Surgical table for direct anterior surgical approach of the hip

Abstract

Surgical table for providing hyperextension of the hip joint during direct anterior approach without need for lowering the distal end of the operating table. The attachment will allow external rotation as well as adduction for better exposure of the proximal end of the femur. It further allow for motorized traction of the lower extremity controlled by the operating surgeon. The inventive device conveniently incorporates a femoral elevator mechanism that will raise the proximal end of the femoral bone for better visualization through the surgical wound and easier reaming of the femoral canal.

Claims

1. A surgical operating table comprising: a torso pelvic platform; a thigh platform; a foot strut attachment; a motorized flexing mechanism; and a femoral bone lifting device, wherein said foot strut attachment is firmly attached to the bottom of the thigh platform and consists of a rigid proximal tubular strut having a distal extension tubular strut slidable inside the proximal tubular strut.

2. The surgical operating table of claim 1, wherein the distal end of said distal extension tubular strut includes a foot restraining attachment comprising: a flexible boot having Velcro straps, secured to a vertical sole plate, said vertical sole plate having a shaft and a pivot joint to allow rotation to the right or the left; and a knob for locking the shaft thereby securing said flexible boot the desired position.

3. The surgical operating table of claim 1, wherein said proximal tubular strut further comprises a traction/distraction mechanism comprising: a threaded plate secured within said distal tubular extension; a motor conveniently situated inside proximal tubular strut; and a screw worm gear secured to said motor for moving said threaded plate distally or proximally when said motor is activated to turn clockwise counterclockwise, thereby causing the distal tubular extension to telescopically slide within said proximal tubular strut.

4. The surgical operating table of claim 1, wherein said thigh platform provides a central longitudinal section which is hinged distally so that it can be raised proximally providing pressure on the posterior surface of the thigh and pushing the femoral bone up where the proximal end will be brought up closer to the surgical wound.

5. The surgical operating table of claim 1, wherein said torso pelvic supporting platform further comprises: torso pelvic platform; a right removable corner extension for supporting the right hip; a left removable corner extension for supporting the left hip, wherein said removable corner extensions are secured to said torso pelvic platform with stabilizing rods and locking bolts.

6. The surgical operating table of claim 5, wherein said torso pelvic supporting platform is connected to the thigh platform via a removable hinge.

7. The surgical operating table of claim 6, wherein the lower extremity thigh platform is situated distal to said hinge to provide support for the thigh.

8. The surgical operating table of claim 5, wherein said torso pelvic supporting plate comprises a central hole for accepting a central pelvic post.

9. A surgical operating table comprising: a torso pelvic platform; a thigh platform; a foot strut attachment; a motorized flexing mechanism; and a femoral bone lifting device, wherein said motorized flexing mechanism further comprises: a motor situated in the main table hydraulic lift column and attached to a screw worm gear, which will travel up and down as it turns clockwise or counterclockwise.

10. A surgical operating table comprising: a torso pelvic platform; a thigh platform; a foot strut attachment; a motorized flexing mechanism; a femoral bone lifting device; a femoral elevator plate situated in said thigh platform; a sliding wedge having a slopped upper surface in contact with the lower surface of said femoral elevator plate; a screw worm gear conveniently located within a proximal tubular strut to move said sliding wedge distally; and a motor located within said proximal tubular strut for driving said screw worm gear thereby for causing said sliding wedge to lift the elevator plate upward proximally and push the femur upward.

11. The surgical operating table of claim 10, further comprising a foot pedal connected to said motor for control by the operating surgeon.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The present invention can be easily understood by creating that subsequent detailed description of the preferred embodiment thereof with references made to the accompanying drawings, wherein:

(2) FIG. 1 is a side view of operating table and attachment in flat position.

(3) FIG. 2 is a side view of operating table and attachment in flexed position with lower extremity strut attached.

(4) FIG. 3 is a perspective view of the lower extremity attachment strut.

(5) FIG. 4 is a side view of the lower extremity tubular strut.

(6) FIG. 5 is a side view of the lower extremity thigh rest and tubular strut with the femoral elevator in the down position.

(7) FIG. 6 is a side view of the lower extremity thigh rest and strut with femoral elevator up.

DETAILED DESCRIPTION OF THE INVENTION

(8) Turning now descriptively to the drawings, in which similar references characters denote similar elements throughout the several views, the attached figures illustrate the operative table and its innovative components.

(9) Referring to FIG. 1, the patient is placed in supine position over the operating table with his body resting over the torso pelvic platform 4. Conventional Hydraulic unit 1 allows raising or lowering the operating table to the appropriate height. The patient lower extremity foam cushion 5 is placed under lower extremity and over the lower end of the table 7. The central post 3 is inserted between the lower extremities to stabilize the pelvis and prevent him from sliding off the table when traction is applied to the lower extremity. The patient's head is placed over the headrest 2.

(10) Now referring to FIG. 2, where the flexing mechanism is activated via motor 6 which raises the pelvic bone of the patient causing the proximal torso pelvic platform 4 and distal lower extremity plate 19 to flex. This will cause the patient supporting structures to flex at the level of the locking bolt 18. The lower extremity on the operated side is then supported by the lower extremity plate having a extension in a form of proximal tubular strut 10, which rests over the lower extremity rest 7. Said strut having a foot boot 9 for holding the foot and situated at the end of the lower extremity strut. The foot is then secured with Velcro straps 16. In another embodiment, the foot may be secured using conventional ski boot buckles. Foot boot 9 is attached to vertical end plate 44 via shaft 36 (See FIG. 4). The vertical end plate 44 is firmly attached to the distal tubular strut 11. It is to be noted that said boot attachment and can be rotated clockwise and counterclockwise then locked in position using locking knob 12. Furthermore, the lower extremity thigh platform 19 and the tubular extensions 10 and 11 are capable of abduction (Right) and adduction (left) around pivot 25. The lower extremity attachment is interchangeable between right and left operated hip.

(11) FIG. 3, illustrates a lower extremity extension strut and foot attachment comprising torso pelvic platform 4 having corner extensions 17 and 20, conveniently removable on either side prior to surgery for improved X-rays transparency. The removable corner extensions are securely attached to the torso pelvic platform 4 by two stabilizing pins 21 and 47 and locking bolt 18. The torso plate 4 is elevated by the lifting motor 6 (FIG. 2), which will place the operated hip joint in extension. The torso pelvic platform provides a circular hole 24 for receiving the central post 3 (FIG. 2, 3). The lower extremity unit comprises a proximal tubular strut 10 firmly attached to thigh platform 19. A distal extension tubular strut 11 slidably located into the proximal tubular strut 10. Furthermore, foot-restraining attachment is attached to the end of the distal extension tubular strut 11. The later comprises a boot 9 with Velcro fasteners or ski boot buckles 16 attached to a vertical sole plate 15 having a shaft 36 going through a tube and a locking knob 12. The later allows the boot to rotate in clockwise or counterclockwise position. A cylinder wheel 13 allows the foot extension unit to slide onto the foldable lower extremity rest 7.

(12) Referring now to FIG. 4, which depicts the traction mechanism situated in the proximal tubular strut 10, comprising motor 28 with gearbox 35 and screw worm gear having threaded shaft 27. A threaded plate 31 firmly attached inside the proximal end of extension tubular strut 11, which is slidably situated in proximal tubular strut 10. The threaded shaft 27 rotates through the center of the threaded plate 31 causing the extension tubular strut 11 to slide forward or backward depending on the direction of rotation of threaded shaft 27. Furthermore, the distal end of the extension tube strut 11 provides an attachment to secure the foot. Said attachment comprises a vertical plate 44 firmly attached to the end of extension tube strut 11 and boot 9 having restraining Velcro straps or ski buckles 16. The sole of the boot 15 having a shaft 36 running into a tubular member allowing the boot to rotate right or left. Knob 12 locks the rotation into position.

(13) FIG. 5, illustrates the mechanism of femoral bone elevator plate 26 movement. Motor 30 is located inside the proximal end of proximal tubular strut 10 and its gear box 37 and screw worm gear 38 which will mechanize the lifting wedge 39. As the latter is pulled distally by the motor it will slide under the femoral elevator plate 26 causing its proximal end to raise and elevate the femoral bone so its proximal end 42 will protrude through the surgical incision 43.

(14) Referring now to FIG. 6, depicts a side sectional view of the femoral elevator mechanism.

(15) The distal movement of the lifting wedge 39 will slide under the femoral plate 26 causing it to rise and push up the femoral bone 41 and its proximal end 42 closer to the skin incision 43. When the operation is complete, reversing the Motor 92 will move the sliding wedge 39 proximally causing the femoral elevator to come down and becomes flat and level with the thigh plate 19. Furthermore, FIG. 6 clearly shows the external rotation of the femur which will improve alignment of the cut femur vis a vis the surgical incision, which will facilitate reaming of the femoral medullary canal.

(16) The surgical table components as described maybe constructed from like metallic alloy, plastic, or composite material. For example, it may be constructed of radiolucent material, allowing intra operative X-ray control.

(17) It is to be understood that the above-described arrangements are only illustrative of the application of the principles of the disclosure. Those skilled in the art may devise numerous modifications and alternative arrangements without departing from the spirit and scope of the disclosure and the claims are intended to cover such modifications and arrangements. Thus, while the disclosure has been shown in the drawings and described above with particularity and detail, it will be apparent to those of ordinary skill in the art that numerous modifications, including but not limited to, variations in size, materials, shape, form, function and manner of operation, Assembly and use may be made without departing from the principles and concepts set forth herein.

(18) It should be understood that this description is not intended to limit the embodiments. Although the invention has been described in connection with a preferred embodiment, it should be understood that various modifications, additions and alterations may be made to the invention by one skilled in the art without departing from the spirit and scope of the invention as defined in the appended claims

(19) The above-described embodiments are intended to be it illustrative in all aspects, rather than restrictive, all the embodiments. Thus, the embodiments are capable of many variations in detailed implementation that can be derived from the description contained herein by a person skilled in the art. No element, act, or instruction used in the description of the present application should be construed as critical or essential to the embodiments unless explicitly described as such.

(20) Alternate embodiments maybe devised without departing from the spirit or the scope of the different aspects of the embodiments.