US3041121A - Surgical table - Google Patents

Description

June 26,Y 1962 A. COMPER 3,041,121

' SURGICALTABLE INVENTOR. ADRIAN COMPER ATTORNEYS A. COMPER SURGICAL TABLE June 26, 1962 4 sheetssheet 2 Filed Sept. 26, 1950 INVENTOR. ADRIAN COMPER l pam( ATTORNEYS June 26, 1962 A. COMPER 3,041,121

SURGICAL TABLE Filed Sept. 26, 1960 4 Sheets-Sheet 3 .R v RE E... oP XS \.,v WM l I l |.I VO 2., E www NG mmv., 1 f 1m www; wil i my. Hm wm n m dm .vhm/ mmm mmm lllwi En b5 m @SWW/7 mi Imml 3 3 i- @i f) BY ,a-za, f 11. y '/Lomzc( ATTORNEYS June 26, 1962 A. coMPER 3,041,121

' SURGICAL TABLE l 4 Sheets-Shet 4 Filed Sept. 26, 1960 Fig. |2 4 n IN VEN TOR ADR/A N OOMPER A TTOR/VEYS Unit This invention relates to surgical tables. Reference is made to the copending application of Karl H. Burzlalf, Egon R. Weickgenannt and George E. Martin, Serial No. 56,803, filed September 19, 1960, for a detailed discussion of the surgical table shown herein.

The surgical operating table of my invention is particularly designed to give the surgeon maximum anatomical exposure within the patients wound with improved and novel means of maintaining his physiologic function by the anesthesiologist and this is a major object of my invention.

In terms of surgery, the human skeletal structure articulates at the cervical spine, lumbar arch, hip and knee joints. These articulations divide the body into the five major regions, the head, the spinal or back section, the pelvic or seat section, the femoral or upper leg section and the lower leg section. For the most advantageous surgical exposure, these tive major regions should assume a tolerable anatomical contour appropriate to the particular procedure, with physiologic distribution of bodyweight pressure over the table surface. However, it is obviously impossible to conform or fit conventional commercial operating tables of but four articulated sections with live major body regions with body articulations between them. Consequent malpositioning of the patient is frequently inevitable with present commercial surgical tables. This serious limitation of present tables often restricts favorable access to the operative site by the surgical team, especially when managing or controlling physiologic deterioration of the patient.

Another major object of my invention is, therefore, to reduce and for the most part avoid these restrictions, and for this purpose I have conceived and evolved an entirely new approach to the problem of providing the surgical team with true postural control of the patient.

In enabling this new technique and other techniques wholly new in this surgical field, the articulating top of the operating table is conformed to the tive major surgical regions of the human anatomy. l have provided an adjustable head section directly under the head of thev patient; a back or spinal section articulating directly under the lumbar arch `and extending to the first thoracic vertebra; a seat or pelvic section with perineal cutout appropriately under the pelvis; a femoral or upper leg section articulating as if from the true hip joints of the patient and extending to the knees thus supporting the thighs; and a lower leg section under the lower legs articulating at the knee joints.

Another object of my invention is, therefore, to provide a table having five sections with articulations between each two adjacent sections whereby each of the ve major regions of the lbody may be independently controlled and positioned with the objective of achieving Amaximum surgical or anatomical exposure, minimal physiological disturbance of the patient and the most convenient application of new surgical techniques which have been developed in recent years.

The differential in the dimensions of the above mentioned five major body regions which embrace the short 3,041,121 Patented June 26, 1962 .ICC

variation in pelvic lengths between short and tall adult persons and children in the teen ages is minimal whereas the differential in both the spinal and femoral lengths is extensive. To meet this problem, the back and femoral sections on the new operating table are telescopic or adjustable in length. Thus, I have conceived an operating table that insures true contour correspondence between the articulations of the table and the articulations of human anatomy for adult or teen-age patients of a large range of heights.

My invention, therefore, has for a further object the provision of a table which is adjustable in length in such a manner that persons of a large range of heights may be accommodated by changing the points of articulation of the table with relation to the four major points of articulation of the skeletal structure.

Still another object of my invention is to provide a table having a plurality of sections at least one of the sections being capable of adjustment in length.

The invention initiates or makes possible new techniques for the care of the patient at operation. Due to the unique construction of the table of my invention, these techniques are available without changing the original position of the operating site. Hypotension induced by surgery and anesthesia may now be controlled in many cases by the simple expedient of elevating the lower eX- tre'mities and V.allowing venous gravity return to the heart. This may be done without placing the entire table in Trendclenburg position. The operative site .and the other organs superior to it may remain in their original position instead of being shifted in a steep downward tilt, thus disturbing the surgical team with the incidental movement of the table and the need for refocusing the surgical light.

My invention, therefore, contemplates a table construction comprising five sections each of which is controlled, either manually or by power, independently of the other, thereby enabling the elevation of the femoral and leg sections and allowing venous gravity to the heart without placing the entire table in Trendelen'burg position.

Another and important object owing from my invention is the fact that ,by the use of live sections articulated in the manner set forth herein and supported from a central seat or pelvic section in many cases the Trendelenburg position can be avoided with its consequent change in the position of the operative site merely by swinging the femoral and leg rest sections upward about the articulation Vbetween ,the pelvic and femoral sections.

Elevation of the lower extremities at the hip joint is most desirable in many situations. Venous vstasis in the legs may be reduced by their elevation during the operation. Such elevation likewise reduces the' amount of abdominal muscular tension and may reduce the total amount of relaxant ding needed. Such elevation would be helpful during all types of pelvic and abdominal laparotomies. Moreover, hypotension induced by the rapidchange from lithotomy position to the flat supine may 1n many cases be prevented or at least reduced by elevation of the femoral .and leg rest section and then gradual reduction in the height of the legs by pivoting the femoral section of the table about the pvot between the femoral section and the pelvic section.

Another object of my invention is to provide a table having five articulated sections corresponding to the five major articulations of the body with the control of the five sections being, when desired, such that the femoral and leg sections may be raised about the posterior edge of the pelvic section without elevating the spinal section so that the operative site in pelvic and abdominal laparotomies remains stationary while the legs are elevated about the hip joint as an axis to reduce abdominal muscular tension,

Sudden changes in position such as occur in the operation of abdominoperineal resection are frequently accompanied by hypotension. This table is uniquely suited to this situation in that adjustment of the patient from supine to lithotomy position may be made without having to move the patient to the foot-end of the table during the operation.

Still 'another object of the invention is to provide a table in which movement of the patient on the table during an operation is minimized, this fact being particularly important in abdominoperineal resections where movement of the patient on the table frequently causes hypotension.

Drainage of the tracheobronchial tree during abdominal laparotomies is facilitated by lowering of the back and head section of the table without disturbing the abdominal site of operation.

Additionally the invention has for an object the lowering or raising of the back and head section without moving the pelvic section and disturbing the operative lsite as, for example, during abdominal laparotomies or in placing the patient in the Kraske position. When in the Kraske position excessive pooling of blood in the upper extremity of the body may be prevented by elevation of the spinal vsection of the table which articulates at the lumbar arch.

lMalposition of the patient on the table reflects in an adverse manner upon the physiology of respiration and circulation. In addition, there may be nerve injuries to the patient. The five sections of the table allow for separate adjustments in the critical areas without the usual shifting of the patient upon the table. Back sprain, which so frequently accompanies the relaxed supine position, is easily mitigated by simple flexion of fthe table in the lumbar area with elevation of the legs from the hip joint.

My invention, therefore, further contemplates a table of ve sections articulated in a manner corresponding to the articulations of the body with two sections of the table being adjustable in length to accommodate patients of a range of heights, this adjustment together with the locations of the articulations minimizing malpositioning of the patient and shifting the patient on the table thereby minimizing nerve injuries to the patient and back sprains.

Other objects and advantages of this invention will be particularly set forth in the claims and will be apparent from the following description, when taken in connection with the accompanying drawings, in which:

FIG. 1 is a top plan view of a iive section table in which the invention of this application is incorporated;

FIG. -2 is a side elevation thereof;

FIG. 3 is a schematic view showing the tive sections of the table and indicating the articulation joints between them;

FIG. 4 is a schematic view similar to FIG. 3 showing the spinal section and the femoral section, telescopically shifted `so as to increase the length of the table to accommodate persons of larger stature;

FIG. 5 is a sectional view taken substantially on the line 5-5 of FIG. 1 in the direction indicated by the arrows;

FIG. 6 is a View, partly in section, looking at the Ibottom of the table and indicating how a part of the -femoral section may be telescopically shifted and located as desired with respect to another part, showing how the telescopically movable part may be removed from the other part and showing how the leg rest section may be removed from and locked with respect to the telescopically movable femoral part;

IFIG. 7 is a view partly in section showing the head end of lthe spinal section;

FIG; ISlis a top plan view of the head rest section; and

FIGS. 9 to 14 inclusive, diagrammatically illustrate 4 some of the very many positions into which the table may be swung and the sections articulated.

This application is related to the table more fully disclosed in application Serial No. 56,803, tiled September 19, 1960, and is directed broadly to the concept of a ve 'section table having articulations conforming anatomically to the four major articulations of the human body; the adjustability of the spinal and femoral sections to enable the table to be adjusted in length to fit most teenagers and adults; the removability of some of the sections and parts of the sections to adapt the table to certain surgical procedures; and the use of a perineal cutout located as shown so that the patient does not have to be shifted during perineal procedures. Other applications presently to be led relate to specific mechanisms and constructions adapted to carry out the above broad concepts.

The surgical table of this invention comprises a table having a t-able surface, generally indicated by the numeral 31, for the reception of the patient. The metal table surface is adapted to receive one or more cushions (not shown) for the comfort of the patient. The table includes a base 32 from which the ltable surface is supported; pump and motor housing, generally indicated by the numeral 33; a control box, generally indicated by the numeral 34, which houses the valves for actuating the various hydraulic mechanisms; and a plurality of control handles 36, in this case five, for separately controlling each of the operations of raising and lowering the various sections with respect to each other, raising `and lowering the table surface 31 as a whole and laterally and longitudinally tilting the table. In FIGS. 9 to y14 I have illustrated diagrammatically a few of the more important positions, from a surgical standpoint, in which the patient -may be placed.

The base 32 is mounted on four casters 37 which are provided with locking means (not shown) to hold the casters against movement when the table is in use, as lshown and particularly described in Karl iH. Burzlal application Serial No. 777,870 filed December 3, 1958.

A pedestal or support column, generally indicated by the numeral 38, is mounted on the base 32 and supports the table or table surface 31. The table comprises tive sections a headrest section 39, a spinal or back section 41--41 (iFIGS. 3 and 4), a pelvic or seat section 42, a femoral section 43--43 (FIGS. 3 and 4), and a foot or leg rest section 44. The headrest section 39 is manually operated, as presently will appear, the spinal section is operated by a hydraulic piston and cylinder assembly, generally indicated by the numeral 46, and the femoral section 43 is operated by a hydraulic piston and cylinder assembly indicated by the numeral 47.

'Referring now to FIG. 3 the table 31 is raised and lowered by `a hydraulic piston `and cylinder assembly, not shown herein but shown and described in the above mentioned application. Lateral tilt of the table about a longitudinal axis is `accomplished by a cylinder and a piston assembly, generally indicated by the numeral 49. Movement of the table to Trendelenburg (FIG. 9) or reverse Trendelenburg (FIG. 1l) positions, that is, pivoting the table about `a horizontal transverse axis, is accomplished by a piston and cylinder assembly generally indicated by the numeral 51.

The primary functions of the table are power operated and controlled and the hydraulic cylinders above mentioned are fed with oil under pressure pursuant to actuation of the control handles 36 to actuate the table sections in accordance with the necessities of the surgical operation lbeing performed all as fully described in application Serial No. 56,803, filed September 19, 1960.

Referring to FIG. 5 depending below and integral with the pelvic section of the table top, is a bifurcated bracket or boss 216 which is connected to the upper end of a piston rod 217 secured to the piston of the Trendelenburg cylinder 51 by a universal joint 218. A ful1 description of the Trendelenburg cylinder and its connecting parts is given in application Serial No. 56,803, filed September 19, 1960.

Referring now to FIGS. l and 2, the table includes side rails 261, 262 and 263 on each side of the table. The side rails are rigidly secured to the various sections by means indicated at 264 having spacers 265 (FIG. 5) mounted thereon. These side rails are for the purpose of adjustably holding clamps for arm rests, leg rests, or stirrups, an anesthetic screen and other removable accessories with which the table may be equipped. Between the pelvic section and the spinal section, these side rails are overlapped and former with openings to receive 'hinge pins 266 on opposite sides of the table.

Depending from the pelvic section 42 (FIG. 5) are a pair of bosses 291 which have a cutout 292 between them. A pair of support plates 293 are fixed by means of a plurality of screws 294 threaded into the bosses and pass through the plates 293. lCarried at the lower end of the femoral cylinder 47 is a pair of pivot pins 296 which are supported in the bottom of the cylinder and extend outwardly through apertures 297 in the plates 293, The femoral cylinder 47 is free to swing about the axis of the pivot pins 296.

The femoral cylinder has a piston mounted therein to either side of which oil may be'adrnitted. Simultaneously with the application of oil to one side of the piston, oil is exhausted back to a sump from the other side thereof. A piston rod 298 is secured to the piston (FIG. 5) and is pivoted to .a boss depending from the lower side of the femoral section 43. Part of the mechanism for articulating the femoral section is shown in FIG. 5. It is unnecessary to describe it any further herein since it is disclosed in application Serial No, 56,803, filed September 19, 1960, and more fully disclosed `and claimed in an application iiled in the name of Egon Weickgenannt, Serial No. 58,443, filed September 26, 1960.

Referring now to FIG. l (see .also FIGS. 3 and 4) the pelvic section has what is known in the art as a perineal cutout 331. When the table is to be used for perineal operations, the femoral section must be moved to an outof-the-way position so that the surgeon is 'able to be seated close to the perineal cutout. For this reason, the compound movement of the femoral section, `as described in the above mentioned application, is necessary.

As shown in FIG. `6 which is a sectional view of the underside of the femoral and leg rest table sections, the leg rest section 44 is removable from the femoral section 43. For this purpose the femoral section has an yadapter 351 secured thereto by screws on each side of the table. Each adapter has a track or ways 352 therein for the reception of a vslide member 353 mounted on the leg rest Vsection 44. The slide member 353 on each side of the table has a nger piece 356 which is pivoted at 354 by which'the inger piece may be swung about the pivot 354. The end of the linger piece has a locking pin 357 pivoted thereto which lits into a bore 358 formed in the adapter 351 end of the femoral section. A spring 359 normally holds the slide member in the position of the parts shown in FIG. 6.

When the foot section'is to be removed, the finger pieces 356 on each side of the table are pressed inward against the action of springs`359 to withdraw locking pins 357 from the bores 358. The slide members 353 may then be moved to the right, as viewed in FIG. 6, in the ways 352 and the foot section slid olf the end of the femoral section. When replacing the foot section, the opposite of this operation is performed.

In most adults, the difference in their heights primarily occurs in their legs and in their spinal or back sections. For this reason the back or spinal section 41 and the femoral section 43 are made adjustable in length. The means for adjustment of the length of these two sections is the same so that 'a description of one will suftice;

In FIG. 3 the fixed spinal section has been indicated by -the numeral 41 while the movable spinal section has been indicated by the numeral 41. The spinal cylinder 46 is pivoted to the xed section 41. Similarly the fixed femoral section has been indicated by the numeral 43 and the movable femoral section by the numeral 43. The femoral hydraulic cylinder 47 is pivoted to the fixed femoral section 43'.

The adjustability of the spinal and femoral sections is illustrated in FIG. 6. The xed femoral section 43 is shown at the left of FIG. 6. To enable this adjustability and removability of the adjustable section 43, the Iunderside of the fixed `section 43 is provided with a track or ways 360 on each side thereof. One side of each of the ways has a plurality of, in this case five, openings or bores 362 for the reception of locking pins 363. Rollers 364 are rotatably mounted on pins 366 suitably fixed to the movable femoral part 43.

The locking pin 363 is normally pressed toward locking relation with one of the bores 362 by a spring 370 mounted in a recess which seats in a part of the casting and presses against a snap ring 365 mounted in a groove formed in the locking pin. A set screw 370" enables adjustment of the locking pin 363. A fitting 367 is secured to the locking pin and receives an eccentric pin 368. The eccentric pin is eccentrically secured to a rotatable member 369 mounted on a shaft 371 which has a fiat side. A bearing member 372 is located in a bore formed in a wall 374 formed on the underside of the removable section 43. The bearing member 372 is fixed and the shaft rotates within it. A set screw 373 extending through the casting holds the bearing member against movement longitudinally and rotationally in the bore. The shaft 371 has a at extension 376 which is secured in any suitable manner to a hand release piece 377. Upon loosening and resetting the set screw 370', hand release piece 377 may be set as desired.

It will now be understood that upon moving the hand release piece, the shaft 3711 will be rotated and the eccentric pin 361 will rotate to reciprocate the fitting 367. This action will withdraw the locking pin 363 against the action of spring 370 from the particular bore 362 in which it is seated. The movable section 43 may then be shifted with relation to the fixed section to the desired posias diagrammatically illustrated in FIG. 4. In FIG. 3 the movable spinal section 41 and the movable femoral section 43 have been superimposed over the fixed sections 41' and 43 respectively. In FIG. 4 the spinal and femoral sections have been extended their maximum distance. As will be apparent from FIG. 6, the movable femoral section y43 may 'be completely removed from the fixed section 43. Similarly the movable spinal section 41 may be completely removed from the fixed spinal section 41. A stop pin 375 and cutout stop plate 361 (FIG. 6) prevent unintended removal when extending the section. In order to remove the section, the section has to be lightly'lifted when the stop pin touches the stop plate.

In the performance of certain operations the upper legs must be raised While the lower legs may be allowed to retain their original position or may be raised if desired. Such a position is illustrated in FIG. 13. A similar raising of the upper legs may be accomplished merely by activating the femoral cylinder to allow venous gravity return to the heart. This avoids the necessity of placing the entire table in Trendelenburg and interrupting an operation on the upper part of the body. Other surgical situations exist where the upper legs must be raised and the lower legs lowered.

The combination of the particular articulation of the femoral section with respect to the pelvic section and the length adjustability of the femoral section enables Ythe positioning of the parts 43 and 44 of FIG. 13 without causing pressure on any part of the legs. By adjustmg the length of the femoral section to fit the patient so that the joint between the femoral section and the leg rest section lies directly below the knee Ijoint,`the femoral section may be raised without changing the relationship of the knee joint with respect to the joint in the table. This is so because the femoral section swings about an axis above the table surface as described in the above mentioned application. Cases have been known, when using present surgical tables and failure of the surgical team to use adequate additional padding, where the legs of the patient had to be amputated due to long exposure of the lower legs to pressure.

The head rest section 39 is removable from the spinal section 41 as will presently appear. Thus the head rest section 39, the removable spinal section 41, the removable leg rest section 44 and the removable femoral seetion 43 may all be removed from the table leaving only the seat or pelvic section 42 and the short sections 41 and 43 articulated with respect to the pelvic sections. All the actuating elements previousl;l described are operatively connected to these sections.

Referring now to FIG. 2, the head rest section 39 has been shown. The head rest 39 may be swung about a pivot 386 secured to an arm 387 the end of which is split at 388. The head rest assembly may pivot about a pivot 389 and Ibe locked in any desired adjusted position. For this purpose the arm 387 is split at 391 and a hand operated clamp 392 opens and closes the gaps at 388 and 391, to release the head rest assembly to enable it to be shifted and locked in a desired adjusted position. The head rest, for example, may be shifted so that it hangs downward normal to the plane of spinal section 41 or at its other extreme rests on the spinal section either normal theerto or at a tilt angle. The single hand lever locks both clamps 388 and 391. The specific manner in which this is accomplished is old and well known and per se does not constitute part of the present invention.

As previously mentioned the head rest section is removable from the spinal section 41. This is illustrated in FIG. 8. For this purpose attached to the arm 387 is a connecting piece `401 which has a bracket 402 secured thereto. The bracket 402 has two forks 403 rigidly secured thereto which lt into bores 404 formed in the underside of the spinal section 41. The forks are locked in the bores by hand clamps 406 the ends of which engage the forks. `Within limits the head rest assembly may be shifted toward and away from the spinal section 41. The head rest assembly has side extensions 407 which carry side rails 4018. The side rails are for the purpose of supporting an anesthetic screen assembly and for this reason are movable with the head rest.

The leg rest section 44 is releasably locked with respect to the movable part 43 of the femoral section. This locking means, located on the underside of the leg rest section, comprises a multiplicity of discs 410 and 409 only two of which have been shown. The discs 410 are splined to a casing 411 while the discs 409 are splined to a shaft or rod 41.2 as shown at 413.

A hand release lever 414 extends below the end of the leg rest section, is supported in any suitable manner and has adjustable stops 416. The inner end of the lever 414 is fitted to a cam 417 which has two flat spots 4118 and 419. The cam 417 actuates a pair of pushrods 421 and 422 through rollers riding on the cams. The pushrods include threaded members 423 having nuts 424 thereon threaded into sockets in the pushrods. A U- shaped mounting 425 for slidably receiving the pushrods is supported fromthe leg rest section. A spring 426 coiled in a cage 427 carried by the leg rest section is extended and tied to the hand release lever 414 as shown at 428.V

In the solid line position of the release lever 414, the cam is rotated from the position of FIG. 6 and the pressure of the spring and the action of the cam is such as to exert pressure on pressure members 430 rigidly connected to the threaded members 423. The force exerted 8 on the pressure members 430 may be varied by adjusting the nuts 424.

The casing 411 is fixed to the leg rest section and rotates with it about the axis of the shaft 412. The shaft 412 is fixed to the slide member 353. When pressure is applied on the outer plate 410, the discs are free to shift and apply pressure between the discs 410 and 409 and since the shaft 41.2 is iixed in position, the casing 411 is rigidly held and the leg rest is locked in the desired adjusted position with respect to the movable part 43 of the femoral section.

To release the leg rest section the hand release lever is shifted to the dotted line position which frees the discs 410 and 4019k from frictional engagement and permits rotation of the leg rest section about the axis of the shafts 412. When the leg rest section reaches the desired position o-f adjustment, the hand release lever is released and the spring 426 snaps the cam 417 to locking position to apply pressure on the discs and lock the leg rest in the adjusted position. The action is therefore a self-locking one. Moreover, because the locking mechanism is approximately on the axis of articulation, the leg rest section may be rotated through an arc of or more. Angular locked positions of the leg rest with respect to the movable part 43 of the femoral section are shown in FIGS. 13 and 14.

Adults and teen-agers vary greatly in height but most of this variation occurs in the legs and the upper trunk. Variations in Alengths from the neck upward and from the knees downward are unimportant as these are the end sections of the table and in any event the head rest section can be `adjusted with respect to the spinal section as indicated in FIGS. 7 and 8. The variation in length of the pelvic section in adults and teen-agers is not great. Therefore, by adjusting the length of the spinal section and the femoral section the table may be made to iit most adults and teen-agers. By adjusting these -sections and adjusting the headrest with respect to the femoral section, the articulation ybetween the head rest and the spinal section may be located directly under the neck; the length of the spinal `section may be adjusted to conform to the length of the back of the patient; the articulation of thel spinal section with respect to the pelvic section will be substantially under the lumbar arch; the articulation between the pelvic section and the femoral section will be substantially under the hip joint; and the femoral section may be adjusted in length to conform to the length of the upper legs of the patient so that the articulation between the leg rest section and the femoral section is directly under the knee joint.

Moreover, Ias previously mentioned and more fully described in the above mentioned applications, upon removal of the leg rest section and the removable part of the femoral section, the remainder of the femoral section may be swung downward and out of the way to enable access to the perineal cutout 331.

In FIGS. 9 to 14 inclusive I have shown a few representative positions in which the table of my invention may be placed but it will be appreciated that many more positions of the table sections are possible. FIG. 9 shows the Trendelenburg position for Venous return to the heart. The anesthetist places the patient in this position when necessary during surgery. However, with the table of my invention because it can -be articulated at the pelvis, venous return can usually be accomplished with the table, for example in the position of FIG. l0, merely by swinging the femoral and leg rest sections about the articulation between the pelvic and femoral sections.

The position of the table sections shown in FIG. 11 is known as the reverse Trendelenburg position. This position of the table sections is employed in, for example, thyroidectomy and in gall bladder surgery.

The position of the table sections shown n FIG. 12 is used in kidney and chest surgery. The position of the "able (FIG. 13) sections (FIG. 13) either with or without the headrest removed, is employed in neurosurgery and in cranitomy. The position shown in FIG. 14 either with the head rest section as shown or placed at right ingles to and on the top of the spinal section is employed in culdoscopic and sigmoidoscopic examinations and operations.

It will be appreciated that in all the positions of the table sections shown and many others, the table may be adjusted and tailored to t the patient with the attendant minimizing of pressure points and shock during surgery. While I have shown and described the preferred form of mechanism of my invention it will be apparent that various modifications and changes may be made therein, particularly in lthe form and relation of parts, without departing from the spirit of my invention as set forth in the appended claims.

I claim:

l. A surgical table or the like comprising, in combination, at least five table sections, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said sections being articulated with respect to each other and being of such length as to accommodate a man of average height so that the articulation between the head section and the spinal section is located substantially at the neck, the articulation between the spinal section and the pelvic section is located substantially at the lumbar arch, the articulation between the pelvic section and the femoral section is located adjacent the hip joint and the articulation between the femoral section and the leg section is located substantially at the knee joints and means for articulating said sections.

2. A surgical table in accordance with claim 1 in which at least one of said sections is adjustable in length.

3. A surgical table in accordance with claim 1 in which the spinal section has at least two parts and means are provided for telescoping said parts to vary the length of the spinal section.

4. A surgical table in accordance with claim 1 in which the femoral section has at least two parts and means are provided for telescoping said parts to vary the length of the femoral section.

5. A surgical table in accordance with claim 1 in which the spinal section and the femoral section each have at least two parts and means are provided for telescoping said parts to vary the lengths of the spinal section and the femoral section.

6. A surgical table or the like comprising, in combination, at least live table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said connections providing means for `articulating said table sections with respect to each other and a perineal cutout in said pelvic section.

7. A surgical table or the like comprising, in combination, at least five table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said connections providing means for articulating said table sections with respect to each other, a perineal cutout in said pelvic section and means in said table sections for changing the location of at least two of said points of articulation with respect to said pelvic section.

8. A surgical table or the like comprising, in combination, at least live table sections, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said sections being articulated with respect to each other and being of such length as to accommodate a man of average height so that the articulation between the head section and the spinal section is located substantially at the neck, the articulation between the spinal section and the pelvic section is located substantially at the lumbar arch, the articulation between the pelvic section and the femoral section Y l@ is located adjacent the hip joint, the articulation between the femoral section and the leg section is located substantially at the knee joints, a perineal cutout in said pelvic section and means for adjusting the length of said spinal section and said femoral section to accommodate the table to persons of heights varying from the average and means for articulating said sections.

9. A surgical table or the like comprising, in combination, a plurality of table sections including a head rest section removably attached to one of the other sections, side rails for an anesthetic screen rigidly attached only to said head rest section, said head rest section being adjustable toward and away from the section to which it is attached so that simultaneously with such adjustment the anesthetic screen is automatically adjusted.

10. A surgical table or the like comprising, in combination, at least five table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said connections providing means for articulating said table sections with respect to each other and means for increasing or decreasing the length of at least one of said sections.

ll. A surgical table or the like comprising, in combination, at least live table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said connections providing means for articulating said table sections with respect to each other and said pelvic section being between said spinal section and said femoral section.

12. A surgical table or the like comprising, in combination, at least ve table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said spinal section having at least two parts, means for telescoping said parts to vary the length of the spinal section, means for articulating each of said sections with respect to its adjacent section and means for tilting at least some of said sections including said pelvic section.

13. A surgical table or the like comprising, in combination, at least tive table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said femoral section having at least two parts, means for telescoping said parts to Vary the length of the femoral section, means for articulating each of said sections with respect to its adjacent section and means for tilting at least some of said sections including said pelvic section.

14. A surgical table or the like comprising, in combination, at least five table sections connected in series, said table sections including a head section, a spinal section, a pelvic section, a femoral section and a leg section, said spinal section and said femoral section each having at least two parts, means for telescoping said parts to vary the length of the spinal and the femoral sections, means for articlulating each of said sections with respect to its adjacent section and means for tilting at least some of said sections including said pelvic section.

15. A surgical table or the like comprising, in combination, a pelvic section, a spinal section, articulated with respect to said pelvic section on one side thereof, a femoral section articulated with respect to said pelvic section on the other side thereof, means for raising and lowering the spinal section and the femoral section independently of each other without changing the position of the pelvic section, a head rest section articulated with respect to said spinal section, a leg rest section articulated with respect to said femoral section, said head rest section and said leg rest section being removable from the sections with respect to which they are articulated.

16. A surgical table or the like comprising, in combination, a pelvic section, a spinal section, articulated with respect to said pelvic section on one side thereof, a femoral -section articulated with respect to said pelvic section on References Cited in the le of this patent UNITED STATES PATENTS 7,789 Shoerrberger Nov. 19, 1850 12 Glasin May 17, 1949 Buckley Oct. 16, 1951 Nimmo Dec. 23, 1952 Davis et al Jan. 25, 1955 Fullwoodet al. June 4, 1957 McDonald Mar. 25, 1958 McDonald July 21, 1959 FOREIGN PATENTS Germany Apr. 9, 1959

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