Device for supporting at least one arm of an operating person during a surgical operation

A device for supporting at least one arm of an operating person during a surgical or medical operation comprises at least one supporting element for supporting the at least one arm of the operating person, the supporting element being arranged at a carrying structure for carrying the at least one supporting element. The carrying structure is configured such that the at least one supporting element can be lowered or raised for adjusting the height of the operating person's arm. The carrying structure comprises a control mechanism for lowering or raising the at least one supporting element, wherein the control mechanism includes a force load switch for activating the lowering or raising of the at least one supporting element, wherein the force load switch activates the lowering or raising of the at least one supporting element upon detecting compressive and/or tensile forces or motions acting via the at least one supporting element on the force load switch.

CROSS-REFERENCE TO OTHER APPLICATION

The present application claims priority of European patent application 03 013 263.9 filed on Jun. 12, 2003.

BACKGROUND OF THE INVENTION

The invention relates to a device for supporting at least one arm of an operating person during a surgical or medical operation.

A device of the kind mentioned at the outset, which can also be designated as an arm rest, is used as a support of the surgeon's or the surgical assistant's arm during an operation in order to increase steadiness of movement and reduce fatigue. Taking into consideration that a surgical operation can take up several hours and the surgical personnel carries out such an operation in a standing position, an arm rest of the aforementioned kind will be effective in avoiding a loss of preciseness of the manipulations carried out by the operating person.

The device comprises at least one supporting element for supporting the at least one arm of, for example, the surgeon. The supporting element is arranged at a carrying structure for carrying the at least one supporting element, wherein the carrying structure should be adapted to be mounted on a side of the operating table or in front of a surgical stool. However, the carrying structure of the device according to the invention can also be configured as a self-standing structure which can stand on the floor of the operating room beside the operating table.

A device known from DE 195 04 838 A1 is a supporting device integrated into an operating stool which can also be integrated in the operating table. The operating stool comprises an adjustable arm rest supporting the arms or hands of the surgeon leaning over the operating area.

However, in that document it is not disclosed how to adjust the height of the supporting element and, accordingly, the surgeon's or surgical assistance arm or hand.

SUMMARY OF THE INVENTION

Therefore, it is an object of the present invention to provide a device of the kind mentioned at the outset which allows the person the arm of which is supported by the at least one supporting element, to easily adjust the height of the at least one supporting element. The adjustment of the at least one supporting element should not distract the operating person from the surgical operation.

According to an aspect of the invention, a device for supporting at least one arm of an operating person during surgical or medical operation is provided, comprising a carrying structure carrying at least one supporting element for supporting the at least one arm of the operating person, the carrying structure being configured such that the at least one supporting element can be lowered or raised for adjusting the height of the operating person's arm, a control mechanism for lowering or raising the at least one supporting element, wherein the control mechanism includes a force load switch for activating the lowering or raising of the at least one supporting element, wherein the force load switch activates the lowering or raising of the at least one supporting element upon detecting at least one of compressive forces, tensile forces and motions acting via the at least one supporting element on the force load switch.

By means of the control mechanism including the force load switch for activating the lowering or raising of the at least one supporting element, the arm rest according to the present invention can be adjusted intuitively by the operating person, whose arm is supported by the device, by exerting compressive (push) and/or tensile (pull) forces on the at least one supporting element or by moving same. These compressive and/or tensile forces or motions can be simply exerted by the arm resting on the at least one supporting element even without moving the operating hand so that the surgeon or surgical assistant has not to interrupt the current manipulations within the surgical procedure in order to adjust the height of his or her arm. Thus, the device according to the invention renders it possible to intuitively adjust the height of his or her arm in order to find the most convenient position thereof. The adjustment of the at least one supporting element can be done very quickly and very easily without the need of specific tools or aid of other persons.

In a preferred refinement, the force load switch is designed such that the at least one supporting element remains in a tight position when the force load switch detects a force exerted by the at least one supporting element in an unloaded condition thereof or a compressive force exceeding the force in the unloaded condition.

While it would be possible within the scope of the invention to design the force load switch such that the supporting element is lowered or raised when a firm compressive force is exerted on the at least one supporting element, the present refinement has the advantage that the device is more reliable, because an unwanted lowering of the at least one supporting element is avoided when the user of the device heavily leans with his or her arm on the at least one supporting element. Also, in an unloaded condition of the at least one supporting element, i.e. when the force load switch detects substantially the weight of the at least one supporting element, the control mechanism is inactivated and the at least one supporting element maintains its position.

In a further preferred refinement, the control mechanism is designed such that the at least one supporting element is lowered or raised when the force load switch detects tensile forces.

Again, this measure has the advantage that the control mechanism for lowering or raising the at least one supporting element is only activated when the operating person raises his or her arm at least slightly. In the normal operating position of the operating person with his or her arm resting on the at least one supporting element the control mechanism is inactivated thereby avoiding lowering or raising of the at least one supporting element when it is not desired by the operating person.

In a further preferred refinement the control mechanism is designed such that the at least one supporting element remains in its height position when the force load switch detects a tensile force which is in a range of about 0 to about 5 N, preferably about 0 to about 2 N.

This measure has the advantage that the control mechanism is not too sensitive to the movement of the arm of the user when carrying out the necessary manipulations within, for example, the surgical procedure. This means that even in case that the user raises his or her arm slightly, the control mechanism is not activated and the supporting element remains in its position.

In this connection, it is further preferred if the maximum tensile force which does not activate the control mechanism, is adjustable.

In that way, the sensitivity of the device can be adapted to the specific requirements of the respective person using the device.

In a further preferred refinement, the control mechanism is designed such that the at least one supporting element is lowered, when the force load switch detects a tensile force exceeding a first upper force limit at which the at least one supporting element still remains in its position, and the supporting element is raised, when the force exceeds a second upper force limit at which the supporting element is lowered.

Thus, the at least one supporting element can be lowered by the surgeon or surgical assistant the arm of which rests on the at least one supporting element by raising his or her arm by a small force, wherein it is not necessary to move the hand or hands which can continue to carry out the manipulations in the surgical operation. Lowering of the at least one supporting element is, thus, highly facilitated by just raising the arm supported by the at least one supporting element. The lowering of the at least one supporting element is then stopped by just leaning again the arm on the at least one supporting element, as described before.

Furthermore, raising of the supporting element can also easily be activated by the surgeon or surgical assistant him- or her-self by exerting a larger tensile force on the at least one supporting element. Again, the raising of the at least one supporting element is stopped by just resting the arm on the at least one supporting element.

In a further preferred refinement the control mechanism is designed such that the supporting element is raised only, when the force detected by the force load switch exceeds the second upper force limit by a predetermined amount.

The advantage here is that the forces for lowering the supporting element on the one hand and raising the supporting element on the other hand are sufficiently distinguishable for the user of the device. Thus, an unwanted switching between the lowering of the at least one supporting element and the raising of the at least one supporting element is avoided.

In a further preferred refinement the control mechanism is designed such that the at least one supporting element is lowered when the force load switch detects a tensile force which is a range of about 0 to 10 N, preferably about 2 to about 6 N.

In a further preferred refinement the control mechanism is designed such that the at least one supporting element is raised when the force load switch detects a tensile force which is at least about 3 N, preferably at least about 8 N.

In a further preferred refinement, the control mechanism is designed such that the at least one supporting element is raised only when the force load switch detects a tensile force which is at least about 1 N, preferably about 2 N larger than the maximum force responsive to which the force load switch activates lowering of the at least one supporting element.

The aforementioned ranges and values of forces upon detection of which the force load switch activates the lowering, the raising or inactivates same, can easily be summoned up without large efforts by the user and represent advantageous examples of the first and second upper force limits mentioned before.

It is to be understood that the above references to “tensile” forces can also be understood as forces which lower the weight exerted on the force load switch by the at least one supporting element in the unloaded condition thereof. The latter force can be regarded as the zero point of the force, while compressive forces have a negative value and tensile forces a positive value.

While in the afore-going the activating of the lowering or raising of the at least one supporting element has been described by raising the surgeon's or surgical assistance arm by tensile forces in different degrees, it can be also envisaged within the scope of the present invention to activate lowering and raising of the at least one supporting element by exerting the tensile forces in different directions, for example, by exerting a force onto the at least one supporting element in opposite sideward directions.

In a further preferred refinement the carrying structure comprises at least one carrying arm, which is pivotable about a horizontal or substantially horizontal pivot axis in substantially upward and/or downward direction such that pivoting of the carrying arm about the pivot axis raises or lowers the at least one supporting element.

This measure has the advantage that changes of the height position of the at least one supporting element can be adjusted in a suitable manner by changing the angle of the at least one carrying arm carrying the at least one supporting element.

In this connection it is preferred if the at least one carrying arm is pivotable about the horizontal or substantially horizontal axis in a range of about +50° to −50°, preferably +20° to −25°, with respect to the horizontal.

With this range of angles of movement of the at least one carrying arm a sufficient large range of continuous height positions of the at least one supporting element can be adjusted. By limiting the movement of the at least one carrying arm in downward direction it is advantageously prevented that the at least one carrying arm comes into contact with the patient, also in a fault condition of the device.

In a further preferred refinement the at least one carrying arm is pivotable about a vertical or substantially vertical pivot axis, the arm being preferably pivotable by 360° about this axis.

This measure has the advantage that not merely the height position of the at least one supporting element can be adjusted, but the at least one supporting element can also be moved in other spatial directions so that the surgeon's or surgical assistant's arm can be moved in positions most convenient for the specific manipulation to be carried out in the surgical operation, while permanently supported by the at least one supporting element.

If the afore-mentioned pivot axis is inclined with respect to the vertical and oriented in a proper direction, the supporting element can move on a curved path with respect to the horizontal when pivoted about the axis, and is in its lowest position near to the surgical site.

In a further preferred refinement the control mechanism further comprises a stop cooperating with the at least one carrying arm for controlling the pivotement of the carrying arm, the stop being arranged under the carrying arm for supporting same and being movable in vertical or substantially vertical direction.

At least in case that the carrying arm is also pivotable about a vertical or substantially vertical axis, the stop is arranged such that it moves with the carrying arm.

By means of the stop a constructional simple mechanism for lowering and raising the at least one carrying arm and, thereby, the at least one supporting element is provided. The further advantage is that the stop, arranged under the carrying arm, prevents dropping of the carrying arm onto the patient in a fault condition of the device.

In this context, it is preferred if the stop is driven by an electrical motor which is activated by the force load switch.

By this measure, the control mechanism can be constituted by a low number of parts, namely the force load switch, the adjustable stop and the electrical motor resulting in a low cost arm rest device.

In a further preferred refinement the power of the motor is small such that it is not sufficient to overcome the frictional forces of the carrying structure to lower the stop, except a tensile force is exerted on the at least one supporting element.

This measure has the advantage that the motor can never lower the at least one supporting element in a fault condition, for example in case that the force load switch triggers the motor to lower the stop although the at least one supporting element is in an unloaded condition or even in a loaded condition.

In a further preferred refinement a signalling device is provided generating an audible and/or visible signal when the at least one supporting element is being lowered or raised.

The advantage of this measure is that the user of the device can immediately recognize a movement of the at least one supporting element in upward or downward direction. Thus, when the user of the device wishes to lower or raise the at least one supporting element and activates the lowering or raising by, for example, exerting respective tensile forces onto the at least one force load switch as described before, he or she can immediately verify by the audible or visible signal as to whether his or her command has triggered the desired motion of the at least one supporting element.

In this context, it is preferred if the signalling device generates different signals for upward and downward motion of the at least one supporting element.

By this measure, the feedback of the movement of the control mechanism to the user is improved, because it is rendered possible to distinguish between the upward and downward motion due to the different signals for both motions.

In a further preferred refinement the at least one supporting element has a portion for supporting the arm and at least one portion for the arm to exert tensile forces on the supporting element.

This measure has the advantage that, on the one hand, the surgeon's or surgical assistant's arm can rest securely on the at least one supporting element, and, on the other hand, this configuration of the at least one supporting element allows the user of the device to command the lowering and raising of the at least one supporting element as described above, namely by simply exerting tensile forces onto the force load switch via the at least one supporting element without the need of using the hand of the other arm, and without moving the hand of the arm supported by the at least one supporting element.

In a further preferred refinement the at least one supporting element has a lateral opening for withdrawing the arm from the supporting element.

This measure has the advantage that the surgeon has to simply slide the arm out sideways from the at least one supporting element for removing his arm from the device.

In a further preferred refinement the at least one supporting element is attached at the carrying structure in a manner pivotable about a horizontal or substantially horizontal pivot axis and/or about a vertical or substantially vertical pivot axis.

By this measure, the number of the degrees of freedom of movement of the at least one supporting element is further enhanced so that the user can move his or her arm in the most convenient position with respect to the operating side, while the arm is permanently supported from underneath.

In this context, it is preferred if the at least one supporting element is pivotable about the horizontal axis by an angle in a range of +90° to −90° with respect to the vertical and/or about the vertical axis by 360°.

With these ranges of possible motions of the at least one supporting element, an optimal adjustability of the at least one supporting element is provided.

In a further preferred refinement the carrying structure comprises a mounting portion adapted for attaching the structure at the side rail of an operating table.

In this configuration, the device according to the invention can be advantageously attached at a side of an operating table. The device can thus support the user's arm or arms from the same or the opposite side of the operating table. The mounting portion can comprise a clamp, and the mounting portion can be configured such that the device can be quickly removed from the operating table by lifting it out of the clamp.

In a further preferred refinement the device comprises two supporting elements for independently supporting both arms of a surgeon during a surgical operation.

By this measure, the advantage is achieved that both arms of a surgeon or surgical assistant can be supported during a surgical operation, thereby further reducing fatigue and enhancing the precision of the manipulations carried out by the operating person.

Further features and advantages will be apparent from the following description and the accompanying drawings.

It is to be understood that the features mentioned before and those features yet to be explained hereinafter are not only applicable in the given combination, but also in other combinations or in isolation without departing the scope of the present invention.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

FIG. 1shows a device labelled in its entirety with reference numeral10for supporting at least one arm of an operating person (not shown) during a surgical or medical operation.

The device10can be used for all surgical disciplines.

The device10comprises at least one supporting element12for supporting the at least one arm of, for example, the surgeon or surgical assistant.

The supporting element12is arranged at a carrying structure14for carrying the at least one supporting element12.

The carrying structure14comprises a first carrying arm extending vertically or substantially vertically, a second carrying arm18extending horizontally or substantially horizontally, and a third carrying arm20extending horizontally or substantially horizontally.

The carrying structure14further comprises a mounting portion22comprising a clamp24receiving the first carrying arm16. The clamp24can be attached to a rail26of an operating table28. The first carrying arm16can be lifted out of the clamp24for removing the device10from the table28.

A height h of the second carrying arm18can be adjusted by vertically moving the first carrying arm16within the clamp24. The height h of the second carrying arm18from the top of the rail26can be adjusted in a range from 100 to 600 mm, preferably from 120 to 570 mm.

The first carrying arm16is connected with the second carrying arm18via a first joint30. The second carrying arm18can be pivoted about a first vertical or substantially vertical axis32by an angle of from 0° to 360°. A length l1of the second carrying arm18is in the range of 120 mm to 250 mm, and is preferably about 180 mm.

The third carrying arm20is connected with the second carrying arm18by a second joint34. The second joint34allows the third carrying arm20to pivot about a second vertical or substantially vertical pivot axis36in a range of 0° to 360°, preferably. A length l2of the third carrying arm20is in the range of about 150 mm to 350 mm, preferably 250 mm.

The supporting element12is arranged at the outermost end of the third carrying arm20and extends substantially upright from the latter. Further, the supporting element12is mounted on a third joint38allowing the supporting element12to pivot about a first horizontal or substantially horizontal axis40in a range from about −90° to +90° with respect to the vertical. In addition, the supporting element12is connected with the third carrying arm20via a fourth joint42allowing the supporting element12to be pivoted about a third vertical or substantially vertical pivot axis44in a range from 0° to 360°.

The supporting element12is configured in form of a cup such that it surrounds the arm of the operating person when inserted into the cup by at least 180°, preferably 270° as shown in FIG.1. In other words, the supporting element12has at least one lower portion48on which the arm, in most cases the forearm of the operating person can rest, and an upper portion50which is arranged above or on the upper side of the arm of the operating person when inserted in the cup. In addition the supporting element12has a lateral opening51for withdrawing the surgeon's arm.

Further, the carrying structure14is configured such that the at least one supporting element12can be lowered or raised for preferably continuously adjusting the height of the arm of the operating person as will be described hereinafter in more detail. It is to be understood that the afore-mentioned adjustment of the height of the supporting element12is provided in addition to the height adjustability of the first carrying arm16which has been already described above.

The adjustment of the supporting element12to be described hereinafter is, rather than the adjustability of the first carrying arm16, a self-adapting adjustability, which is actuated by a control mechanism which will be described below.

The carrying structure14is configured such that at least the third carrying arm20is also pivotable about a second horizontal or substantially horizontal pivot axis52. The range of pivotment of the third carrying arm20about the axis52is from about +30° to −30° from the horizontal, preferably from about +20° to about −25°.

With reference toFIG. 2, the control mechanism comprises a stop54arranged under the third carrying arm20in a distance from the pivot axis52and movable together with the third carrying arm20when the latter is pivoted about the axis36. The stop54cooperates with the third carrying arm20by supporting same from the underside thereof. The stop54is configured as a threaded rod56which passes through a stationary threaded bore58. By rotating the threaded rod56about its longitudinal axis in the one or the other direction, the stop54moves upward or downward in vertical direction and, thereby, raises or lowers the third carrying arm20and, thus, the supporting element12.

The stop54is immovable with respect to the third carrying arm except the upward and downward motion for pivoting the carrying arm20as described before.

The stop54is driven by an electrical motor60. The electrical motor60is bi-directional in order to rotate the stop54in the one or the other direction, and is operatively connected with the stop54via a gear arrangement62, for example.

The control mechanism further includes a force load switch64, which is configured as a load cell, which is operatively connected with the supporting element12and activates the lowering or raising of the supporting element12upon detecting compressive and/or tensile forces acting via the supporting element12on the force load switch64.

The force load switch64is connected with the electrical motor60via a control circuit, which is simply illustrated inFIG. 2as a line66.

In dependence on tensile and/or compressive forces, the force load switch64activates the motor60to rotate the stop54in the one direction for raising the supporting element12, or in the opposite direction for lowering the supporting element12, or the force load switch64stops the electrical motor60so that the supporting element12remains in the adjusted position, as will be described hereinafter in more detail with reference to FIG.3.

FIG. 3shows a diagram where the force F acting on the force load switch64is drawn as a vector, and, therefore can have positive values and negative values. The zero point (0 N) has been chosen in this representation as the force which is detected by the force load switch64in an unloaded condition of the supporting element12. This is the condition when the supporting element12acts with its own weight together with the structural parts of the carrying structure14between the force load switch64and the supporting element12on the force load switch64. In this condition, i.e. when the force load switch64detects a force of 0 N, the force load switch64does not activate the motor60or gives a signal to the electrical motor60to stand still.

The supporting element12also remains in its height position when the force load switch64detects a compressive force exceeding the force in the unloaded condition of the supporting element12. This is the case when the surgeon has inserted his or her arm into the supporting element12and leans on the lower portion48thereof. Such compressive forces correspond to a negative value of the force F. In each case, when the force F has a negative value the supporting element12remains in its height position. Nevertheless, the supporting element12can be moved about the horizontal axis40and about the vertical axis44in this situation, and also the movements of the carrying arms20and18about the axis36and32are free in this situation while the surgeon's arm securely rests on the supporting element12.

A connecting arm66between the supporting element12and the joint38is as short as possible in order to not diminish the sensation of the surgeon's arm and not to affect the preciseness of the surgical operation.

There is another interval A of forces F from about 0 to about 5 N, in the present embodiment from about 0 to about 2 N of tensile forces which will also not cause the force load switch64, when detected by it to activate the motor60to lower or to raise the stop54. Thus, range A is a buffer range of forces, the upper limit of which is preferably adjustable to the requirements of the user of the device10and which prevents undesired activating of the motor60for lowering or raising the supporting element12. In other words, interval A prevents the device10being too sensitive to the movements of the surgeon's arm which normally occur in a surgical procedure, for example when operating a medical instrument.

Following to range A there is a range L of tensile forces which, when detected by the force load switch64cause the latter to activate the motor60, namely to rotate the stop54in a direction which lowers the stop54and, therefore, the third carrying arm20and, thereby, the supporting element12.

In the present embodiment, the range L begins at about 2 N and ends at about 6 N, but the lower limit of the range L can also be 0 N and 10 N; the upper limit can be about the limits can preferably be adjustable according to the surgeon's needs.

Another range R of tensile forces F which exceed at least about 3 N, in the present embodiment at least about 8 N cause the force load switch64when detected by same to trigger the electrical motor60to rotate the stop64in the opposite direction in order to raise the stop54, thus the third carrying arm20and, thereby, the supporting element12.

The tensile forces mentioned before can simply be exerted by the surgeon's arm inserted in the supporting element12by raising the surgeon's arm in the supporting element12and thereby coming into contact with the upper portion50of the supporting element12, thereby exerting the activation force onto the force load switch64. Thus, in order to lower the supporting element12, the surgeon raises his or her arm with a small force, and in order to raise the supporting element12, he or she raises the arm with a larger force. In any case, the surgeon can keep the hand of the same arm supported by the supporting element still so that there is no interference between adjusting the height position of the supporting element and the surgical procedure actually carried out.

In order to increase the operational safety of the device, there is provided another range S2of forces, namely tensile forces which, when detected by the force load switch64, do not cause same to activate the electrical motor60, but to stop the motor60or to inactivate the motor60thereby maintaining the actual height position of the supporting element12. This range S2of forces is an interval of at least 1 N, preferably at least about 2 N above the maximum force responsive to which the force load switch64would activate lowering of the supporting element12, i.e. preferably about 2 N larger than the upper limit of the range L of forces.

The power of the electrical motor60is chosen such that friction in the device10can only be overcome when the operating person takes some of the weight of the carrying structure14by raising his or her arm in the supporting element12.

Further, the power of the motor is preferably such that the supporting element12goes from fully lowered to fully raised in approximately ten seconds.

The device10further comprises a signalling device (not shown) for generating an audible and/or visible signal when the at least one supporting element12is being lowered or raised. The signalling device generates different signals for upward and downward motion of the at least one supporting element12.