Patent Publication Number: US-2009235457-A1

Title: Medical Table Foot and Leg Support System

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates to medical exam tables, and more particularly relates to a foot and leg support system for removable attachment to an exam table of the type typically used for performing gynecology exams. The system allows a doctor to easily replace the conventional stirrup type foot and leg supports with boot-type foot and leg supports which allows a much more comfortable and prolonged support for the patient&#39;s feet and legs. As such, a doctor may easily and quickly convert their office exam table into a procedure table allowing more extensive medical procedures to be performed on the patient due to the prolonged support of the patient&#39;s feet and legs. 
     Exam tables with foot and leg supports are commonly used in a medical office for performing obstetric/gynecological or other examinations of a patient. Foot supports extend from the end of the table upon which the patient supports each foot with the legs in an abduction position which allows the obstetrician/gynecologist to perform the exam. There are several different types of leg supports, the most common being the so-called “stirrup” leg support wherein a heel is placed upon a respective heel support mounted to the end of a bar extending from the end of the table. Another type is the so-called “knee crutch” type which supports the leg under the knee. This type of support is not favored by many doctors or patients since it does not secure the patient&#39;s feet which simply hang free. 
     Yet another type of leg support is the so-called “boot” type which supports the full foot and extends up the back of the calf to a point between the ankle and knee. The boot-type support is considered more supportive and secure, allowing a patient to be supported over an extended period of time and are thus typically found on surgical operating room (“OR”) tables which are much more expensive (e.g., about $50,000.00) than exam tables (e.g., about $800.00 to about $7,000.00). 
     Medical office exams requiring patient leg support typically last about 5 minutes and the stirrup type of foot rest is the standard exam-type support system used in most doctor offices. For procedures lasting longer than about 5 minutes, the Inee-crutch type leg support is typically used, however, the knee-crutch is not designed to keep a patient comfortable much longer than about 20 minutes and furthermore do not stabilize the legs to a significant degree. For example, neither the stirrup nor knee-crutch types of leg supports would secure a patient&#39;s legs to the degree necessary to perform an involved surgical procedure such as a vasectomy or labiaplasty, for example. Furthermore, as stated above, many patient&#39;s report feeling undignified in the knee-crutch type of support since their legs are allowed to “dangle” from the support making them feel physically (and thus also mentally) vulnerable and insecure. It will thus be realized that exam tables having stirrup or knee-crutch type leg supports are not suitable for stabilizing and supporting a patient&#39;s legs during a surgical or other medical procedure lasting more than about 5 to 20 minutes. 
     Rising medical costs have resulted in the migration of many medical procedures from the hospital to an ambulatory (outpatient) surgical center or the doctor&#39;s personal office. Unfortunately, the exam tables found in most doctor offices are not designed to perform prolonged surgical procedures for the reasons explained above. Due to the relatively high cost of the OR tables, doctors are reluctant to purchase these tables for their offices. There therefore exists a need for a “procedure type” foot and leg support system which can be easily fitted to an existing exam table, allowing the doctor to quickly convert his or her exam table into a procedure table. 
     SUMMARY OF THE INVENTION 
     The present invention addresses the above need by providing a patient foot and leg support system which converts a typical gynecological examination table into a procedure table. The term “gynecological” or “GYN” is used herein for the sake of convenience only, it being understood that the medical tables and invention described herein may be used for medical procedures other than strictly gynecology or obstetrics (e.g., proctology, urology, and various genitalia procedures, etc.). 
     The patient foot and leg support system of the present invention includes a pair of foot and leg support assemblies with each assembly including a boot-type support mounted to a first end of a support bar. Should the GYN exam table have stirrup (or other) type of leg supports already installed, these are first removed in accordance with the stirrup manufacturer&#39;s instruction manual. In a typical GYN exam table, the stirrup support bars extend into the table and may be alternately extended for use, and then retracted into the table to a storage position. A screw is attached at the end of each support bar inside the table and acts as a stop to prevent the bar from fully separating from the table. A bracket is provided at each support bar table entry point which allows the support bar to be selectively pivoted laterally which allows the doctor to position the patient&#39;s leg at the desired angle for examination. 
     As stated above, the present invention provides a pair of boot-type support bars which may replace existing stirrup or other exam-type of foot and leg supports on a GYN exam table. The doctor or assistant first accesses the ends of the existing support bars inside the table and removes the screws which prevent the bars from separating from the table as explained above. This allows the existing support bars to be removed from the table. The doctor or assistant then inserts the support bars of the present invention into the spaces previously occupied by the existing support bars. The inventive support bars are secured to the table using a cotter pin or the like which does not require a tool to attach and remove from the respective support bar. The cotter pins may then also replace the screws when it is desired to switch the support bars back to the stirrup or other exam-type support bars. As such, the doctor or assistant may quickly and easily switch between exam-type support bars and the present procedure-type support bars. 
     The boot-type foot and leg supports of the present invention are attached to the ends of the support bars extending from the table. The boot is a contoured piece and open at the front. A removable liner is positioned on the inside surface of the boot and on which the patient rests their foot. The boot includes a rear wall which extends behind the calf to provide additional support to the patient&#39;s leg. Straps are provided to secure the foot in the boot. 
     The boot is mounted to a metal plate which in turn is mounted to and extends along the end of the second segment of the support bar. The end of the second support bar extends at an angle with respect to the first end of the first support bar, the opposite end of which extends into and connects to the table. In a preferred embodiment, the metal plate is tilted at an angle with respect to the axis of the second support bar so as to position the patient&#39;s legs in an abduction position for the medical procedure. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view of an embodiment of the invention installed on an examination table; 
         FIG. 2  is a fragmented top plan view of an embodiment of the invention showing one method of attaching the support bars to the table; 
         FIG. 3  is a fragmented perspective view of the right leg support of  FIG. 1 ; 
         FIG. 4  is a fragmented front elevational view of the left boot support plate of  FIG. 1 ; 
         FIG. 5  is a front elevational view of a lateral securing bar; 
         FIG. 6  is a fragmented top plan view showing the securing bar of  FIG. 5  attached to the support bars of the present invention; and 
         FIG. 7  is a fragmented perspective view showing an alternate embodiment of the support bar. 
     
    
    
     DETAILED DESCRIPTION 
     Referring now to the drawing, there is seen in  FIG. 1  a GYN exam table  10  to which an embodiment of the inventive foot and leg support system  12  has been removably attached. Table  10  is a typical prior art GYN exam table used in a doctor&#39;s office to perform routine gynecological exams. In this particular model of exam table, the bottom half  14  of the table pad  16  pivots upwardly to expose and provide access to the inside cavity  18  of the table platform  20  as seen in  FIG. 2 . Other exam table models may provide inside access through apertures formed in the sides of the table, for example. 
     As explained above, should the doctor desire to change his/her existing office exam table into a procedure table, the existing stirrup or other exam-type of support bars are first removed from the table by accessing the inside cavity  18  thereof and removing the screws or other securing elements from the ends of the support bars (this step not shown). The exam-type support bars may then be withdrawn and separated from the table platform  20  through the platform apertures  20   a,    20   b  positioned adjacent either side of the platform edge  20 ′. 
     Once the existing stirrup or other exam-type support bars are removed, the boot-type support bars  12  of the present invention are attached to table  10  by inserting the first end  22   a,    24   a  of support bar segment  22 ,  24  into platform apertures  20   a,    20   b,  respectively. Another set of smaller apertures  26 ,  28  are provided within area  18  into which the respective support bars  22 ,  24  extend and may pivot as seen best in  FIG. 2 . Support bars  22 ,  24  are pivotable to allow the doctor to position the bars  22 ,  24  at a desired angular position with respect to the table  10  (see, e.g., bar  24  as shown in an alternate angular position in dotted outline in  FIG. 2 ). To secure the bar  22 ,  24  at the desired angle, bracket (not shown) having a boss  36 ,  38  may be provided through which each support bar  22 ,  24  extends, respectively, such that the brackets pivot together with their respective support bar  22 ,  24 . The boss  36 ,  38  is sized to extend into one of several holes  32 ,  34  arranged in arcuate fashion in a respective bracket or plate  30  spaced above the platform floor  20 c. Although a boss and array of holes are shown, it is understood there are many other ways of allowing selective pivotable movement to the support bars as is understood by those skilled in the art. Since the majority of the weight of the bars are at the ends extending from the table, the support bars  22 ,  24  will be pressed upwardly against plate  30  and thereby secure the boss within a respective hole. When it is desired to change the pivotal position of the support bar, the doctor simply lifts the extended end of the support bar which releases the boss from its respective hole and pivots the bar to the selected angular position. 
     A manually operable securing element such as a lynch pin or cotter pin  40 ,  42 , for example, may be attached through a respective hole formed adjacent support bar first ends  22   a,    24   a  to prevent accidental separation of support bars  22 ,  24  from table  10 . Cotter pins  40 , 42  are longer than the diameter of apertures  26 ,  28  such that bars  22 ,  24  cannot be withdrawn therefrom without first removing cotter pins  40 , 42 . Since the cotter pins do not require any special tools for attachment or removal, the doctor or assistant may easily and quickly attach and remove the pins as desired when switching between the present inventive boot-type foot and leg support system and the stirrup or other exam-type foot and leg supports. It will thus be appreciated that the cotter pins or other manually operable securing element may also replace the screws typically used on exam table support bars as explained above. As such, the doctor or assistant may quickly and easily switch between the exam-type supports and the boot-type supports as necessary for his/her practice. 
     Referring now also to  FIGS. 3 and 4 , boot-type supports  12   a,    12   b  each include a second segment of support bar  40 ,  42  attached at first ends  40   b,    42   b  thereof to second ends  22   b,    24   b  of the first support bar  22 ,  24 , respectively. Second support bars  40 ,  42  extend upwardly at a desired angle “A” with respect to respective first support bar  22 ,  24 . Angle A may be between about 20 and about 45 degrees, is more preferably between about 30 and 40 degrees, and is most preferably about 35 degrees. Second support bar  40 ,  42  may be integrally formed with respective first support bar  22 ,  24  as seen in  FIGS. 1 and 3 , or formed separately as seen in  FIG. 7 . In the embodiment of  FIG. 7 , second support bar  43  is slidable along first support bar  44  and may be secured in a selected position therealong by clamp  46 . Clamp  46  may include nylon glides, for example, (not shown) through which bar  44  extends to facilitate the sliding motion of clamp  46  therealong. This embodiment thus allows the doctor to position the boot at a selected distance from the table which, in turn, bends the patient&#39;s knees at the desired angle. 
     A boot support plate  48 ,  50  is welded or otherwise firmly secured in traversing relation to second support bar  40 ,  42  adjacent the terminal ends  40   a,    42 a thereof, respectively. Plate  48 ,  50  each further include a rear wall  48   b,    50   b  (rear wall  50   b  not shown) extending upwardly from the rear edge  48 a,  50 a thereof, respectively. Each plate  48 ,  50  may further be tilted outwardly (away from each other and table  10 ) at an angle “B” ( FIG. 4 ) defined between a vertical axis y-y of the plate rear wall  48   b,    50   b  and a vertical axis x-x of the support bar end  40   a.  Tilting plate  48 ,  50  positions the patient&#39;s legs in a more desirable abduction position. Angle B may be between about 0 to about 15 degrees, is more preferably between about 5 and 12 degrees, and is most preferably about 10 degrees. It is also noted that although plate  48  is shown traversing support bar  40  in generally parallel relation thereto, plate  48  may be aligned in non-parallel relation thereto depending on the desired patient foot and leg placement. A support boot  52 ,  54  is secured to a respective plate  48 ,  50 , via rivets R or other suitable means (see also  FIG. 7 ). Each boot  52 ,  54  is preferably open at the front to allow the patient to easily place their foot within a respective boot. The boot has a bottom and upwardly extending calf support to provide a comfortable and secure support for the patient&#39;s foot. In the preferred embodiment, the boot is generically shaped such that the same boot may fit either the right or left foot. A liner  56 ,  58  may be provided which is removably attached to the inside surface of the boot  52 ,  54  to provide further cushioning and support to the patient&#39;s foot and leg. The liner may be made of a disposable and/or washable material such that it may be easily replaced as needed. The liner may have multiple layers with a foam core layer. The inner surface of the boot may include a VELCRO patch (not shown) or the like to allow the removable yet secure attachment of the liner thereto. For example, the VELCRO patch may be the hook side of VELCRO and the bottom layer of the liner may be a loop-type of material that will removably stick to the hook side of the VELCRO. To further secure the patient&#39;s foot within the boot, one or more straps S may be provided which wrap over the patient&#39;s foot and leg to secure it to the respective boot. The straps S may be cut as needed from a roll of VELFOAM, for example, and secured to the boot  52 ,  54  by VELCRO hook patches P applied to the boot such that the straps S are completely separable from the boot  52 ,  54  and may therefore be easily replaced as necessary. 
     Referring now to  FIGS. 5 and 6 , an optional brace bar  60  may be provided to more firmly secure support bars  22 ,  24  in their set position for the medical procedure. Brace bar  60  extends between and removably attaches to support bars  22 ,  24  via U-shaped brackets  62 ,  64  although other suitable removable attachment mechanisms may be used as desired. Brace bar  60  may be constructed as a single piece, but is more preferably constructed as a pair of telescoping segments  60   a,    60   b  that are adjustable in length to accommodate the varied angular positions at which the support bars  22 ,  24  may be set. As such, the brackets  62 ,  64  may be slid along bars  22 ,  24  with the simultaneous telescoping of bar poles  60   a,    60   b  until the desired placement of brace bar  60  is reached. Once in the desired position (e.g., close to the table edge  14   a ), the doctor simply secures the poles  60   a,    60   b  in place via clamp  66 . 
     As explained above, the invention thus provides a patient foot and leg support system which may be easily and quickly attached to and replace exam-type supports on a standard GYN exam table. The boot-type supports of the present invention are configured and positioned to provide maximum patient comfort over the prolonged periods demanding of certain medical procedures which would not otherwise be possible using the exam-type foot and leg supports typically used with GYN exam tables. As such, a doctor may easily convert their existing GYN exam table into a procedure table within their office as desired.