Modular, Sterilizable Table for Use in Medical Procedures
A modular sterilizable surgical table that obviates the need for sterile drapes is particularly adapted for use during surgery in hospital operating rooms or in a veterinary health care facility. The table may include a movable base to which a plurality of posts is fixedly attached. A plurality of sterilizable sleeves may be detachably coupled to the plurality of posts. A first sterilizable shelf structured to hold sterilized medical instruments and/or supplies during a medical procedure is detachably coupled to at least one of the sleeves. A second sterilizable shelf structured to hold sterilized medical instruments and/or supplies is detachably coupled to at least another one of the sleeves. Each of the sleeves and shelves is each removable from the table sterilization. The shelves may be adjustable and include one or more lips to retain items placed on the shelves.
This application is a continuation-in-part of application Ser. No. 11/436,609 filed on May 29, 2006, which claims benefit of U.S. Provisional Application No. 60/682,851 filed on May 20, 2005.
BACKGROUND OF THE INVENTIONThe invention relates generally to medical tables and, more particularly, to an improved medical table that is compact and eliminates the need for sterilized drapes or disposable covers.
Various types of specialized equipment are used to perform surgeries and other medical procedures. In particular, stainless-steel tables found in doctor's offices and operating rooms are used to hold a wide variety of sterilized medical instruments and supplies during surgical or other medical procedures.
The requirement for such tables originates from the needs of doctors and nurses to quickly reach a medical instrument or accessory during various medical or surgical procedures. The requirement that medical instruments and supplies, as well as work surfaces of the table itself, be sterilized prior to use (and kept sterile until used) derives from rigorous local, state, and/or national health codes, and/or standard medical practices.
For example, many hospital regulations require routine sterilization of all parts of medical tables used in surgery that are at about thirty inches or higher from the floor of an operating room. As another example, the Centers For Disease Control and various medical organizations strongly recommend the routine sterilization of medical instruments, examination tables, and other medical equipment. Because most conventional surgical tables are not easily disassembled for sterilization, the sterilization requirements are typically met by laying a sterilized disposable drape (cover) on the table surface(s) prior to the start of a medical procedure and then disposing of the drape(s) after the procedure is completed. In contrast, smaller medical instruments and supplies are typically sterilized in an autoclave located in the hospital or other healthcare facility. Examples of acceptable instrument sterilization methods include steam under pressure, dry heat, chemical vapor, radiation, cold sterilization, or ethylene oxide gas.
Conventional surgical tables are typically made from surgical grade stainless steel and their size makes them bulky and awkward to use. Such tables generally have two or more horizontal shelves stacked one above the other and attached to four upright corner posts. The edges of the shelves and other parts of the tables are typically rounded to avoid snagging or tearing a sterilized disposable surgical drape that is laid over a particular shelf or shelves. To provide mobility, such tables are commonly equipped with an anti-static wheel at each bottom corner. The lower and upper shelves of conventional tables are structured to hold instrument sterilization trays and baskets, lap trays, scope trays, plastic baskets, wire baskets, packaged medical supplies and accessories, and other health care products.
The sizes of conventional tables vary, but a typical surgical table measures about seventy-two inches wide, about thirty-four inches high, and about twenty-four inches deep, and has a uni-body construction that prevents sterilizing the table (or its components) in standard hospital autoclaves, which typically measure about three feet wide, about six feet tall, and about five feet deep. Thus, conventional surgical tables used in the operating rooms of most hospitals cannot be readily sterilized using steam under pressure, dry heat, chemical vapor, or other types of sterilization methods. Consequently, the shelves of conventional surgical tables are covered with sterile disposable surgical drapes prior to use. A typical use of a conventional surgical table is described below.
Prior to a surgery, a nurse or technician will prepare the operating room. This is typically accomplished by cleaning the surgical table using a hand-scrubbing method and/or an ultrasonic cleaning method. Once the table is cleaned, the nurse covers the table's work surface(s) with a sterilized disposable surgical drape (or drapes). After the drape(s) have been properly positioned, the nurse loads previously sterilized medical instruments and/or supplies directly onto the surgical drape(s). Generally, the instruments themselves will have been removed from the hospital autoclave a short time before; however, sterilized pre-packaged instruments and/or supplies may be loaded onto the drapes as well. Typical medical instruments and/or supplies may include kits of surgical instruments and medical devices and materials appropriate to the particular surgery that will be performed, as well as autoclave instrument sterilization trays and other sterilization receptacles. Depending on the medical procedure involved, it is not uncommon for a six foot long conventional surgical table to be covered from end to end (and front to back) with sterilized instruments and/or supplies by the time the nurse completes the preparations.
During surgery, the nurse is typically positioned between the doctor and the surgical table. From this position, the nurse can retrieve sterilized instruments and/or supplies and hand them to the doctor as necessary. The nurse can also take contaminated instruments from the doctor and place them on the surgical drape or in sterilization receptacles that were pre-positioned on the surgical table. Because most conventional surgical tables are about six feet long, the nurse often has to move back and forth from one end of the table to the other in order to retrieve (or set down) a sterilized or contaminated item. The size of the table hinders free and easy movement of the table and the people in and around the operating room. Small operating rooms further exacerbate this problem, because the bulky dimensions of a conventional surgical table leaves the nurse (and/or doctor(s)) with little floor space in which to work. Additionally, instruments and/or drapes positioned on the table may fall to the floor if the table is bumped or a drape is snagged. After the surgery or other medical procedure is finished, the drapes are considered to be biohazards, and must be properly incinerated, which increases disposal costs and adds regulatory compliance.
Health care equipment suppliers have proposed numerous approaches for configuring surgical tables and methods for sterilizing them. For instance, one conventional configuration solution adds a top shelf to the table. This top shelf is as long as the tabletop, but slightly narrower. Although the plane of the top shelf is not adjustable relative to the plane of the tabletop, the top shelf may be raised and lowered between heights of about twelve inches to about fifteen inches above the tabletop. This adjustability feature allows persons of about five feet four inches or less to reach instruments on the top shelf without having to use step stools. However, this conventional approach suffers drawbacks in that in addition to traversing the six foot length of the table, the nurse may also have to tilt the trays or baskets on the top shelf and/or stand on tiptoe or on a step stool) to see what instruments and/or supplies are inside. Moreover, instrument trays and other supplies are likely to fall off the narrow top shelf and cascade onto those on the tabletop. Additionally, use of the top shelf requires an extra disposable drape, which increases the hospital's overhead costs.
Yet another proposed, but to Applicant's knowledge never commercialized, approach is disclosed in U.S. Pat. No. 4,927,214 to Kaufman, et al., which discloses an operating room instrument table assembly formed of a plurality of modular table units. Each table unit includes castor wheel supports, a base frame attached to the castor wheel supports, a table top support frame connected to the base frame, and a removable table top detachably connected to the table top support frame. The removable table top is sterilizable as a unit with the instruments used in a medical procedure. The bare frame includes two upright posts. The table top support frame includes two tabular supports connected by a center connector. Each tabular support is sized to fit over one of the upright posts.
One disadvantage associated with this operating room instrument table is that it consumes a large area of floor space since only a single table top is included for each movable base/table support frame. Further, if a larger work area is desired, then separate table tops, each on its own movable base, must be disposed side-by-side, and or in a circular configuration, with the surgeon or nurse in the middle. This leads to yet another disadvantage, which is that the person handling the instruments is not free to move about the operating room, but rather is confined within the center of the modular table units. To move about the operating room, the person must push one of the modular table units out of position, and risk bumping another table unit and thereby knocking instruments into disarray and/or onto the floor. Additionally, to access instruments during a medical procedure, the person may be required to move back and forth from one portion of the table to another. During long medical procedures, this may generate fatigue and/or increase the risk that instruments may be bumped and/or dropped. In addition, only the table top is removable for sterilization. The table support frame (e.g. tubular supports connected by a center connector) remains connected to the movable base, and thus is not sterilizable with the removable table top and/or the instruments.
Another approach is disclosed in U.S. Pat. No. 6,189,459 to DeAngelis, which describes a collapsible auxiliary instrument shelf for use in surgical operating rooms. As described in this patent, a conventional surgical table includes a main shelf that is supported at each corner by a leg. A castor is attached to the bottom of each leg. The auxiliary shelf is supported above the main shelf by a pair of posts. Each post is affixed to one of the rear legs that support the main shelf.
One disadvantage of this apparatus is that neither the auxiliary shelf nor the surgical table to which it is attached are detachable for sterilization. Another disadvantage is that paper and/or clear plastic surgical drapes, with all the drawbacks referenced above, must be used to cover the auxiliary shelf and table before the auxiliary shelf and table can be used in surgery. A further disadvantage is that the auxiliary shelf cannot be angled relative to the main shelf. Consequently, it is difficult for a user of the table to view and/or access items placed on the auxiliary shelf.
Yet another proposed approach is disclosed in U.S. Pat. No. 5,551,674 to Boyd, et al., which discloses an accessory tray for use in a surgery, and, more particularly, a sterilizable accessory tray for supporting absorbent material pads for use in neurosurgery. The tray is supported on a conventional surgical stand, which has a movable base, an adjustable support pole attached the base, and a single shelf cantilevered from the top of the support pole. The accessory tray is removable from and in a fixed angular position relative to the shelf of the surgical stand. However, the shelf and other parts of the surgical stand cannot be readily disassembled and sterilized. Preferably, the accessory tray is made of a disposable plastic material, but it may also be made of a sterilizable plastic or metal material.
A disadvantage of the accessory tray of Boyd, et al. is that the tray is particularly adapted to store sterile absorbent pads commonly used in neurosurgery to absorb blood or retain accumulated blood or brain fluids, meaning it has little if any utility for other medical procedures. Although the accessory tray may be removed from the shelf and sterilized, the tray, much like a surgical drape, is preferably removed and thrown away. Consequently, each use of the surgical stand requires either a new sterilized disposable drape or a new sterilized accessory tray. Another disadvantage of this apparatus is that the shelf of the surgical stand is equipped with a continuous raised lip that tends to retain blood and other fluids drained from any used surgical instruments and/or supplies that may be placed on the shelf during a procedure.
Although today's health care facilities are crowded with new types of medical devices, instruments, equipment, and packaged supplies, virtually no significant improvements have been made to the commercially available medical tables themselves, particularly those used during surgical procedures in hospital operating rooms.
Recent medical studies have generated stringent sterilization requirements, most of which are difficult or impossible to satisfy simply by hand cleaning and ultrasonic cleaning alone. In addition to being bulky and non-ergonomic, conventional surgical tables are difficult to sterilize and are costly because they require the use of expensive sterilized disposable drapes.
Thus, there is a need for an improved configuration of a surgical table, particularly a compact table, used during surgery in a hospital operating room, which is easier to sterilize and use in surgery than conventional surgical tables.
SUMMARY OF THE INVENTIONThe invention meets the foregoing needs and avoids the drawbacks and disadvantages of the prior art by providing a compact, ergonomically-designed, medical table for use in surgery and other medical procedures that has components that may be readily disassembled and sterilized in a standard autoclave of the type typically found in hospitals, thereby either completely obviating the need for conventional disposable drapes or making their use optional.
A table manufactured according to the invention may be used in surgeries or other medical procedures performed in human health care facilities or in animal health care facilities. Both types of medical facilities may include autoclaves or similar sterilizers. The table of the invention may be used either to store medical equipment and/or instruments or as a workspace for performing a medical procedure. Users of a table manufactured according to the invention may include, but are not limited to, veterinarians, traditional doctors and surgeons, medical staff, and other persons who work in the animal or the health care industry.
Accordingly, in one aspect of the invention, a modular surgical table has a movable base to which a plurality of posts may be fixedly attached. A plurality of sterilizable sleeves is detachably coupled to the plurality of lower support members. A first sterilizable platform structured to hold sterilized medical instruments and/or supplies during a medical procedure is detachably coupled to at least one of the sleeves. A second sterilizable platform structured to hold sterilized medical instruments and/or supplies during a medical procedure is detachably coupled to at least another one of the upper support members. Each of the upper support members, the first sterilizable platform, and the second sterilizable platform is removable from the table for sterilization, which obviates the need for sterilized surgical drapes and facilitates re-use of the table in additional medical procedures.
In another aspect of the invention, the lower support members may be generally upright posts that extend upwardly from the base, and the upper support members may be generally vertical sleeves, each having an opening that receives at least a portion of one of the lower support members. A gap may separate the first and second platforms or they may overlap and/or be coupled together. The height and/or angle of the first and second platforms may each be adjustable relative to a floor upon which the table is supported. At least one of the first and second platforms may comprise a shelf. The support members and the platforms may be sized to fit within an opening of a standard hospital autoclave, which typically has a width of about three feet, a height of about six feet, and a depth of about five feet. Additionally, the surgical table may be used during surgical or non-surgical medical procedures performed in a hospital, doctor's office, or health care facility.
The first sterilizable platform may occupy a fixed, first generally planar position that is generally parallel or non-parallel to a second generally planar position occupied by the second sterilizable platform. The second platform may occupy a fixed vertical position higher than a fixed vertical position of the first platform, and the second platform may be disposed behind the first platform. Additionally, at least one of the platforms may be adjustable such that the first and second platforms occupy substantially similar or substantially different vertical positions. At least one of the platforms may further comprise a lateral support member fixedly or detachably coupled to one of the upper support members. Moreover, means for adjusting at least one of the height, angle, and/or horizontal position of the first and second platforms may be provided.
In another aspect of the invention, at least one of the first and second platforms may comprise a plurality of panels occupying positions in substantially the same or substantially different planes. The panels of each platform may be fixed or adjustable relative to each other. At least one platform of the first and second platforms may include a rim extending upwardly from the plane of the platform that prevents the medical instruments and/or supplies from sliding off either the first platform or said second platform. The rim may include a gap, optionally formed at a corner where two rims meet, to conduct fluid away from the at least one platform. The components of the modular surgical table may be made from surgical-grade 304 stainless-steel, or similar material(s). The panels of each platform may also be detachably interlocked by a tab-and-slot arrangement or other means known in the art to form a substantially smooth and/or continuous platform surface.
According to another aspect of the invention, a method may be provided for sterilizing a drapeless surgical table used in a medical procedure, the table having a separable support member and a platform. The method may include, inter alia, sterilizing the platform and separable support member in a standard hospital autoclave; removing the platform and separable support member from the standard hospital autoclave upon completion of a sterilization cycle; assembling the sterilized platform and separable support member onto a sterilizable movable base; and placing sterilized medical instruments and/or supplies directly onto the platform without use of any surgical drapes. The platform may also be inserted and/or removed from the autoclave with one or more other objects attached thereto. Such objects include, but are not limited to, baskets of instruments or instruments themselves.
According to yet another embodiment, the surgical table may include first means for movably supporting the table on a floor, and second means for supporting sterilized medical instruments and/or supplies during a medical procedure, as well as third means for supporting the second means on the first means. The second and third means may be removable from the first means for sterilization, thereby obviating a need for sterilized surgical drapes and facilitating re-use of the table in additional medical procedures. Additionally, the surgical table may include fourth means for adjusting a planar angle of the second means and fifth means for adjusting a height of said second means. The fifth means may be operatively connected to the third means.
In yet another embodiment, a modular surgical table includes a movable base having a plurality of support members attached thereto, each support member may have a platform support. The table also includes a first and second sterilizable platforms that can be removably connected to corresponding platform supports. The first and second platforms are held in place relative to the respective panels supports using a releasable locking mechanism. The sterilizable platforms are removable from the table for sterilization. Thus, the need for sterilized surgical drapes is obviated, which facilitates re-use of the table for additional medical procedures.
If appropriately sized, embodiments of the invention may provide ability to store about the same quantity of surgical instruments and packaged medical supplies as a conventional surgical table, but may do so within the confines of a floor area having exemplary dimensions of about forty inches by about thirty-eight inches. This configuration saves floor space and allows a nurse or other user to readily retrieve instruments and supplies while standing or sitting in a virtually stationary position. Most importantly, however, the surgical table may be used without costly disposable surgical drapes. Standard commercial components may be used with minimal modification (for example, standard sheets and tubes of surgical-grade stainless steel) to form the table of the invention. Thus, manufacturing costs should not be adversely impacted and embodiments of the invention may be competitively priced.
Additional features, advantages, and embodiments of the invention may be set forth in the following detailed description, drawings, and claims, including methods of using the invention to perform various medical procedures. Although numerous implementations and examples of the invention are set forth herein—including in this “Summary of Invention” section—the examples and implementations described herein are not intended to limit the scope of the invention.
In the accompanying drawings:
One or more of the cross-braces 115 may serve as a foot rail. In one embodiment, the table 100 may be equipped with one or more clips or brackets so that two tables can be attached and/or moved together. Each detachable shelf 107A, 107B, 109A, and 109B may be configured to support at least sixty pounds, but the loading may change based upon the desired application.
Each post 114A, 114B, 116A, and 116B has a portion detachably connected to a corresponding one of upper support sleeves 103A, 103B, 105A, and 105B, respectively. For example, the bottom portion of the sleeve 103A may slidably fit over a narrower cross-sectional top portion of the corresponding post 14A. A friction-fit or detent or other connection may be used to fix the relative position of each sleeve and mated post.
For example, as shown in
The posts 114B, 116A, and 116B and corresponding sleeves 103B, 105A, and 105B may be configured in a like manner to detachably couple to each other in a flush-mounted (or non-flush mounted) position. In either case, the sleeves 103A, 103B, 105A, and 105B occupy pre-determined vertical positions along a length of their corresponding posts 114A, 114B, 116A, and 116B.
Like the posts 14A, 114B, 116A, and 116B, the corresponding sleeves 103A, 103B, 105A, and 105B may be formed of any suitable material for use in surgical and other medical procedures, including but not limited to, tubed, surgical-grade, 304 stainless-steel, which may be laser-cut or die-cut from blanks. If the posts 14A, 114B, 116A, and 116B each have the same fixed height, the rear sleeves 105A and 105B may have a fixed height that is greater than a fixed height of the front sleeves 103A and 103B. Alternatively, if the sleeves 103A, 103B, 105A, and 105B each have the same fixed height, the rear posts 116A and 116B may have a fixed height that is greater than a fixed height of the front posts 14A and 114B. This will enable a shelf supported by the rear sleeves and posts to occupy a different vertical position than a shelf supported by the front sleeves and posts, as discussed in more detail below. In another embodiment, the posts 114A, 114B, 116A, and 116B may each occupy vertical positions relative to the sleeves 103A, 103B, 105A, and 105B that are infinitely adjustable or adjustable in predetermined increments. Of course, any other configurations that permit the total length of the post-sleeve combination to be adjustable in length may be used.
As shown in
Although the panels 107A and 107B are illustratively shown at substantially the same height and planar orientation, it is contemplated that the panels 107A and 107B may be individually positioned at the same and/or different heights and/or the same and/or different planar angles. Similarly, although the panels 109A and 109B are illustratively shown at substantially the same height and/or planar orientation, it is contemplated that each of panels 109A and 109B may be individually positioned at the same and/or different heights and/or the same and/or different planar angles (relative to each other and/or to the heights of the panels 107A and 107B).
The plane of the detachable back shelf 109 may be parallel to, but preferably intersects the plane of the front shelf 107 at a small angle as shown in
To increase retentive functions and utility, the front shelf 107 may have a raised lip 111 formed or attached about its entire perimeter, except for one or more corners, where a gap may optionally be provided between otherwise adjoining raised lips. The one or more corner gaps may be structured to allow fluid collected on the shelf 107 to drain. Of course, other fluid draining means known to a skilled artisan may also be used. As shown in
Additionally, the back shelf 109 may have a raised lip 113 formed about a portion of its entire perimeter, except for one or more corners, where a gap may optionally be provided between otherwise adjoining raised lips. The one or more corner gaps may be provided to allow fluid collected on the shelf 109 to drain. As shown in
The front shelf 107 and the back shelf 109, and their component panels, may each be laser-cut or die-cut from any suitable material for use in surgical and other medical procedures, such as a planar sheet of sterilizable, surgical-grade, 304 stainless-steel. Other manufacturing techniques known in the art may also be employed.
The angled back shelf 109 also permits a user of the surgical table to easily and freely access the interiors of boxes, baskets, or trays placed on the back shelf. Raised lip 113 is provided at the front edge of the back shelf 109 to prevent the boxes, baskets, or trays from sliding onto the lower front shelf 107. Similarly, raised lips 113 on the left side and right side of the back shelf 109 prevent the boxes, baskets, or trays from sliding off the back shelf 109 and onto the floor of an operating room. Of course, the back shelf 109 may also be structured to have an angle with the horizontal that is infinitely adjustable or that is adjustable in predetermined increments.
Preferably, the plane of the front shelf 107 parallels the horizontal to provide a flat work surface that is positioned at a lower height than the back shelf 109. The horizontal front shelf 107 may be used to store medical instruments and/or supplies removed from a box, basket, or tray stored on the back shelf 109. In one embodiment of the invention, the plane of the front shelf 107 is fixed relative to the horizontal. A raised lip 111 formed along each of the perimeter edges of the front shelf 107 prevents instruments and/or supplies from sliding off the front shelf 107 and onto the floor of an operating room. Of course, the front shelf 107 may also be structured to have an angle with the horizontal that is infinitely adjustable or that is adjustable in predetermined increments.
The dimensions of the table 100 may vary depending on its desired use. However, in one particularly advantageous embodiment designed for use in hospital operating rooms, the overall depth 117 of the table 100 may measure about forty-three inches from the front edge of the front shelf 107 to the back edge of the back shelf 109. The depth 119 of the front shelf 107 may measure about twenty-one inches. The width 121 of each of the shelves 107 and 109 may measure about forty inches. The height of shelf 107 above the floor is discussed below in
Referring again to
The top portion of the front sleeve 103B may be secured in the recess 133 by a friction-fit, a set screw, and/or other known attachment means. Similarly, the back panel 109B may be supported by a support gusset 126, which extends across the full or partial width of the panel 109B. The gusset 126 may be fixedly connected to the underside of the panel 109B by welding or other attachment means known to a skilled artisan.
The gusset 126 also may be provided with a recess 135 that slidably and detachably fits over the top portion of the back sleeve 105B, which may be bent to angle the panel 109B relative to the sleeve, as discussed below. The top portion of the back sleeve 105B may be secured in the recess 135 by a friction-fit, set screw, and/or other attachment means known to a skilled artisan.
As shown in
While
The table 100 may further include means for adjustably tilting one or both of the shelves 107 and 109 in any number of pre-set or infinitely variable positions relative to the horizontal. Means for adjusting the height of each shelf above the floor in any number of pre-set or infinitely variable positions may also be provided. Any such adjustment means known to a skilled artisan may be employed, e.g., means for altering the length of one or more of the sleeves 103A, 103B, 105A, and 105B and/or means for altering the length of one or more of the posts 114A, 114B, 116A, and 116B as discussed above. Moreover, one or more of the lower posts and/or upper sleeves (and/or one or both of the shelves 107 and 109) may be equipped with hydraulic, pneumatic, electromagnetic strut, pin-detent, or other mechanical, and/or electromechanical assemblies permitting limited relative movement between the posts, sleeves, and/or shelves. By way of illustration and not limitation, the front shelf 107 and/or the rear shelf 109 may vertically adjust using a stainless steel gas spring, such as those sold under the “Inox” tradename, in each vertical post and one or more CMA cable actuators to adjust the height. An embodiment of a table having one or more cable actuators is illustrated in
Although the table 100 illustrated in
As mentioned above, the table 100 obviates the need for disposable, sterilized, surgical drapes to cover non-sterilized portions of the table, e.g., the shelves. Using the table 100 without sterilized drapes is possible because the shelves 107 and 109, and sleeves 103A, 103B, 105A, and 105B of the table 100 may be detached from each other (and from the base 101) and are sized to fit within a hospital autoclave having dimensions in the illustrative range of about four feet to about five feet deep, about thirty-five inches to about thirty-seven inches wide, and about five feet to about six feet tall.
In some health care facilities, the autoclaves may be equipped with wheeled carts. The carts may be equipped to receive sterilization baskets that have been pre-loaded with contaminated instruments, instrument trays, and other medical devices. Once a cart has been loaded, it is placed inside the autoclave, the autoclave door is shut, and the steam or other sterilization process begins. The dimensions of the detachable components of the table 100 may be particularly adapted so that each component will readily fit in one or more pieces on an autoclave cart or in one or more of its sterilization baskets. Optionally, one or more of the detachable components of the surgical table 100 may be placed within a sterilizable packaging material prior to insertion in the autoclave.
Steam, hot air, or chemical vapor sterilization of medical instruments and/or the detachable parts of the table 100 will require varying degrees of time, depending on the load, arrangement, packaging material, and temperature, as well as the type of sterilizing agent, as the skilled artisan will readily recognize.
Various methods exist to evaluate the effectiveness of the sterilization process. For example, chemical indicators that change color after being exposed to a sterilizing agent may be affixed to the baskets, packaging material, or the detachable parts themselves to indicate that the items have been processed through the autoclave. Because chemical indicators do not measure microbial kill, spore-testing or other biological indicators should be used in conjunction with chemical indicators to confirm the efficacy of the sterilization process. Illustratively, an indicator containing microbial spores may be included in a sterilization load and subjected to the sterilization cycle. Once the cycle has been completed, the spores may be incubated in a nutrient medium and evaluated to see whether a suitably high percentage has been neutralized.
In general, the recommended settings for a steam thermal autoclave include 250° F. at 20 PSI for at least thirty minutes followed by fast exhaust and dry cycles. Unwrapped instruments or the detachable parts of the surgical table may be “flash” sterilized using 270° F. at 30 PSI for about four to seven minutes followed by a fast exhaust cycle. These settings are representative only. Different model autoclaves may operate with different settings. In addition to steam sterilization, radiation and chemical methods (ethylene oxide gas) may also be used to sterilize the detachable parts of the surgical table 100.
In use, the assembled and sterilized surgical table 100 may be positioned in a portion of a health care facility, such as an operating room of a hospital. A medical professional, such as a nurse or technician, may load the back shelf 109 with instrument sterilization trays and/or boxes, baskets, or trays of packaged medical supplies. The medical professional may then remove individual instruments from the sterilization trays and/or supplies/kits from the opened packages and place these items directly on the front shelf 107. Thereafter, as the medical procedure is performed, the instruments and supplies may be passed back and forth between the table 100, the medical professional, and the doctor(s). Once the procedure is finished, the medical professional may discard any contaminated items on the table 100 that are disposable, and may place any non-disposable contaminated items into appropriate receptacles for cleaning and loading onto the autoclave cart. Then the medical professional or other technician may disassemble the table 100 for cleaning and sterilization.
Referring to
Once sterilization is complete, the medical professional may reassemble the surgical table 100 using a reverse process. For example, the medical professional may first retrieve the front sleeve 103A from the autoclave cart and slidably fit the bottom end of sleeve 103A over the corresponding top portion of post 114A. This process may be repeated for each of the remaining sleeves 103B, 105A, and 105B, which are slidably fit over the top portions of their corresponding posts 114A, 116A, and 116B. Next, the front shelf 107 (or one of its panels 107A and 107B) may be removed from the autoclave cart and positioned such that one or both of its recessed bases 133 slidably fit over the top portion of one or both front sleeves 103A and 103B. Then the back shelf 109 (or one of its panels 109A and 109B) may be removed from the autoclave cart and positioned such that one or both of its recessed bases 135 slidably fit over the top portion of one or more sleeves 105A and 105B. Thereafter, the table 100 may be loaded with medical instruments and supplies as previously described.
Referring to
Each post 214 and 216 may have a portion detachably connected to a corresponding one of upper sleeves 203 and 205. For example, the bottom portions of sleeves 203 and 205 may slidably fit over a narrower cross-sectional top portion of corresponding posts 214 and 216, respectively. Each shelf and/or post-sleeve combination of the table 200 may be formed of the same materials and have the same cross-sectional shape as each shelf and/or post-sleeve combination of table 100.
Like the shelves of table 100, the shelves 207 and 209 of the table 200 are detachable from their support sleeves, 203 and 205, respectively. The shelf 209 supported by the rear post/sleeve combination may occupy a different vertical position than the shelf 207 supported by the front post/sleeve combination. Additionally, the plane of the back shelf 209 may be parallel to, but preferably intersects the plane of the front shelf 207 at a small angle of about 10° from the horizontal as shown in
Like the shelves of table 100, each shelf 207 and 209 of table 200 may have a blunted raised lip along an edge (or edges) thereof to prevent items placed on either shelf from falling off. A gap (not shown) may be provided between otherwise adjoining raised lips or may be eliminated altogether.
As shown in
Like the table 100, table 200 may include one or more gussets 224 and 226 mounted underneath the front shelf 207 and the back shelf 209, respectively. Like the gussets of table 100, gusset 224 of table 200 may include a recess 233 that slidably and detachably couples to a corresponding portion of sleeve 203. Similarly, gusset 226 of table 200 may include a recess 235 that slidably and detachably couples to a corresponding portion of sleeve 205. A v-shaped gusset is shown in
Like table 100, the table 200 may have virtually any number and size of shelves, posts, and/or sleeves, but maximum benefits are achieved when at least the shelves and the detachable sleeves are sized to fit within a standard hospital sterilization unit. Additionally, the back shelf 209 of table 200 may be adjustable upwards and downwards in a range 241 of about eleven to twelve inches between a first lowered position and a second raised position. While
Like the table 100, the table 200 may further include means for adjustably tilting one or both of the shelves 207 and 209 in any number of pre-set or infinitely variable positions relative to the horizontal. Means for adjusting the height of each shelf above the floor in any number of pre-set or infinitely variable positions may also be provided. Such means may be the same or similar to the means described above with reference to table 100.
The dimensions of the surgical table 200 will vary depending on its desired use. However, in one particularly advantageous embodiment shown in
As illustratively shown in
Illustratively, the front shelf 207 may include a raised lip 211A formed along a front edge thereof, a raised lip 211B formed along a left edge thereof, a raised lip 211C formed along a right edge thereof, and a raised lip 211D formed along a back edge thereof. The raised lips 211A, 211B, 211C, and 211D may be formed of a continuous or a segmented material (i.e., a lip may include notches or gaps distributed along a length thereof). In a similar manner, the back shelf 209 may include a raised lip 211E formed along a front edge thereof, a raised lip 211F formed along a left edge thereof, a raised lip 211G formed along a back edged thereof, and a raised lip 211H formed along a right edge thereof. Alternatively, one or more of the raised lips 211A, 211B, 211C, 211D, 211E, 211F, 211G, or 211H may be omitted. Each raised lip may extend above the plane of the shelf a sufficient distance to prevent surgical instruments or supplies from sliding off the table.
The tops and/or corner edges of each lip may be rounded to prevent cuts or scrapes. Additionally, a gap may be formed at one or more of the intersections of the raised lips of the front shelf 207, such as the intersection of the raised lips 211A and 211C, to facilitate the draining of fluids from the surface of the front shelf 207. Likewise, a gap may be formed at one or more of the intersections of the raised lips of the rear shelf 209, such as the intersection of the raised lips 211E and lip 211F, to facilitate the draining of fluids from the surface of the back shelf 209.
The base 201 of the table 200 illustrates the use of an optional cable actuator 206 that may be used to adjust the height of one or more of the shelves 207 and 209.
Referring to
As shown best in
The rear shelf 307 may be detachably attached to three rear sleeves 305, each of which has a flanged lower portion 351, as shown best in
Similarly, the front shelf 307 may be detachably attached to three front sleeves 303, each of which has a flanged lower portion 355, as shown best in
The front sleeves 303, rear sleeves 305, front posts 314, rear posts 316, front shelf 307, rear shelf 309, and the base 301 may be formed of welded surgical-grade stainless steel or other similar material(s). In addition to welding, or in lieu thereof, the components of the surgical table 300 may be fastened together using any suitable type of fastening means known to the skilled artisan.
Like the table 100, the rear shelf 309 of table 300 may angle downwards towards the front shelf 307. Additionally, the rear shelf 309 may overhang the front shelf 307 such that the front edge 360 of the rear shelf 309 overlaps the back edge 362 of the lower shelf 307. As mentioned above, the front shelf 307, rear shelf 309, rear sleeves 305, and front sleeves 303 may be detached from the base 301 and inserted into a standard sized hospital autoclave for sterilizing. Methods of disassembly, sterilization, assembly, and use of the table 300 parallels those previously described with reference to table 100 and 200, and thus are not repeated here.
One or more of the rear upright support posts 316 may have their bottom ends fixedly or removably coupled to the cross-brace 315A and/or the outer members 363A and 363B. Similarly, one or more of the front upright support posts 314 may have their bottom ends fixedly or removably coupled to the cross-brace 315B and/or to the outer members 363A and 363B. The upper portions of the rear upright support posts 316 and the upper portions of the front upright support posts 314 may be spaced a predetermined distance apart by fixedly or removably coupling one or more cross-braces 315C therebetween. Each cross-brace 315C may be arranged such that its longitudinal axis intersects a longitudinal axis of the posts 316 and/or 314.
The top ends of the rear posts 316 are slidably received in the lower portions 351 of the upper rear sleeves 305. Similarly, the top ends of the front posts 314 are slidably received in the lower portions 355 of the upper front sleeves 303. The top ends of the upper rear sleeves 305 may be detachably coupled to the rear shelf 309 and/or to a backplate 365 thereof. Similarly, the top ends of the upper front sleeves 303A may be detachably coupled to the front shelf 307 and/or to a backplate 367 thereof. Each backplate 365 and 367 may extend downwardly from a rear edge of the corresponding shelf 307 or 309.
The panel 107A may have raised lips 111A, 111B, and 111C on three of its perimeter edges, preferably, a top lip 111A, a left side lip 111B, and a front lip 111C, similar to the other lips described above. The lips 111A, 111B, and 111C may be formed by bending the appropriate perimeter edges upwards, as shown in
As shown in
When two v-shaped gussets 126A are placed back-to-back, the gussets 126A form a generally X-shape when viewing the underside of the panel 109A in plan, again as best shown in
Like the other components of the table 100, the gussets 126A may be formed of stainless steel, or other suitable material(s). The gussets 126A may be fixedly or detachably and/or adjustably coupled to the panel 109A using welding or other fastening means known to the skilled artisan.
The gussets 124A may be configured to fixedly or adjustably tilt the plane of the panel 107A at an angle of about 10° with the horizontal. Preferably, however, the gussets 124A secure the plane of the shelf 107A parallel or substantially parallel to a flat, non-inclined floor. Like the other components of the table 100, the gussets 124A may be formed of stainless steel, or other suitable material(s). The gussets 124A may be fixedly or adjustably coupled to the panel 107A using welding or other fastening means known to the skilled artisan.
In use, the front left panel 107A is coupled to its corresponding upper sleeve 105A, as previously described. Then, the front right panel 107B is coupled to its corresponding upper sleeve 105B as previously described and simultaneously interlocked with the adjacent front left panel 107A by overlapping the left edge 112B of the front right panel 107B with the right edge 112A of the front left panel 107A and by inserting the tabs 147 into the corresponding slots 146A that are formed along the right edge 112A of the front left panel 107A. Because the right edge 112A of the front left panel 107A is offset below the plane of the panel 107A, the two overlapping edges will mate to form a substantially flush seam such that the work surfaces of each adjacent panel 107A and 107B are substantially even. Additionally, because the front lip 111D of the front right panel 107B extends all the way to the very edge 112B, a portion of the front lip 111D will overlap the left edge 112A of the front left panel 107A and adjoin the front lip 111C that is formed on the front left panel 107A. In this manner, the shelf 107 as a whole is provided with a substantially continuous raised lip along its front edge. Although not shown in
As more clearly shown in
Referring again to
Looking at
The table 400 may include a pair of horizontal shelf supports 447 connected by welding or other suitable means between posts 414A and 416A, and posts 414B and 416B. Shelf supports 447 supports a storage shelf 449 that provides an additional working surface or place where instrument, supplies or other materials may be stored. The storage shelf 449 may have a raised lip 445 on one or more sides that serve the same purpose as the lips 411, 413 on the front and back shelves 407, 409.
Each shelf panel 407A, 407B, 409A, 409b may be readily and securely attached to and removed from the respective posts 414A, 414B, 416A, 416B by a locking mechanism 443, which will be described in further detail below.
Referring to
The panel 407a can then slide in a first horizontal direction along the slot portion of openings 440 (as shown by the arrow H) so that the slot portions of the openings 440A, which has a width much less than the diameter of the stud 451, secures the panel 407a to the support to prevent movement in a vertical direction. As the panel 407A slides horizontally, the engagement portion 443A will “catch” the fixing plate 451 when its mating aperture 451B passes over of the locking mechanism 443. The biasing force applied by the locking mechanism 443 to the engagement portion 443A will force it into the mating aperture 451A to secure the panel 407 and prevent horizontal movement relative to the post.
The panel 407a can be easily detached from its post 414A by pulling the J-shaped actuator 443B downwardly to overcome the biasing force applied to the engagement portion 443A, which will cause it to become disengaged from the mating aperture 451A so that the panel can slide in a second horizontal direction, opposite the first horizontal direction H. Once the studs 451 are realigned with the keyhole portions of the openings 440, the panel 407A can be lifted upwardly and detached from the post 414A.
As noted previously, while the posts 414A, 414B, 416A, 416B in this embodiment are shown to be one-piece posts extending from the base 401 to the shelves 407, 409, each post, however, could also be divided into sections, such as a lower post section and upper support sleeve section, such as provided in table 100 of
The frame 500 includes a base 502 formed from four box-section structural elements. Caster wheels 504 are mounted at the corner of the frame. A pair of front upright members 506 and a pair of rear upright members 508 are welded to the base, and extend vertically upward from it. The uprights are braced near their upper ends by side, front and rear braces 510, 512 and 514 respectively. A pair of short vertical braces 516 are welded to the side braces, near the rear uprights.
A pair of parallel front carriage brackets 518 are connected to the top braces, preferably by welding, overlapping the front uprights, and a pair of parallel rear carriage brackets 518′ are connected, preferably by welding, across the tops of the vertical braces and the rear uprights. The front and rear brackets are not parallel to each other, inasmuch as the lower (front) brackets 518 are horizontal and the rear (upper) brackets 518′ are inclined with respect to the horizontal at the small acute angle α described above.
As best seen in
The carriage 526 is a sturdy metal element having a flat central portion 528 with downturned parallel flanges 530 at opposite lateral edges. The slide part 524 is connected to one of these flanges by screws or rivets.
An array of (preferably four) keyhole-shaped apertures 532 is formed in the central portion 528. On carriage 526, the apertures are aligned all facing the same way, with their larger ends to the left, their lengths running in a lateral direction perpendicular to the flanges 530. The apertures on carriage 526′ are aligned in the opposite direction, so that no matter which side of the table a person is standing on, the direction of removal is perceived as right-to-left.
The slides 520 support the carriage 526 and enable it to move unidirectionally along the fixed horizontal axis “H”, which is parallel to the slides. The carriage 526 cannot move in any other direction, and cannot yaw, pitch or roll.
Even along its sliding axis “H”, the carriage is normally prevented from moving by a pair of latch pins 534 which extend upward through the respective front uprights 506 from the base to and through the carriage brackets 518. A steel angle element 536 is securely fixed to each of the flanges 530 of the carriage 526, with the protruding horizontal flange of each angle element in the path of one of the latch pins. This flange is perforated by a series of holes, into any one of which the pin can enter from below to immobilize the carriage. A spring 538 within the upright biases the pin upward, causing it to seat in one of the holes. A treadle 540 is provided at the bottom of the frame to disengage the pins. The treadle is connected to the pair of pins controlling the table top above it, and pressing on the treadle retracts the pins from the holes in the perforated flanges 530, freeing the carriage.
The rear carriage components are identical to those for the front carriage, and each is indicated with a corresponding reference number with a prime added. It may be seen that each carriage 526, 526′ is controlled by a respective treadle 540, 540′.
A table top is mounted on each of the carriages. The tops are identical, except that the upper, inclined, one 542′ is provided with an upturned lip 544 along its lowermost edge, to prevent small items from rolling off. The corresponding edge on the lower, horizontal, top 542 is turned downward.
One of the tops is shown upside down in
Four headed studs 554 are welded to the base plate, at an array spacing corresponding to the spacing of the keyhole apertures in the carriages. The heads 556 of the studs are sized to fit through large ends of the keyholes 532, and their necks 558 are sized to fit within the small ends of the keyholes, so the tables can be installed on their respective carriages simply by inserting the studs heads into the keyholes, and then pushing the top laterally—in a horizontal direction perpendicular to the movement axes of both of the carriages—to lock the tops to the carriages. An advantage of this arrangement is that a person cannot accidentally disengage the table top by leaning against the front end of the table, or by pushing or pulling on it (while stepping one the treadle) to reposition the table. A deliberate lateral force is required.
To provide added security against accidental dislodgement of the table tops, a retactable plunger device 560 (see
A table manufactured according to the invention may further include a shelf customized to support a basket (not shown) containing a medical instrument kit, such that the shelf and connected basket may be sterilized together in a standard hospital autoclave without separating the shelf and basket from each other. This arrangement reduces set-up time by permitting a nurse or medical technician to assemble the shelf (with basket attached) on the table base after simultaneously removing the shelf and its attached basket from the autoclave.
The invention is subject to other modifications. For example, one or more of the raised lips 113 of the rear shelf 109 and/or one or more of the raised lips 111 of the front shelf 107 of
Claims
1. A surgical accessory table comprising
- a frame including a movable base, plural uprights extending upward from said base, and plural braces interconnecting said uprights near the upper ends,
- a pair of carriages supported by said frame, each said carriage comprising a planar segment and a pair of flanges formed at opposite ends of the planar segment, the planar segment having plural keyhole apertures formed therein,
- the carriages being mounted to move linearly along respective fixed, non-parallel non-collinear axes, one of which is horizontal and one of which is inclined at an acute angle to horizontal,
- plural table tops, each removably connected to a respective one of said carriages by stud fasteners which engage or disengage which the table top is slid laterally in a horizontal direction perpendicular to the axis of movement of the respective carriage.
2. The surgical accessory table of claim 1, wherein the acute angle is fixed and cannot be varied.
3. The surgical accessory table of claim 2, wherein the acute angle is less than the angle of repose for surgical instruments.
4. The surgical accessory table of claim 2, wherein the acute angle is in the range of 5° to 15°.
5. The surgical accessory table of claim 2, wherein the acute angle is about 10°.
6. The surgical accessory table of claim 1, wherein said axes are coplanar, so the upper table moves in a plane that would intersect the plane of the lower table, but the slides limit movement that prevents the tops from striking one another.
7. The surgical accessory table of claim 1, wherein each of the carriages may be fixed in position along its axis of movement by a latch mechanism.
8. The surgical accessory table of claim 7, wherein the latch mechanism comprises at least one element, affixed to the carriage, having plural holes therein and at least one movable pin, contained within the frame, capable of entering one of the holes.
9. The surgical accessory table of claim 8, further comprising a spring for biasing the pin into engagement with one of said holes.
10. The surgical accessory table of claim 1, further comprising a treadle connected to at least one of the pins in such a way that depressing the treadle retracts the pin connected thereto out of engagement with said holes.
11. The surgical accessory table of claim 1, wherein the stud fasteners are headed studs on one of the table top and the carriage, and corresponding keyhole apertures are formed in one of the carriage and the table top.
12. The surgical accessory table of claim 11, wherein each carriage has the keyhole apertures aligned all in the same direction, with their length perpendicular to the axis of movement of the respective carriage.
13. The surgical accessory table of claim 12, wherein the keyhole apertures on one carriage are aligned in a direction opposite those of the keyhole apertures on the other carriage.
14. The surgical accessory table of claim 1, further comprising a locking device comprising a retractable plunger which seats in a hole in the table top to prevent the stud fasteners from being disengaged accidentally from the keyhole slots.
Type: Application
Filed: Nov 30, 2007
Publication Date: Jun 26, 2008
Inventors: Scott D. Hodges (Oultewah, TN), S. Craig Humphreys (Chattanooga, TN), Ira B. Young (Chattanooga, TN), Christopher B. Young (Chattanooga, TN)
Application Number: 11/948,089
International Classification: A47F 5/12 (20060101);