Abstract:
The present disclosure concerns embodiments of an operating support that supports a surgeon in a sitting position straddling a patient. By straddling the patient, the surgeon is ideally positioned to perform certain types of laparoscopic surgery, such as pelvic surgery, which requires the use of relatively long surgical instruments. The operating support supports the surgeon in a more ergonomically correct position that reduces the stress and strain on the surgeon&#39;s body as compared to the conventional technique of performing laparoscopic surgery in a standing position at one side of the operating table.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application is a continuation of U.S. patent application Ser. No. 12/194,388, filed Aug. 19, 2008, which claims the benefit of U.S. Provisional Application No. 60/965,791, filed Aug. 21, 2007, both of which are incorporated herein by reference. 
     
    
     FIELD 
       [0002]    The present disclosure concerns embodiments of an operating support for a surgeon performing a medical procedure (e.g., surgery) on a patient. 
       BACKGROUND 
       [0003]    During laparoscopic surgery, the surgeon typically stands to one side of the operating table while manipulating relatively long instruments and while viewing the procedure on a video monitor. Unfortunately, the surgeon has little opportunity to move the body and change posture, which often leads to fatigue and pain. Thus, there is a strong need for an apparatus to support the surgeon during such procedures in a manner that reduces the stress and strain on the surgeon&#39;s body. 
       SUMMARY 
       [0004]    The present disclosure concerns embodiments of an operating support that supports a surgeon in a sitting position straddling a patient. By straddling the patient, the surgeon is ideally positioned to perform certain types of laparoscopic surgery, such as pelvic surgery, which requires the use of relatively long surgical instruments. The operating support places the surgeon in a more ergonomically correct position that reduces the stress and strain on the surgeon&#39;s body as compared to the conventional technique of performing laparoscopic surgery in a standing position at one side of the operating table. The position of the surgeon relative to the patient also provides other doctors or nurses access to the patient during the procedure, for example if the anesthesiologist must attend to the patient. 
         [0005]    The operating support in disclosed embodiments includes a frame structure that supports a seat such that an end portion of an operating table can be positioned directly underneath the seat to allow the surgeon to straddle a patient positioned on (e.g., lying down) the operating table. The seat can be vertically adjustable relative to the frame structure to allow the seat to be positioned at a desired height relative to the patient. The operating support also can include foot supports for supporting the surgeon&#39;s feet, a chest support for supporting the surgeon&#39;s chest, and arm supports for supporting the surgeon&#39;s arms. The foot supports, the chest support, and the arm supports also can be vertically adjustable to suit the individual needs of the surgeon. 
         [0006]    The frame structure desirably has light-weight construction so that the operating support can be easily positioned for use and transported between operating theaters. In certain embodiments, the frame structure can be constructed from tubular frame members and desirably is made from a light-weight material such as steel, aluminum or any of various other suitable metals, alloys, polymers, or composite materials. This provides a light-weight construction allowing for easy positioning and transporting of the operating support. If it becomes necessary during surgery to provide additional access to the patient, for example if the anesthesiologist requires additional access to the patient, the surgeon can quickly dismount the operating support. The operating support then can be easily moved away from the patient to provide other doctors or nurses additional access the patient. 
         [0007]    In one representative embodiment, an operating support for a surgeon performing a medical procedure on a patient positioned on an operating table comprises a seat adapted to support the buttocks of the surgeon and a frame structure supporting the seat. The frame structure is configured to be positioned relative to the operating table such that the seat is positioned over the operating table and the surgeon, while sitting in the seat, can straddle the patient. 
         [0008]    In another representative embodiment, an operating support for a surgeon performing a medical procedure on a patient positioned on an operating table comprises a frame structure comprising first and second laterally spaced, vertically extending support members, and a seat supported between the first and second support members. The support members are spaced from each other such that an end portion of the operating table can be positioned between the support members and beneath the seat to allow the surgeon to straddle the patient at a position above and over the patient. 
         [0009]    In another representative embodiment, a surgical system comprises an operating table for supporting a patient, and a support apparatus for a surgeon performing a medical procedure on the patient. The support apparatus comprises a seat adapted to support the buttocks of the surgeon, and means for supporting the seat at a position over and above an end portion of the operating table such that the surgeon, while sitting in the seat, can straddle the patient. 
         [0010]    In another representative embodiment, a method of performing a medical procedure on a patient positioned on an operating table is provided. The method comprises sitting on an operating support at a position above and over the patient while straddling the patient, and performing a surgical procedure on the patient. 
         [0011]    The foregoing and other features and advantages of the invention will become more apparent from the following detailed description, which proceeds with reference to the accompanying figures. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0012]      FIG. 1  is a side view of an operating support for a surgeon, according to one embodiment. 
           [0013]      FIG. 2  is a front view of the operating support shown in  FIG. 1 . 
           [0014]      FIG. 3  is a perspective view of the operating support shown in  FIG. 1 . 
           [0015]      FIG. 4  is a top plan view of the operating support shown in  FIG. 1 . 
           [0016]      FIGS. 5 and 6  are side views showing how the seat can be removed from the operating support. 
           [0017]      FIG. 7  is a perspective view of the arm support assembly of the operating support shown partially in section. 
           [0018]      FIG. 8  is an elevation view of the lower end portion of one of the arm supports and one end portion of the shaft of the arm support assembly. 
           [0019]      FIG. 9  is a perspective view of the lower end portion of one of the arm supports and one end of the bracket assembly that supports the arm support assembly on the operating support. 
           [0020]      FIG. 10  is a perspective view of the bracket assembly for the arm support assembly. 
           [0021]      FIG. 11  is a perspective view of the lower end portion of one of the arm supports and one end portion of the shaft of the arm support assembly shown with the bearing housing removed for purposes of illustration. 
           [0022]      FIG. 12  is an enlarged side view showing one of the brackets of the bracket assembly mounted on horizontal rungs of the operating support. 
           [0023]      FIG. 13  is a side view of the operating support of  FIG. 1  being used to support a surgeon in a position straddling a patient lying on an operating table. 
           [0024]      FIG. 14  is a perspective view of the operating support and operating table shown in  FIG. 13 . 
       
    
    
     DETAILED DESCRIPTION 
       [0025]    As used herein, the singular forms “a,” “an,” and “the” refer to one or more than one, unless the context clearly dictates otherwise. 
         [0026]    As used herein, the term “includes” means “comprises.” For example, a device that includes or comprises A and B contains A and B but may optionally contain C or other components other than A and B. A device that includes or comprises A or B may contain A or B or A and B, and optionally one or more other components such as C. 
         [0027]    Referring first to  FIGS. 1-4 , there is shown one embodiment of an operating support, or saddle, indicated generally at  10 , that supports a surgeon in an ergonomically correct position for performing certain types of medical procedures, and in particular surgical procedures. The operating support  10  can be used while performing surgery on a patient positioned on (e.g., lying down) an operating table (e.g., the operating table  12  shown in  FIGS. 13 and 14 ) or on a patient chair that can recline (e.g., a dentist chair) to position the patient in a lying-down or near lying-down position. The operating support  10  can be used to support the surgeon in a seated position straddling the patient to reduce stress and strain on the surgeon&#39;s body while performing certain types of surgery, especially laparoscopic surgery (e.g., pelvic surgery). The support can used for performing various other types of procedures, including, without limitation, interventional radiology procedures, maxillo-facial surgery, abdominal surgery, cardiac surgery, thoracic surgery, dental procedures, neurosurgical procedures, and orthopedics, to name a few. 
         [0028]    The operating support  10  in the illustrated embodiment includes a seat  14  adapted to support the buttocks of the surgeon and a frame structure  16  that supports the seat  14 . The frame structure  16  is configured to be positioned relative to the operating table  12  such that the seat  14  can be positioned above and over an end portion of the table  12  as illustrated in  FIGS. 13 and 14 . 
         [0029]    As best shown in  FIGS. 1-4 , the frame structure  16  in particular embodiments includes first and second main support members  18   a,    18   b,  respectively, positioned on opposite sides of the seat  14 . The support members  18   a,    18   b  can be connected to each other by a cross member  20  at the top of the frame structure and can extend downwardly and forwardly from the cross member  20 . As best shown in  FIG. 4 , the support members  18   a,    18   b  also can extend laterally outwardly away from the seat moving in a direction toward the floor to provide a larger footprint at the base of the frame structure for better stability. The support members  18   a,    18   b  are laterally spaced from each other on opposite sides of the seat a distance sufficient to allow an end portion of the operating table  12  to be positioned between the support members and underneath the seat  14 . This allows the surgeon to be supported in a seated position straddling the patient, as depicted in  FIGS. 13 and 14 . 
         [0030]    As shown in  FIG. 3 , the frame structure  16  additionally can include rear support members  22   a,    22   b  having upper ends connected to the support members  18   a,    18   b  and lower ends supported on the floor. The lower ends of the rear support members  22   a ,  22   b  can be connected to each other by a lower cross member  50 . One or more cross members  24  can extend between the main support member  18   a  and the rear support member  22   a  and between the main support member  18   b  and the rear support member  22   b.    
         [0031]    The lower ends of the support members  18   a,    18   b  can have support pads  52   a ,  52   b,  respectively, contacting the floor ( FIG. 2 ). The support pads  52   a,    52   b  can be made of a low-friction material, for example a low-friction polymer such as high density polyethylene or Deiron®, so that the support  10  can be easily moved in the operating theater. In alternative embodiments, the lower ends of the support members  18   a,    18   b  and/or the lower ends of the rear support members  22   a,    22   b  can include wheels to facilitate positioning and transporting the support  10 . Such wheels can be provided with locks to prevent the wheels from the moving during surgery. 
         [0032]    As best shown in  FIGS. 2 and 3 , the frame structure  16  in particular embodiments can also include a support frame assembly  26  (also referred to herein as a seat support member), which can have an upper end connected to the cross member  20  and a lower end connected to a cross member  28  extending between and connected to the rear support members  22   a,    22   b.  The support frame assembly  26  in the illustrated embodiment includes elongated vertical posts  30  extending vertically between cross members  20  and  28  and a plurality of vertically spaced, horizontally disposed rungs, or bars,  32  extending between and connected to the vertical posts  30 . 
         [0033]    The seat  14  can include a seat cushion  34  and a seat frame  36  supporting the seat cushion. The seat frame  36  desirably is vertically adjustable to adjust the height of the seat along the support frame assembly  26 . For example, the seat frame  36  can include a rear portion  38  ( FIG. 1 ) that is configured to be removably mounted to the rungs  32 . The seat can be easily adjusted to a desired height by removing the seat frame  36  from support frame assembly  26  and placing the seat frame  36  on rungs  32  at a desired height. 
         [0034]      FIG. 5  is an enlarged view of the rear end portion  38  of the seat frame  36 , according to one embodiment. The rear end portion  38  can be formed from two laterally spaced side plates  104 , each of which is positioned adjacent a respective post  30  of the support frame assembly  26 . As shown, each side plate  104  can be formed with an upwardly curved protrusion, or hook portion,  106  that extends between two adjacent rungs  32 . Each side plate  104  can also be formed with another protrusion  108  that extends between two adjacent rungs  32  below protrusion  106 . By virtue of the engagement of the protrusions  106 ,  108  with the rungs  32 , the seat  14  is retained in a horizontal position against the weight of the user. 
         [0035]    As shown in  FIG. 6 , the seat  14  can be removed from the support frame assembly  26  by lifting the front end of the seat upwardly until the lower protrusion  108  clears the corresponding rungs  32 , and then sliding the seat downwardly to remove the upper protrusion  106  from the corresponding rungs  32 . Other techniques or mechanisms can be used to permit the seat  14  to be vertically adjustable. For example, the seat can be mounted on a vertical screw mechanism that is operable to adjust the height of the seat. 
         [0036]    Referring again to  FIG. 1 , the operating support  10  can include a chest support  54  adapted to support the chest of the surgeon during use. The chest support desirably is adjustable in the forward and rearward directions (as indicated by double-headed arrow  56  in  FIG. 1 ) as well as upwardly and downwardly (as indicated by double-headed arrow  58  in  FIG. 1 ) to satisfy the individual needs and preferences of the surgeon. In the illustrated embodiment, for example, the chest support  54  includes a chest support pad  60  that is supported on and adjustable relative to a chest-support frame  62 . The frame  62  in the illustrated form includes a horizontal lower portion  64  extending from and connected to the seat frame  36  and a vertical upper portion  66  extending upwardly from the forward end of the lower portion  64 . The lower portion  64  and the upper portion  66  can be formed from two parallel, elongate frame members  68 , as best shown in  FIG. 2 . The chest pad  60  can be adjustably mounted to the frame  62  by an adjustment knob  70  that has a threaded shaft that extends through the frame members  68  and into a threaded opening in the chest pad. The chest pad  60  can be adjusted to a desired height along the frame members  68  by loosening the knob  70 , sliding the chest pad  60  to the desired height, and then tightening the knob  70  to secure the chest pad in place against the frame members  68 . 
         [0037]    The chest support  54  can be similarly adjusted in the fore-aft direction (toward and away from the front of the seat). For example, as shown in  FIG. 2 , the chest-support frame  62  can be secured to the lower surface of the seat frame  36  by an adjustment knob  74  having a threaded shaft  76  that extends through frame members  68  and into a threaded opening in the lower surface of the seat frame  36 . The knob  74  can be loosened to permit fore-aft adjustment of the chest-support frame  62  relative to the seat frame. Tightening the knob  74  secures the chest-support frame  62  to the seat frame at the desired fore-aft position. 
         [0038]    Furthermore, in certain embodiments, the angle of the chest support  54  relative to a vertical plane can be adjusted to allow the user to lean closer to or farther away from the patient. For example, the upwardly extending frame portion that supports the chest support (e.g., upper portion  66 ) can be pivotably mounted at its lower end portion to permit pivoting of the frame portion and the chest support  54  relative to a vertical plane. Any suitable techniques or mechanisms can be used to permit pivoting of the frame portion to a desired angle relative to the vertical plane and to lock the frame portion at the desired position. In one implementation, a push button, lever, or similar control mechanism can be used such that activation of the control mechanism is effective to allow pivoting of the chest support to a desired position and release of the control mechanism retains the chest support at the desired position, similar to the controls used to adjust the position of a seat in an automobile. 
         [0039]    The operating support  10  can include first and second foot supports  76   a,    76   b  adapted to the support the right and left feet, respectively, of the surgeon. The foot supports  76   a,    76   b  desirably are vertically adjustable to satisfy the particular needs of the user. For example, in the illustrated embodiment, the foot supports  76   a,    76   b  are mountable to and adjustable along the length of the support members  18   a,    18   b.  As best shown in  FIG. 1 , each foot support  76   a,    76   b  can include a horizontally disposed foot pad  78 , a bracket  80  and an extension arm  82  extending between and connecting the foot pad to the bracket. To permit vertical adjustment of the foot supports, each bracket  80  can be formed with a plurality of pins or prongs (not shown) that can be inserted into apertures  86  formed along the length of the respective support member  18   a,    18   b.  Other techniques or mechanisms also can be used to mount foot supports  76   a,    76   b  to the support members  18   a,    18   b.  For example, the brackets  80  can be secured to support members  18   a,    18   b  with bolts, screws, or other types of fasteners. 
         [0040]    The operating support can further include an arm support assembly  42  coupled to and supported by the frame structure  16 . The arm support assembly  42  can include first and second arm supports  88   a,    88   b  for supporting the arms of the surgeon. Each arm support  88   a,    88   b  can include an arm rest  90  mounted on the forward end of a support arm  92 . As best shown in  FIG. 2 , the support arm  92  of each support  88   a,    88   b  extends downwardly from the respective arm rest  90  and rearwardly toward the seat support member  26 . The lower end portion of each support arm  92  can be connected to a respective pivot mechanism  94 . The pivot mechanisms  94  are connected to opposite ends of a shaft  96  ( FIG. 7 ), which in turn can be removably mounted to the support frame assembly  26 . 
         [0041]    Each pivot mechanism  94  can be configured to permit pivoting movement of the respective arm support  88   a,    88   b  about two separate pivot axes. For example, in the illustrated embodiment, each pivot mechanism  94  allows for pivoting movement of the respective arm support about a vertical pivot axis and a horizontal pivot axis. This allows each arm support to be pivoted upwardly and downwardly about a horizontal pivot axis between a lowered position (shown in solid lines in  FIG. 1 ) adjacent the surgeon and a raised position away from surgeon (shown in dashed lines in  FIG. 1 ), in the directions indicated by double-headed arrow  98  in  FIG. 1 . Each arm support also can be pivoted about a respective vertical axis between a forward position (shown in solid lines in  FIG. 4 ) adjacent the surgeon and a rearward position (shown in dashed lines in  FIG. 4 ) away from surgeon, independent of pivoting movement about its horizontal axis, as indicated by double-headed arrow  100 . 
         [0042]    As best shown in  FIG. 7 , each pivot mechanism  94  in the illustrated embodiment comprises a bearing housing  110  that receives the lower end portion of a respective support arm  92 . The pivot mechanism  94  can include an upper bearing  112  and a lower bearing  114  retained between the housing  110  and the lower portion of the support arm  92 . The housing  110  and the bearings  112 ,  114  can be retained on the lower end portion of the support arm  92  by a tapered lock nut assembly. 
         [0043]    The lock nut assembly in the illustrated embodiment comprises a cap portion  116  having an enlarged head portion  118  and an extension portion  120  that extends into the lower portion of the support arm  92 . A screw  122  extends through a threaded opening in the cap portion  116  and a corresponding threaded opening in a tapered nut  124 . The nut  124  has an angled lower surface that bears against an angled upper surface of the extension portion  120 . When the screw  122  is tightened, the nut  124  rotates relative to the cap portion  116 . By virtue of the angled surfaces of the nut  124  and the extension portion  120 , the nut  124  is urged against the inner surface of the support arm  92 , securing the lock nut assembly at the lower end of the support arm  92 . The lock nut assembly retains the bearings and the bearing housing in place between the head portion  118  and a flange member  126  of the support arm  92  while allowing pivoting movement of the support arm  92  relative to the bearing housing about a vertical pivot axis V ( FIG. 8 ). 
         [0044]    As best shown in  FIG. 11 , the lower end portion of the support arm  92  can be formed with an elongated opening  128  that receives the adjacent end portion  130  of the shaft  96 . The arc length of the opening  130  defines the angle through which the support arm  92  can pivot about its vertical axis V. The shaft end portion  130  serves as a stop that limits pivoting movement of the support arm  92  about its vertical pivot axis. Thus, as the support arm is pivoted about its vertical axis, the shaft end portion  130  can contact the opposing sides of the opening  130  to limit pivoting of the support arm  92  between the forward and rear positions shown in  FIG. 1 . 
         [0045]    Referring again to  FIG. 7 , the bearing housing  110  in the illustrated configuration can include a horizontally extending, shaft-receiving portion  132  that houses an adjacent portion of the shaft  96 . As best shown in  FIG. 9 , the shaft  96  can be fixedly secured to the bearing housing  110  by a screw  134  that extends through the shaft-receiving portion  132  and is tightened into a threaded opening in the shaft  96 . In this manner, both support arms  92  pivot together about the horizontal axis defined by the shaft  96 . In alternative embodiments, the support arms  92  can be configured to pivot independently of each other about the horizontal pivot axis. 
         [0046]    As best shown in  FIGS. 7 and 10 , a bracket assembly  136  can be mounted on the shaft  96  between the pivot mechanisms  94 . The bracket assembly  136  in the illustrated configuration is configured to allow the arm support assembly  42  to be removed from and placed on any of the rungs  32  ( FIG. 3 ) to adjust the vertical position of the assembly  42 . 
         [0047]    The bracket assembly  136  in certain embodiments includes first and second spaced-apart brackets  138  secured to the ends of an elongated tubular cross member  140  that houses a central portion of the shaft  96 . A bearing  142  can be disposed on the shaft  96  adjacent each bracket  138 . As best shown in  FIG. 12 , each bracket  138  can be formed with curved hook portions  144  and  146  configured to be placed around horizontal rungs  32  for supporting the arm support assembly  42  on the frame structure  16 . To remove or adjust the height of the arm support assembly  42 , the assembly  42  is lifted up until the hook portions clear the rungs, and then moved rearwardly away from the rungs. The arm support assembly  42  can be supported on any two rungs to suit the needs of the user. 
         [0048]    Upward and downward pivoting movement of the support arms  92  can be limited by a stop member  148  extending from each housing portion  132  into a curved opening or slot  150  formed in the adjacent bracket  138  ( FIGS. 8 and 9 ). In use, the support arms  92  and the bearing housings  110  can be pivoted upwardly and downwardly about the horizontal pivot axis, with such motion being limited by the arc length of the slot  150 . In alternative embodiments, only one stop member  148  and corresponding slot  150  can be provided since the support arms  92  in the illustrated embodiment are interconnected by shaft  96  to pivot together about the horizontal pivot axis. 
         [0049]    In alternative embodiments, the arm supports  88   a,    88   b  can be mounted for pivotal movement about respective vertical axes V but are prevented from pivoting upwardly and downwardly about a horizontal axis. In still other embodiments, the arm supports  88   a,    88   b  can pivot about a horizontal axis but are prevented from pivoting about respective vertical axes. 
         [0050]    The frame structure desirably has light-weight construction so that the operating support can be easily positioned for use and transported between operating theaters. As shown in the illustrated embodiment, the frame structure  16  can be constructed from tubular frame members desirably made from a light-weight material such as steel, aluminum or any of various suitable alloys. This provides a light-weight construction allowing for easy positioning and transporting of the operating support. In alternative embodiments, the frame structure can have a different construction that does not utilize tubular frame members. 
         [0051]      FIGS. 13 and 14  illustrate the use of the operating support  10  for performing laparoscopic surgery, and in particular laparoscopic pelvic surgery, on a patient positioned on an operating table  12 . As shown, the operating support  10  is positioned such that the front end portion of the operating table  12  extends beneath the seat  14 . This allows the surgeon to sit at a position straddling the upper body of the patient. In this position, the surgeon can more easily manipulate the relatively long instruments used in laparoscopic surgery with less stress and strain on the surgeon&#39;s body. The position of the surgeon relative to the patient also provides other doctors or nurses access to the patient during the procedure, for example if the anesthesiologist must attend to the patient. If it becomes necessary during surgery to provide additional access to the upper body of the patient, for example if the anesthesiologist requires additional access to the patient, the surgeon can quickly move one of the arm supports  88   a,    88   b  to its rearward and/or raised position to permit the surgeon to dismount the operating support. The operating support then can be easily moved away from the patient to provide other doctors or nurses additional access the patient. 
         [0052]    In use, portions of the operating support  10  and/or the surgeon can be covered with a disposable, sterile drape to reduce the risk of contamination. For example, as shown in  FIG. 2 , separate drapes  160  can be provided to cover the arm supports  88   a ,  88   b  or portions thereof and a drape  162  can be provided to cover the chest support  54  or portions thereof. As shown in  FIG. 13 , another drape  164  can be provided to cover the patient and the legs of the surgeon. The drape  164  in the illustrated example has an opening and two side portions that extend around the waist of the surgeon and are tied off or otherwise connected to each other at the back of the surgeon, as indicated at  166 . The size and shape of the drape  164  can be altered to suit the particular procedure being performed. Although not shown in  FIG. 13 , in a specific implementation, the drapes  160 ,  162  are used together with the drape  164 . Following the medical procedure, the used drapes can be disposed of and replaced with new drapes. 
         [0053]    The drapes can be made from any of various materials that are used for making commercially available surgical drapes, such as fabrics, polymeric materials, paper, or combinations thereof. 
         [0054]    In view of the many possible embodiments to which the principles of the disclosed invention may be applied, it should be recognized that the illustrated embodiments are only preferred examples of the invention and should not be taken as limiting the scope of the invention. Rather, the scope of the invention is defined by the following claims. We therefore claim as our invention all that comes within the scope and spirit of these claims.