface  122  of base  120  and place the patient in right lateral recumbence, with cradle body  110  in the position of  FIG. 2 . This causes gravity to draw the spleen, bowel and body tissues to the right side of the animal&#39;s pressurized body cavity to allow the abdominal viscera to be viewed and the left ovariouterine complex to be identified and appropriate surgical procedures to be performed.  
         [0022]     The cradle and patient are then rotated about rotational axis A-B to bring cradle body side  112  to rest upon support surface  122  of base  120  and place the patient in left lateral recumbence, with cradle body  110  in the position of  FIG. 3 . This causes gravity to draw the bowel, pancreas and body tissues to the left side of the animal&#39;s pressurized body cavity to allow the right ovarian pedicle to be identified, and appropriate surgical procedures performed in a similar fashion to the left side procedure.  
         [0023]     Upon completion of the right side surgical procedure, cradle body  110  is returned to the position of  FIGS. 1 and 6  and, locking pin  140  is again passed through locking pin hole  142  of end panel  128  and into locking pin hole  144  of cradle body side wall  114  to lock cradle body  110  in that position such that the patient is once again placed in dorsal recumbence in the cradle body with cradle body sides  112  and  114  retaining the animal in a centered position with cradle base  116  supporting the center of the animals back.  
         [0024]     A second, caudal portal is then established at the caudal midline with a trocar, through which the right and left ovary and associated tissues are removed through the body wall and final internal surgical procedures are performed. Both portal sites are then closed.  
         [0025]     Those familiar with the art will note that, while application of an exemplary embodiment of the present invention for a veterinary laparoscopic assisted OHE procedure has been explained, the tiltable surgical cradle of the present invention may have applications other than for this veterinary laparoscopic spaying procedure. For example, applications might include procedures on other animals, exploratory endoscopic procedures, and procedures in human medicine.  
         [0026]     Further, while an exemplary surgical cradle comprising embodiments of the present invention has been shown, it will be understood, of course, that the invention is not limited to this embodiment. Modification may be made by those skilled in the art, particularly in light of the foregoing teachings. For example, the cradle support base might be provided with legs so it could be utilized standing directly on a floor or the surgical cradle might otherwise be integrated with a conventional operating table. The base of the cradle body might be rounded and allowed to rest directly upon the support base supporting surface while fixed in place by alternating flexible straps fixed to the cradle body at one end and to the support surface at the other. A plurality of end panel holes might be provided to allow the cradle to be locked in positions other than those of strict dorsal or lateral recumbency. It is, therefore, contemplated by the appended claims to cover any such modification which incorporates the essential features of this invention or which encompasses the spirit and scope of the invention.