阅读说明：本技术 具有锁定旋转接头的医用保持臂 (Medical holding arm with locking swivel ) 是由 G·科赫 于 2018-05-03 设计创作，主要内容包括：本发明涉及一种医用保持臂(10),包括：抓握端(13)；耦合端(11)；位于耦合端上的旋转接头(16),用于使保持臂绕摆动轴线(A1)摆动并且用于使保持臂绕倾斜轴线(A2)倾斜；以及夹紧机构,利用所述夹紧机构能选择性地锁定或释放旋转接头。旋转接头(16)允许保持臂(10)仅绕倾斜轴线(A2)和摆动轴线(A1)转动。所述倾斜装置具有倾斜元件和圆柱形工作面,倾斜元件配合在圆柱形工作面上。摆动装置具有导向环和至少一个容纳导向环的环形导向面。中心体,所述圆柱形工作面和所述至少一个环形导向平面在中心体上构成,所述中心体位于旋转接头的中央。倾斜元件作为夹紧机构的部件同样起夹紧箍的作用,使得所述夹紧箍通过夹紧中心体(22、24)而既夹住倾斜装置也夹住摆动装置,以防止发生转动。(The invention relates to a medical retaining arm (10) comprising: a gripping end (13); a coupling end (11); a swivel joint (16) on the coupling end for swinging the holding arm about a swinging axis (A1) and for tilting the holding arm about a tilting axis (A2); and a clamping mechanism with which the rotary joint can be selectively locked or released. The swivel joint (16) allows the holding arm (10) to rotate only about the tilting axis (A2) and the swivel axis (A1). The tilting device has a tilting element and a cylindrical working surface on which the tilting element is fitted. The oscillating device has a guide ring and at least one annular guide surface which receives the guide ring. A central body on which the cylindrical working surface and the at least one annular guide plane are formed, the central body being located in the center of the rotary joint. The tilting element also acts as a clamping bail as part of the clamping mechanism, so that the clamping bail clamps both the tilting device and the pivoting device by means of the clamping central bodies (22, 24) against rotation.)

1. A medical retaining arm (10) comprising:

-a gripping end (13) for gripping and operating the holding arm (10);

-a coupling end (11) for connecting the holding arm to a patient receiving part, such as an operating table (1);

-a swivel joint (16) at the coupling end for swinging the holding arm about a swinging axis (a1) and for tilting the holding arm about a tilting axis (a2) intersecting the swinging axis;

-a clamping mechanism (28) with which it is possible to selectively:

a) locking the rotary joint such that the holding arm (10) is prevented from rotating about the swivel axis and the tilt axis;

b) loosening the swivel joint so that the retaining arm is free to rotate about two axes (a1, a 2);

-a release lever (18) at the gripping end (13) for releasing the clamping mechanism (28);

-a support beam (12) for carrying a medical device (14), the support beam extending between a gripping end (13) and a coupling end (11); and

-force transmission means (41, 43, 45) for transmitting a release force from the release lever (18) to the clamping mechanism, said force transmission means being provided in and/or on the support beam,

it is characterized in that the preparation method is characterized in that,

-a rotary joint (16):

a) allowing only the rotation of the holding arm (10) about the tilting axis (a2) and the swinging axis (a 1);

b) comprising tilting means for tilting the holding arm (10) about a tilting axis (a2), said tilting means comprising a tilting element (26) and a cylindrical work surface (22a, 24a) on which the tilting element is fitted so that the cylindrical work surface and the tilting element can rotate relative to each other about the tilting axis (a 2);

c) comprising a pivoting device for pivoting the holding arm (10) about a pivot axis (A1), said pivoting device having a guide ring (36) and at least one annular guide surface (30, 32) receiving the guide ring, such that the guide ring and the at least one annular guide surface can be rotated relative to one another about the pivot axis (A1); and

d) comprising a central body (22, 24) which is located in the center of the rotary joint and on which the cylindrical running surface (22a, 24a) and the at least one annular guide surface (30, 32) are formed;

the tilting element (26) also acts as a clamping bail as part of the clamping mechanism, so that the clamping bail clamps both the tilting device and the pivoting device by clamping the central body (22, 24) against rotation.

2. Medical holding arm (10) according to claim 1, wherein the cylindrical working surface (22a, 24a) extends completely once around the tilting axis (a 2).

3. Medical retaining arm (10) according to one of the preceding claims, wherein the central body comprises two guide bodies (22, 24) arranged in mirror image to each other, in each guide body (22, 24) an annular guide surface (30, 32) for the guide ring being formed, and on the outside of each guide body a part (22a, 24a) of the cylindrical working surface being formed such that the two parts together form the entire cylindrical working surface.

4. Medical retaining arm (10) according to one of the preceding claims, wherein the central body has a cavity (33) in its interior for accommodating a guide ring.

5. Medical retaining arm (10) according to one of the preceding claims, additionally having a connector (20) on the gripping end, which carries a guide ring (36) and has an engagement piece (21) for connection to a patient receiving part.

6. Medical holding arm according to claim 5, wherein the guide ring (36) is accommodated between the prongs (37) of the forked end (39) of the connector.

7. Medical retaining arm (10) according to one of the preceding claims, wherein the clamping mechanism (28) comprises a spring device (42) which pretensions the clampband in the locked position.

8. Medical holding arm (10) according to claim 7, wherein the clamping mechanism (28) further comprises an excenter device (46) via which the spring device acts on the clampband.

9. Medical retaining arm (10) according to claim 8, wherein the spring means (42) comprises at least one disc spring and the eccentric means (46) comprises at least one eccentric rod.

10. Medical retaining arm (10) according to claim 9, wherein each eccentric rod (46) has an eccentric end in the form of an eccentric disc (47) and an operating end (49) which is connected with the disc spring (42) and the eccentric end (47) is connected with the tip of the clampband (26) through which the rotational axis (YY) of the eccentric rod extends.

11. Medical holding arm (10) according to one of the preceding claims, wherein the force transmission means comprise the following:

-a master cylinder (41) arranged on the gripping end;

-a slave cylinder (45) arranged on the coupling end; and

-a hydraulic line (43) extending through the interior of the support beam hydraulically connecting the master cylinder with the slave cylinder.

12. Medical retaining arm (10) according to claim 11 in combination with one of the claims 7 to 10, wherein the slave cylinder (45) hydraulically releases the pretension of the spring means upon operation of the release lever.

13. Medical holding arm (10) according to one of the preceding claims, wherein the swing axis (a1) and the tilt axis (a2) are respectively perpendicular to the longitudinal axis (X-X) of the medical holding arm (10) and are oriented perpendicular to each other.

14. Medical holding arm (10) according to one of the preceding claims, wherein the medical holding arm is a tensile beam (10).

15. Medical holding arm (10) according to one of the preceding claims, additionally having a grip (40) on the gripping end, which grip is arranged beside the release lever (18) such that the medical holding arm (10) can be gripped by one person with one hand on the release lever (18) and with the other hand on the grip (40), in particular when the clamping mechanism (28) is released.

16. Operating table (1) comprising a medical holding arm according to one of the preceding claims.

Technical Field

The present invention relates to a medical holding arm according to the preamble of claim 1.

Background

Such retaining arms are known. Such a holding arm is provided by the enterprise Mizuho OSI as a component of the operating table. The surgical table is sold under the ProFx brand. A description of the ProFx surgical table can be found on the internet.

This known holding arm is connected to the operating table by means of a ball joint with a ball and socket. Due to the ball joint, the holding arm can be turned to different directions. Thus, the surgeon can bring the position of the patient's leg, which is fixed to the holding arm, to a posture that is optimal for the operation. When the patient's leg is properly oriented, the retention arm may be locked by a clamping mechanism. For this purpose, the ball socket is mechanically clamped to the ball. Precisely, the rotary lever at the end of the holding arm, which acts on the ball socket via a torsion shaft arranged inside the beam, is here turned.

Such known retaining arms have, inter alia, the following disadvantages:

the user must apply a large closing force with the rotary lever. Furthermore, the user is only provided with a fixed adjustment path for the rotary lever and must ensure that a sufficient pretensioning force is generated between the ball socket and the ball via the adjustment path and the holding arm is thereby securely fixed;

the ball and socket run dry with a high coefficient of friction with respect to each other. Thus, in use, at least one friction partner wears due to the rotation of the holding arm;

due to wear on the friction side, a supplementary adjustment of the clamping mechanism is periodically required in order to move the rotary lever always in the same area;

the exposed ball surface is contaminated and dirt may be transported into the joint, which in the long term can lead to damage of the ball joint;

since the user in the unlocked state must carry the load of the holding arm with one hand and must carry out the closing process with great effort with the other hand, there is the risk that the holding arm and thus also the patient's leg may be accidentally lowered before the holding arm is securely locked.

Another retaining arm described in WO 2007/080454 a2 is also known to the person skilled in the art. Such known retaining arms are sold by Smith & Nephew as part of a hip positioning system. A description of the system can be found on the internet.

The holding arm can also be rotated by means of a lockable ball joint, see fig. 5 and 6 of WO 2007/080454 a 2. The locking and release of the ball joint is achieved by a knob located on the end of the retaining arm. The ball joint appears to lock automatically if the user inadvertently releases the retaining arm.

Such known retaining arms have, inter alia, the following disadvantages:

as in the case of the retaining arm of Mizuho OZI, regular supplementary adjustments of the clamping mechanism are required due to wear of the ball surface;

the same problem of contamination of the ball surface exists;

in use on an operating table, the free positioning of the C-arm is impaired and imaging is impaired during X-ray examinations of a patient, since the ball joint and the retaining arm form an obstacle and are opaque to X-rays.

It is therefore desirable to improve these known retaining arms in such a way that they can be locked and unlocked more reliably, with less maintenance required and more easily.

Disclosure of Invention

It is therefore an object of the present invention to provide a medical holding arm with a lockable swivel joint, wherein the swivel joint can be locked and unlocked reliably, with low maintenance and simply in everyday use.

According to the invention, said object is achieved in a retaining arm as defined in the preamble having the features of the characterizing portion of claim 1.

By designing the swivel joint as a central body surrounded by the tilting and clamping band with separate tilting and pivoting means, it is possible to apply a large clamping force to the swivel joint in a targeted manner.

In known solutions with a spherical joint, the clamping in all directions is based solely on the frictional resistance generated between the ball and the socket and depends directly on the diameter of the ball and socket. This frictional resistance becomes less and less reliable over time due to wear of the ball and contamination of the ball surface.

However, in the present invention, the clamping is based on two separate components, on the one hand the frictional resistance between the annular guide surface of the central body and the guide ring, and on the other hand the frictional resistance between the cylindrical working surface of the central body and the tilt/clamp band. In the present invention, the guide ring can be kept small since a low torque is expected in the oscillating movement. The significantly higher torque in the tilting direction is absorbed by the clampband acting as tilting element, which has a correspondingly adapted, in particular larger diameter. That is, the clampband in the clamped state only has to withstand a torque in the tilting direction, but not any form of torque that can act on the retaining arms, as in the ball socket known from the prior art described above.

Furthermore, the friction surfaces of the rotary joint are subjected to less wear in the present invention by the claimed construction. Furthermore, since the friction surface is encapsulated with respect to the environment, it is not contaminated. Thus, the risk of rotary joint failure and associated maintenance costs are significantly reduced.

The friction surfaces can be in particular oil-lubricated, so that no significant wear occurs. Furthermore, the friction surface can be completely closed, so that dirt can be prevented from entering or lubricant can be prevented from flowing out.

Preferred embodiments of the invention are the subject matter of the dependent claims. All the features listed in the dependent claims can be combined with one another as desired, provided that they are technically feasible.

The invention also relates to an operating table with a medical holding arm as defined in the claims.

Drawings

Exemplary embodiments of the invention are described below with reference to the drawings, in which like reference numerals denote like or mutually corresponding elements, respectively.

Wherein:

fig. 1 shows a schematic view of an operating table according to the invention;

FIG. 2 illustrates a medical holding arm with a lockable swivel according to one embodiment of the invention;

FIG. 3 is a detail view of the swivel joint in the retaining arm shown in FIG. 2;

FIG. 4 illustrates a release lever that can be used in the retention arm shown in FIG. 2;

FIG. 5 shows the connector of the retention arm of FIG. 2;

FIG. 6 shows the central body of the swivel in FIG. 3 and a clampband acting as a tilting element; and

fig. 7 and 8 show the clamping mechanism of the holding arm in fig. 2.

Detailed Description

In the following description, exemplary embodiments of the invention are described with reference to the drawings. The figures herein are not necessarily to scale, various features being shown schematically.

It is to be noted here that the features and components described below can each be combined with one another independently of whether they have been described in connection with a single embodiment. The combination of features in the individual embodiments is intended merely to illustrate the basic design and operating principle of the claimed device.

As shown in fig. 1, operating table 1 includes a patient support surface 2, a column 3, and a foot 4. For performing orthopaedic surgery, a medical holding arm 10, in this case a tension beam, can be used, by means of which the leg of the patient P can be fixed in a desired position, where either a pulling force can be applied to the leg or the leg can be rotated about its longitudinal axis. By means of the swivel joint 16, the stretching beam 10 can be oriented and fixed in space relative to the operating table 1 or in general relative to the structure to which one end of the stretching beam is fixed.

It is emphasized that, according to the invention, the rotary joint 16 is arranged as far as possible in the direction of the head of the patient P in the mounted state on the operating table 1 (see fig. 1). The rotary joint 16 should in particular be located at least at the level of the hip of the patient or even above the hip of the patient, viewed in the direction of the head. Thus, when the hip of the patient has to be viewed transparently by means of the C-arm, the rotary joint is then located outside the region of interest in X-ray technology. Here, the stretching beam 10 is preferably made of a material transparent to radiation used in imaging. In the solution known from WO 2007/080454 a2, the rotary joint is located below the crotch of the patient, which makes imaging by means of a C-arm difficult.

The holding arm 10 shown in fig. 2 comprises a support beam 12 on which a carriage 14 is mounted. The carriage 14 is movable along the longitudinal axis X-X of the support beam 12. For example, a bracket may be mounted on the skate 14 to clamp the patient's foot (see fig. 1). The support beam 12 is preferably made of a material that is transparent to X-rays. In this way, when X-ray irradiation is performed on the patient P, it is not necessary to first remove the support beam 12 from the region to be X-ray irradiated, because the support beam does not appear in the subsequent X-ray image. For example, the support beam 12 may be made of a carbon fiber composite material.

At the first coupling end 11 of the holding arm 10, a rotary joint 16 is attached, by means of which the holding arm 10 can be rotated about two axes relative to the operating table 1. The swivel joint 16 is thus a cardanic joint, which defines a swivel axis a1 about which the holding arm 10 can be swiveled in the horizontal direction, and a tilt axis a2 about which the holding arm 10 can be tilted in the vertical direction.

On the second gripping end 13 of the holding arm 10, a release lever 18 is mounted, by means of which the rotary joint 16 can be locked or released. In addition to the release lever 18, a grip handle 40 is provided. Thus, a user may stand at the foot end of a patient, grasp the grip handle 40 with one hand, and pull the release lever 18 upward with the other hand and hold it there to release the swivel joint 16, whereby the user may position the patient's leg in the space in a desired position. When the desired position is reached, the user may again lock the rotary joint 16 by releasing the release lever 18 as described below.

Upon lifting the release lever, the release lever 18 rotates upward about the tilt axis a 2.

Fig. 3, 5 and 6 show the rotary joint 16 and a connecting element 20, which is connected to the operating table 1, for example by a plug connection or the like. For this purpose, the connecting piece 20 has an engaging piece 21.

The swivel 16 includes a guide ring 36, hubs 22, 24 and a clampband 26. The central body consists of two guide bodies 22, 24 arranged in mirror image to each other. The guide bodies 22, 24 define between them a cavity 33 for accommodating a guide ring 36.

The guide ring 36 is accommodated between the two guide bodies 22, 24 so as to be rotatable about a pivot axis a 1. Which are attached by their two flat faces to the respective annular guide surfaces 30, 32. The guide ring 36 is received between the tines 37 of the forked end 39 of the connector 20.

The clamping band 26, which is fixedly connected to the support beam 12, is mounted on the cylindrical running surfaces 22a, 24a of the central bodies 22, 24 so as to be rotatable about the tilting axis a 2. The clampband 26 and the cylindrical running surfaces 22a, 24a together form a tilting device for tilting the holding arm 10 about the tilting axis a 2. Thus, clampband 26 forms a tilting element.

As part of the clamping mechanism 28, the clampband 26 may be tightened around the guide bodies 22, 24 in such a way that rotation of the clampband 26 relative to the guide bodies 22, 24 and also rotation of the guide ring 36 relative to the guide bodies 22, 24 are prevented.

The pressure exerted by the clampband 26 on the two guide bodies 22, 24 is exerted in the same manner via the guide bodies on the end planes of the guide ring 36.

As can be seen in particular in fig. 6, the two guide bodies 22, 24 are pressed against one another by means of the clamping band 26 and against the guide ring 36 (not shown in fig. 6) by means of corresponding contact surfaces in the form of annular guide surfaces 30, 32 between the guide bodies 22, 24, so that the rotary joint 16 is fixed at the two axes of rotation a1, a 2.

The annular guide surfaces 30, 32 form together with the guide ring 36 a pivoting device for pivoting the holding arm 10 about the pivot axis a 1.

Furthermore, it can be seen in fig. 6 that the annular guide surfaces 30, 32 of the guide bodies 22, 24 can be designed with one or more guide projections 34 in the shape of circular arcs in order to guide the rotary movement of the guide ring 36 between the guide bodies 22, 24 about the pivot axis a 1. In fig. 6, a single circular arc-shaped guide projection 34 is shown, but it is also conceivable to provide a plurality of guide projections 34, each corresponding to a circular arc segment.

As shown in fig. 5, the coupling piece 20 comprises a guide ring 36, the respective end face 38 of which serves as a contact surface between the coupling piece 20 and the guide bodies 22, 24, and the one or more guide projections 34 of the guide bodies 22, 24 engage into the inner edge of the guide ring.

Alternatively, guide projections or other guide means may also be provided on the contact surface 38 of the guide ring 36. In another embodiment, the contact surface 38 can also be conical or spherical in design. Here, the contact surface should cause tensioning under a force applied in the axial direction relative to the axis of oscillation.

The release lever 18 is shown in fig. 4. In the present embodiment, a lever pair or handle pair is provided, wherein the user can pull the movable release lever 18 onto the rigid grip 40. Thus, the user can support and move the beam 12 and, for example, the patient's leg secured to the beam, by the rigid handle 40, and at the same time open the clamping mechanism 28 with the release lever 18. When the movable release lever 18 is raised all the way up to the stop, the load of the patient's leg is in the user's hands, which minimizes the risk of accidental lowering. This helps to achieve safe use. In this operation, hydraulic fluid from a master cylinder 41 mounted immediately adjacent to the release lever 18 is directed to a slave cylinder 45 (see fig. 7) via a hydraulic line 43 extending in the beam 12, so that the clamping mechanism 28 is brought from its locked basic position into the release position. The two hydraulic cylinders 41, 45 together with the hydraulic line 43 form a force transmission device.

In the locked basic position shown in fig. 7, the disk spring set 42 presses a matching eccentric lever 46 by means of a pressure lever 44 into a position in which the eccentric lever pulls the end of the clampband 26 in the tangential direction and thereby presses the clampband 26 against the cylindrical running surface of the guide bodies 22, 24, so that the movement of the rotary joint 16 about the two rotational axes a1, a2 is locked.

Thus, the clamping mechanism 28 includes the clampband 26, the disc spring set 42, the strut 44, and the eccentric rod 46. Two eccentric rods 46 are provided on either side of the clampband 26. The eccentric rods are connected in the present case by webs, since the eccentric rods must jointly perform the same movement. The two eccentric rods 46 form a unitary component with the web.

Each eccentric rod 46 has an eccentric end 47 in the form of an eccentric disc and an operating end 49. The axis of rotation Y-Y of the eccentric rod 46 extends through the end of the clampband 26. The eccentric axis of rotation Y-Y is parallel to the tilt axis a 2.

The clampband 26 is thus operated by the pivotable eccentric lever 46 in order to produce a force transmission (Kraft ü bersetzeng) in the direction of the clampband 26, the disc spring assembly 42 exerts a pressure on the long lever arm of the eccentric 46 via the associated pressure lever 44 and thus produces the required closing force in the rest state.

Upon actuation of the release lever 18, the clamping mechanism 28 is transferred from the locked basic position shown in fig. 7 and 8 into a release position, in which the coupling piece 20 is allowed to move about the pivot axis a1 and the clampband 26 is allowed to move about the tilt axis a2 relative to the guide bodies 22, 24 (see fig. 3), in that the eccentric lever 46 is moved against the spring force of the disk spring set 42, so that the pressure force of the clampband 26 is dissipated onto the outer circumferential surfaces of the guide bodies 22, 24 and the clampband 26 and the coupling piece 20 are thereby movable relative to the guide bodies 22, 24. The hydraulic slave cylinder 45, which acts counter to the spring force, is connected to the master cylinder 41 via a hydraulic line 43 extending in the cross beam 12, which the user can act on at the other end of the cross beam 12 via the release lever 18.

Each of the hydraulic slave cylinders 45, acting in opposite directions, is connected to the master cylinder 12 by a hydraulic line 43 extending in the beam 12, on the other end of the beam 12 the user can act on the slave cylinder 41 by means of the release lever 18.

If the user operates the release lever 18, liquid is drained in the master cylinder and delivered to the slave cylinder. The slave cylinder acts against the disc spring set 42 and unloads the clampband. The clampband 26 is open and may effect movement about two rotational axes a1, a 2. If the operator releases the release lever 18, the spring assembly 42 presses back on the slave cylinder and acts again on the clampband 26 with its force, and the system is locked.

The present invention thus provides a rotary mechanism about two mutually perpendicular axes a1, a2 which are simultaneously clamped by the clamping mechanism 28, and provides a locking principle in which the closing force is applied by the spring assembly and the operator only needs to apply a force for release. If the operator releases the release lever 18, the rotary union 16 will automatically fall back to the secure locked position. Thereby, an uncontrolled downward fall of the stretching beam together with the patient's leg, for example, can be avoided when the operator inadvertently loosens the stretching beam.

In the embodiment shown here, two guide bodies are used for the swivel joint, which guide bodies lie on the horizontal plane 38 of the guide ring 36 and can be pivoted about a vertical axis. The outer surfaces of the two guide bodies form a common cylindrical circumference, the axis a2 of which is oriented horizontally and in the basic position perpendicular to the longitudinal axis of the patient. This common cylindrical circumference is surrounded by a clampband 26 which is connected to the beam 12 and which, in the untensioned state, allows the beam to rotate about the cylindrical circumference. If the clampband 26 is now tightened, the normal force between the cylindrical outer surfaces 22a, 24a of the guide bodies 22, 24 and the clampband 26 is increased, but also between the guide bodies 22, 24 and the plane between the guide rings 36. In this way both movements can be locked and released in one operation.

It is also conceivable, however, to use differently shaped joint elements instead of the guide bodies if a joint which can be rotated about at least two axes of rotation can be realized thereby and if a clamping mechanism which can be used to lock the movement of the joint simultaneously in two axes can be realized.

Here, the medical holding arm according to the invention has the advantage that safe operation can be ensured, since the swivel joint which allows the holding arm to be moved relative to the operating table will automatically lock if the user inadvertently drops the holding arm with or without the patient's leg fixed thereto.

Thus, the holding arm does not fall uncontrollably onto the ground. With the release lever 18 and the grip handle 40 mounted on the foot end of the patient, the user can use both hands to guide and support the retaining arm during adjustment, thereby allowing safe and ergonomic adjustment of the position of the retaining arm 10.

The described clamping mechanism 28 in cooperation with the selected design of the rotary union 16 and the gripping end 13 of the holding arm 10 enables a reliable locking of the rotary union 16 despite the high forces and torques acting on the rotary union due to the large length of the holding arm 10. The locking mechanism known from WO 2007/080454 a2, which uses a simple handle 118 and a ball joint, cannot reliably withstand the high torques which occur as a result of the connection of the long retaining arm 10 to the operating table 10 remote from the hip of the patient. In the solution of the invention described here, the required high clamping forces can be achieved in particular by means of hydraulics and by means of a large transmission ratio (for example a ratio of 1:10) of the eccentric rod 46. The user can overcome the large clamping force with less effort due to the long lever arm of the release lever 18.