FRAMEWORK FOR LYING POSITIONING OF PATIENTS DURING SURGICAL PROCEDURE

Abstract

An accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising at least one support structure (110, 210, 310, 1410) having an adjustable length, a frame (122, 222, 322, 422) extending from a proximal to a distal end, wherein the distal end of the frame is configured to be rotationally coupled to the surgical table, and a multi-axis joint (108, 208, 308, 408) mounted on at least one support structure rotatably coupled to the proximal end of the frame, wherein the multi-axis joint has at least one rotational degree of freedom about a tilt axis of the frame and a second rotational degree of freedom about an axis orthogonal to the tilt axis of the frame. Figure for the abbreviation: Figure 1

Description

Title of the invention: FRAME FOR LYING POSITIONING OF PATIENTS DURING SURGERY

[0001] TECHNOLOGICAL BACKGROUND This disclosure relates to a frame that can be removably attached to a surgical table to support parts of a patient's body during surgery. More specifically, the present invention relates to a frame that can be removably attached to surgical tables and configured to support the arms, parts of the torso, the head and legs, or other body parts of a patient during surgery, such as, for example, spinal surgery.

[0002] Standard surgical tables or beds, also called surgical beds or operating room tables, have surgical accessory rails for mounting patient support devices used during surgical procedures, a support column, and a base with patient support sections that are moved by electric linear or hydraulic actuators to position a patient as desired. The surgical table may be height-adjustable. The patient support section(s) may pivot or tilt relative to the base of the surgical table. These patient support sections may pivot or tilt together by the same amount or degree relative to the base of the surgical table.The patient support sections of these standard surgical tables may have metal frames that may also include other metallic components that could interfere with a surgeon's ability to obtain high-resolution fluoroscopic images of a patient during surgery. High-resolution images of this type can be critical for ensuring the safe and effective implantation of screws, rods, replacement discs, or other necessary hardware near spinal cord or neck nerves. Therefore, many standard surgical tables are unsuitable for spinal or other orthopedic procedures.

[0003] Specialized surgical tables have been developed for spinal surgery. For example, the Jackson table, the Trios table, the Andrews table, and the Allen Advanced™ table were designed specifically for spinal surgery. Examples of the Jackson table can be found in US patents Nos. 5,088,706; 5,131,106; 5,613,254; and 6,260,220. An example can be found The "Andrews" table is described in US Patent No. 5,444,882. An example of the Allen Advanced™ table can be found in US Patent No. 2017 / 0,354,563 A1. These specialized tables include radiolucent side rails that allow for intraoperative adjustment of the patient's position. These various types of freestanding, specialized surgical tables are very expensive and occupy a significant amount of valuable operating room space when in use or in storage. Finally, these tables are only necessary for a small percentage of orthopedic or spinal surgeries that can be performed in a hospital.

[0004] The current technique includes substantially radiolucent table extensions that are removably attached to surgical tables, enabling support for a patient during spinal surgery or other surgical procedures in which radiographic or fluoroscopic images of the patient's upper body are to be acquired. See, for example, US Patent Nos. 4,995,067; 5,758,374; 6,003,174; 6,584,630; and 6,813,788. Each of the devices disclosed in the patents listed above includes a table or similar structure underlying the patient that can be removably attached to an underlying surgical table. In certain surgical procedures in which a patient is in a supine position, it is desirable for the patient's abdomen to hang downwards without obstruction so as not to be supported by the surface of the underlying table.This allows blood to pool in the abdomen and away from the surgical site, namely the spine or cervical vertebrae. Consequently, some table extensions with such tabletops or panels may not be suitable for certain spinal surgical procedures. Furthermore, many known table extensions attached to an associated surgical table do not allow the extension to pivot relative to the surgical table in a way that would permit sufficient torso flexion of the patient to place the lumbar region of the spine in a more lordotic (i.e., more arched) or kyphotic (i.e., flattened or sloping) position than when the patient simply lies flat with the lumbar region of the spine in its naturally arched position.

[0005] Attempts have been made to solve the above problems using radiolucent table extensions that pivot at the point of attachment where they are removably coupled to the surgical table. These table extensions include a straight accessory frame with generally radiolucent side rails that can be removably attached to a surgical table. Two radiolucent side rails, having a straight cross-section, are spaced parallel to each other with support elements connecting the side rails. forming a straight frame. These frames are equipped with a variety of padded patient support devices that can be removably attached to support a patient. These patient support devices include those for the chest, arms, and legs; all can be moved or adjusted up and down the side rails to facilitate secure patient positioning. These patient support devices feature a lock that can be in the locked or unlocked position. They are designed to prevent pressure ulcers, nerve damage, and other problems caused by the patient being in a supine position during prolonged spinal procedures. The patient support devices must not move relative to the frame during surgery. To move or adjust their position, they must be placed in the unlocked position.For example, a practitioner can adjust their position on the side rail to properly support a patient when they are unlocked, and then lock them in place once the patient is positioned as desired. An example of such a frame with patient support devices is illustrated by US Patent No. 7,699,262 B2, the "Allen Flex Frame." This frame has a U-shaped base to which it is attached and which remains fixed to the floor unless tilted, so that its casters then come into contact with the floor, allowing it to be rolled from one location to another. One end of the radiolucent rectangular frame is removably attached to a surgical table, while the other end of the frame is attached to a support structure. The support structure is both extendable upward from the floor and retractable downward from the floor by means of a manual locking screw.A ball joint is present in the support base, which is attached to the support structure at its lower end. The support structure, at its upper end, is attached to one end of the frame. The ball joint allows the support structure to pivot around the support base, while the first end of the frame can tilt forward and backward and side to side relative to the support base or the floor. The second end of the frame can pivot relative to the surgical table by means of a distal pivoting element. This distal pivoting element of the frame can be removably coupled to the distal end of a surgical table. The base is fixed relative to displacement in this design.When articulated, the movements dependent on the frame relative to the support structure, the support structure relative to the frame, the support structure relative to the surgical table, and the frame relative to the surgical table allow the patient to be positioned supine in various positions. This facilitates imaging of the patient's torso or spine while allowing the practitioner access. at the surgical site. Another attempt by ISO Medical of Japan fixes the upper distal end of the frame and allows a wheeled base to move around an axis defined by the vertical support column which is attached to the wheeled base at its lower end, and whereby the frame is fixed to the upper end of the support column.

[0006] The two frames above have two pivoting rotation axes: one at a first end of the frame and one at a second end of the frame, while also allowing movement around or about an axis bifurcating the base and generally perpendicular to the ground. More specifically, these designs allow: a. rotation and tilting of the first end of the frame about an axis that is generally parallel to the ground and generally perpendicular to the support structure; and b. movement of the first end of the frame about an axis that bifurcates the first end of the frame where it is coupled to the support structure, and which is generally perpendicular to the frame's side rails; and c. tilting of the second end of the frame up or down about an axis that bifurcates the proximal pivoting element where the frame and the surgical table are removably coupled.

[0007] The patient support devices on the frames described above support parts of the patient's body and are configured to fit closely and snugly against the frame's side rails. These patient support devices have a locking mechanism which, when in the first position, allows the devices to be moved up and down on the side rails to position them as desired. Conversely, when the locking mechanism is in the second position, it immobilizes the patient support devices in place, thus preventing their unintentional movement relative to the frame during the procedure and / or when the frame is articulated. It is crucial that these patient support devices remain in place during surgery and do not move relative to the frame.

[0008] One drawback of the frame designs described above is that when the support structure moves in space around its base (while the top remains fixed) or around its top (while the base remains fixed) in response to the hinge of the surgical table, the frame is subjected to torsional and bending (torsion) forces that deform the frame's side members and can cause the cross-section of both the side members and the frame to lose its rectangularity, potentially damaging or breaking the side members. These bending and torsional forces result from the mismatch between the frame's degrees of freedom of movement and those of the surgical table to which it is removably attached.

[0009] These temporary changes in the geometry of the spar elements and / or the frame can cause the patient support devices (formed to fit tightly onto the spars) to become unlocked, thus allowing their uncontrolled movement relative to the frame during surgery. This loss of rectangularity in the spars can also cause the patient support devices to detach from the frame. Such uncontrolled movement and / or detachment of these patient support devices presents a clinical hazard, as uncontrolled patient movement during spinal surgery is very dangerous.Furthermore, although the frames in the current technique fold and store on their bases, the side rails are too long to fit into the base or the base's storage hooks without an adjustment channel allowing them to be moved outward from the support element to which they are attached. In addition, these frames may require the removal of any patient support devices attached to the frame before storing it in the non-use position. This removal of patient support devices adds an extra step when the practitioner attempts to store the accessory frame on the base.

[0010] SUMMARY Due to the disadvantages described in the current technique, there is a need for a surgical frame for surgical intervention in a supine or spinal position, whose freedom of movement corresponds to the freedom of movement of the surgical table to which it is removably coupled.

[0011] This correspondence of degrees of freedom of movement between the frame and the surgical table to which it is removably attached can eliminate the torsional and bending forces experienced by the frame and its side members during use. This can prevent uncontrolled movement or even detachment of the patient support devices during surgical procedures while allowing easy storage of the accessory with a minimum of steps. In addition, breakage and / or cracking of the frame side members can be prevented.

[0012] At least one embodiment of the present invention includes an accessory or accessory system that is used with a surgical table, and a method of using such accessory or accessory system that has one or more of the features listed in this disclosure or one or more features or combinations thereof that, alone or in combination, may fall within the scope of the present invention.

[0013] An accessory intended to be attached to a surgical table capable of supporting parts of a patient's body during a surgical procedure comprises a straight frame of radiolucent elements ("spars"), with two such spaced spars generally parallel to each other and connected by one or Several support elements and / or pivoting elements are spaced generally perpendicular to the side members. The side members are straight. A support structure may have a base, a support column attached to the base, and an adjustment column that extends upward and away from and / or retracts downward into the support column. In some embodiments, a lockable rotating head may have an upper surface, a lower surface, a distal horizontal surface, and a proximal horizontal surface. The lockable rotating head may be fixed at its lower surface to the upper surface of the adjustment column. The rotating head may rotate about an axis perpendicular to the ground and extending downward toward the center of the adjustment column, the support column, and the ground.The rotating head may have a recess formed in its distal horizontal surface, into which the distal part of a multi-axis joint can be coupled. This recess in the rotating head may have a hole formed in its horizontal surface.

[0014] In one embodiment, the multi-axis joint may include a main clamp having a circular cutout formed at its proximal end. The main clamp may also have a housing at its distal end, with a single horizontal cutout bifurcating the housing. This bifurcation creates upper and lower clamping housings. This bifurcation extends through the main clamp housing and may also bifurcate a portion of the circumference of the circular cutout formed at its proximal end. The distal clamp housing has an upper clamp housing and a lower clamp housing, and a proximal surface with an upper (top) and lower surface. The lower clamp housing may have a horizontal channel or hole formed in its distal horizontal surface and extending along a portion of its length.The upper collet housing may have a hole or recess formed in its upper surface, which is usually perpendicular to the horizontal hole or channel formed through part of the length of the lower collet housing, and into which it fits. An oblique stacking washer or a stack of disc springs may be inserted into a vertical hole in the upper surface of the collet housing with a cap placed over this hole after the stacking washer has been inserted. The operation and construction of an oblique stacking washer system are well understood and will not be described here.When in place and capped, the angled stacking washer applies constant pressure to the upper and lower collet housings, closing the gap caused by the bifurcation or cut between them, while simultaneously reducing the diameter of the collet's rotating hub by closing the bifurcation or cut made through the circular cutout of the main collet.

[0015] The channel formed through a portion of the lower gripper housing can align with a hole formed in and through a recess formed in the proximal horizontal surface of a rotating head in certain embodiments, the hole exiting from the distal horizontal surface of the rotating head.

[0016] A proximal end of a rotating cam may have a cam block formed or attached thereto. The distal end of the cam may have a handle attached thereto. The proximal end of this cam may be inserted through the horizontal hole formed in and through the proximal and distal horizontal surfaces of the rotating head.

[0017] The cam with a cam block can further be inserted into the horizontal channel formed through a portion of the length of the lower gripper housing. The cam block attached to or formed in the proximal end of the cam can be aligned once it is placed in this channel formed in the lower gripper housing and can align with the vertical hole formed in and through the upper gripper housing and which exits into the horizontal channel of the lower gripper housing.

[0018] The distal end of the cam with the cam block may have a handle which, when rotated, can move the cam from a first position to a second position.

[0019] The cam block on the proximal end of the cam can interact with the lower end or the lower surface of an oblique washer or a stack of disc springs that has been placed in the horizontal hole formed through the upper clamp housing. When placed in a second position, the proximal end of the cam with the cam block interacts with the bottom of the oblique washers or the stack of disc springs and pushes upwards against them.This interaction between the cam block and the oblique stacking washer exerts an upward force against the oblique stacking washer, releasing the pressure exerted by the oblique stacking washer on the upper and lower collet housings and on the bifurcation made in the circular cutout of the main collet, and thus allows the horizontal cutout formed through the collet housing and the cutout made through a surface part of the circular cutout of the main collet to open up and thereby increase the diameter of the circular cutout part of the main collet.

[0020] A suitable metal can be used to form a rotating hub. The rotating hub can be circular in shape with an outer circumference and can be flat on its lateral surfaces with a hole formed through its center and four through holes formed around the central hole. Two round hemispherical segments made of a suitable material or metal can be placed around the circumference of the rotating hub. The hemispherical segments have an outer circumference with a curved surface and an inner circumference with a curved surface, and the two surfaces having a common radius. The outer surface of the hemispherical segments can be matched with the outer surface / circumference of the rotating hub. The rotating hub with the two hemispherical segments matched to its outer surface can be placed in the circular cutout portion of the main clamp. The circular cutout portion of the main clamp can be shaped so that it closely matches the hemispherical segments mounted on the rotating hub.The combination of hemispherical segments and the rotating hub can be contained within the circular cutout of the rotating hub by placing a caliper pivot element through the center of the two hemispherical segments and the central hole of the rotating hub, with each end of the caliper pivot element attached to the first yoke end of a caliper. Circular cover plates can be sized to match the outer circumference of the rotating hub. These circular cover plates can have a hole formed in their center and sized to accept the caliper pivot element, and four through holes that correspond to the four holes formed through the rotating hub. The circular cover plates can also have four holes located and formed around the central hole.The caliper pivot element may have a retaining pin fitted through holes formed at or near each end of the pivot element. The caliper pivot element may be round, and in some embodiments, it may be threaded at one or both ends. In other embodiments, the caliper pivot element may have a hole formed near each end. In other embodiments, the caliper pivot element may have a cap at one end and be threaded at the other end. Retaining bolts may be placed through four through holes formed in a first circular plate. These retaining bolts may be pushed through and out of corresponding retaining holes in the rotating hub and fitted in and through four holes formed in a second, opposite circular plate fitted on the opposite side of the rotating hub.The fixing bolts can be capped at one end and fixed to the cover plates by placing a tab over the exposed threaded ends of the fixing bolts.

[0021] A stirrup may have first and second yoke ends with holes in each end.

[0022] The caliper pivoting element can be placed through the holes in one end of the caliper bracket, then through the hole formed in the center of a first circular cover plate, then passed through the center of the hole in the rotating hub, and then exited through the rotation hole formed in the center of the second circular plate of cover. The ends of the caliper pivot bolts can be threaded and can be capped by a tab.

[0023] The threaded ends of the stirrup pivoting element can then be capped by tabs creating a multi-axis joint from this set of semi-spherical segments-rotating hub-main clamp.

[0024] The cam can be placed in a second position that allows the angled washers or spring stackers to apply pressure to the upper and lower housings of the rotating hub, thereby closing the gap between its upper and lower housings and reducing the diameter of the circular cutout portion of the rotating hub. When this occurs, pressure is applied to the semi-spherical segments matched to the inner circumference of the rotating hub, thus locking the semi-spherical segments and the multi-axis joint assembly against movement.

[0025] Conversely, when the cam is rotated to a first position, the cam block pushes against the oblique stack or the stack of disc springs and releases the pressure exerted against the upper and lower housings of the clamp and the cutout in the surface of the rotating hub. The release of the pressure exerted by the inner surface of the circular portion of the rotating hub against the matched outer surface of the semi-spherical segments unlocks the multi-axis joint, thus allowing its movement.

[0026] Some embodiments include a bracket that connects the multi-axis to the first end of a frame. The bracket may have a first clevis end with corresponding through holes in each of its two tenons and a second clevis end with corresponding through holes in each of its two tenons.

[0027] In one embodiment, the threaded ends of the stirrup pivot element projecting from the circular plates of the multi-axis joint can be positioned in and through the through holes in each tenon of the first yoke end of a stirrup. In this embodiment, tabs can be placed on the projecting threaded ends, thereby securing the first yoke end of the stirrup to the multi-axis joint.

[0028] In other embodiments, the stirrup pivoting element can be equipped with a key or a fixing pin placed through holes formed in each end of the stirrup pivoting element to fix it in place.

[0029] The stirrup may have a second, opposite yoke end that is opposite the first yoke end of the stirrup. The second yoke end of the stirrup may be fixed to a first end of the frame by at least one distal pivoting element. In some embodiments, two distal pivoting elements may be present. The distal pivoting element(s) may be threaded at each end. In some embodiments, the distal pivoting element is round in cross-section.

[0030] The distal pivoting element can be inserted through a through hole in a tenon of the second yoke end of the stirrup, then into and through holes formed in the distal region of each spar, then into the opposite through hole in the second yoke end of the stirrup and capped by a tab at the threaded ends of the distal pivoting element, thus coupling one end of the stirrup to the first end of a frame.

[0031] In one embodiment, the rotating head, the multi-axis joint, and the stirrup, together with their associated pivoting and rotating elements, comprise a gimbal which, in combination with the proximal pivoting element that secures the frame to the surgical table, allows the straight frame to move or be articulated around six axes of rotation. Up to two of the axes of rotation can be locked against rotation by placing the cam of the multi-axis joint in the second position in one embodiment. The rotatable head can also be locked against rotation by a lever inserted in the rotatable head which, when placed in the second position, strikes the head, blocking any rotation. When in the first position, this lever allows the rotatable head to rotate if desired.

[0032] The accessory may further have a proximal coupling device that allows a second end of the straight frame to be pivotally coupled to the surgical table so that two of the side rails extend away from the surgical table. The straight frame can be articulated relative to the surgical table in response to displaced parts of the surgical table and / or in response to displacement of the support or adjustment column. The side rails may be configured such that two of the side rails are generally parallel to each other, with at least one support element fixing the side rails to each other, and with such support element(s) generally perpendicular to the side rails.

[0033] The side rails can be spaced and arranged so that the upper body of a patient can be supported by the accessory and at least part of the patient's legs can be supported by the surgical table during surgical procedures. The frame may have at least one pivoting element connecting the side rails at its second end. The distal and proximal pivoting elements of the first and second ends of the frame are generally parallel to each other and generally perpendicular to the frame's side rails. There may be a pivoting element at the first end of the frame, while there may also be a pivoting element at a second end. of the frame. In other embodiments, there may be two pivoting elements at one end of the frame and at least one pivoting element at the other end of the frame. A pivoting element may also serve as a support structure extending from the inner surface of at least one side member to the inner surface of the opposite side member.

[0034] In other embodiments, the first end of the frame is attached to the second end of the stirrup bracket by two or more pivoting elements rather than a single pivoting element. The pivoting coupling using a proximal pivoting element between the surgical table and the second end of the frame makes it possible to make the spine of an associated patient more lordotic or kyphotic before, during, and after surgery simply by raising or lowering the surgical table and / or raising or lowering the adjustment column of the accessory. The distal pivoting element(s) attaching the first end of the frame to a second end of a stirrup bracket allow the first end of the frame to pivot up and down relative to the base of the accessory and the base of the surgical table to which the frame is removably coupled.Each side of the frame can move up and down relative to the base of the surgical table when the adjustment column is raised or lowered and / or if the surgical table is raised or lowered. Furthermore, the frame can move from side to side in response to the movement or articulation of the surgical table. This is accomplished via the rotation axes of the rotating head and the multi-axis joint, which is attached to the first end of the stirrup yoke and the second end of the stirrup yoke, which is coupled to the first end of the frame by a pivoting element.

[0035] When the rotating cam is in the second position, the unlocking of the multi-axis joint and the possibility of movement of the stirrup to which the multi-axis joint is fixed and of the frame to which the stirrup is fixed allow the multi-axis joint to rotate in reaction to the movement of the surgical table when it is articulated and to the movement of the adjustment column when it is moved.

[0036] Furthermore, when the cam is in the second position, the multi-axis joint is locked against its movement and simultaneously prevents movement of the frame in at least two axes. The articulation of the surgical table through its ranges of motion can be achieved, for example, using one or more electric linear actuators of the surgical table.

[0037] Patient support devices may have a channel formed along their length, designed to fit closely onto the side rails. The patient support devices may be removably attached to the side rails and may have latches with a locked position and an unlocked position. Parts The patient's body can be positioned on the patient support devices. In the locked position, the patient support devices cannot be moved along the side rails. In the unlocked position, the patient support devices can be moved along the side rails, allowing them to be positioned under the patient's body as desired. Patient support devices may include devices to support the chest, arms, hips, and other body parts.

[0038] Patient support devices can be coupled to the side rails and may include head supports, chest supports, hip supports, arm boards (arm supports), and leg supports, among others. The accessory can be used without panels or table sections extending under the patient's abdomen, thus allowing the patient's abdomen to hang downwards without any obstruction. Panels or sections can be attached to the radiolucent side rails and can support padding cushions.

[0039] The coupling device between the second end of the frame and the distal end of the surgical table may include at least one proximal pivoting element that generally extends horizontally from at least one of the side rails. The coupling device may further include at least one proximal clamp that can be coupled to a surgical table and that is capable of receiving the proximal pivoting element, which allows the pivoting movement or rotation of the second end of the frame around the generally horizontal axis of the pivoting element. The proximal clamp may also include a clamp body with a channel sized to receive an accessory rail of the surgical table and a clamping screw that can press against the accessory rail, and a clamping knob that removably couples the proximal clamp to the surgical table.The clamp may include a spring-loaded lever arm extending from the clamp body, while the clamp may have a curved surface or opening where the proximal pivoting element can be captured by the spring-loaded lever arm. In addition, the clamp may have a second clamping screw or a system that compresses the rail acceptance channel onto the surgical table's lateral rail.

[0040] The proximal pivoting element may have grooves or spirals formed around its circumference and threaded ends. The proximal pivoting element may also have a circular retaining plate attached to each of its ends. Each spar may have an end cap fitted to its proximal end. The proximal spar end caps may have a spring-loaded actuator located in a channel formed through it. When the spring-loaded actuator is in the neutral position, it exerts pressure on and prevents movement of the proximal pivoting element. When it When pressed or pushed, the actuator allows outward movement of the distal pivoting element and the retaining plates attached to it, thus allowing the distal pivoting element to be removably attached to various widths of surgical tables.

[0041] The proximal pivoting element may have retaining plates with threaded holes that can be fixed to the threaded ends of the proximal pivoting element.

[0042] During the articulation of the frame relative to the surgical table, the proximal pivoting element can rotate and slide on the curved surface of the opening formed in one end of the proximal clamp.

[0043] The proximal clamp may have a spring-loaded lever arm that is movable between a second position which locks when in the neutral position and which, when moved into a second position, allows the proximal pivoting element to be withdrawn from the opening of the clamp.

[0044] Each spar may comprise a carbon fiber tube and a filler material inside the tube. The filler material may comprise polyurethane foam. The tube or spar may generally be quadrilateral in cross-section. In some embodiments, the spar may have a width of approximately 1.25 inches (3.175 cm) and a height of approximately 1.5 inches (approximately 3.80 cm). In some embodiments, at least two spars may generally be parallel to each other and spaced 14 inches (approximately 35.6 cm) apart, measured between the inside surfaces of opposite spars, or approximately 17.5 inches (approximately 44.5 cm) apart, measured from the outside surface of one spar to the outside surface of the opposite and generally parallel spar.In these embodiments, the fact that the frame is composed of side rail elements in this arrangement allows any patient support accessory, which can otherwise be attached to Jackson, Allen Advanced or other specialized tables, to be attached to the side rail elements of these above frame embodiments.

[0045] In addition to this disclosure, an accessory that can be attached to a surgical table to support a patient during surgery, or that can be removably attached to a surgical table to support a patient, can be stored when not in use. This storable accessory may include a frame that is generally rectilinear in shape, having at least two radiolucent side rails that are rectilinear in cross-section, these side rails being generally parallel to each other and with at least one support element connecting the side rails. At least one pivoting element extends outward from the medial surface of a side rail and connects it to the opposite side rail. In some embodiments, the at least one pivoting element acts as the structural element connecting the two longerons. In other embodiments, there is at least one pivoting element and one support element extending outwards from the medial surface of one longeron and connected to the opposite longeron. The at least one pivoting element or support element is generally perpendicular to the longerons.

[0046] The accessory may further have an accessory base with a support column coupled to the base. The support column is generally perpendicular to the ground and the base. The support column may have an adjustment column that fits into it and extends both inward and outward. The support column may further have electric linear actuators that can move the adjustment column outward and upward from the support column, or that can pull the adjustment column downward into the support column.

[0047] In some embodiments, there may be only one support column extending from the base, which is driven up and down by linear actuators embedded in the column. The base may include a straight or U-shaped base frame and a pair of hooks. In other embodiments, the base may have a four-sided shape or may have an "X" shape with a central area to which the support column is attached. The base may be weighted to improve the anti-tipping properties of the accessory. In other embodiments, the base may include a base frame with cutouts, or a notch formed in the upper surface of the base to accept a second end of the frame when the accessory is not in the operating position.

[0048] The frame may include one or more pivoting elements extending outward from the radiolucent side rails at the first and second ends of the frame. One or more of the pivoting elements at the second end of the frame may rest on hooks formed or fitted to the top or side of the base. In other embodiments, at least one distal pivoting element may rest in V-shaped base cutouts in the upper surface of the base when the frame is in the storage position. In other embodiments, hooks may extend from one side of the base. In some embodiments, the hooks may extend from both sides of the base. In other embodiments, the hooks may extend upward from the front upper surface of the base.The hooks can be formed into or fitted onto the surface of the base.

[0049] A surgical table may have a base with a column which, using electric linear actuators, allows the surgical table to be raised or lowered and tilted during or before a surgical procedure. The surgical table may feature lateral rails extending longitudinally along its length, on which patient support devices can be mounted.

[0050] The accessory may further include a pair of distal clamps that can be coupled to the side rails of the surgical table. A proximal pivoting element of the accessory can be coupled to the distal clamps when the frame is in the operating position. The distal clamps can be removably attached to the side rails at the distal end of the surgical table.

[0051] A universal joint may include a rotating head fixed at its lower surface to the upper region of the adjustment column, or in some embodiments at the upper surface of the adjustment column, and a multi-axis joint coupled to the proximal horizontal surface of the rotating head, which is fixed at its proximal end to a bracket with two clevis ends. The rotating head may be rotatable and lockable, with the axis of rotation generally perpendicular to the ground and parallel to the adjustment column. The multi-axis joint may have a cam inserted therein that allows rotation about at least three axes when the cam is in the first position, and is simultaneously locked against rotation about at least two of these axes when the cam is in the second position.The multi-axis joint can rotate around three axes simultaneously, including a first axis that is generally parallel to the ground and perpendicular to the frame (the horizontal multi-axis joint axis), allowing up to 360° of rotation around this axis. The multi-axis joint can rotate around a second axis that is generally perpendicular to the ground and parallel to the adjustment column (the perpendicular joint axis), allowing up to approximately 250° of rotation around this axis. Finally, the multi-axis joint can rotate around a third axis that is generally parallel to the ground and parallel to the frame rails, allowing up to approximately 250° of rotation around this axis. These axes of rotation are shown in [Fig. 1].

[0052] A stirrup may have opposing first and second yoke ends. A stirrup pivoting element may be located on and project from the opposing cover plates of the multi-axis joint. The first yoke end of the stirrup may have holes formed therein, into which the stirrup pivoting element may be inserted and capped, thereby coupling the first yoke end of the stirrup to the multi-axis joint.

[0053] The longitudinal members at the first end of the frame can be fixed to the first end of the stirrup yoke by a distal pivoting element in certain embodiments, the pivoting element generally being perpendicular to the longitudinal members. In other embodiments, the longitudinal members at the first end of the frame can be fixed to a first end The yoke of a stirrup is secured by two pivoting elements. The second end of the stirrup yoke can be attached to the multi-axis joint via a stirrup pivoting element projecting from the multi-axis joint. The multi-axis joint allows movement in three axes and can be locked against rotation about two of these axes when the rotating cam is in the second position. The rotating head to which the multi-axis joint is coupled can be adjusted on a mounting location fixed to the upper region of the adjustment column. The mounting location can be configured to allow the rotating head to rotate up to approximately 450° in a plane generally parallel to the ground.

[0054] A second end of the frame can be removably fixed to the distal end of a surgical table by a proximal pivoting element. The gimbal can comprise: a stirrup with two clevis ends, with a second clevis end coupled to one or more distal pivoting elements, a multi-axis joint allowing movement in three axes of rotation, and which can be locked against any movement around two of these axes of rotation and which is fixed at its proximal end to a first clevis end of the stirrup, and a head that can be rotated and locked, which is fixed to the distal side of the multi-axis joint.

[0055] The distal pivoting element, or in certain embodiments, the distal pivoting elements, may be fixed to one end of a stirrup's yoke. The distal pivoting element may also be fixed to the first end of the frame.

[0056] The gimbal allows the first end of the frame to pivot around the generally parallel axes of the stirrup support pivoting element and the distal pivoting element when the adjustment column is raised and lowered and / or when the surgical table is raised and lowered.

[0057] The multi-axis joint has a stirrup pivot element projecting from cover plates coupled to the two outer horizontal surfaces of the multi-axis joint. The stirrup pivot element can connect the multi-axis joint to the second end of the stirrup yoke, while a distal pivot element can fix the first end of the stirrup yoke to the first end of the frame.

[0058] A multi-axis joint can allow rotational movement around at least five axes, including at least the following axes:

[0059] Rotation axis EE passing through the rotating head which is generally perpendicular to the ground and which generally passes through the center of the adjustment column and the support column into which it fits.

[0060] Axis of rotation CC which is generally parallel to the ground and generally passes through the center of the multi-axis joint.

[0061] Rotation axis DD which passes through the multi-axis joint, which is generally perpendicular to the ground and generally parallel to the adjustment column.

[0062] Rotation axis FF which passes through the multi-axis joint which is generally perpendicular to the adjustment column and generally parallel to the ground and generally passes along the longitudinal axis of the frame and generally bifurcates the surgical table.

[0063] BB rotation axis which passes through the distal pivot bolts fixing the first end of a caliper bracket to the first end of the frame.

[0064] Rotation axis AA in which the frame rotates around a proximal pivoting element, the axis generally being parallel to the ground and to the rotation axis BB.

[0065] The multi-axis joint can be locked simultaneously against at least two axes of rotation. Securing the second end of the frame to the distal end of a surgical table by the proximal pivoting element can further allow the frame to pivot around the lateral and longitudinal axes of the side rails extending from the support column. This pivoting around the axis of the proximal pivoting element can occur due to the operation of linear actuators in the surgical table that raise and lower it, or due to the raising and lowering of the adjustment column.

[0066] Linear actuators in the surgical table can tilt the table relative to the floor and articulate the table surface to an angle of up to approximately 600° with respect to a plane perpendicular to the floor. More specifically, the multi-axis joint and the bracket to which the frame is attached allow the frame to tilt about an axis that extends parallel to the surface of the surgical table and the floor when the surgical table is articulated about these planes.

[0067] The gimbal allows the first end of the frame to move from side to side in a plane parallel to the ground when the surgical table is articulated through its ranges of motion. The gimbal also allows the frame to which it is attached to move from side to side in a plane parallel to the ground when the surgical table is inclined at an angle to the ground and when the head section is lowered and the foot section is raised (the "Trendelenburg position") without disturbing the rectangularity of the frame and the cross-section of the side members.

[0068] By raising or lowering the surgical table or the adjustment column, the proximal pivoting element allows the second end of the frame to pivot relative to the surgical table, the floor and the accessory base.

[0069] The rotating head can be fixed to the upper surface of the adjustment column at one end, and fixed to the multi-axis joint at the other end. The multi-axis joint can be attached to a stirrup at the distal end of the stirrup or at its second clevis end. The stirrup, at its proximal end or its first clevis end, can be attached to the distal pivoting element or, in one embodiment, to distal pivoting bolts. The distal pivoting bolts or the distal pivoting element are, in turn, coupled to a first end of the frame. The adjustment column can be extendable from the support column in which it is housed or fitted to increase the elevation of the first end of the frame relative to the base. The adjustment column to which the frame is coupled can be retractable within the support column in which it is housed to decrease the elevation of the first end of the frame relative to the base.The adjustment column may have internally housed electric linear actuators, which can be used to raise and lower the extension column or extend it upwards from the support column in which it is housed.

[0070] The accessory may further include a set of casters coupled to the base, which has a support column extending upwards and away from it. The casters may be spaced away from the floor when the base is in a normal operating position, while in one embodiment, the casters may engage with the floor, allowing the base and associated frame to be moved for transport. In other embodiments, the casters may have a spring-loaded actuator and a locking pedal. Once engaged, the casters are locked in place. In other embodiments, when the locking pedal is engaged, the casters extend away from the accessory base, and the base settles onto the floor, thus stabilizing the accessory. A handle may be coupled to the upper region of the support column.In other embodiments, a handle may be coupled to the upper region of the adjustment column. The handle may be grasped to push the wheeled base to a desired location or, alternatively, it may be used to pull the accessory into the desired position. The handle may include a horizontal bar having gripping portions on the side opposite its point of attachment to the accessory.

[0071] Furthermore, according to this disclosure, an accessory may include a frame, a base that can be supported on a floor during a surgical procedure, and a support column extending upward from the base. The support column may have a housing in which one or more adjustment columns may reside and to which they are coupled. The adjustment column may also serve as a second support column for the accessory. The support column may have linear actuators coupled to the adjustment columns which, when they can operating, can cause the adjustment columns upwards and away from the base, or alternatively the linear actuator can pull the adjustment column into the support column and downwards relative to the base, thus changing the effective height of the support column.

[0072] A panel that can be coupled to the side rails may also be provided. The ends of the panels may be supported on the support elements, the side rails, or the pivoting elements, so that the panels span a defined gap between the frame elements. At least one end of the panel may have a notch in it, through which a portion of one of the frame elements is exposed. One side of a side rail clamp may be coupled to a portion of one of the frame elements or side rails exposed in the notch. A second side of the side rail clamp may have an accessory rail attached to it. A second clamp may be coupled to the accessory rail. The second clamp may be removably coupled to an armboard or other accessories. A mattress or cushion may be removably attached to the panel.The mattress may have a section that covers the notch and the first clamp when the mattress is attached to the panel.

[0073] An additional feature which, alone or in combination with any other feature, such as those listed above, may comprise a material falling within the scope of the present invention and will be obvious to the person skilled in the art after examination of the following detailed description of illustrative embodiments which illustrate different ways of implementing the embodiments as they are currently conceived.

[0074] An accessory has a substantially straight radiolucent frame with two straight cross-sectionally spaced longitudinal members, spaced support elements, a ground-supported column, adjustment columns housed within and extending from the support column, and an electrical linear actuator attached to the adjustment column, a rotating head with a top surface, a bottom surface, and a proximal horizontal surface. The adjustment column and the rotating head are coupled at the top surface of the adjustment column and the bottom surface of the rotating head. The rotating head can rotate about an axis of rotation. The rotating head is attached to a pivot joint that has freedom of movement about three axes of rotation.The pivot joint is in turn fixed to a stirrup at its first end, and the second end of the stirrup is coupled to one end of the frame via a distal pivoting element. The distal pivoting element allows the first end of the frame to pivot around an axis of rotation. A second end of the frame can be removably coupled via a proximal pivoting element to the distal end of a [missing word - likely "joint"]. A surgical table that allows the second end of the frame to pivot around another axis of rotation. The frame, including the rotating head, the pivoting joint, and the proximal and distal pivoting elements, has freedom of movement around at least six axes of rotation. These axes of rotation are shown in [Fig. 1] and are referenced as axis AA, axis BB, axis CC, axis DD, axis EE, and axis FF, where an embodiment of the disclosure frame 122 is illustrated along with the surgical table 002 to which it is removably coupled. At least two axes of rotation of the frame can be simultaneously locked and unlocked against rotation, while the EE axis of rotation of the frame can be independently locked against rotation.

[0075] The frame is mobile to a compact storage position with the other end of the frame supported on the base. The frame may have leg, chest, or hip supports (“patient support devices”) removably attached to it. Patient support devices can be moved up and down the frame's side rails when in an unlocked position and held in place on the side rails when in a locked position. The frame is designed so that the patient support devices do not have to be removed when storing the accessory frame. A set of lockable casters is provided on the base of the accessory to allow it to be rolled from one location to another and locked in place once in the desired location.

[0076] Another embodiment relates to an accessory intended to be attached to a surgical table that supports at least one part of a patient's body. The accessory may include a surgical table that allows the straight frame to move or be articulated about six axes of rotation. The accessory includes at least one support structure having an adjustable length, a frame extending from a proximal end to a distal end, wherein the distal end of the frame is configured to be rotationally coupled to the surgical table, and a multi-axis joint mounted on at least one support structure rotationally coupled to the proximal end of the frame, wherein the multi-axis joint has at least one rotational degree of freedom about an axis of inclination of the frame and a second rotational degree of freedom about an axis orthogonal to the axis of inclination of the frame.

[0077] In another embodiment of the accessory, the frame includes two spar elements each extending from the proximal end to the distal end of the frame, and each spar element is rotationally coupled at a distal end thereof to the surgical table.

[0078] In another embodiment, the accessory includes a bracket configured to couple the multi-axis joint to the longitudinal members, such that the multi-axis joint can allow simultaneous rotations of the bracket around the tilt axis of the frame and the axis orthogonal to the tilt axis of the frame.

[0079] Another embodiment relates to an accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising at least one support structure having an adjustable height, a frame extending from a proximal end to a distal end, wherein the distal end of the frame is configured to be rotationally coupled to the surgical table, a multi-axis joint mounted on at least one support structure, wherein the multi-axis joint has at least three rotational degrees of freedom, and a stirrup having a proximal end that is coupled to a distal end of the multi-axis joint and a distal end that is rotationally coupled to the proximal end of the frame,in which the coupling of the distal end of the multi-axis joint to the proximal end of the stapes allows rotation of the stapes around at least three rotational degrees of freedom, thereby allowing rotation of the frame around at least three rotational degrees of freedom.

[0080] In another embodiment, the accessory includes a coupling device which pivotally and removably couples the distal end of the frame to the surgical table such that at least two longitudinal members can move in response to a movement of the surgical table and / or a movement of at least one support structure.

[0081] In another embodiment, a displacement of the multi-axis joint around at least two of the at least three rotational degrees of freedom can be simultaneously locked and unlocked.

[0082] Another embodiment relates to an accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising at least one support structure extending from a proximal end to a distal end, wherein the proximal end of the at least one support structure is movable along a longitudinal axis of the support structure so as to adjust a length of the at least one support structure, a frame comprising at least two spar elements each extending from a proximal end to a distal end, wherein the distal end of each of the spar elements is rotationally coupled to the surgical table, a multi-axis joint mounted on the proximal end of the support structure,a stirrup rotatably coupled to the proximal end of one of the at least two spar elements and rotatably coupled to the proximal end of another of the at least two spar elements such that the stirrup can rotate around, of an axis substantially orthogonal to a longitudinal axis of each of the spar elements, wherein the multi-axis joint is coupled to the stirrup and is configured to permit rotation of the stirrup around an axis orthogonal to a tilt axis of the frame simultaneously with a rotation of the frame around the tilt axis.

[0083] In another embodiment, the accessory further comprises a platform coupled in a fixed manner to the distal end of at least one support structure.

[0084] In another embodiment, at least one support structure has a telescopic beam.

[0085] In another embodiment, the frame can move around six axes of rotation.

[0086] In another embodiment, the accessory further comprises a rotating lockable head which couples the multi-axis joint to the support structure, in which the rotating lockable head can rotate around a longitudinal axis of the support structure.

[0087] In another embodiment, the rotating locking head includes a lever that is movable between a first position and a second position, in which when the lever is in the first position, the rotating locking head is rotating, and when the lever is in the second position, the rotating locking head is locked against rotation.

[0088] In another embodiment, the surgical table allows the frame to move or be articulated around six axes of rotation.

[0089] In another embodiment, the frame is a straight frame comprising radiotransparent elements.

[0090] In another embodiment, the accessory further comprises a rotating lockable head fixed to an upper surface of the support structure, the rotating lockable head being configured to rotate about an axis perpendicular to the ground and which descends along the center of an adjustment column and a support column and the ground, in which a distal part of a multi-axis joint is coupled.

[0091] In another embodiment, the multi-axis joint comprises a main clamp in which a circular cutout is made, a rotating hub in which a through hole is formed, a stirrup pivoting element configured to be rotationally adjusted in the through hole, semi-spherical segments configured to be placed around the circumference of the rotating hub and positioned inside the circular cutout, in which the stirrup is rotationally coupled to the stirrup pivoting element to allow rotation of the stirrup around the stirrup pivoting element.

[0092] Another embodiment relates to an accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising a surgical table which permits the straight frame to move or be articulated about six axes of rotation, at least one support structure having an adjustable length, a frame extending from a proximal end to a distal end, in which the distal end of the frame is configured to be rotationally coupled to the surgical table; and at least two or more joints mounted on the at least one support structure rotationally coupled to the proximal end of the frame, in which the at least two or more joints have at least one first degree of rotational freedom about an axis of inclination of the frame and a second degree of rotational freedom about an axis orthogonal to the axis of inclination of the frame.

[0093] Another embodiment relates to a clamp configured to attach to a surgical accessory rail having an outer side and an inner side, the clamp comprising a clamp body in which a table rail acceptance channel is formed, configured to receive the surgical accessory rail, and first and second holes formed in the clamp body, first and second threaded screws extending through the first and second holes, respectively, a first knob fitted on the first threaded screw, wherein a rotation of the first knob causes one end of the first threaded screw to strike an outer side of the surgical accessory rail, thus fixing the clamp to the outer side of the surgical accessory rail, a swing arm having a tip extending from the swing arm, and a second knob fitted on the second threaded screw.in which a rotation of the second knob causes one end of the second threaded screw to strike the swing arm, causing the swing arm to tilt such that a surface of the tip strikes an inner side of the surgical accessory rail, thus fixing the clamp to the inner side of the surgical accessory rail.

[0094] In another embodiment, a stirrup may have a first and a second clevis end. The first end of the frame may be fixed to a first clevis end. A second clevis end of the stirrup may be fixed to a connector.

[0095] The connector can be attached via a first end of the yoke to a series of joints which in turn connect to a pivot joint at a first end of a frame. In this embodiment, the connector can be attached to the adjustment column. The connector may have a distal section and a proximal section, each section generally being perpendicular to the other.

[0096] The proximal connector section can be rotatable and can be locked against rotation. The frame can be pivotable and have at least two pivot joints at its distal end so that it pivots by relative to the adjustment column, allowing the frame to be stored on a base without adjusting the stringers outwards or inwards relative to the connector.

[0097] In one embodiment, a universal joint may include a connector fixed at its distal end to the upper region of the adjustment column, or in some embodiments to the upper surface of the adjustment column, the connector being fixed at its proximal end to a bracket with two clevis ends. A connector may include a distal connector section generally parallel to the adjustment column and a proximal connector section generally perpendicular to the adjustment column.

[0098] In this embodiment, the proximal connector section can be rotated and locked, and is generally parallel to the ground. The distal connector section can be rotated and locked, and is generally perpendicular to the ground. The connector can be circular or oval in cross-section, and can be constructed from two tube sections fixed or fitted together.

[0099] The two connector sections may be made of hollow tubes. A stirrup may have opposing first and second clevis ends. The proximal connector section may have a proximal cap fitted onto the front surface of its proximal end, the proximal cap having a slot in its distal end and a stirrup support pivot element located in the slot. The slot may generally be parallel to the ground. The stirrup pivot element may have a through hole formed midway along its length. The proximal cap of the proximal connector may have aligned holes formed in and through its upper and lower surfaces. A vertical pivot element may include a bolt with a capped end and a threaded end plus a lug.The vertical pivoting element can be placed through the hole in the upper central proximal surface of the proximal cap and in and through a through hole located in the middle of the stirrup pivoting element, then in and through the hole formed in the lower surface of the proximal cap and capped with the tab at its threaded end.

[0100] In one embodiment, side members at the first end of the frame can be attached to the first end of the yoke by a distal pivoting element. The pivoting element can generally be perpendicular to the side members. In other embodiments, the side members at the first end of the frame can be attached to the stirrup pivoting element by two pivoting elements, and the second end of the yoke can be attached to the stirrup support pivoting element. The first end of the stirrup yoke can be attached to the distal pivoting element, which is in turn attached to a first end of the frame.

[0101] The proximal connector section can be rotated up to 90 degrees and locked. The distal connector section can be fitted into a hole formed in the upper surface of the adjustment column. There may be a flange fixed or formed in the circumference of the lower region of the distal connector section that fits against a collar positioned around or near the top of the hole in the upper surface of the adjustment column, and fixed thereto. This flange-collar combination allows the distal connector section to rotate in the hole, which can be locked against rotation.

[0102] A second end of the frame can be removably fixed to the distal end of a surgical table by means of a proximal pivoting element.

[0103] In some embodiments, a universal joint includes a yoke with two yoke ends, a rotating proximal connector section, a rotating distal connector section, a vertical pivoting element coupled to the proximal connector section, a yoke pivoting element coupled to the vertical pivoting element and to a second yoke end of the yoke, and the second yoke end of the yoke coupled to a distal pivoting element.

[0104] The distal pivoting element, in this embodiment, can be fixed to a first end of the frame by allowing the first end of the frame to pivot around the generally parallel axes of the stirrup support pivoting element and the distal pivoting element when the adjustment column is raised and lowered and / or when the surgical table is raised and lowered.

[0105] The vertical pivoting element can fix the stirrup pivoting element to the proximal connector section by allowing the frame to move from side to side in a plane generally horizontal to the ground.

[0106] The proximal connector section can be fixed to the distal connector section which is generally perpendicular to the ground and generally perpendicular to the proximal connector section.

[0107] The proximal connector section can be rotated about an axis which is generally parallel to the ground and perpendicular to the distal connector section.

[0108] The distal connector section can be fitted into a hole formed in the upper surface of the adjustment column and can be allowed to rotate about an axis extending through the center of the adjustment column and which is generally perpendicular to the ground. The rotation of the distal connector section allows the frame to move from side to side in a plane generally parallel to the ground.

[0109] In this embodiment, the gimbal allows rotational movement around at least five axes. Securing the second end of the frame to the distal end of a surgical table by the proximal pivoting element can further allow pivoting of the frame around the lateral and longitudinal axes of the longerons extending from the support column. This pivoting around the axis of the proximal pivoting element can occur due to the operation of linear actuators in the surgical table that raise or lower it, or due to the operation of linear actuators in the support column raising and lowering the adjustment column.

[0110] In this embodiment, the gimbal allows the first end of the frame to move from side to side in a plane parallel to the ground when the surgical table is articulated through its ranges of motion. More specifically, the vertical pivoting element allows the stirrup to which it is indirectly attached and the frame to which the stirrup is further attached to move from side to side in a plane parallel to the ground when the surgical table is inclined at an angle to the ground and when the head section is lowered and the foot section is raised (the "Trendelenburg" position) without disturbing the rectangularity of the frame or the cross-section of the side members.

[0111] In one embodiment, the adjustment column is attached to the connector at its distal end. The proximal end of the connector is attached to a stirrup at the distal end of the stirrup. The stirrup, at its proximal end, is attached to the distal pivoting element, which is coupled to the first end of the frame. The adjustment column can be extended from the support column in which it is housed or fitted inside the support column to increase the elevation of the first end of the frame relative to the base. The adjustment column to which the frame is coupled can be retracted inside the support column in which it is housed to decrease the elevation of the first end of the frame relative to the base.The adjustment column may have internally housed electric linear actuators, which can be used to raise and lower the extension column.

[0112] In some embodiments, the gimbal can also be fixed to the first end of the frame with a proximal pivoting element fixed to a second end of the frame. The proximal pivoting element can be removably coupled to the distal end of the surgical table. The gimbal and the proximal pivoting element can be configured to allow movement of the accessory around up to six axes of rotation due to the movement of the adjustment column and / or the joint of the surgical table.

[0113] In some embodiments, the gimbal may include a connector with a rotating distal connector section that is fixed to the upper region of the adjustment column and a rotating proximal connector section fixed to the first end clevis of the caliper with two opposing clevis ends.

[0114] Furthermore, the gimbal may include a connector formed from a hollow tube in certain embodiments. The connector may be formed or manufactured from metal or a hard polymer or a combination thereof, or other suitable materials. The connector may also be formed or molded as a monolith or may consist of two or more hollow tubes or half-hollow tubes fitted together. The connector may have a distal section that is generally parallel to the extension column and generally perpendicular to the ground, and a proximal section that is generally perpendicular to the adjustment column and generally parallel to the ground, the two connector sections forming an "L"-shaped connector.

[0115] The proximal connector section, which includes a portion of the gimbal, may generally be parallel to the ground while being generally perpendicular to the support column, the adjustment column, and the distal connector section. The proximal connector section may be rotatable relative to the distal connector section. The proximal connector section may be locked in place to prevent further rotation relative to the accessory by means of a brake attached to the distal end of a handle. This brake handle may be fitted into a hole in the distal connector section, and its distal end may engage with gear-like features formed in the distal region of the proximal connector section. The proximal connector section may have a proximal cap attached to its end or formed in its proximal end.In some embodiments, the proximal cap may be hemispherical in shape, while the distal end of the proximal connector section may be a hollow tube and thus sized so that the proximal cap fits closely onto, and can be fixed to, the proximal end of the proximal connector section. The front surface of the proximal cap may have a generally horizontal slot formed thereon, the slot being usually parallel to the ground and the base of the accessory while being generally perpendicular to the adjustment column. Coaxial holes may be formed in and through the center of the upper surface and one center of the lower surface of the connector cap.

[0116] In some embodiments, a stirrup pivot element may include a bolt threaded at both ends, which may have a through hole formed at a point midway along its length. There may be a vertical pivot element comprising a bolt with a cap at one end and threaded at the other end, and a tab for capping the threaded end. The stirrup pivot support element may be attached to the connector cap by placing the vertical pivot element in and through the coaxial hole in the upper surface of the connector cap, in and through a hole formed midway along The length of the yoke pivot element is inserted into and through the coaxial hole formed in the underside of the connector cap. The vertical pivot element can then be secured in place by fastening and tightening the tab around its threaded end. The vertical pivot element allows rotational movement of the yoke and the attached frame around the element in a plane that is generally horizontal relative to the ground and the accessory base.

[0117] In other embodiments, coaxial holes are formed in the proximal upper and lower surfaces of the proximal connector section which has a slot formed in its proximal front surface, the slot being generally parallel to the ground and the accessory base.

[0118] In one embodiment, a stirrup may be formed of metal, carbon fiber, or other suitable materials. The stirrup may include two opposing clevis ends, comprising a first clevis end and a second clevis end. The prongs of the second clevis end may be spaced to fit around or fit close to the outer surface of the connector cap or the distal region of the proximal connector section. The second clevis end of the stirrup may have holes formed within it, sized to accept each end of the stirrup pivot element. The stirrup pivot element may include a bolt with threaded ends in some embodiments.The stirrup pivot element can be placed through the holes in the second clevis end, while threaded nuts can be engaged on the threaded ends of the stirrup pivot element to couple it to the second clevis end. The first clevis end may have holes formed in its end region. The forks of the second clevis end may be spaced so that its outer surface fits closely against the inner surface of the distal region of the side rails. The first end of the frame may include the distal region of both side rails and a distal pivot support element that connects the side rails. The distal region of the side rails may have a through hole formed through them.A proximal coupling device with a straight cross-section may have a channel-like shape within it to accept the spar, allowing the coupling device to fit snugly onto the spar. The proximal coupling device may have coaxial through holes formed in its lateral and medial surfaces. The distal pivoting support element is typically perpendicular to the spars and has threaded ends. The threaded ends of the distal pivoting support element can be fitted into and through holes in the proximal clevis end of the stirrup, then into and through corresponding holes in the distal coupling device, and finally into and through holes formed in the region. distal to the lateral surfaces of the side rails. Lug nuts can be applied to each threaded end of the distal pivoting element, fixing the proximal clevis end of the stirrup, the distal pivoting element and the two side rails together, and forming a universal joint.

[0119] A stirrup formed of metallic hard plastic polymers or carbon fibers, or a combination of two or more of these materials, may include two opposing clevis ends, one being a first clevis end and the other a proximal end. In one embodiment, the distal clevis end may be dimensioned to fit the outer surface of the proximal cap of the proximal connector section and aligned with the slot formed in the proximal cap, which is generally horizontal with respect to the ground and the accessory base. In other embodiments, the second clevis end of the stirrup may be dimensioned to fit the outer surface of the distal region of the proximal connector section and aligned with a portion of a slot formed in the front surface of the proximal connector section, which is generally horizontal with respect to the ground and the accessory base.

[0120] The first end of the frame may include a distal pivoting element that spans the two longerons and is coupled to the second end of the yoke of the stirrup and to the two longerons. The stirrup has a first yoke end that can be attached to a stirrup support pivoting element. The stirrup support pivoting element can in turn be attached to the vertical pivoting element. The vertical pivoting element can be connected to the proximal connector section. The proximal connector section can be attached to the distal connector section via a through hole sized to accept the proximal section. A flange on the distal end of the proximal connector section that fits around and is bolted to its distal end, attaching it to the distal connector section but allowing it to rotate freely, can be used.A brake handle that can be fitted into a hole in the rear upper surface of the distal connector section. The distal end of the brake handle can interface with gear-like features formed in the outer circumference of the distal region of the distal connector section. When engaged in the gear-like cutouts, the brake handle can lock the proximal connector section against rotation. The proximal connector section is typically parallel to the ground, while the distal connector section is typically perpendicular to the ground.

[0121] An anti-rotation handle can be fitted into a hole in the rear surface of the adjustment column, the distal end of the handle being able to interface with the anti-rotation features of the distal connector section to lock it against rotation. When the handle is released, the distal end no longer interfaces with the anti-rotation feature of the distal connector section, allowing the distal connector section to rotate.

[0122] BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a perspective view of an embodiment of the invention comprising certain details of the invention and the axes of rotation around which a frame can move. Figure 2 is a perspective view of a distal part of another embodiment of the invention. Fig. 3A is an exploded view of certain aspects of a part of at least one embodiment of the invention comprising parts of a rotating head and a main gripper including a part of the multi-axis joint. Fig. 3B is a perspective view of certain aspects of the frame, including an exploded view of some elements of the rotating head, the frame, the patient support devices attached to the frame's side rails, and the surgical table. Figure 4 is an exploded view of a multi-axis joint. [Fig.4A] is an exploded view of some elements of the distal end of the frame. Figure [Fig. 4B] illustrates some aspects of the distal part of the frame. [Fig.4C] is a perspective and exploded view of some elements of the frame. Figure 5 provides a perspective view and some details of the proximal end of at least one embodiment of the invention. Figure 6 illustrates certain aspects of at least one embodiment of the invention comprising the proximal pivoting element and the proximal clamp. Fig. 7 is a side view of a portion of at least one embodiment of the invention comprising the proximal clamp. Figure 8 is a top cross-sectional view of certain aspects of at least one embodiment of the invention comprising the proximal clamp. Figure 9 is a top cross-sectional view of some aspects of the proximal clamp. The [Fig. 10] is a cross-sectional view of some aspects of the accessory's patient support devices. The [Fig.1 1] is a perspective and exploded view of the proximal part of at least one embodiment of the invention. Figure 12 is a cross-sectional view of the proximal part of at least one embodiment of the invention. The [Fig. 13] is a torn perspective view of some components of the proximal pivoting elements. The [Fig. 14] is a cross-sectional view looking towards the distal end and the base of the invention.

[0123] DETAILED DESCRIPTION Figure 1 is a perspective view of an embodiment of the invention, comprising six axes of rotation around which a frame can move. As shown in Figure 1, the accessory has a wheeled storage base, a telescopic support structure 110 extending opposite the base and coupled to a first end of a multi-axis joint 108, which is in turn coupled at its second end to a frame 122 having a first end and a second end removably attached to a surgical table 102. The frame 122 has side rails 104 coupled by a distal pivoting element 134 and a proximal pivoting element 118. The proximal pivoting element 118 is removably coupled to a distal end of the surgical table 102. The distal pivoting element 134 connects a stirrup 132 to a first end of the frame 122.The multi-axis joint 108 allows rotation about three axes C, D and G (parallel to the longitudinal member). The rotating head 109 allows rotation about an axis E which is generally perpendicular to the ground and parallel to a longitudinal axis of the support structure 110. The stirrup 132 comprises two opposing clevis ends which are coupled to the multi-axis joint 108, and two distal ends which are rotationally connected to the pivoting element 134, thus coupling the multi-axis joint 108 to a first end of the frame 122. Rotation axes about which the frame 122 can be articulated are indicated by reference numerals in [Fig. 1] and can include the following six rotation axes: .

[0124] Axis AA, where the frame 122 rotates around the proximal pivoting element 118, the axis being generally parallel to the ground and to the axis of rotation BB;

[0125] Axis BB, where the frame rotates around the distal pivoting element 134, which is generally parallel to the ground and generally parallel to the axis of rotation AA; and,

[0126] Axis CC, which bifurcates the multi-axis joint 108;

[0127] Axis DD, which bifurcates the multi-axis articulation 108;

[0128] Axis EE, which bifurcates the rotating head 109 and the support structure 110 and is generally perpendicular to the axes of rotation AA and BB;

[0129] Axis FF, which bifurcates the multi-axis joint 108 and is generally perpendicular to the ground and generally extends along the midpoint of the surgical table and is generally perpendicular to the other axes of rotation.

[0130] Figure 2 illustrates certain aspects of part of an embodiment of The accessory comprises two generally parallel side rails 204, a floor-mounted base 220 with casters 216 and caster locks 223. A recess 224 is formed in the upper surface of the floor-supported base 220 as shown in sectional view AA. The support column 210 is fitted into the upper surface of the floor-mounted base 220. An extendable vertical support is attached to the base 220. The extendable vertical support includes a support column 210 and at least one adjustment column 227 fitted into the support column 210, which are used to extend the height of the extendable vertical support. Two or three or more adjustment columns may be used. Linear actuators (not shown) may be fitted inside the support column 210 and attached (not shown) to the adjustment column 227, allowing the adjustment columns to be extended upward and away from the base 220, or lowered or retracted into the support column 210. A mounting plate 262 is mounted on an internal mounting collar (not shown) that is fitted to the underside (not shown) of the upper surface of the adjustment column 227. A locking handle 229 is fitted into the distal horizontal surface of the rotatably lockable head 226.The multi-axis joint 208 can be fitted into a recess formed in a proximal horizontal surface of the rotatably lockable head 226 and coupled thereto. The stirrup 232 has a second clevis end 232B with a through hole 232C and a first clevis end 232A with a through hole 233 formed at each end. The through hole 233 is sized to accept a threaded bolt 228A. A distal mounting cap 206 may have a through hole 206A through its lateral and medial surfaces. In some embodiments, the distal mounting cap 206 may have a spar acceptance channel 206B formed through it and sized to accept a spar 204. The distal region of the spar 204 can be fitted into the acceptance channel 206B. The spar 204 may have a through hole 204A formed in and through the sides in its distal region.The distal mounting cap 206 can be adjusted or slid over the distal region of the spar 204 so that holes 206A and 204A align. The first clevis end 232A of the stirrup 232 can be fitted into and through the hole 206A in the distal mounting cap 206 and the hole 204A in the spar 204. A stirrup collar 228 can then be slid over the portion of the first clevis end 232A of the stirrup 232 that protrudes from the lateral side of the distal mounting cap 206. A stirrup pin 228A can be threaded at one end and can be slid through a hole 233 formed in and through the first clevis end 232A of the stirrup 232. A tab 228B can then be attached to the threaded end of the stirrup pin 228A, thereby securing the first clevis end 232A of the stirrup 232 to the spar 204.

[0131] Figure 3A illustrates certain aspects of one embodiment of the disclosure, namely the rotating head and other details of the distal end of the frame 322 (see Figure 3B). The mounting plate 342 has through holes 342B formed in and through its upper surface, and threaded holes 342Q formed in its upper surface. The upper surface of the adjustment column 327 has Threaded holes 327A are formed in its upper surface. Threaded bolts 359 can be passed into and through the holes 342B in the upper surface of the mounting plate 342 and screwed into the threaded holes 327A in the upper surface of an adjustment column 327, thus securing the mounting plate 342 to the adjustment column 327. In this embodiment, the mounting plate 342 may have a retaining ring 342L that matches a lower distal surface 301C of the upper head plate 301. A washer 337 has through holes 342T formed around its through hole 342R formed through its center. The washer 337 can be attached to the mounting plate 342 by passing threaded bolts 337B through the holes 342T and into the threaded holes 342Q of the mounting plate 342.A bearing alignment device 336 has through holes formed through its top plate, while the bottom of a bearing alignment post 336C has a threaded hole 336T formed in the central lower surface of its end, as shown in the bottom view AA. A coupling ring 349 has a central through hole 349P formed in its center, and through holes 349A formed around the central through hole 349P. A top plate 335 has through holes 335R formed around its outer circumference and a hole 335C formed in and through its center, as shown in the top view BB.

[0132] Annular bearings 330 can be clamped between a coupling ring 349 and the top plate 335. The washer 337 can be coupled to the mounting plate 342 by passing bolts 337B through the through holes 342T, and screwing them into the threaded holes 342Q. The bolts 336A can be placed in and through the holes 336B of the bearing alignment device 336 and in and through the holes 335R of the top plate 335 and in and through the holes 349A of the washer 349. The bearing alignment piece 336C of the bearing alignment device 336 can be passed in and through the center through hole 335C of the top plate 335, then in and through the hole 349P of the washer 349 and in and through the center through hole 342R of the washer 337.The lower plate 369, with the through hole 369B formed in and through its center, can be positioned around the portion of the bearing alignment post 336C that protrudes outward from the hole 342K in the lower surface of the mounting plate 342. The hole 369B formed in the center of the lower plate 369 is smaller than the threaded bolt cap 369A. A threaded bolt 369 can then be fitted into a threaded hole (not shown) formed in the lower surface of the bearing alignment post 336C.

[0133] A cover 358 with a circular portion 358A can be fitted onto the upper head plate 301. The flexible cover 321T can be placed over the clamp The main 321 has a circular cutout 325 when the main clamp 321 is assembled. The actuating handle 329 can be coupled to the distal end of the cam 311, while cam blocks 313 can be coupled to the proximal end of the cam 311.

[0134] The stirrup 332 is coupled to the multi-axis joint 308 at its upper end and to the distal pivot joint (not shown) at its lower end. The distal pivot joint (not shown) is attached to the proximal spar coupling device 399. The proximal spar coupling device 399 has channels (not shown) sized to accept the spars 304, and the spars can be adjusted within the coupling device using the channels. Patient support devices 370 can be adjusted onto the spars 304.

[0135] Fig. 3B shows another aspect of an embodiment of the invention comprising an exploded view of the rotating head 326 and the multi-axis joint 308 and a perspective view of side rails 304 with patient support devices 357 attached to the side rails. The frame 322 can be attached to the surgical table 302 via a proximal pivoting element 391, which is removably coupled to a proximal clamp. This clamp, in turn, is removably coupled to accessory rails 342 or to a surgical table 302. The side rails 304 are attached to the proximal side rail cap 391 and the distal side rail cap 399 by means of a proximal pivoting joint 351 attached to the proximal side rail cap 391 and distal pivoting elements 334 attached to the distal side rail cap 399. The stirrup 332 is coupled to the distal pivoting elements 334 at its lower end and to the multi-axis joint 308 at its upper end.

[0136] An exploded view of certain components of the multi-axis joint 308 is also shown, including the main clamp 321 with the circular cutout 325 and the flexible cover 321T. The cam 311 has a handle 329 and a cam block 311 to which it can be coupled. When the cam is in a second position, the multi-axis joint is locked against its movement and simultaneously prevents movement of the frame along at least two axes. Up to two of the axes of rotation can be locked against rotation by placing the cam of the multi-axis joint in the second position. The cover 358 with the circular portion 358A can be positioned over the upper head plate 301.The components of the rotating head 326 include the top plate 301, the bearing alignment device 336, the top plate 335, the annular bearings 330, the coupling ring 349, the washer 337 and the mounting plate 342. The base 323 with the storage bowl 324 formed in its proximal front surface has rollers 316 with locks 323. The storage bowl 324 can be formed. such that it can support the proximal end of the frame 322 when the frame is moved into a vertical storage position, thus placing the accessory in a compact storage position with the frame supported on the base 320. The support column 310 is formed in the upper surface of the base 320. The adjustment columns 327 and 327A extend upwards and away from the support column 310, thus forming a vertical support with an adjustable height.

[0137] Figure 4 is a perspective view of one aspect of the invention, namely the multi-axis joint 408. A multi-axis joint subassembly 441 has a stirrup pivot element 453 with a horizontal cutout / slot 453A formed in its circumference and extending along its length, and dimensioned to accept the entire length of a capture element 456 and half the width of the capture element. The stirrup pivot element 453 has through holes 453B at each of its ends. The rotating hub 454 has a through hole 454B formed in and through its center, and dimensioned to accept the stirrup pivot element 453. The through hole 454B has an acceptance cutout 454C formed in its inner circumference and extending along the inner surface of the through hole 454B. The 454 rotary hub features 454A keyway cutouts designed to accept 452 keyways.The capture element 456 is dimensioned to fit along the entire length L of the cutout 454C, with half its width W captured within it and the other half extending beyond the length of the cutout. Hemispherical segments 445 are positioned around the rotating hub 454. The hemispherical segments 445 can be made of cast iron, aluminum, or any similar metal. The caliper pivot element 453 is positioned through the through hole 454B in the rotating hub 454, with the capture element 456 positioned in a slot 453A and the key-discs 452 positioned in the key-disc cutout 454A. The hemispherical segments 445 are then fitted around the external curved surface of the rotating hub 454 and are placed inside the circular cutout 423 of the main clamp 421. The cover plates 455 have through holes 455A formed through them.Cover plates 455 are placed on the outer surface of the rotating hub 454. Holes 455A correspond to through holes 454C in the rotating hub 454. Bolts 455B, capped at one end and threaded at the other, are inserted into and through holes 455A in one cover plate 455, then into and through holes 454C in the rotating hub 454, and into and through holes 455A in the opposite cover plate. The bolts 455B are then secured by tabs 455C. The caliper pivot element 453 can be slid into and through the through hole 455D in a first cover plate 455, and then through the through hole 454B formed in and through the surface of the rotating element 454. so that the horizontal slot 453A in the pivoting element 453 captures the width of the capture element 456. The stirrup pivoting element 453 can be pushed through the lateral surface of a second capture plate 455. The ends of the stirrup pivoting element 453 protrude from the outer surfaces of the first and second capture plates 455. The collar 448 has a through hole 448A formed in its circumference and is positioned around each protruding end of the stirrup pivoting element 453. The threaded bolt 449, capped at one end, can be inserted into and through the through hole 448 and secured in place by a tab 449B. The placement of the collar 448 fixed by the threaded bolt 449 around the pivoting element of the caliper 453 fixes semi-spherical segments 445 in the circular cutout 423 of the main clamp 421.

[0138] Figure 4A shows another embodiment of the disclosure comprising a stirrup 432 having a first clevis end 432A and a second clevis end 432B. Through holes 432D and 432C are formed in the tenons of the first clevis end 432A and the second clevis end 432B, respectively. The main gripper 421 has a circular cutout 423 formed within it, with a slot 422A formed in a portion of its distal circumference. The slot 422A separates the upper gripper housing 425 from the lower gripper housing 425A. Section AA is a side view of the distal side of the main gripper 421 where the slot 422A separates the upper gripper housing 425 from the lower gripper housing 425B. A 425C channel is formed from the distal surface of the lower gripper housing 425A and extends over most of the length of the lower gripper housing.A through hole 417 is formed in the upper surface of the upper collet housing 425 and extends into and through the upper surface of the lower collet housing 425A, where it intersects the channel 425C. An angled stacking washer or spring stacking washers 412 can be inserted into the through hole 417 such that a portion of them protrudes into the channel 425C and is capped and held in place by the cap 412A. The hemispherical segments 445 are dimensioned so that their inner circumference fits closely around the outer circumference of the rotating hub 454. The outer circumference of the hemispherical segments 445 is dimensioned to fit closely against the inner surface of the circular cutout 423 in the main collet 421.The rotating hub 454, with the hemispherical segments 445 fitted around its outer circumference, can be placed in the circular cutout 423 of the main clamp 421. The rotating hub 454 has a hole formed in its center. The caliper pivot element 453 can be slid into and through the hole 432C in the second end of the clevis 432B of the caliper 432. The caliper pivot element 453 can then be slid through the hole 454B. at the center of the rotating hub 454 while it rests inside the circular cutout 423 of the main clamp 421. Furthermore, the other end of the caliper pivot element 453 can be slid through the hole 432C formed in the tenon of the second end of the clevis 432B of the caliper 432. Cover plates 455 can be mounted on each side of the rotating hub 454 (see [Fig. 4]). Threaded bolts 455B can be fitted in and through corresponding holes in the cover plate 455 and in and through holes in the side of the rotating hub 454 (see [Fig. 4]) and out of the position where they are capped by tabs 455C (see [Fig. 4]). The 453 caliper pivot element has a threaded hole 448D formed in each end and a threaded bolt with a cap 448C can be screwed into the threaded holes.The distal pivoting element 443 can be adjusted through the through hole 499C in the distal spar cap 499 with a channel 499E formed in its proximal surface. The channel 499E is sized to accept a spar 404 and has through holes 499B formed in and through its lower surface. The distal pivoting element 443 can be slid through holes 499C in the distal spar cap 499 and into and through holes 432D formed in the tenon of the first clevis end 432A of the stirrup 432. The distal pivoting element 443 can further be slid into and through the hole 499C in the distant distal spar cap 499. A threaded hole 443B is formed in the ends of the distal pivoting element 443. A collar 434 has a hole 434C formed in its center.A threaded bolt 434A can be slid through the hole 434C in the collar 434 and screwed into the threaded hole 443B formed in the end of the distal pivot member 443, thus securing the distal pivot member to the distal spar cap 499. The distal spar cap 499 has a channel 499E formed in its proximal surface, sized to accept spars 404. The channel 449E has through holes 499B formed through its lower surface, which correspond to and are equivalent to the spacing of threaded holes 404A formed in the lower surface of the spar 404. A spar 404 can be installed in the channel 499E of the distal spar cap 499. Threaded bolts 499D can be passed through through holes 499B in the lower surface of the distal spar cap 499 and be screwed into 404A threaded holes, securing the 404 longerons to the distal longeron cap.

[0139] Figure 4B illustrates certain aspects of at least one embodiment of the disclosure comprising a multi-axis joint 441 with a main clamp 421 having a hole 417 formed within it, into which an oblique stacking washer or a disc spring washer 412 can be inserted and covered with a cap 412A. The channel 425C is formed in the distal surface of the clamp housing 425B and extends over most of the length of the clamp housing. The stirrup 432 fixes the multi-axis joint 441 to the distal pivoting element 443. The distal pivoting element 443 is fitted in and through through holes (not shown) in corresponding distal spar caps 499. The distal spar cap 499 has a channel (not shown) which allows the spar 404 to be fitted into the channel, thereby fixing the frame spars 422 to the stirrup 432.

[0140] Figure 4C is a view of certain aspects of at least one embodiment of the disclosure comprising a stirrup 432 having a first yoke end 432A and a second yoke end 432B. Through holes 432D and 432C are formed in the tenons of the first yoke end 432A and the second yoke end 432B, respectively. The main gripper 421 has a circular cutout 423 formed therein with a slot 422A formed in a portion of its distal circumference. The slot 422A separates the upper gripper housing 425 from the lower gripper housing 425A. Section AA is a side view of the distal side of the main gripper 421 where the slot 422A separates the upper gripper housing 425 from the lower gripper housing 425A. The 425C channel is formed from the distal surface of the lower gripper housing 425A and extends over most of the length of the lower gripper housing.The through hole 417 is formed in the upper surface of the upper collet housing 425 and extends into and through the upper surface of the lower collet housing 425A, where it intersects the channel 425C. The hemispherical segments 445 are dimensioned so that their inner circumference fits closely around the outer circumference of the rotating hub 454. The outer circumference of the hemispherical segments 445 is dimensioned to fit closely against the inner surface of the circular cutout 423 in the main collet 421. The rotating hub 454, with the hemispherical segments 445 fitted around its outer circumference, can be placed in the circular cutout 423 of the main collet 421. The rotating hub 454 may have a hole formed in its center.The caliper pivot element 453 can be slid in and through the hole 423C in the second end of the yoke 432B of the caliper 432. The caliper pivot element 453 can then be slid through the hole in the center of the rotating hub 454 while resting inside the circular cutout 423 of the main clamp 421. Furthermore, the other end of the caliper pivot element 453 can be slid through the hole 432C formed in the tenon of the second end of the yoke 432B of the caliper 432. Cover plates 455 can be mounted on each side of the rotating hub 454. Threaded bolts 455B can be mounted in and through corresponding holes in the cover plate 455 and in and through holes 455A in the side of the rotating hub 454. (see [Fig.4]) where they are capped by tabs 455C (see [Fig.4]). The stirrup pivoting element 454 has a threaded hole 448D formed in each. A threaded bolt with a cap 448C can be screwed into the threaded holes at the end. The distal pivoting element 443 can be adjusted through the through hole 499C in the distal spar cap 499 with the channel 499E formed in its proximal surface. The channel 499E is sized to accept a spar 404 and has through holes 499B formed in and through its lower surface. The distal pivoting element 443 can be slid through holes 499C in the distal spar cap 499 and into and through holes 432D formed in the tenon of the first clevis end 432A of the stirrup 432. The distal pivoting element 443 can further be slid into and through the hole 499C in the distant distal spar cap 499. A threaded hole 443B is formed in the ends of the distal pivoting element 443. A collar 434 has a hole 434C formed in its center.The threaded bolt 434A can be slid through the hole 434C in the collar 434 and screwed into the threaded hole 443B formed in the end of the distal pivot element 443, thus securing the distal pivot element to the distal spar cap 499. Through holes 432D are formed in and through the distal and proximal surfaces of the first clevis end 432A of the stirrup 432. Corresponding through holes 443E are formed in and through the distal pivot element 443. Threaded bolts 432 at both ends are fitted through corresponding holes 432E in the distal surface of the second clevis end 432A and into and through through holes in the distal pivot element 443 and capped with tabs, thus securing the second clevis of the stirrup to the pivot element. distal. .

[0141] As described above, the combination of the rotational degrees of freedom of the rotating head, the multi-axis joint, and the stirrup allows the degrees of freedom of movement to be matched between the frame and the surgical table, thereby minimizing the torsional and bending forces experienced by the frame and its side members during use. This can prevent uncontrolled movement or even detachment of the patient support devices during surgical procedures while allowing for easy storage of the accessory with a minimum of steps.

[0142] Figure 5 provides details of an embodiment of the accessory comprising the proximal pivoting element 591, which rests in the proximal protective tube 580 and removably connects the second end of the frame 522 to the distal end of the surgical table (not shown). The proximal spar cap tube 561 has coaxial holes 561D formed through its lateral and medial sides, and also has a channel 561A formed in its distal side, sized to accept the spars 504. The coaxial hole 561D is formed through the sides of the proximal spar cap 561. The distal pivoting element 560 has holes formed in the distal region of its end. The device The proximal coupling 561 can be slid over the proximal end region of the longerons 504. The proximal coupling device 561 may have an actuating button 561D that can be pressed to release and allow the proximal pivoting element 591 to be adjusted outward or inward in the direction of arrow AA (see [Fig. 11] for details). The proximal pivoting element 591 can be slid in and through and then out of the holes 561B formed through the proximal longeron cap 561 and into the proximal protective tube 580. A retaining plate 560A with a hole 560R can be fitted over the end of the proximal pivoting element 591 (see [Fig. 11] for details). A 560G plate with a hole in its center can be placed over the 560R hole on the outside side of the 560A retaining plate.A screw 560F can be passed through a hole in the plate 560G and screwed into the threaded hole 560J formed in the end of the proximal pivot element 591. A hole 560K in the collar 560T formed on the inner surface of the retaining plate 560A can be aligned with the hole 560K in the proximal pivot element 591, and the screw 560F inserted into the holes by fixing the proximal pivot element 591 to the retaining plate 560A. [Fig. 1] provides further details on the proximal pivot element / proximal protective tube assembly.

[0143] Figure 6 illustrates another embodiment of the disclosure, including a medial lateral view of the proximal clamp 650, comprising a clamp body 651 with a table rail acceptance channel 652 formed through a portion of its length and fitted onto the surgical table lateral rail 653. The proximal clamp 650 has an opening (not shown) formed in its distal end and sized to accept the proximal pivoting element 691, and has a spring-loaded lever arm 75IC (see Figure 7) which, when activated, can pivot and lock the proximal pivoting element 691 in place. The proximal pivoting element 691 has a retaining plate 680A attached to each end (see Figure 6).Buttons 651A and 65 IB are attached to the threaded stud 65 IP which is fitted into holes in the lateral side of the proximal clamp 650 and which, when tightened, can strike the surgical accessory rail 653 in the channel 652. Detail C in [Fig.6] is shown in more detail in [Fig.8], which provides detail of the safety lock on the proximal clamp 651.

[0144] Figure 7 illustrates another embodiment of the invention including certain aspects of the proximal gripper 751 from section BB of Figure 6. These aspects include an opening 751B formed in the distal end of the proximal gripper 751, sized to accept the proximal pivoting element 760. The lever arm 75 IC has a spring 751N which allows the lever arm 75 IC to be released when the proximal pivoting element 791 is captured in the opening 751B. A rail surgical accessory 753 is fitted into channel 752 which is formed in the proximal end of proximal clamp 751 and which extends over most of the length of the proximal clamp.

[0145] [Fig.8] illustrates certain aspects of one embodiment of the disclosure, namely detail C of [Fig.6]. Buttons 851A and 851B are fitted onto threaded studs 85 IP and held in place by screws 85 IP which are inserted into the hole (not shown) of the buttons. Threaded ends of threaded studs 85 IP are fitted into holes (not shown) formed in and through the lateral side of the proximal clamp 851. The threaded stud 85 IP of the button 85 IB can be rotated so that the end 851Z strikes and pushes against a first side / outer side of the surgical accessory rail 853 fitted into the channel 852 formed in the distal end of the proximal clamp 851, thus removably fixing / securing the proximal clamp 851 to the first side / outer side of the surgical accessory rail 853. The middle drawing of [Fig. 8] shows an opening 851U that is formed in the distal medial side of the proximal clamp 851.A swing arm 851G with a through hole 85 IL formed through it is fitted onto a pin 851F. The pin 851F is positioned and secured in a hole (not shown) formed in the opening 851U. A clamping knob 851A has a threaded stud 85 IP secured to it by the screw 851E and is screwed into a hole (not shown) formed through the lateral side of the proximal clamp 851 and protruding into the opening 851U. The distal end of the surgical accessory rail 853 is fitted into a channel 852 formed in the proximal end of the proximal clamp 851 and extending over most of the clamp's length. When the 851A button is tightened, its distal end strikes the 851 swing arm, causing it to tilt so that the 85 IN tip extending from the swing arm strikes a second side / inner side of the 853 surgical accessory rail.This allows for the creation of a clamping force on both the outer and inner sides of the 853 accessory rail using clamping knobs mounted on the outside of the surgical accessory rail, thus securely fixing the proximal clamp to the surgical accessory rail.

[0146] Figure 9 provides further details of the proximal gripper, namely the knob 95IB. The knob 95IB has a hole 951E in its underside, into which a screw 981E is fitted to secure the knob to a threaded stud 951e with a flared end 951Z. The stud 951e is fitted into a hole (not shown) formed in a lateral side of the gripper body 951. The gripper body 951 has a channel 952 formed in its proximal end, which extends along most of the length of the gripper body. The gripper body 951 is fitted into and onto the channel 952. When the knob 95IB is rotated, the flared end 951Z pushes against the rail 953 in the channel 952, thus locking the gripper body 951 to the rail 953.

[0147] Figure 10 shows details of an embodiment of the accessory, namely a patient support device 1057, which is an example of an accessory support device. The patient support device 1057 comprises a cushion 1061 attached to a support frame 1069 with the upper plate 1069A inclined at an angle Z with respect to a generally horizontal line defined by PP, where the angle Z may be between 100° and 600°. The channel 1064 is formed through the length of the support frame 1069 and is dimensioned to fit onto the side rails (not shown) of the frame (not shown). The lock 1059 is spring-loaded via a spring 1059A pressed against a stringer (not shown) in the channel 1064 and fixed to the support mount 1069 by a pin 1959B, as illustrated in section AA.A lock 1059 is applied against the spar (not shown) in a channel 1064, thereby locking the support frame 1069 against movement of the patient support device 1057 from a movement along the spar.

[0148] Figure 11 illustrates details of an exploded view of components of one aspect of an embodiment of the invention. A longeron 1104 has threaded holes 1104D formed in its lower proximal surface. Section TT shows a view of the proximal longeron cap 1181 with a rectangular hole 1181P formed in its upper surface and a hole 1181x formed in the central lower proximal surface, and threaded holes 1181K formed in its distal lower surface and spaced and corresponding to similar holes formed in the proximal region of the lower surface of the longerons 1104.

[0149] A protective tube 1180 has threaded holes 1180S formed in and through its walls. The threaded bolt 1180T with a tab can be passed through the hole 118IX and into and through holes 1180Y formed in and through the walls of the protective tube 1180, coupling the proximal protective tube 1180 and the proximal spar cap 1181. A hole 1180Z is formed in the proximal surface of the proximal spar cap 1181 and is aligned with a through hole 1180S formed in and through the end region of the protective tube 1180. The threaded bolt 1180T can pass into and through holes 118IX and 1180S and be capped by tabs, thus fixing the proximal protective tube 1180 to the proximal spar cap 1181.

[0150] The distal pivoting element 1191 has threads formed in a portion of its circumference. The threaded hole 1191H is formed on an inner end of the proximal pivoting element 1191. An inner collar 1192 can be fitted onto an inner end of the proximal pivoting element 1191, while a screw 1191A can be passed through a hole in the inner collar and screwed into the threaded hole 1191H. The inner end of the proximal pivoting element 1191 can be slid through a channel 1181N of the proximal spar cap 1181. and right up to the protective tube 1180. The inner collar 1180Z can be adjusted around the outer end of the proximal pivot element 1191 with the threaded hole 1191H. A flat head screw 1191A can be placed through a hole in an outer collar 1180Z in and through the hole 1180V, then in and through the hole in a retaining plate 1180A, then in and through a hole in the inner collar 1180T and screwed into a hole 1180Q formed in the outer end of the proximal pivot element 1191, thus fixing the retaining plate to the proximal pivot element. The pivoting element 1191 can be slid into and through a channel 1181N formed through the lateral and medial sides of the proximal spar cap 1181. A loaded spring-loaded locking assembly 118 IL with a button 1181D can be placed in the hole 1189P in the proximal spar cap 1181, thereby capturing the proximal pivoting element 1191.

[0151] [Fig. 12] illustrates certain aspects of disclosure, including a side section view QQ of [Fig. 5] of the stressed actuator assembly 128 IL when placed inside the hole (not shown) formed in the proximal region of the upper surface of the proximal spar cap 1281.

[0152] An actuator button 1281D has threaded holes (not visible) formed in its lower surface. Exertion rods 1281J are threaded at their upper ends and can be screwed into threaded holes (not visible) in the lower surface of the actuator button 1281D.

[0153] View AA illustrates a bottom view of an embodiment of a proximal spar cap 1281 with threaded bolts 128IG screwed into threaded through holes (not visible) formed in the lower surface of the spar cap 1281. The lower surface of the spar cap 1281 also has threaded holes 1281V formed through it. The lower surface of the proximal region of a spar 1204 has threaded holes 1204D formed therein which correspond to threaded holes 1281H in the lower surface of the proximal region of the proximal spar cap 1281. View AA shows the arrangement of holes (not visible) and the locations of the ends of the threaded bolts 128IG and 1281H.

[0154] A load block 1293 has a semi-circular cutout formed in its upper section, shaped to accept the outer surface of the proximal pivoting element 1291. (See [Fig. 13] for further details). The load block 1293 has holes (not visible) into which springs can be loaded, thereby loading the load block in an upward direction indicated by arrow B. Loading rods 1281J have threaded holes formed in and through their lower end, allowing the threaded bolt 128IG to be inserted into holes 1281V in the lower surface of the cap. The proximal spar 1281 is connected to the proximal spar 1281 and to and through a hole formed (not visible) in the bottom of the load actuator assembly 128 IL and to the threaded hole formed in the lower end of the load rod 1281 J. By screwing bolts 128IG into and through holes 1281V in the lower surface of the proximal spar 1281 and into and through holes (not visible) in the bottom of the load actuator assembly 128 IL and from there into threaded holes formed in the lower section of the load rod 1281 J, the load assembly is coupled to the proximal spar cap 1281. Figure 13 provides further details of an embodiment of a load actuator assembly 1281.

[0155] Figure 13 provides another illustration of the sectional view QQ of Figure 5, including a proximal spar cap 1381 comprising a cutout 1381U with bolt cutouts 1380 formed in and through its upper surface and extending lengthwise to the lower surface of the spar cap. Bolts 1381 may have threaded holes 1381Q formed in their lower end surface. A cutout 1381U may be formed in the upper surface of the proximal spar cap 1381 and sized to accept an actuation button 1381D. The 1381D actuation button may include 138 IP cutouts formed in its lower surface, sized to accept the upper end of a 1381 J bolt. 1381J bolts may be placed in 1380 bolt cutouts, and threaded bolts with caps larger than the bolt cutouts may be screwed into the 1381Q threaded hole.The stressed element has a cutout 1396H formed within it and dimensioned to accept a portion of the circumference of the proximal pivoting element 1391 and with a radius equal to that of a lateral hole 1396H formed through the width of the proximal spar cap 1381. Springs 1396A can be placed in holes 1396B formed in the bottom of a stressing element 1396. The stressing element 1396 can be placed in a cutout (not shown) formed in the central lower surface of a lateral hole 1396H with springs 1396A in the holes 1396B. When the proximal pivoting element 1391 is placed in and through the lateral hole 1396H, it is possible to see that the stressing element 1396 is stressed upwards by springs 1396A, thus locking it against movement.Pressing or pushing down on button 1381D releases the stressing element 1396 from a thrust against the distal pivoting element 1391, thus allowing movement of the pivoting element in the direction of arrow YY.

[0156] Figure 14 provides certain details of the accessory by looking towards the distal end and the base of the invention. The base 1420 is supported by casters 1416 and has a frame cup 1424 formed in its proximal front surface. In this mode of In realization, the support structure 1410 has adjustment columns 1427 and 1427A fitted into it, the adjustment columns being able to be extended upwards and away from the support structure or withdrawn downwards into the support structure.

[0157] The patient support device 1457 is an example of a patient support device. The patient support device 1457 may include a cushion 1461 attached to the support frame 1469, with the upper plate 1469A inclined at an angle Z with respect to a generally horizontal line defined by PP, where the angle Z may be between 100° and 600°. A channel (not shown) is formed through the length of the support frame 1469 and sized to fit over side rails 1404 on which it can be slid. A lock 1459 is spring-loaded by means of a spring (not shown) applied against a side rail 1404 in the channel (not shown), locking the patient support device 1457 against movement along the side rail.The multi-axis joint 1441 is coupled to the stirrup 1432 at its distal end, while the proximal end of the stirrup 1432 is fixed to the distal end of the frame (not shown).

[0158] A person skilled in the art will appreciate that various modifications can be made to the above embodiments without departing from the scope of the invention.

[0159] The detailed description above refers to the accompanying drawings. Identical or similar references may have been used in the drawings or in the description to designate identical or similar parts. Furthermore, similarly named elements may perform similar functions and may be similarly designed, unless otherwise specified. Details are presented to provide an understanding of the exemplary embodiments. Some embodiments, for example, alternative embodiments, may be implemented without some of these details. In other cases, well-known techniques, procedures, and components have not been described in detail to avoid obscuring the described embodiments.

[0160] The preceding description of embodiments has been presented for illustrative purposes only. It is not exhaustive and does not limit the embodiments to the precise form disclosed. Although several embodiments and exemplary features are described, modifications, adaptations, and other implementations may be possible without departing from the spirit and scope of the embodiments. Accordingly, unless explicitly stated otherwise, the descriptions relate to one or more embodiments and should not be interpreted as limiting the embodiments as a whole. This is true regardless of whether the disclosure indicates that a feature relates to "a," "the," "some," "one or more," "certain," or " various modes of realization. As used here, the singular forms "a," "an," and "the" can include the plural forms, unless the context clearly dictates otherwise. Furthermore, the term "coupled" does not preclude the presence of intermediate elements between the coupled elements. Moreover, indicating that a feature may exist indicates that the feature may exist in one or more modes of realization.

[0161] In this disclosure, the terms “include,” “comprise,” “contain,” and “have,” when used after a set or system, mean open inclusion and do not preclude the addition of other unlisted members to the set or system. Furthermore, unless otherwise stated or inferred from the context, the conjunction “or,” if used, is not exclusive but rather inclusive, meaning both and / or. Additionally, if these terms are used, a subset of a set may include one or more members of the set, including all.

[0162] Furthermore, if used in this disclosure, and unless otherwise indicated or inferred, a first variable is an increasing function of a second variable if the first variable does not decrease and, on the contrary, generally increases when the second variable increases. On the other hand, a first variable is a decreasing function of a second variable if the first variable does not increase and, on the contrary, generally decreases when the second variable increases. In a certain embodiment, a first variable may be an increasing or decreasing function of a second variable if, respectively, the first variable is directly or inversely proportional to the second variable.

[0163] The disclosed systems, processes, and devices are not limited to any specific aspect or characteristic or combination thereof, nor do they require that one or more specific advantages be present or that any problems be solved. All theories of operation are intended to facilitate explanation, but the disclosed systems, processes, and devices are not limited to such theories of operation.

[0164] Modifications and variations are possible in light of the teachings above, or may be acquired from the practical application of the embodiments. For example, the described steps need not be performed in the same sequence discussed or with the same degree of separation. Similarly, various steps may be omitted, repeated, combined, or performed in parallel, if necessary, to achieve identical or similar objectives. Likewise, the described systems need not necessarily include all the parts described in the embodiments, and may also include other parts not described in the embodiments. Accordingly, the embodiments are not limited to the details described above. Furthermore, this disclosure is directed towards all the new and non-obvious characteristics and aspects of the various disclosed embodiments, alone and in various combinations and sub-combinations with each other.

[0165] Although the present disclosure has been specifically described in conjunction with specific embodiments, many variants, modifications, and variations will become apparent in light of the foregoing description. It is therefore envisaged that the present invention encompasses all such variants, modifications, and variations within the true spirit and scope of this disclosure.

Claims

Demands

1. Accessory for attachment to a surgical table that supports at least one part of a patient's body, the accessory comprising: at least one support structure (110, 210, 310, 1410) having an adjustable length; a straight frame (122, 222, 322, 422) extending from a proximal end to a distal end, wherein the distal end of the frame is configured to be rotationally coupled to the surgical table allowing the straight frame (122, 222, 322, 422) to move or be articulated about six axes of rotation; and a multi-axis joint (108, 208, 308, 408) mounted on at least one support structure rotatably coupled to the proximal end of the frame, wherein the multi-axis joint has at least one first rotational degree of freedom about an axis of inclination of the frame and a second rotational degree of freedom about an axis orthogonal to the axis of inclination of the frame.

2. The accessory according to claim 1, wherein the frame (122, 222, 322, 422) includes two spar elements (104, 204, 304, 404) each extending from the proximal end to the distal end of the frame, and each spar element is configured to be rotationally coupled at a distal end thereof to the surgical table (102, 302).

3. The accessory according to claim 2, further comprising a bracket (132, 232, 332) configured to couple the multi-axis joint (108, 208, 308) to the longitudinal members (104, 204, 304), such that the multi-axis joint can allow simultaneous rotations of the bracket around the tilt axis of the frame and the axis orthogonal to the tilt axis of the frame.

4. Accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising: at least one support structure (110, 210, 310, 1410) having an adjustable height; a frame (122, 222, 322, 422) extending from a proximal end to a distal end, in which the distal end of the frame is configured to be rotationally coupled to the surgical table; a multi-axis joint (108, 208, 308, 408) mounted on at least one support structure, in which the multi-axis joint has at least three rotational degrees of freedom; and a stirrup (132, 232, 332) having a proximal end which is coupled to a distal end of the multi-axis joint (108, 208, 308, 408) and a distal end which is rotationally coupled to the proximal end of the frame, wherein the coupling of the distal end of the multi-axis joint (108, 208, 308, 408) to the proximal end of the stirrup (132, 232, 332) permits rotation of the stirrup (132, 232, 332) around at least three rotational degrees of freedom, thereby permitting rotation of the frame (122, 222, 322, 422) around at least three rotational degrees of freedom.

5. The accessory according to claim 4, further comprising a coupling device (399) which is configured to pivotally and removably couple the distal end of the frame to the surgical table such that at least two spar elements (304) can move in response to the movement of the surgical table and / or the movement of at least one support structure.

6. The accessory according to claim 4, wherein the movement of the multi-axis joint (108, 208, 308, 408) around at least two of the at least three rotational degrees of freedom can be locked and unlocked simultaneously.

7. An accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising: at least one support structure (110, 210, 310, 1410) extending from a proximal end to a distal end, wherein the proximal end of the at least one support structure is movable along a longitudinal axis of the support structure so as to adjust a length of the at least one support structure; a frame (122, 222, 322, 422) comprising at least two spar elements (104, 204, 304, 404) each extending from a proximal end to a distal end, wherein the distal end of each of the spar elements (104, 204, 304, 404) is configured to be rotationally coupled to the surgical table; a multi-axis joint (108, 208, 308, 408) mounted at the proximal end of the support structure, a stirrup (132, 232, 332) rotationally coupled to the proximal end of one of the at least two spar elements (104, 204, 304, 404) and rotationally coupled to the proximal end of another of the at least two spar elements (104, 204, 304, 404) such that the stirrup (132, 232, 332) can rotate about an axis substantially orthogonal to a longitudinal axis of each of the spar elements (104, 204, 304, 404); in which the multi-axis joint (108, 208, 308, 408) is coupled to the stirrup (132, 232, 332) and is configured to permit rotation of the stirrup (132, 232, 332) around an axis orthogonal to a tilt axis of the frame simultaneously with a rotation of the frame (122, 222, 322, 422) around the tilt axis.

8. The accessory according to claim 7, further comprising a platform fixedly coupled to the distal end of at least one support structure (110, 210, 310, 1410).

9. The accessory according to claim 7, wherein at least one support structure (110) has a telescopic beam.

10. The accessory according to claim 1, wherein the frame (122, 222, 322, 422) can move around six axes of rotation.

11. The accessory according to claim 1, further comprising a rotating lockable head (226, 326) which couples the multi-axis joint (208, 308) to the support structure (210, 310), wherein the rotating lockable head (226, 326) can rotate about a longitudinal axis of the support structure.

12. The accessory according to claim 11, wherein the rotating lockable head (226, 326) comprises a lever which is movable between a first position and a second position, wherein when the lever is in the first position, the rotating lockable head (226, 326) is rotating, and when the lever is in the second position, the rotating lockable head (226, 326) is locked against rotation.

13. The accessory according to claim 1, wherein the frame (122, 222, 322, 422) is a straight frame comprising radiotransparent elements.

14. The accessory according to claim 1, claim 4 or claim 7, further comprising a rotating lockable head (226, 326) fixed to an upper surface of the support structure, the rotating lockable head (226, 326) being configured to rotate around an axis perpendicular to the ground and which descends along the center of an adjustment column (227, 327) and a support column (210, 310) and the ground, in which a distal part of a multi-axis joint is coupled.

15. The accessory according to claim 1, claim 4 or claim 7, wherein the multi-axis joint (108, 208, 308, 408) comprises a main clamp (321, 421) in which a circular cutout is formed, a rotating hub (454) in which a through hole (454B) is formed, a stirrup pivot element (453) configured to be rotatably fitted in the through hole (454B), semi-spherical segments (445) configured to be placed around the circumference of the rotating hub and positioned inside the circular cutout (325), wherein the stirrup (132, 232, 332) is rotatably coupled to the stirrup pivot element (453) to allow rotation of the stirrup (132, 232, 332) around the pivot element stirrup (453).

16. An accessory intended to be attached to a surgical table that supports at least one part of a patient's body, the accessory comprising: at least one support structure having an adjustable length; a straight frame extending from a proximal end to a distal end, wherein the distal end of the frame is configured to be rotationally coupled to the surgical table allowing the straight frame to move or be articulated about six axes of rotation; and at least two or more joints mounted on the at least one support structure rotatably coupled to the proximal end of the frame, wherein the at least two or more joints have at least one first degree of rotational freedom about an axis of inclination of the frame and a second degree of rotational freedom about an axis orthogonal to the axis of inclination of the frame.

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