JP4836082B2 - Medical posture holding device - Google Patents

Description

  The present invention holds the subject or the subject in a specific posture when moving the subject or the subject in a specific posture from the operating table to the examination table of the image diagnostic apparatus. The present invention relates to a medical posture holding apparatus that can move between an operating table and an examination table of an image diagnostic apparatus.

  Conventionally, when a doctor performs a surgical operation on a treated person in an operating room, the doctor places the treated person on an operating table fixed in the operating room, and the posture is such that the treated person can easily operate the treated person. Surgical operation. The operating table on which this healer is placed is fixed in the operating room, and the top plate of the operating table can be operated so that the doctor can be placed in a posture that makes it easy for the doctor to operate.

  In abdominal surgery, some of the upper abdominal organs are hidden above the radial arch, and it is often difficult to expand the visual field, and organs on the dorsal side of the upper abdomen, such as the pancreas and adrenal gland, If you have a laparotomy, because of the deep position, you tend to have a hard time developing the field of view.

  Therefore, conventionally, a substantially horizontal lumbar plate that supports the patient's waist and buttocks is fixed to a column (column) that is fixed to the floor, and a substantially horizontal leg plate that supports the lower half of the patient to be treated at one end of the lumbar plate. Provided on the extension of the leg plate and the waist plate, a drive mechanism mounting plate is provided at the other end of the waist plate, and the drive mechanism mounting plate has a predetermined level more than the leg plate in a substantially horizontal state via the drive mechanism. There has been proposed an operating table that is provided with a back plate that rises in height and a slide mechanism that moves the back plate in the horizontal direction and places the patient to bend his chest (for example, Patent Document 1). reference.).

  On the other hand, conventionally, a doctor makes a diagnosis on a subject or a subject, performs a surgical operation as necessary, and observes the progress after the operation. The follow-up after this operation is performed using an image diagnostic apparatus such as an MRI apparatus (nuclear magnetic resonance imaging apparatus).

  For a series of operations from such surgery to follow-up after surgery, conventionally, surgical operations are performed in the operating room. After the operation is completed, if necessary, it can be moved to a place different from the operating room. A person to be treated is transported to an image diagnostic room provided, and the person to be treated is placed on an examination table of the image diagnostic apparatus, and progress is observed by the image diagnostic apparatus. For this reason, the loss of time from the operating table in the operating room to the placement of the patient on the examination table in the diagnostic imaging room is time, mental and physical for both the patient and the operating doctor. It is a burden. Furthermore, if inappropriateness of surgery is discovered by observing the progress of the diagnostic imaging apparatus after completion of surgery and reoperation is required, the patient is transported from the examination table in the diagnostic imaging room to the operating table in the surgical room. Loss of time to placement can result in major bleeding or urgent matters, which can result in risk for both the patient and physician.

Therefore, conventionally, in an operating table apparatus in which an examination space is integrated into an operation space and the body position of the patient can be arbitrarily set, the operating table apparatus is further close to the examination space by the MRI apparatus for the purpose of the operation. There has been proposed an operating table device linked to an MRI apparatus that has a structure having a transport means that connects an operating region that is installed at an arbitrary position and that can appropriately perform an MRI examination during an operation ( For example, see Patent Document 2.) That is, this operating table apparatus 1 is provided with a rail receiving portion 13 on its leg base, and is configured to be movable on a rail 14 provided at the lower part of the MRI apparatus 2. By combining both the receiving portion 13 and the rail 14 of the MRI apparatus 2, the positions of the MRI apparatus 2 and the operating table apparatus 1 can be arbitrarily set. Further, a rail is provided on the floor surface, and a rail receiving portion 13 is installed on the operating table device 1 so that the operating table device 1 can move to any location along the guide of the rail on the floor surface. ing.
JP2002-126017 JP2000-232969

  Depending on the surgical site, for example, it is necessary to check the surgical site of the patient using an image diagnostic device while the patient is supine to warp the chest and performing surgery in this position. When it occurs, it is suitable to continue the operation by taking an image with the diagnostic imaging apparatus while maintaining the posture of the patient.

  However, according to Patent Document 1, a substantially horizontal waist plate that supports the waist and buttocks of the patient to be treated is fixed to a column (column) fixed to the floor, and the lower body portion of the patient to be treated is supported at one end of the waist plate. A substantially horizontal leg plate is provided, provided on the extension of the leg plate and the waist plate, a drive mechanism mounting plate is provided on the other end of the waist plate, and the leg plate remains in a substantially horizontal state via the drive mechanism on the drive mechanism mounting plate. In addition, a back plate that rises by a predetermined height and a slide mechanism that moves the back plate in the horizontal direction are provided. For this reason, according to Patent Document 1, the person to be treated is supine to bend the chest depending on the part of the operation, and the patient is treated using the image diagnostic apparatus while performing the operation in this posture. When it is necessary to confirm the surgical site of a person, there is a problem that imaging cannot be performed with the diagnostic imaging apparatus while maintaining the posture of the patient.

  According to Patent Document 2, the patient can be placed on the operating table, and during or after surgery, the operating table of the operating table apparatus can be moved and inserted into the MRI apparatus to perform MRI examination. There is a problem that it is impossible to lie the patient to bend the chest depending on the part of the operation.

  On the other hand, if the operating table of the existing operating table apparatus or the examination table of the existing diagnostic imaging apparatus is greatly improved, it can be used. However, in order to remodel medical equipment, Article 14-9 of the Pharmaceutical Affairs Law In accordance with paragraphs 10 and 10, approval or notification must be made according to the degree of modification, and such approval or notification requires expertise and takes time and cost. In addition, the remodeled medical device becomes an unapproved device due to the remodeling, and is subject to institutional restrictions and disadvantages such as inapplicability of insurance to medical practice using it. For this reason, according to Patent Documents 1 and 2, the above-described problems cannot be improved without remodeling the operating table of the existing operating table apparatus or the inspection table of the existing diagnostic imaging apparatus.

  According to the present invention, the patient is placed in the necessary posture according to the contents of the operation, or during the operation, or after the patient is placed in the necessary posture and the operation is performed, It is an object of the present invention to provide a medical position holding apparatus capable of moving from an operating table of an operating table apparatus to an examination table of an image diagnostic apparatus while maintaining the posture.

  The present invention is a plate-shaped receiving portion that can be placed on a subject or a subject, and the subject or the subject can be changed to a required posture according to the contents of the examination or the operation, While supporting the receiving portion, the subject or the subject placed on the receiving portion changes the receiving portion according to the posture required according to the contents of the examination or the operation, A support mechanism for holding the changed state, a receiving means and the support mechanism are provided in the upper part, and provided with moving means that can move in the lower part, on the operating table of the operating table apparatus, on the stretcher, and the examination table of the diagnostic imaging apparatus It is characterized by comprising a base that moves above.

  According to the present invention, the receiving portion and the support mechanism are provided at the base, the subject or the treatment subject is placed in an arbitrary posture by the receiving portion and the support mechanism, and moved from the operating table of the operating table device onto the stretcher, The stretcher is moved to the examination table of the diagnostic imaging apparatus, and the subject or the subject is moved from the stretcher to the examination table of the diagnostic imaging apparatus by moving the base portion to which the receiving part and the support mechanism are attached. The subject or the subject can be moved between the operating table of the operating table apparatus and the examination table of the diagnostic imaging apparatus while maintaining the posture taken on the receiving unit by the treating person.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows an embodiment of a medical posture holding apparatus according to the present invention. FIG. 1 shows a state in which the medical posture holding apparatus according to the present invention is placed on an operating table of an operating table apparatus.

In FIG. 1, the medical posture holding device 1 is configured by a receiving portion 2, a support mechanism 3, and a base portion 4.
The receiving portion 2 has a plate-like member 5, and is configured so that a subject or a subject can be placed on the plate-like member 5. The plate-like member of the receiving portion 2 is divided at a substantially central portion and is constituted by two plate-like members 5A and 5B. A shaft 7 is attached to the divided portion 6 of the plate-like members 5A and 5B, and the plate-like member 5A and the plate-like member 5B are rotatably connected via the shaft 7. Then, by pushing up the divided portion 6 of the plate-like members 5A and 5B, the posture of the subject or the subject to be placed on the back on the receiving portion 2 is changed to a posture in which the body is warped. Be able to. The degree of warping of the subject or the subject can be adjusted by the upward push-up position of the divided portions 6 of the plate-like members 5A and 5B.

  The support mechanism 3 includes two support rods 8A and 8B (the support rod 8B is hidden and not shown in FIG. 1) and a hydraulic cylinder 9. The two support rods 8A and 8B are provided at both ends of the receiving portion 2 in the width direction. The hydraulic cylinder 9 is attached to the base 4, and the tip of the cylinder lot of the hydraulic cylinder 9 is attached to the divided portion 6 of the plate-like members 5 </ b> A and 5 </ b> B of the receiving portion 2. When the hydraulic cylinder 9 is driven and the tip of the cylinder lot is pushed out, the plate members 5A, 8B, 8B, 8B (the support bar 8B is hidden and not shown in FIG. 1) work together. The 5B division part 6 is pushed up.

  In FIG. 1, the support mechanism 3 is composed of two support rods 8 </ b> A and 8 </ b> B (the support rod 8 </ b> B is hidden and not shown in FIG. 1) and the hydraulic cylinder 9. As shown in FIG. 2, the plate-like member 5 of the receiving portion 2 is divided into a plurality (three in FIG. 2), and the divided plate-like members 5a, 5b, 5c are respectively hydraulic cylinders 10A, 10B, You may make it drive by 10C.

  In FIG. 1, the support mechanism 3 divides the plate-like member 5 of the receiving portion 2 into two plate-like members 5A and 5B, and uses a hydraulic cylinder 9 as means for pushing up the divided portion 6 upward. As shown in FIG. 3, a guide 11 is attached to the base 4, a slider 12 is attached to the guide 11, and a support rod 13 that is rotatably attached to the divided portion 6 is rotated on the slider 12. It may be attached movably, and the dividing part 6 of the plate-like members 5A, 5B may be pushed up in cooperation with the two support rods 8A, 8B by moving the slider 12. The slider 12 is provided with a screw-type lock 12A, and the slider 12 can be fixed at an arbitrary position by the lock 12A.

  Further, as shown in FIG. 4, the support mechanism 3 divides the plate-like member 5 of the receiving portion 2 into a plurality (three in FIG. 2), and the center of the divided plate-like members 5a, 5b, 5c. A pair of magnets 14A and 14B may be attached to the plate-like member 5b and the base 4 corresponding to the above, and the pair of magnets 14A and 14B may be levitated. Reference numerals 14 a, 14 b, 14 c, and 14 d are wires that stop the movement of the plate-like member 5 of the receiving portion 2.

  Further, as shown in FIG. 5, the support mechanism 3 divides the plate-like member 5 of the receiving portion 2 into a plurality of pieces (three pieces in FIG. 2), and the center of the divided plate-like members 5a, 5b, 5c. Two support rods 8A and 8B (the support rod 8B is hidden and not shown in FIG. 5) are provided at both ends in the width direction of the plate-like member 5b, and the cylinder lot of the hydraulic cylinder 9 attached to the base portion 4 is provided. By rotating the hydraulic cylinder 9 and rotatably attaching the tip of the plate to the plate-like member 5b, the two support rods 8A and 8B (the support rod 8B is hidden and not shown in FIG. 1) work together. You may make it push up the plate-shaped member 5b.

  As shown in FIG. 1, the base 4 has a substrate 15 formed in a plate shape. The receiving portion 2 and the support mechanism 3 are attached to the upper surface of the substrate 15. A guide 16A is provided at one end of the receiving portion 2, and two guides 16B and 16C are provided at the other end, respectively. A slider 17A is attached to the guide 16A, and sliders 17B and 17C (the slider 17C is hidden and not shown in FIG. 1) are attached to the guides 16B and 16C, respectively. Although not shown in FIG. 1, the sliders 17A, 17B, and 17C are provided with screw-type locks 18A, 18B, and 18C, respectively.

  When the hydraulic cylinder 9 is driven, the tip of the cylinder lot is pushed out, and the hydraulic cylinder 9 and the two support rods 8A and 8B work together to push up the dividing portion 6 of the plate-like members 5A and 5B. At this time, sliders 17A, 17B, and 17C provided at both ends of the plate-like members 5A and 5B of the receiving portion 2 slide on the guides 16A, 16B, and 16C, and the plate-like members 5A and 5B are shown in FIG. A mountain-shaped slope like this is formed. This inclination angle is adjusted by the degree of protrusion of the cylinder lot of the hydraulic cylinder 9. Then, the position where the dividing portion 6 of the plate-like members 5A and 5B is pushed up is determined by adjustment by the hydraulic cylinder 9, and the position is fixed by the locks 18A, 18B and 18C so that the position does not fluctuate.

  A moving means 19 is provided on the lower surface of the base 4. The moving means 19 is for moving the base 4 on the top plate of the operating table of the operating table device, on the stretcher, and on the top plate of the examination table of the diagnostic imaging apparatus. In FIG. 1, the moving means 19 has wheels 20 a, 20 b, 20 c, 20 d, at appropriate locations on the base 4 (in FIG. 1, at both ends in the width direction of the substrate 15 and three locations in the length direction of the substrate 15). 20e and 20f are attached. The wheels 20a, 20b, 20c, 20d, 20e, and 20f (the wheels 20d, 20e, and 20f are hidden and not displayed in FIG. 1) are provided on the operating table 21 of the operating table device on which the base 4 is placed. Two rails provided on the top plate 22 and the stretcher (in FIG. 1, only the top plate 22 of the operating table 21 is shown, but on the stretcher and the top plate of the examination table of the diagnostic imaging apparatus) (Also provided) for traveling on 23A and 23B.

  In FIG. 3, screw type locks 18A, 18B, and 18C are used to slide on the guides 16A, 16B, and 16C of the sliders 17A, 17B, and 17C and fix them to specific positions. As shown in FIG. 6, a groove 24A is dug in a guide 24 provided on the upper surface of the substrate 15, and a link portion provided in a hydraulic cylinder 25 (in FIG. 6, only the hydraulic cylinder 25 is shown, but a support bar is also the same). The groove 26 </ b> A is dug into the groove 26, and the groove 26 </ b> A of the link portion 26 can be prevented from sliding by being fitted into the groove 24 </ b> A of the guide 24. In order to eliminate the upward detachment of the link portion 26 from the guide 24, it is possible to fix by inserting a sandwiching tool 27 formed in a U shape so as to sandwich the link portion 26 and the guide 24. FIG. 7 shows an example in which the shape of the groove is changed according to the direction of the force acting on the guide.

  In FIG. 1, the substrate 15 of the base 4 is composed of a single plate-like member. However, as shown in FIG. 8, the substrate 15 of the base 4 is divided into a plurality of parts. Further, each of the substrates 15 may be provided with a hydraulic cylinder to drive the receiving portion, and the base portion 4 divided into a plurality may be connected by a connecting mechanism.

  In the case of surgery, the medical position holding apparatus 1 configured as described above first places the medical position holding apparatus 1 on the top plate 22 of the operating table 21 of the operating table apparatus as shown in FIG. . Then, according to the contents of the operation, the posture of the person to be treated is changed by driving the support mechanism 3 (as if the body is bent in a supine state). This is to help the surgeon's vision without forcing the patient to take an unreasonable posture. For example, in abdominal surgery, a part of the upper abdominal organ is hidden above the radial arch, and it is often difficult to expand the field of view. In addition, organs on the dorsal side of the upper abdomen, such as the pancreas and adrenal gland, are located deep when opened from the abdominal side, so they tend to struggle to develop the field of view, so that the position helps the surgeon's vision. ing.

  After placing the medical posture holding device 1 on the top plate 22 of the operating table 21 of the operating table device and performing an operation on the patient, the stretcher 40 is applied to the top plate 22 of the operating table 21 of the operating table device. The end of the top plate 41 is connected. At this time, the rails 42A and 42B provided on the top plate 41 of the stretcher 40 are connected to the rails 23A and 23B of the top plate 22 of the operating table 21 of the operating table device. Therefore, the wheels 20a, 20b, 20c, 20d, 20e, and 20f of the medical posture holding device 1 are rolled to bring the medical posture holding device 1 onto the rails 23A and 23B of the top plate 22 of the operating table 21 of the operating table device. And the wheels 20a, 20b, 20c, 20d, 20e, and 20f of the medical posture holding apparatus 1 are rolled on rails 42A and 42B provided on the top plate 41 of the stretcher 40. In this way, the medical posture holding device 1 is moved on the top plate 41 of the stretcher 40 while holding the posture of the patient. When the medical posture holding apparatus 1 is placed on the top plate 41 of the stretcher 40, the stretcher 40 is moved to connect the end of the examination table 31 of the diagnostic imaging apparatus 30. At this time, the rails 42A and 42B provided on the top plate 41 of the stretcher 40 are connected to the rails 33A and 33B of the top plate 32 of the inspection table 31 of the diagnostic imaging apparatus 30.

  Therefore, the wheels 20 a, 20 b, 20 c, 20 d, 20 e, and 20 f of the medical posture holding device 1 are rolled to move the medical posture holding device 1 on the rails 42 </ b> A and 42 </ b> B of the top plate 41 of the stretcher 40. It is connected to rails 33A and 33B of the top plate 32 of the examination table 31 of the diagnostic imaging apparatus 30. Accordingly, the wheels 20a, b, c, d, e, and f of the medical posture holding apparatus 1 are rolled to move on the rails 42A and 42B provided on the top plate 41 of the stretcher 40 to perform image diagnosis. The wheels 20a, 20b, 20c, 20d, 20e, and 20f of the medical posture holding apparatus 1 are rolled on the rails 33A and 33B of the top plate 32 of the examination table 31 of the apparatus (MRI apparatus) 30. The examination table 31 of the diagnostic imaging apparatus 30 is inserted into the diagnostic imaging apparatus 30 to image the affected area and perform diagnostic imaging.

  In this way, the medical posture holding apparatus 1 is placed on the examination table 31 of the diagnostic imaging apparatus 30 while holding the medical posture holding apparatus 1 on the examination table 31 of the diagnostic imaging apparatus 30 while maintaining the posture of the patient. It is possible to move onto the top plate 32 of the examination table 31 of the diagnostic imaging apparatus 30 via the top plate 41 of the stretcher 40 while maintaining the position of the therapist.

  FIG. 10 shows another embodiment of the medical posture holding apparatus according to the present invention. FIG. 10 shows a state in which the medical posture holding apparatus according to the present invention is placed on the operating table of the operating table apparatus.

In FIG. 10, the medical posture holding device 50 includes a receiving part 51, a support mechanism 52, and a base part 53.
The receiving portion 51 has a plate-like member 54 formed in a horseshoe shape, and is configured so that the subject's leg or the subject's leg can be placed on the plate-like member 54. Yes. The plate-like member 54 of the receiving portion 51 has a shape suitable for placing the subject's leg or the subject's leg.

  The support mechanism 52 includes two arms 55A and 55B to which the plate-like member 54 is attached, and four support rods 56A, 56B, 56C, and 56D that support the arms 55A and 55B. One end of each of the support bars 56A, 56B, 56C, and 56D is rotatably attached to the base 53, and the other end is rotatably attached to the arms 55A and 55B. Arms 57A and 57B are attached to both ends of the two arms 55A and 55B, and the two arms 55A and 55B are reinforced by the arms 57A and 57B.

  Further, one end of each of drive arms 58A and 58B is attached to both ends of the arm 55B so as to be rotatable. Ball screws 59A and 59B are attached to the other ends of the drive arms 58A and 58B. The ball screws 59A and 59B are screwed into worm gears 61A and 61B of the drive device 60. Accordingly, when the drive device 60 is driven to rotate the worm gears 61A and 61B, the ball screws 59A and 59B move, and the other ends of the drive arms 58A and 58B to which the ball screws 59A and 59B are attached move up and down. The position of the plate-like member 54 can be changed.

  The base 53 has a substrate 62 formed in a plate shape. A receiving portion 51 and a support mechanism 52 are attached to the upper surface of the substrate 62. A moving means 63 is provided on the lower surface of the base 53. This moving means 63 is for moving the base 53 on the top plate of the operating table of the operating table device, on the stretcher, and on the top plate of the examination table of the diagnostic imaging apparatus. In FIG. 10, the moving means 63 has wheels 64 a, 64 b, 64 c, 64 d, at appropriate positions of the base 53 (in FIG. 10, at both ends in the width direction of the substrate 62 and at three positions in the length direction of the substrate 62). 64e and 6464f are attached. The wheels 64a, 64b, 64c, 64d, 64e, and f (the wheels 64d, 64e, and 64f are hidden and not displayed in FIG. 1) are provided on the operating table 21 of the operating table device on which the base 53 is placed. Two rails provided on the top plate 22 and the stretcher (in FIG. 10, only the top plate 22 of the operating table 21 is shown, but on the stretcher and the top plate of the examination table of the diagnostic imaging apparatus) (Also provided) for traveling on 23A and 23B.

  10, 65a, 65b, 65c, 65d are fixing bolts for fixing the substrate 62 of the base 53 to a specific position of the top plate 22 of the operating table 21 of the operating table device.

1 is an overall configuration perspective view showing a first embodiment of a medical posture holding apparatus according to the present invention. It is a figure which shows another Example of the receiving part and support mechanism of the medical posture holding apparatus shown in FIG. It is a figure which shows another Example of the support mechanism of the medical posture holding | maintenance apparatus shown in FIG. It is a figure which shows another Example of the support mechanism of the medical posture holding apparatus shown in FIG. It is a figure which shows another Example of the receiving part of the medical posture holding | maintenance apparatus shown in FIG. It is a figure which shows the Example which applied the slide lock mechanism of the support mechanism of the medical posture holding apparatus shown in FIG. It is a figure which shows the modification of the slide lock mechanism of the support mechanism of the medical posture holding apparatus shown in FIG. It is a figure which shows another Example of the receiving part of the medical posture holding apparatus shown in FIG. 1, a base, and a support mechanism. It is a figure for demonstrating the operation | movement which moves the medical position holding apparatus shown in FIG. 1 on the stretcher from the top plate of the operating table of an operating table apparatus, and on the top plate of the examination table of an image diagnostic apparatus. It is a whole composition perspective view showing the 2nd example of a medical posture maintenance device concerning the present invention.

Explanation of symbols

1,50 ……………… Medical position holding device 2,51 ……………… Receiver 3,52 ……………… Support mechanism 4,53 ……………… Base 5,51… …………… Plate-like member 6 ……………………… Dividing part 9 ……………………… Hydraulic cylinder 15 …………………… Substrate 19 ………………… …transportation

Claims (6)

A plate-shaped receiving part on which the subject or the subject is placed, and the subject or the subject can be changed to a necessary posture according to the content of the examination or the operation,
While supporting the receiving portion, the subject or the subject placed on the receiving portion changes the receiving portion according to the posture required according to the contents of the examination or the operation, A support mechanism for holding the changed state;
The receiving part and the support mechanism are provided in the upper part, provided with moving means that can move in the lower part, a base part that moves on the operating table of the operating table apparatus, on the stretcher, on the examination table of the diagnostic imaging apparatus,
A medical posture holding apparatus characterized by comprising: The receiving part is divided into one or a plurality of parts so that the receiving part can be bent at one place or a plurality of places, and the subject or the subject is placed on the receiving part on the back and the contents of the examination Alternatively, the medical posture holding apparatus according to claim 1, wherein the medical posture holding device can be changed in accordance with the posture of curving the body according to the content of the operation. The medical position holding apparatus according to claim 1 or 2, wherein the support mechanism moves the bent part of the receiving part up and down. The support mechanism that moves the bent portion of the receiving portion up and down is any one of a hydraulic cylinder that pushes up the bent portion, an air cylinder that pushes up the bent portion, and a magnet that pushes up the bent portion. The medical posture holding apparatus as described. The medical posture holding apparatus according to claim 1, wherein the moving means of the base is a wheel attached to a lower part. The medical posture holding device is necessary for the patient to be treated according to the contents of the operation by moving on the operating table of the operating table device, the stretcher, and the examination table of the diagnostic imaging device by the moving means of the base. Diagnostic imaging device from the operating table of the operating table device while maintaining the posture of the patient while performing the surgery while taking the correct posture or after performing the surgery with the patient to take the necessary posture The medical posture holding apparatus according to claim 1, wherein the apparatus is capable of moving to an examination table.

Images