Patent Description:
A typical surgical table includes head end and foot end support units and a support top which spans between and is supported by the support units. The typical arrangement of the support top relative to the support units may be satisfactory for many surgeries. For other surgeries the typical arrangement may be suboptimal because it does not always afford the surgeon optimal access to the patient's surgical site. This application describes a reconfigurable surgical table that improves the surgeon's access to the surgical site.

<CIT> provides a surgical table including a central bottom portion. The surgical table includes a support top, first and second support units longitudinally spaced apart, and a pair of positioning assemblies capable of vertically lifting the support top. The surgical table further includes at least one first wheel adjacent a first end of the table, at least one second wheel adjacent a second end of the table, and a first stabilizing bar connected to the first wheel and the second wheel.

<CIT> provides a surgical table extension feature comprising a patient support structure, a large area base, and a support leg. A first joint having at least two degrees of freedom is located between the patient support structure and the support leg. A second joint also having at least two degrees of freedom is located between the base and the support leg.

The present invention relates to a patient support device comprising a support top, a head support unit partially supporting the support top, a foot support unit longitudinally spaced from the head support unit, and an adaptor associated with the foot support unit. The adaptor is removably securable to the foot support unit so that the adaptor and foot support unit cooperate to partially support the support top so that the support top extends footwardly beyond the foot support unit. The foot support unit includes a base, a pedestal extending vertically upwardly from the base, and a crown configured to be removably securable to the pedestal. The foot support unit being configurable in a baseline configuration in which the crown, which is incompatible with the supporting the support top, resides atop the pedestal. The foot support unit also being configurable in a non-baseline configuration in which the adaptor, which is compatible with supporting the support top, resides atop the pedestal in lieu of the crown.

Further preferable features of the invention are defined in the dependent subclaims.

Reference will now be made to embodiments of the invention, examples of which are illustrated in the accompanying drawings. Features similar to or the same as features already described may be identified by the same reference numerals already used. The terms "substantially" and "about" may be used herein to represent the inherent degree of uncertainty that may be attributed to any quantitative comparison, value, measurement or other representation. These terms are also used herein to represent the degree by which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue.

Referring to <FIG>, a patient support device such as a surgical table <NUM> includes a head support unit <NUM> and a foot support unit <NUM> spaced longitudinally from the head support unit. As is evident from <FIG> and <FIG> "head" and "foot" are used to distinguish between the two support units but do not necessarily correspond to the orientation of the patient.

A connecting member <NUM> extends longitudinally between the head support unit and the foot support unit and connects the support units to each other. The connecting member may be a fixed length member or may be an adjustable length member constructed of, for example, telescoping tubes.

Head unit <NUM> comprises a base <NUM>, casters <NUM> extending from the bottom of the base, and a column <NUM> extending vertically upwardly from the base. The column comprises a primary elevator <NUM> which is height adjustable relative to base <NUM>, for example by a hydraulic system. The column also includes a secondary elevator <NUM> attached to the primary elevator. The height of the secondary elevator relative to primary elevator is fixed, however the secondary elevator includes two or more attachment stations <NUM> to which a first end 101A of a baseline patient support top 100A can be attached. The baseline support top 100A is a member of a set of baseline support tops indicated generally by reference numeral <NUM>. The attachment stations are indicated schematically by triangular symbols and are vertically separated from each other.

Foot unit <NUM> comprises a base <NUM>, casters <NUM> extending from the bottom of the base, and a column <NUM> extending vertically upwardly from the base. The column comprises a primary elevator <NUM> which includes a pedestal portion <NUM> and a crown <NUM>. The crown is attachable to and detachable from the pedestal. The primary elevator is height adjustable relative to base <NUM>, for example by a hydraulic system. The column also includes a secondary elevator <NUM> attached to the primary elevator, specifically to crown <NUM>. The height of the secondary elevator relative to primary elevator is fixed, however the secondary elevator includes two or more attachment stations <NUM> to which a second end 102A of patient support top 100A can be attached. The attachment stations are indicated schematically by triangle symbols and are vertically separated from each other. Crown <NUM> is attachable to and detachable from pedestal <NUM>. <FIG> shows the crown attached to the pedestal so that the primary elevator comprises the pedestal and the crown. <FIG> shows the crown having been removed and replaced by an adaptor 90A, which is described in more detail below, so that the primary elevator comprises the pedestal and the adaptor.

The first end 101A of the support top is attached to the head secondary elevator <NUM> at a selected attachment station <NUM>, and the second end 102A of the support top is attached to the foot secondary elevator <NUM> at a selected attachment station <NUM>. "First" and "second" are used herein to conveniently distinguish between longitudinally opposite ends of the support top but do not necessarily correspond to the orientation of the patient. The secondary elevators <NUM>, <NUM> are the interfaces between the longitudinal ends 101A, 102A of the support top 100A and the support units <NUM>, <NUM>. The load borne by the secondary elevators is transferred to the floor by way of the primary elevators <NUM>, <NUM>, bases <NUM>, <NUM> and casters <NUM>, <NUM>. In practice, a staff member chooses attachment stations and heights of the height adjustable primary elevators to position the patient at a desired height and inclination (e.g. level, inclined head down, inclined foot down).

Various accessories may be attached to the baseline support top as well as to the members of set of alternate support tops which are described more completely below and are illustrated in <FIG> and <FIG>. Example accessories are illustrated only in connection with the alternate support tops of <FIG> and <FIG>. The example accessories include pads <NUM>, traction assemblies <NUM>, limb supports <NUM>, and perineal posts <NUM>.

At least the foot support unit, and therefore the patient support device as a whole, is configurable in a baseline configuration. The baseline configuration includes a baseline support top 100A and crown <NUM> as seen in <FIG>. At least the foot support unit, and therefore the patient support device as a whole, is also configurable in a non-baseline configuration. The non-baseline configuration includes an alternate support top such as a prone surgery support top 200A of <FIG> or a hip surgery support top 200B of <FIG>. The alternate support tops 200A, 200B are members of a set of alternate support tops indicated generally by reference numeral <NUM>. The terms "non-baseline" and "alternate" are used herein to differentiate between different configurations and support tops, not to suggest that the alternate configurations and tops are inferior or less preferred in comparison to a baseline configuration or support top.

<FIG> show the foot support unit, and therefore the patient support device as a whole, configured in the baseline configuration in which crown <NUM> resides atop pedestal <NUM> and is physically connected thereto. As used herein, "atop" means "on top of", not just at the same elevation or approximately the same elevation. Even when the crown is not connected to the pedestal it is nevertheless associated with the pedestal and the foot support unit in the sense that it is attachable to and detachable from the pedestal. The crown is compatible with supporting a baseline support top but is incompatible with supporting an alternate support top. Accordingly, the baseline configuration includes a baseline top, such as top 100A of <FIG>, selected from a first or baseline set of support tops having at least one member. The first end of the baseline top is attached to secondary elevator of the head support unit. The second end of the baseline support top is attached to secondary elevator of the foot support unit.

When a baseline support top is used, the head support unit and the foot support unit each partially support the baseline support top and, taken collectively, support all the weight of the support top. As used herein, unless specified otherwise, the weight of the baseline support top includes the weight of the support top itself and any weight borne by the support top (e.g.the weight of any accessories and of the patient).

The baseline arrangement of the support top relative to the support units may be satisfactory for many surgeries but may be suboptimal for others. If the surgeon stands to the right of the foot support unit as seen in <FIG>, the surgeon is longitudinally separated from the patient by at least distance DLONG, which may be unsatisfactory. If the surgeon is conducting surgery on the patient's cervical spine, she may be constrained to stand in the corner <NUM> defined by support unit base <NUM> and the edge <NUM> of the support top and therefore may not be able to position or maneuver her body for best access to the surgical site.

<FIG>, <FIG>, <FIG> and <FIG> show the foot support unit, and therefore the patient support device as a whole, configured in the non-baseline configuration. In the non-baseline configuration, adaptor 90A resides atop pedestal <NUM> in lieu of crown <NUM> of the baseline configuration. <FIG> shows the crown being removed from the pedestal in preparation for securement of the adaptor to the pedestal. Use of the crown and the adaptor is mutually exclusive. The adaptor is physically connnected to the pedestal. Even when the adaptor is not connected to the pedestal it is nevertheless associated with the pedestal and the foot support unit in the sense that it is securable to and removable from the pedestal. The adaptor is compatible with supporting an alternate support top but is incompatible with supporting a baseline support top. Accordingly the non-baseline configuration includes an alternate top, such as tops 200A, 200B of <FIG> and <FIG>, selected from a second or alternate set of support tops having at least one member. The alternate support top is attached to secondary elevator <NUM> of the head support unit. The alternate support top is also attached to secondary elevator <NUM> of the foot support unit. The alternate support top and the adaptor are distinct components, i.e. they are not integrated into a single unit.

When an alternate support top is used, the head support unit and the foot support unit each partially support the alternate support top and, taken collectively, support all the weight of the support top. As used herein, unless specified otherwise, the weight of the alternate support top includes the weight of the support top itself and any weight borne by the support top (e.g. the weight of any accessories and of the patient).

In the non-baseline configuration the adaptor and foot support unit cooperate to partially support the alternate support top so that the alternate support top extends footwardly beyond the foot support unit. This specification uses the term "overextend" and variants thereof to refer to extension of a support top footwardly beyond the foot support unit or headwardly beyond the head unit. In particular the alternate support top extends footwardly beyond the foot support unit by a prescribed distance DP. The prescribed distance may be defined by a surgical access requirement. One example of a surgical access requirement may be seen by comparing FIGA. 1A and 1B to <FIG>. If the surgeon stands to the right of the foot support unit as seen in <FIG>, the surgeon is longitudinally separated from the patient by at least distance DLONG, which may be unsatisfactory. If the surgeon is conducting surgery on the patient's cervical spine, she may be constrained to stand in the corner <NUM> defined by support unit base <NUM> and the edge <NUM> of the support top. As a result the surgeon may not be able to position herself or maneuver her body for best access to the surgical site. By contrast, in <FIG> the surgeon is less constrained. The surgeon can position herself laterally close to the patient, and can also step left or right (parallel to the longitudinal dimension of the surgical table). Indeed, the surgeon has access to the patient along the entire length of arc of access <NUM>.

Alternatively or additionally the prescribed distance may be expressed in terms of anthropometric parameters. For example the prescribed distance may be <NUM>% of the height of a 99th percentile male so that up to <NUM>% of a 99th percentile male patient (and a larger percentage of a smaller patient) can be positioned footwardly beyond the footwardmost edge <NUM> of the foot support unit. One source of anthropometric data is "<NPL>.

<FIG> and <FIG> show an example adaptor 90A as seen from above and as seen from below as a result of having been rotated <NUM> degrees about axis <NUM>. The adaptor is securable to and removable from pedestal portion <NUM> of foot column <NUM>. The adaptor and column include one or more connection or binding sites <NUM>, <NUM> respectively. When the binding sites are engaged with each other the adaptor is securely connected to the pedestal so that the adaptor cannot be moved relative to the column in the horizontal or vertical directions, nor can it rotate relative to the column. When the binding sites are disengaged from each other, the adaptor can be removed from the column by sliding it horizontally toward head support unit <NUM> in much the same way that the crown of the baseline configuration is shown being removed in <FIG>. Removal in the longitudinally headward direction has the advantage that when a support top is connected to both the head support unit <NUM> and the foot support unit <NUM>, the units themselves prevent unintended movement of the adaptor toward the head support unit. The top side of the adaptor includes a first connector <NUM> which cooperates with a mating element or connector <NUM> on the underside of the support top to keep the support top securely connected to the adaptor, and therefore to the pedestal. Connector <NUM> may also convey services such as electricity <NUM>, electrical grounding <NUM>, data <NUM>, hydraulic fluid <NUM> and pneumatic fluid <NUM>.

The bottom side of the adaptor includes a connector <NUM>. The pedestal includes a mating connector <NUM>. The connectors convey a service to the alternate support top or to accessories attached to the alternate support top. Example services include electrical energy <NUM>, electrical grounding <NUM>, data <NUM>, hydraulics <NUM> and pneumatics <NUM> (e.g. hydraulic fluid or air to power accessories).

As already noted, use of "head" and "foot" is used herein to distinguish between distinct support units. In the examples of <FIG> only one of the two support units, specifically the unit closer to the right side of the illustration, is shown as being reconfigured to accommodate an alternate support top. However the foregoing description applies equally to the support unit illustrated closer to the left side of the illustration by simply redesignating that unit as the foot unit and the other unit as the head unit. Moreover both units can be reconfigurable between a baseline configuration and an alternate configuration.

<FIG> illustrates the general concept of a patient support system. The system includes a head support unit <NUM>, and a foot support unit <NUM> longitudinally spaced from the head support unit. As seen at the center left of the illustration the head support unit and the foot support unit are in a baseline configuration. The baseline configuration of the patient support system includes a first or baseline set <NUM> of support tops comprising n members <NUM> through n, and identified individually by 100A, 100B, and so forth. The first set of support tops has at least one member and may have two or more members. Each member of the first set of support tops is supportable partially by the baseline configured head support unit and partially by the baseline configured foot support unit as signified by the arrows leading from the members of the first set to the space between the baseline configured support units.

The system also includes a second or alternate set <NUM> of support tops comprising m members <NUM> through m, and identified individually by 200A, 200B, and so forth. The second set of support tops has at least one member and may have two or more members. The members of the second set of support tops are unsupportable by the combination of the baseline configured head support unit and the baseline configured foot support unit. In other words although the baseline configured head support unit may be able to partially support one end of a member of the second set, the baseline configured head support unit and the baseline configured foot support unit, acting together, cannot provide complete and satisfactory support for any of the members of the second set of support tops. This incompatibility is signified by the interrupted arrows extending from the members of the second set toward the baseline configured support units at the center left of the illustration.

As seen at the center right of the illustration the foot support unit is reconfigurable to a non-baseline configuration so that each member of the second set of support tops is supportable partially by the head support unit and partially by the foot support unit. This compatibility is signified by the arrows leading from the members of the second set to the space between the non-baseline configured support units. At least one member of the second set, when supported by a non-baseline configured foot support unit, extends footwardly beyond the foot support unit by a prescribed distance DP. The members of the first set of support tops are unsupportable by the head support unit and the non-baseline configured foot support unit. This incompatibility is signified by the interrupted arrows extending from the members of the first set toward the support units at the center right of the illustration.

The patient support system also includes a group <NUM> of adaptors comprising p members <NUM> through p, and identified individually by 90A, 90B, and so forth. The adaptor set <NUM> has at least one member and may have two or more members. The adaptor or adaptors of the adaptor set are used in the way already described to effect the reconfiguration of the foot support unit to the non-baseline configuration. The illustrated adaptor set includes at least a first adaptor 90A useable to effect reconfiguration of a specified one of the two support units (either the head support unit <NUM> or the foot support unit <NUM>) to the non-baseline configuration in order to accommodate connection of a member of the second set of support tops. The illustrated adaptor set may also include a second adaptor (e.g. 90B) useable to effect reconfiguration of the specified one of the two support units to the non-baseline configuration for a different member of the second set of support tops.

<FIG> is similar to <FIG> but shows an embodiment of the patient support system in which both the head and foot support units are reconfigured from the baseline state to the non-baseline state in order to support a member of the second set of support tops. The letter suffixes A, B, etc. applied to numeral <NUM> indicate different styles of adaptors, e.g. adaptors that differ from each other in order to accommodate differences among the members of the set of alternate support tops. The hyphenated numerals "-<NUM>", "-<NUM>", etc. indicate that the inventory of adaptors includes multiple adaptors of the style indicated by the letter suffix. As illustrated in <FIG> the adaptors used at the head support unit <NUM> and the adaptor used at the foot support unit <NUM> are physically the same as each other and are therefore interchangable between the support units. That is, adaptor 90A-<NUM> can be used to reconfigure the foot support unit and adaptor 90A-<NUM> to reconfigure the head support unit, or vice versa for a given style of top, e.g. top 200A.

<FIG> is similar to <FIG> except that the adaptor used to effect the reconfiguration of head support unit <NUM> from the baseline state to the non-baseline state and the adaptor used to effect the reconfiguration of foot support unit <NUM> are physically different from each other and therefore are non-interchangable between the support units. In other words, for at least one support top from the second set, an adaptor 90A (selected from the sub-group of identical adaptors 90A-<NUM>, 90A-<NUM>,. ) is the adaptor required to achieve compatibility between the support top and the head support unit <NUM>, while an adaptor 90B (selected from the group of identical adaptors 90B-<NUM>, 90B-<NUM>,. ) is the adaptor required to achieve compatibility between the support top and the foot support unit <NUM>.

Continuing to refer to <FIG>, <FIG> shows that at least one member of the second set of support tops, when supported by a non-baseline configured unit, overextends footwardly (i.e. extends footwardly beyond the foot support unit) by a prescribed distance DP1 and overextends headwardly (i.e. extends headwardly beyond the head support unit) by a prescribed distance DP2. <FIG> shows that at least one member of the second set of support tops, when supported by a non-baseline configured unit, overextends footwardly by a prescribed distance but does not overextend headwardly. In yet another alternative, not illustrated, at least one member of the second set, when supported by a non-baseline configured unit, overextends headwardly by a prescribed distance but does not overextend footwardly. Once again the prescribed distances can differ from each other.

<FIG> shows a support top which overextends in only one direction in the context of interchangeable adaptors. <FIG> shows a support top which overextends in both directions in the context of non-interchangeable adaptors. However the patient support system may, alternatively or additionally, include adaptors and alternate tops such that the tops overextend in only one direction with non-interchangable adaptors and tops that overextend in both directions with interchangable adaptors.

In view of the foregoing certain details of the patient support device can now be better appreciated. Referring to <FIG> the crown is detachable from and attachable to the pedestal in a longitudinally horizontal direction. The crown and pedestal include latch components <NUM>, <NUM>. When the latch is engaged the crown is securely connected to the foot column so that the crown cannot be move relative to the column in the horizontal or vertical directions, nor can it rotate relative to the column. When the latch is disengaged, for example by operation of a user accessible trigger <NUM>, the crown can be removed from the column by sliding it horizontally toward head support unit <NUM>. Removal in the longitudinally headward direction (i.e. toward the other support unit) has the advantage that when a support top is connected to both the head support unit <NUM> and the foot support unit <NUM>, the units themselves prevent unintended movement of the crown toward the head support unit.

Referring to <FIG>, <FIG>, <FIG>, and <FIG>-<NUM>, the members of the first support top set and/or the members of the second support top set may include an identification element <NUM>. In one example the identifying element is an RFID tag which is readable by an RFID reader located, for example, on or in the foot column. In another example the identifying element is a sensor or exciter of a Hall effect sensor pair. Irrespective of the technology employed, the identification element provides information about the identity of the support top. For example the identification element may provide information to a processor so that the processor can enforce support top specific limitations based on the types of surgery for which the support top is acceptable. Example limitations include maximum allowable speed at which a particular type of support top can be raised or lowered by the column, the maximim or minimum allowable height to which the support top can be raised or lowered and the maximum inclination allowed for the support top.

As is evident from the foregoing description, the adaptor is removable from its host support unit thereby rendering the foot support unit reconfigurable to a baseline configuration in which a baseline support top is supportable by the support unit. The support unit is considered to be reconfigurable to a baseline configuration in the sense that crown <NUM> can be installed on pedestal <NUM> subsequent to removal of adaptor 90A in order to achieve the baseline configuration. In another embodiment the crown is not required to achieve the baseline configuration because pedestal <NUM>, standing alone without the crown, is capable of providing the needed support for the baseline support top. In that case the removal of the adaptor converts the support unit to the baseline configuration rather than putting it in a condition for being reconfigured to the baseline configuration (by attaching a crown).

Claim 1:
A patient support device (<NUM>) comprising:
a support top (<NUM>);
a head support unit (<NUM>) partially supporting the support top;
a foot support unit (<NUM>) longitudinally spaced from the head support unit (<NUM>), and including a base (<NUM>) and a pedestal (<NUM>) extending vertically upwardly from the base (<NUM>);
a crown (<NUM>) configured to be removably securable to the pedestal (<NUM>); and
an adaptor (<NUM>) associated with the foot support unit (<NUM>);
the adaptor (<NUM>) being removably securable to the foot support unit (<NUM>) so that the adaptor (<NUM>) and foot support unit (<NUM>) cooperate to partially support the support top (<NUM>) so that the support top (<NUM>) extends footwardly beyond the foot support unit (<NUM>);
wherein, the foot support unit (<NUM>) is configurable in:
a) a baseline configuration in which the crown (<NUM>), which is incompatible with supporting the support top (<NUM>), resides atop the pedestal (<NUM>); and
b) a non-baseline configuration in which the adaptor (<NUM>), which is compatible with supporting the support top (<NUM>), resides atop the pedestal (<NUM>) in lieu of the crown (<NUM>).