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NL2029875B1 - A fixation arrangement for a patient - Google Patents

A fixation arrangement for a patient Download PDF

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Publication number
NL2029875B1
NL2029875B1 NL2029875A NL2029875A NL2029875B1 NL 2029875 B1 NL2029875 B1 NL 2029875B1 NL 2029875 A NL2029875 A NL 2029875A NL 2029875 A NL2029875 A NL 2029875A NL 2029875 B1 NL2029875 B1 NL 2029875B1
Authority
NL
Netherlands
Prior art keywords
patient
base
extension table
robot
robot arm
Prior art date
Application number
NL2029875A
Other languages
Dutch (nl)
Inventor
Henricus Josephus De Beer Abraham
Original Assignee
Eindhoven Medical Robotics B V
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Eindhoven Medical Robotics B V filed Critical Eindhoven Medical Robotics B V
Priority to NL2029875A priority Critical patent/NL2029875B1/en
Priority to PCT/NL2022/050657 priority patent/WO2023096479A1/en
Application granted granted Critical
Publication of NL2029875B1 publication Critical patent/NL2029875B1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/32—Surgical robots operating autonomously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking
    • A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Robotics (AREA)
  • Neurosurgery (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)

Abstract

The invention deals with a fixation arrangement for a patient, comprising an operating table for accommodating the patient during an operation with a robot arm on the head area of the patient, where a base of the robot arm is supported independently from the operating table and where a fixation device for the head of the patient is fixed to the base of the robot arm. The fixation device for the head is necessary since the robot arm needs to know the exact position of the head during the operation. According to the invention the base of the robot arm comprises an extension table that extends under the patient to support at least the shoulders of the patient. That way serious injury of the neck of the patient is avoided when robot base or operation tab|e move with respect to each other.

Description

Title: A fixation arrangement for a patient
Description:
The invention relates to a fixation arrangement for a patient, comprising an operating table for accommodating the patient during an operation with a robot arm on the head area of the patient, where a base of the robot arm is supported independently from the operating table and where a fixation device for the head of the patient is fixed to the base of the robot arm.
Such an arrangement is known from US10881483B2. With the known robot arm, the head of the patient is fixed to an extension arm of the base of the robot arm.
The known fixation arrangement has several disadvantages. The head of the patient rests on the extension arm of the base. The robot needs to know precisely where the head of the patient is located in reference to an instrument on the robot arm, i.e. the head needs to be fixed with respect to the base and thus to the robot arm itself. The rest of the body of the patient lies on the operating table. The base of the robot arm and the operating table can move independently from each-other. So, when the base of the robot arm or the patient table are moving with respect to each-other for instance by someone bumping into them or when one of the base or table is accidently activated to move, the fixed head of a patient moves with respect to the rest of the body of the patient on the operating table. This can cause a dangerous situation for the patient.
Locking the robot base and the patient table together is not an option, since robot arms are designed as independent machines to be used on different operating tables.
Moreover, the operating table and the robot arm have independent mechanisms to adjust them. Putting the robot arm on the operating table is also not an option since operating tables are of a general design and not meant to host a rather heavy robot arm in addition to the patient.
According to the invention the base of the robot arm is provided with an extension table that can support at least the shoulders of the patient. The base and the extension table form a rigid connection. That way any movement between the base and the operating table is not just taken up by the neck vertebrae of the patient, but also by the shoulders of the patient. This greatly diminishes the risk of any injury to the neck of the patient. The robot base and the operating table can be side by side or the base can be located just on top of the operating table.
Preferably the extension table is removable and can be re-attached to the base. This gives more flexibility during use. For instance, when used for a small patient, a smaller extension table can be used, while for a very tall person, a much larger extension table can be used. Also the extension table will not be in the way when the robot arm is used for operations on other body parts, like the spine, where the risk of injuring the neck is not relevant.
The extension table can be made relatively stiff over its total dimensions. In a preferred embodiment, the extension table is stiffer next to the base, i.e. under the neck of the patient and more flexible further away from the neck in the direction of the shoulders of the patient. This means that the area of the extension table bordering the base of the robot arm and supporting the neck is relatively stiff. In practice at least 10 cm next to the base should be made stiffer, so that for most patients the neck area and a part of the shoulders are supported by the extension table. Further away from the base, beneath the shoulder blades and lower, the extension table can be more flexible, so that the extension table is better able to follow any movement between the operation table and the extension table at that place. This way, no forces are exerted on the neck vertebrae of the patient. The vertebrae beneath the shoulders and lower in the body are much stronger than the vertebrae of the neck. That way there is a smooth, i.e., not abrupt, transition between the extension table and the operating table.
Such a flexibility can be realized by using different materials for the extension table in the vicinity of the base, under the neck and further away from the base. Preferably the thickness of the extension table is less further away from the base. That way a single material can be used for the extension table. The thicker part of the extension table near the base then provides the required stiffness for supporting the neck and the thinner thickness, near or below the shoulders provides more flexibility. In a practical example for an average person, the stiffer part extends from the base for about 30 cm and from 30 cm onwards the extension table becomes gradually thinner.
In a preferred embodiment, the extension table comprises carbon fiber. An extension table made largely of carbon fiber is strong and can easily be formed with a thicker, stiffer and thinner, more flexible part.
In order to make sure that the patient's shoulders and head remain aligned, the extension table is provided with straps that can fix the shoulders of a patient to the extension table. Such straps can run from the extension table through the arm pits and over the chest of the patient. That way, the patient is securely fixed with their head and shoulders aligned and fixed together.
The extension table is provided with ridges to provide sideways support to the body of a patient. This enables an even further fixation of the patient. A sideways movement of the body of the patient is prevented.
Especially for autonomously operating robots a rigid fixation of the head is important, since the robot arm will follow a predetermined path and a surgeon cannot make any corrections. The surgeon can only stop the operation. Thus especially for such operations an extension table is important, since that way, even if small disturbances occur between base and operating table the operation can continue, since there is no risk of serious damage to the neck vertebrae.
DESCRIPTION FIGURES
The invention is further explained in more detail and by way of a non-limiting example with the help of the following drawing in which
Figure 1 shows a fixation arrangement for a patient 2 for performing robot surgery with a robot base 5 and an extension table 10 according to the invention,
Figure 2 shows a robot base 5 and the extension table 10 for fixating the patient 2 to the robot base 5,
Figure 3 shows the extension table 10 as a separate item.
The figures are for explaining only and not drawn to scale.
Figure 1 shows a fixation arrangement 1 for a patient 2, with an operating table 3 for accommodating the patient 2 during an operation with a robot arm 4, where a base 5 of the robot arm 4 is supported by a robot support 6 independently from the operating table 3 and where a fixation device 7 for the head of the patient 2 is fixed to the base 5 of the robot arm 4.
The robot base 5 and the operating table 3 can be side by side or the base 5 can be located just on top of the operating table 3.
Robot parts 4, 5, 6 are rather heavy, so they are normally not placed on top of standard operating tables 3. That means that the robot base 5 and arm 4 are placed on a robot support 6. The support 6 can be a separate table or cabinet that normally houses electronics for the robot, but also monitors can be attached to the support 6. The robot support 6 normally has a means to adjust the height of the robot base 5, so that operations on different heights of the table 3 and of the patient 2 can be performed.
The height of the support 6 is then adjusted, so that the robot base 5 is placed at such a height that the robot arm 4 can easily reach the area where the operation on the patient 2 takes place. For optimal access to a patient 2, the robot base 5 is normally short, i.e., the distance toward a patient 2 should be as small as possible, so that the base 5 can be placed close to a patient.
The robot support 6 can also normally be moved to different areas of the patient 2, like the head or the spine, so that operations on different body parts can be performed.
When operating on the area of the head of the patient 2, the head is fixated to the robot base 5 with a fixation device 7, schematically indicated in figure 1. In practice, such a device 7 can include screws, clamps and/or straps. This fixation of the head to the base 5 of the robot arm 4 is necessary, since the robot arm 4 needs a fixed reference position for the head, so that the head does not move when the robot arm 4 operates on the patient 2. The operation table 3 is normally a standard operation table.
Such tables 3 have the possibility to adjust the height of the table 3 so that a surgeon or robot can easily reach the area to be operated on. The patient 2 is strapped/fixed to the operating table 3 as shown by strap 8, so that the patient 2 cannot move with respect to table 3. In a standard arrangement the table 3 and the robot base 5 can in principle move with respect to each other. The mechanisms that can move support 6 and thus the robot base 5 and the operating table 3 are very strong. They can easily move several hundreds of kilograms. If by accident the mechanisms are activated or 5 if someone or something bumps into the table 3, the robot support 6 or the base 5, there is the risk that the table 3 and the robot base 5 move with respect to each other.
In that case the fixed head of a patient 2 moves with respect to the rest of the body of the patient 2 on the operating table 3. This can cause a dangerous situation for the patient 2 exerting large forces on the neck of patient 2, resulting in serious injury for the patient 2. Locking the robot base 5 and the patient table 3 together is not an option, since robots 4,5,6 are designed as independent machines to be used on different operating tables 3. Moreover, the operating table 3 and the robot have independent mechanisms to adjust them. Putting the robot arm 4 and the base 5 on the operating table 3 is also not an option, since operating tables 3 are of a general design and not meant to host a rather heavy robot arm 4 plus base 5 in addition to the patient 2.
Figures 1 and 2 show that, according to the invention, the base 5 of the robot arm 4 is provided with an extension table 10 that can support at least the shoulders of the patient 2. That way, the neck of the patient 2 is rigidly connected to the shoulder area of the patient 2, meaning that any movement between the base 5 and the operating table 3 is not just taken up by the neck vertebrae of the patient 2, but also by the shoulders of the patient 2. This greatly diminishes the risk of injury to the neck of the patient 2.
Figures 2 and 3 show how the extension table 10 can be removed and can be reattached to the base 5. This gives more flexibility during use. In the example, the extension table 10 is equipped with pins 12 that have a tight fit in holes in the base 5.
But of course, there are more ways to fix the extension table 10 to the base, for instance a bolt-nut construction can be used. Also a more permanent solution for the extension table can be made with hinges and a lock that keeps the extension table 10 in a fixed position to support a patient 2 or stored against or in the robot base support 6. The possibility to remove and refix the extension table 10 is useful when the robot needs to be used for different operations, for instance on the spine, where the extension table 10 is not necessary. Also, different size extension tables 10 can be used. For instance, when used for a small patient, a smaller extension table can be used and for a very tall person, a larger extension table can be used. It is also possible to provide the extension table 10 with a part that can extend the table 10 when necessary. For an average person, the extension table is circa 40 — 60 cm wide and also 40 — 60 cm long.
In a preferred embodiment, the extension table 10 is stiffer next to the base and under the neck of the patient and more flexible further away from the neck in the direction of the shoulders of the patient 2. This means that the area of the extension table 10 bordering the base 5 of the robot arm 4 and supporting the neck is relatively stiff.
Further away from the base 5, beneath the shoulder blades and lower, the extension table can be more flexible, so that the extension table is better able to follow any movement between the operation table 3 and the extension table 10 at that place. This way, no forces are exerted on the neck vertebrae of the patient 2. The vertebrae beneath the shoulders and lower in the body are much stronger than the vertebrae of the neck. That way, there is a smooth, i.e., not abrupt, transition between the extension table 10 and the operating table 3. It is advised that at least the first 10 cm next to the base is stiffer. In general it is sufficient if the first 30 cm of the extension table next to the base 5 is stiffer than the rest of the extension table 10 further away from the base.
In practice, the stiffness of the extension table near the base 5 should be such that the deflection of the extension tale should not exceed 2 mm with a force of 500 N.
Flexibility can be realized by using different materials for the extension table 10 in the vicinity of the base 5, i.e., under the neck and further away from the base 5. Preferably, the thickness of the extension table is less further away from the base. That way a single material can be used for the extension table 10. The thicker part of the extension table 10 near the base 5 then provides the required stiffness for supporting the neck and the thinner part, near or below the shoulders, provides more flexibility, so that the extension table can follow any movement of the table 3. In a practical example for an average person, the stiffer part extends from the base for about 30 cm and from 30 cm onwards the extension table becomes gradually thinner. Of course variations are possible. For instance the first 30cm can have a certain thickness, while beyond the
30cm towards the shoulders the thickness is smaller but the same lower thickness is used throughout the more flexible part.
In a preferred embodiment, the extension table is made of carbon fiber. Carbon fiber is strong and can easily be formed with a thicker, stiff and thinner, flexible part.
Figure 1 shows that, in order to make sure that the patient's shoulders and head remain aligned, the extension table is provided with straps 15 that can fix shoulders of a patient 2 to the extension table 10. Such straps can run from the extension table 10 through the arm pits and over the chest of the patient 2. That way, the patient 2 is securely fixed with their head and shoulders aligned and fixed together. Figure 2 and 3 show that the extension table has holes 16 that can be used to attach the straps 15 to the extension table 10.
Figures 2 and 3 show that the extension table 10 is provided with ridges 17 to provide sideways support to the body of a patient 2. This enables an even further fixation of the patient 2. A sideways movement of the body of the patient 2 is prevented. The ridges 17 can be made of the same material as the extension table 10, but can also be made of a different material, for instance so as not to influence the flexibility of the extension table away from the base 5. The ridges 17 can be made to fit a patient 2, for instance by making them movable sideways, so as to lock the patient. The straps 15 that fix the patient 2 can be fixed to the extension table 10 itself or to the ridges 17.

Claims (9)

CONCLUSIESCONCLUSIONS 1. Een fixatie systeem voor een patiént, omvattend een operatietafel voor het ondersteunen van de patiént tijdens een operatie met een robotarm op het hoofdgebied van de patiënt, waarbij een basis van de robotarm onafhankelijk van de operatietafel wordt ondersteund en waarbij een fixatieapparaat voor het hoofd van de patiënt aan de basis van de robotarm wordt bevestigd, met het kenmerk dat de basis van de robotarm een verlengtafel omvat die zich onder de patiënt uitstrekt om ten minste de schouders van de patiënt te ondersteunen.1. A patient fixation system comprising an operating table for supporting the patient during surgery with a robotic arm on the patient's head area, a base of the robotic arm being supported independently of the operating table, and a head fixation device of the patient is attached to the base of the robotic arm, characterized in that the base of the robotic arm includes an extension table extending below the patient to support at least the shoulders of the patient. 2. Een fixatie systeem voor een patiënt volgens conclusie 1, met het kenmerk dat de verlengtafel van de basis kan worden verwijderd en opnieuw aan de basis kan worden bevestigd.A patient restraint system according to claim 1, characterized in that the extension table can be removed from the base and reattached to the base. 3. Een fixatie systeem voor een patiënt volgens een van de voorgaande conclusies, met het kenmerk dat de verlengtafel stijver is naast de basis en flexibeler is verder weg van de basis van de robotarm.A patient restraint system according to any one of the preceding claims, characterized in that the extension table is stiffer adjacent to the base and more flexible further away from the base of the robotic arm. 4. Een fixatie systeem voor een patiënt volgens conclusie 3, met het kenmerk dat de eerste 10 cm naast de basis stijver zijn.A patient fixation system according to claim 3, characterized in that the first 10 cm adjacent the base are stiffer. 5. Een fixatie systeem voor een patiént volgens een van de voorgaande conclusies, met het kenmerk dat de verlengtafel koolstofvezel omvat.A patient restraint system according to any one of the preceding claims, characterized in that the extension table comprises carbon fibre. 6. Een fixatie systeem voor een patiént volgens een van de voorgaande conclusies, met het kenmerk dat de verlengtafel is voorzien van riemen waarmee de schouders van de patiént aan de verlengtafel kunnen worden bevestigd.A fixation system for a patient according to any one of the preceding claims, characterized in that the extension table is provided with straps with which the shoulders of the patient can be attached to the extension table. 7. Een fixatie systeem voor een patiént volgens een van de voorgaande conclusies, met het kenmerk dat de verlengtafel is voorzien van verhogingen om het lichaam van een patiënt zijdelings te ondersteunen.A patient restraint system according to any one of the preceding claims, characterized in that the extension table is provided with elevations for laterally supporting a patient's body. 8. Een fixatieregeling voor een patiënt volgens één van de voorafgaande conclusies, met het kenmerk dat de robotarm deel uitmaakt van een autonoom werkende robot.A restraint arrangement for a patient according to any one of the preceding claims, characterized in that the robot arm forms part of an autonomously operating robot. 9. Een verlengtafel volgens een der voorgaande conclusies.An extension table according to any one of the preceding claims.
NL2029875A 2021-11-23 2021-11-23 A fixation arrangement for a patient NL2029875B1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
NL2029875A NL2029875B1 (en) 2021-11-23 2021-11-23 A fixation arrangement for a patient
PCT/NL2022/050657 WO2023096479A1 (en) 2021-11-23 2022-11-16 A fixation arrangement for a patient

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
NL2029875A NL2029875B1 (en) 2021-11-23 2021-11-23 A fixation arrangement for a patient

Publications (1)

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NL2029875B1 true NL2029875B1 (en) 2023-06-15

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NL2029875A NL2029875B1 (en) 2021-11-23 2021-11-23 A fixation arrangement for a patient

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WO (1) WO2023096479A1 (en)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014177673A1 (en) * 2013-05-03 2014-11-06 Mdd Europe Limited Immobilisation device
US20170348133A1 (en) * 2015-11-09 2017-12-07 Smart Armour Inc. Spinal support device
US10881483B2 (en) 2015-05-21 2021-01-05 Medtech S.A. Neurosurgical assistance robot
US20210121252A1 (en) * 2018-04-12 2021-04-29 Eindhoven Medical Robotics B.V. Robotic instrument for bone removal

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014177673A1 (en) * 2013-05-03 2014-11-06 Mdd Europe Limited Immobilisation device
US10881483B2 (en) 2015-05-21 2021-01-05 Medtech S.A. Neurosurgical assistance robot
US20170348133A1 (en) * 2015-11-09 2017-12-07 Smart Armour Inc. Spinal support device
US20210121252A1 (en) * 2018-04-12 2021-04-29 Eindhoven Medical Robotics B.V. Robotic instrument for bone removal

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Publication number Publication date
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Effective date: 20241201