Abstract:
A surgical positioning aid includes a n inflatable pillow with a non-inflatable sleeve. The non-inflatable sleeve has two substantially parallel attachment regions secured to a panel of the inflatable pillow and two open end portions to provide access between the non-inflatable sleeve and the inflatable pillow. The space between the non-inflatable sleeve and the inflatable pillow can be telescoped onto a surgical support post in proximity to an operating table. Air then can be directed into the inflatable pillow so that a patient can be supported relative to the post without creating pressure points on the patient.

Description:
[0001]    This application claims priority on U.S. Provisional Application No. 60/900,941 filed on Feb. 12, 2007. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The invention relates to an inflatable positioning aid that can be used in an operating room so that a patient can be positioned conveniently and safely during surgery. 
         [0004]    2. Description of the Related Art 
         [0005]    Positioning aids are used in operating rooms for positioning and supporting a patient during surgery. In this regard, a patient generally is rendered substantially immobile during surgery and is positioned to give the doctor proper access for the surgery. However, the weight of the patient can exert pressure on blood vessels and nerves that can cause serious injuries or other medical complications. Doctors and other medical personnel are generally aware of these problems and often employ rolled up blankets or towels as padding to position a patient in a manner that will shift the weight of the patient to areas of the patient that are well suited to carrying the weight for the duration of the surgery. However, padding compresses under a load and is not adjustable. Hence accurate positioning of a patient is difficult with conventional padding. Additionally, padding is not easily repositioned if the doctor concludes that the patient is not properly oriented for the surgery. Furthermore, padding can create pressure points and can contribute to problems similar to the problems that the padding is intended to avoid. 
         [0006]    U.S. Pat. No. 6,327,724 is assigned to the assignee of the subject application and discloses inflatable positioning aids that overcome many of the problems associated with padding and other non-inflatable positioning aids. The disclosure of U.S. Pat. No. 6,327,324 is incorporated herein by reference. Briefly, the inflatable positioning aids in U.S. Pat. No. 6,327,324 are used by initially placing an inflatable pillow in an uninflated substantially flat condition between the patient and the operating table. The size, shape and position of the inflatable pillow will be selected in accordance with characteristics of the patient and the nature of the surgery. A pump then is employed to direct air into the inflatable pillow. The patient will move in a controlled manner as air is being directed into the inflatable pillow. Thus, the weight of the patient is supported over a broad area by the inflatable pillow. Additionally, the inflatable pillow is positioned so that little or no weight is supported at critical locations, such as at locations near important blood vessels or nerves. 
         [0007]    U.S. Pat. No. 6,327,724 discloses several different configurations for the inflatable positioning aids in accordance with specific needs for different types of surgery. In this regard, FIGS. 1-3 of U.S. Pat. No. 6,327,724 relate to a positioning aid that is particularly well suited for supporting a pregnant woman during certain obstetric procedures, such as a cesarean section. In particular, the inflatable pillow includes top and bottom sheets that are formed from nylon. The sheets are placed at least partly in registration with one another and are secured to one another about the perimeter of at least one of the sheets. The connected sheets thus define a chamber that can receive air. One of the sheets has a fitting that can be connected to an air tube of the inflatable positioning aid. The inflatable pillow further includes a non-inflatable flap that can be disposed under a portion of the patient that can support the weight of the patient without damage or injury. Air then is directed through the air tube and into the inflatable pillow. As a result, the patient will tilt into an orientation that is desirable and effective for the obstetric procedure. The non-inflatable flap prevents the pillow from displacing transversely as the air is being directed into the pillow. The inflatable positioning aid permits the doctor to gradually change the amount of tilt intra-operatively, if necessary, by adding or releasing air. 
         [0008]    A similar inflatable positioning aid is sold by the assignee of the subject invention under the trademark SHOULDER-FLOAT™. The SHOULDER-FLOAT™ inflatable pillow is structurally and functionally similar to the above-described inflatable pillow intended for obstetric purposes. However, the SHOULDER-FLOAT™ inflatable pillow does not require a non-inflatable flap. The absence of the flap reduces cost and size. The SHOULDER-FLOAT™ inflatable pillow is positioned between an operating table and the upper torso of a person who requires shoulder surgery or any other surgery that requires the patient to be in the lateral decubitus position with the weight primarily on one shoulder. Air is directed into the SHOULDER-FLOAT™ inflatable pillow to lift the shoulder and upper torso from the operating table, thereby facilitating any surgery in the lateral decubitus portion and avoiding the above-described pressure related problems. 
         [0009]    The above-described inflatable positioning devices are used to relieve and control pressure points between the patient and the operating table. Some surgery requires the patient to be maintained at a certain position on the plane define by the operating table or to be oriented in a certain manner on the operating table. For example, hip surgery generally requires the patient to be supported on one lateral side so that the hip that is being repaired is in a superior position and accessible to the surgeon. Accordingly, most operating tables are adapted to accommodate stabilizing posts that extend at a specified angle (e.g. vertically) and at specified position on the operating table. Examples of known stabilizing posts are identified by P 1  and P 2  in  FIGS. 1 and 2  herein. As depicted in these figures, the operating room personal will apply padding around the stabilizing post to avoid having a hard contact point that could injure a patient. However, as explained above, padding is not very effective for eliminating pressure point and patients have been know to suffer pressure related injuries despite the use of padding on the surgical stabilizer post. 
         [0010]    Many procedures utilize robotic devices for all or part of the surgery. Robotic devices often are moved relative to coordinates defined by X and Y axes in the plane of the operating table. Accordingly, surgeons may position a patient relative to positioning posts on the operating table so that a patient is at a known location relative to the X and Y axes defined on the operating table. Examples of these positioning posts are identified by P 3  in  FIGS. 3 and 4 . Padding typically is used on the positioning posts P 3  shown in  FIGS. 3 and 4  similar to the padding used on the stabilizer post P 1  and P 2  shown in  FIGS. 1 and 2 . However, the padding used on the prior art positioning post P 3  shown in  FIGS. 3 and 4  can create pressure related injuries to the patient. 
         [0011]    Some surgery, such as surgery on a limb, requires the use of a tourniquet to prevent excessive intraoperative blood loss. Most surgical tourniquets use pneumatic pressure to control the restriction on the blood flow in the limb. The pneumatic pressure in the prior art surgical tourniquet is controlled by a “tourniquet box” that communicates with both a source of air and the tourniquet. The tourniquet box includes an input device for inputting required tourniquet pressure requirements, an output display, sensors for sensing actual pressure in the tourniquet, and a control processor or server for controlling the operation of the tourniquet box. Surgical tourniquets are available from Instrumed, Inc. of Redmond, Wash. and from others, and tourniquet controls are shown in U.S. Pat. No. 7,166,123, U.S. Pat. No. 6,605,103, U.S. Pat. No. 6,589,268, U.S. Pat. No. 6,475,228, U.S. Pat. No. 5,181,522 and U.S. Pat. No. 4,479,494. The disclosures of these patents are incorporated herein by reference. 
         [0012]    The subject invention was made in view of the above-identified problems with stabilizer posts or positioning posts that extend upwardly from or near the operating table to position a patient. 
       SUMMARY OF THE INVENTION 
       [0013]    The invention relates to an inflatable positioning aid for at least partly positioning and supporting a patient in an operating room or other medical environment. The inflatable positioning aid includes an inflatable pillow and means for directing air into the inflatable pillow. The inflatable positioning aid further includes a valve for selectively releasing air from the inflatable pillow. 
         [0014]    The inflatable pillow includes a non-inflatable sleeve connected to spaced apart attachment points on the inflatable pillow. Thus, the non-inflatable sleeve has a section between the spaced apart attachment points that is not secured to the inflatable pillow. With this design, the inflatable positioning aid can be mounted over a stabilizing post or positioning post of an operating table by urging the stabilizer post or positioning post into the space between the inflatable pillow and the non-inflatable sleeve. Air then can be directed into the inflatable pillow to achieve the appropriate pressure level in the pillow for providing a desired degree of cushioning between the patient and the stabilizing post or positioning post. Accordingly, the inflatable positioning aid stabilizes the patient and distributes the pressure on the patient to avoid or minimize the possibility of nerve damage, vessel damage or visceral damage. 
         [0015]    The inflatable positioning device preferably includes inflation tubing that communicates with the inflatable pillow and a stopcock valve incorporated into the inflation tubing. The stopcock valve has an exit port that may be attached to a tourniquet box adaptor for connecting the inflatable pillow and the inflation tubing to a tourniquet box. The tourniquet box has means for controlling pressure of air that can be delivered to a tourniquet, or in this instance to the inflatable positioning aid. The pressure control means of the tourniquet box is set to achieve the desired level of pressure for the inflatable pillow. This pressure can be maintained constantly by the tourniquet box server system to ensure that the pressure applied against the body never exceeds the set pressure despite possible shifting of the patient during surgery. Accordingly, injuries nerve and other pressure-related injuries can be avoided. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]      FIG. 1  is a side elevational view of one example of a prior art surgical stabilizing post. 
           [0017]      FIG. 2  is a perspective view of a prior art surgical stabilizing post. 
           [0018]      FIG. 3  is a side elevational view of a prior art surgical positioning post. 
           [0019]      FIG. 4  is an end elevational view of the prior art surgical positioning post shown in  FIG. 3 . 
           [0020]      FIG. 5  is a front elevational view of a surgical positioning aid in accordance with the subject invention. 
           [0021]      FIG. 6  is a rear elevational view of the surgical positioning aid of  FIG. 5 . 
           [0022]      FIG. 7  is an end elevational view showing the positioning aid mounted on a post. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0023]    An inflatable positioning apparatus in accordance with the subject invention is identified generally by the numeral  10  in  FIGS. 5-7 . The inflatable positioning apparatus  10  includes a tube  12 , a pump  14  and a valve  16 . In addition to the valve  16 , the pump  14  is provided with two one-way valves (not shown). The first one-way valve is operative to permit air to flow from the pump  14  to the tube  12  each time the pump  14  is manually squeezed. However, this first one-way valve prevents a return flow of air from the tube  12  into the pump  14 . The second one-way valve permits air flow from the ambient environment into the pump  14  as the pump  14  resiliently expands from the squeezed condition to the expanded condition. This second one-way valve, however, prevents an outflow of air from the pump to the ambient environment. The tube  12 , the pump  14  and the valve  16  all may be of prior art design. 
         [0024]    The positioning apparatus  10  further includes an inflatable pillow  18  connected to the end of the flexible tube  12  remote from the pump  14 . The inflatable pillow  18  is formed from an elongate substantially rectangular sheet  20  that is folded in half about a fold F to define first and second registered panels  21  and  22 . The sheet  20  is formed from a nylon material with a thickness in the range of 70-400 denier, and preferably about 200 denier. One surface of the sheet  20  is laminated with a layer of urethane that has a thickness of approximately 3.5 mil and the opposite surface of the sheet  20  may have a kiss coat of urethane to a thickness that may be in the range of 0.0025-0.0050 inch. The sheet  20  is folded so that the approximately 3.5 mil layer of urethane faces in on the pillow  18  and so that the kiss coating faces out on the pillow  18 . The kiss coating of urethane on the outer surface of the pillow  18  provides a fluid repellency to the inflatable pillow. In particular, the kiss coating of urethane seals the nylon material of the sheet  20  and at least partly smoothes out the peaks and valleys inherently present in the nylon. As a result, fluids, such as blood or sweat that may be generated during the medical procedure will be repelled. 
         [0025]    A fitting  23  is mounted to the inflatable pillow  18  substantially at the fold F that joins the panels  21  and  22 . The fitting  23  may include a flange and a cylindrical portion extending from the flange. The cylindrical portion is passed through an aperture formed in the sheet  20  at the fold F such that the flange abuts the inner surface of the inflatable pillow  18  at the F. The flange of the fitting  21  then is RF welded to the urethane-coated inner surface of the sheet  200   r  is adhered in position. 
         [0026]    The first panel  21  has substantially parallel top and bottom edges  24  and  26  and a side edge  28  that extends parallel to the fold F between the top and bottom edges  24  and  26 . The second panel  22  also has substantially parallel top and bottom edges  34  and  36  and a side edge  38  extending between the top and bottom edges  34  and  36  and parallel to the fold F. The second panel  22  is folded onto the first panel  21  so that the respective edges register with one another. Areas of the first panel  21  adjacent the edges  24 - 28  and the corresponding areas of the second panel  22  adjacent the edges  34 - 38  then are subjected to an RF welding apparatus that welds the first panel  21  to the second panel  22  around their peripheries from the opposite ends of the fold F. The RF welding apparatus applies pressure and radio frequency energy that causes the urethane lamination on the inner surfaces to bond the two panels  21  and  22  together around their peripheries. Thus, an inflatable region is defined between the panels  21  and  22  and within the area bounded by the peripheries of the panels  21  and  22 . 
         [0027]    A non-inflatable sleeve  42  is secured by RE welding to the outer surface of the second panel  22  as shown most clearly in  FIG. 6 . The kiss coating of urethane on the outer surface of the second panel  22  enables the RF welding process and avoids the use of adhesive. Preferably the RF welding of the non-inflatable sleeve  42  is carried out simultaneously with the RF welding of the flange of the fitting  23  to the urethane-coated inner surface of the sheet  20  before the sheet  20  is folded about the fold F. The peripheral regions of the panels  21  and  22  then are secured together in a subsequent RF welding process after the sheet  20  is folded about the fold F. The non-inflatable sleeve  42  is secured to the second panel  22  at spaced apart first and second substantially linear attachments regions  48  and  50 . The first attachment region  48  is substantially parallel to and near the side edge  38  of the second panel  22 . Similarly, the second attachment region  50  of the sleeve  42  is parallel to and near the fold F between the first and second panels  21  and  22 . Thus, the second attachment region  50  is substantially parallel to the first attachment region  48 . The non-inflatable sleeve  42  further includes top and bottom free edges  52  and  54  that extend between the attachments regions  48  and  50 . The top and bottom free edges  52  and  54  are approximately equally spaced from the respective top and bottom edges  34  and  36  of the second panel  22 . Additionally, the top and bottom free edges  52  and  54  each are smoothly arcuately concave. Thus, the distance between the free top edge  52  of the non-inflatable sleeve  42  and the top  34  of the second panel  22  is greatest at locations approximately centrally between the first and second attachments regions  48  and  50 . Similarly, the distance between the bottom free edge  54  and the bottom edge  36  of the second panel  22  is greatest at locations approximately centrally between the first and second attachments regions  48  and  50 . A continuous post-mounting channel  56  is defined between the non-inflatable sleeve  42  and the inflatable pillow  18  in areas between the attachments regions  48  and  50 . As a result, the channel  56  can be telescoped over the surgical stabilizing post or positioning post P shown in  FIG. 7  or any other such positioning post aligned vertically, horizontally or at any acute angle relative to the top surface of the operating table T. The concave shapes of the top and bottom free edges  52  and  54  of the non-inflatable sleeve  42  facilitate the telescoping of the positioning post P into the channel  56 . The inflatable pillow  18  preferably is oriented on the post P so that the fold F, the fitting  23  and the tube  12  are extending away from the region on the patient that will be worked on by the medical staff. As a result, the positioning apparatus  10  will not interfere with the surgery. 
         [0028]    Air may be directed into the inflatable pillow  18  by manually actuating the hand pump  14  to achieve a desired pressure between the surgical stabilizing post or positioning post and the patient. However, the preferred positioning device further is used with a tourniquet box identified generally by the numeral  60  and a tourniquet box adaptor identified by the numeral  62  in  FIG. 5 . The tourniquet box  60  may be a commercially available unit that generally is used for applying pressure to a tourniquet for controlling blood flow in an injured limb or in a limb that is subject to surgery. For example, the tourniquet box  60  may be one of those disclosed in the above-identified patents, the disclosures of which have been incorporated by reference. In this regard, the tourniquet box  60  includes means for directing compressed air to a tourniquet, a server for maintaining a set pressure level and an input device for setting and changing the pressure. The tourniquet box  60  is set to an appropriate pressure level for the inflatable pillow  18  and cooperates with the pillow  18  via the tourniquet box adaptor  62  for ensuring that the pressure applied between the patient and the surgical stabilizing post or positioning post P does not exceed the set pressure level. The pressure level set for the tourniquet box  60  should be between 20-200 mm of mercury pressure, and preferably between 35 and 100 mm of mercury pressure. In most instances, a pressure level of about 40 mm mercury pressure is appropriate. 
         [0029]    While the invention has been defined with respect to certain preferred embodiments, it is apparent that various changes can be made without departing from the scope of the invention. In this regard, the non-inflatable sleeve may be connected to the inflatable pillow at more edges of the panels of the pillow. Additionally, the pillow can take forms others than the rectangular shape shown in the figures and the attachments of the inflation tubing can be at other locations on the pillow.