Surgical table for use in total hip arthroplasty and method of use thereof

Abstract

To provide a surgical table and a method of use thereof for an anterior-medial approach method used in total hip arthroplasty (THA) for replacing a hip joint with an artificial joint, which can preserve the joint capsule on the lateral or posterior side of the hip joint and thereby reduce the risk of hip dislocation after total hip arthroplasty.SOLUTION: A surgical table and a method of use thereof are provided in which: a patient is placed in a supine position on the upper surface of the surgical table; the lower limb is raised upward at 80 to 100 degrees, and abducted laterally at 80 to 100 degrees; knee is flexed at 80 to 100 degrees and fixed in this state; and, by cutting the pectineus muscle and fixing the lower limb in a laterally abducted state at 80 to 100 degrees, the operator is enabled to approach the hip joint of the patient, whose lower limb is widely spread, from the anterior-medial side.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to an operating table used in total hip replacement surgery and a method for using the same, and more particularly to an operating table used in total hip replacement surgery using an anterior medial approach method, in which the hip joint of a patient is approached from the anterior medial side of the body, and a method for using the same. [Background technology]

[0002] In recent years, it is said that more than 70,000 patients suffering from hip pain undergo total hip arthroplasty (THA) each year to restore function and relieve pain in hip joints that have become damaged, functionally impaired, and painful due to trauma or diseases such as osteoarthritis and osteonecrosis of the femoral head.

[0003] The human hip joint is a joint in which the spherical femoral head, formed at the tip of the femoral neck by bending the femoral shaft proximally upward, inward, and slightly backward, is rotatably inserted into the cup-shaped acetabulum, which opens slightly downward and slightly forward on the outside of the pelvis, and the entire joint is surrounded by a joint capsule (see Figure 10).

[0004] Total hip arthroplasty (THA) is a procedure in which the damaged hip joint is removed using surgical / orthopedic techniques, the spherical femoral head of the femur is replaced with a spherical metal or ceramic one, the cup-shaped acetabulum in the pelvis is replaced with a cup covered with a polymer resin such as polyethylene, and a nerve-free artificial joint (implant) is inserted into the hip joint, thereby restoring hip joint function and eliminating pain.

[0005] Total hip replacement surgery can be broadly divided into an anterior approach, in which the patient's hip joint is approached from the front of the body (assuming the head is facing upwards) (the same applies hereinafter regarding the body direction unless otherwise specified), and a lateral approach, in which the hip joint is approached from the side of the body. Of these, the lateral approach has been widely used for over 30 years and is an effective and proven method.

[0006] However, the lateral approach involves cutting the joint capsule, ligaments, gluteal muscles, etc. on the side or back of the hip joint, and the joint capsule and ligaments remain severed and do not recover even after surgery, which has the aftereffect of making the hip joint prone to dislocating to the back or side of the body if the patient assumes an awkward position after surgery.

[0007] On the other hand, in the lumbar region on the front of the body, there is an area called the femoral triangle, which is made up of the inguinal ligament, sartorius muscle, and adductor longus muscle, and where many organs are concentrated. This area is also home to the femoral vein, femoral artery, lymphatic vessels (femoral ring), femoral nerve, iliopsoas muscle, and lateral femoral cutaneous nerve, among others. Therefore, the anterior approach method, which approaches the hip joint from the front of the patient's body, has been difficult (see, for example, Patent Document 1).

[0008] However, in recent years, rapid advances in X-ray imaging have led to the development of anterior minimally invasive surgery (AMIS), in which total hip replacement surgery is performed under X-ray surveillance through a narrow path that passes through the gaps between many organs on the anterior surface of the body (see, for example, Patent Document 2). Anterior minimally invasive surgery is said to have the advantages of less postoperative pain and scarring, and fewer dislocations, because it does not cut muscles and requires only small incisions.

[0009] However, total hip replacement surgery using AMIS has unresolved issues, such as the need for expensive X-ray equipment and analysis devices, the fact that it is a difficult operation requiring advanced techniques to perform a major operation in a small surgical field in an area where many organs are concentrated, the fact that it is a surgical method that cannot be applied depending on the patient's condition, the fact that surgical results are inconsistent, and the fact that the prognosis of the surgery has not yet been determined, and so it has not been able to fully meet the current great demand for total hip replacement surgery. [Prior art documents] [Patent documents]

[0010] [Patent Document 1] Special Publication No. 2015-504766 [Patent Document 2] Japanese Patent Application Publication No. 2020-99696 Summary of the Invention [Problem to be solved by the invention]

[0011] In this situation, the present invention's total hip arthroplasty (THA), which approaches the patient's hip joint from the inside and anterior of the body, involves externally rotating the patient's lower limbs significantly to move the nerves and blood vessels in front of the hip joint upward, and then approaching the patient's hip joint from the inside and anterior of the body. This preserves the hip joint capsule, ligaments, gluteal muscles, etc. at the posterior or lateral side of the body that would have been cut in the conventional lateral approach, and reduces the after-effects of the conventional lateral approach, which makes the hip joint more likely to dislocate posteriorly or upward after surgery.The objective of this invention is to provide an operating table to be used in total hip arthroplasty using an open-leg anterior approach, and a method for using the same.

[0012] More specifically, the operating table of the present invention aims to provide an operating table that can preserve the hip joint capsule, ligaments, gluteal muscles, etc. at the posterior or lateral sides of the body, which would have been cut in the past, by spreading the patient's legs wide, cutting the pubic muscles, and then externally rotating and fixing the lower legs, and then moving the nerves and blood vessels in the femoral triangle in front of the patient's hip joint upward, and then approaching the hip joint from the inside of the front of the body. [Means for solving the problem]

[0013] The operating table 1 used in the anterior medial approach method for total hip replacement surgery of the present invention has a rectangular operating table body 100, the upper surface of which is an operating surface on which a patient abuts, The operating table body 100 is divided into a body support part 110 and a lower limb support part 120. One of the lower limb holders 120 is a flat table that is rectangular in top view, and is disposed at a corner of the operating table main body 100 near the lower limb and knee 42 of the patient 2 on the side where the surgery is to be performed. The patient's lower limb and knee 42 on the side where the surgery is to be performed are fixed and held on the upper surface by a fixing device 105, and the lower limb holder has removably attached lower limb holder legs 126. The other body support part 110 is the remaining part of the operating table main body 100 excluding the lower limb support part 120, and is a flat platform with a hook-shaped top view, on whose top surface the lower limb and knee 43 of the patient 2 on the side not undergoing surgery are fixed by a fixing device 106, and supports most of the body and weight of the patient 2, and is provided with a plurality of body support part legs 116 of the same length as the lower limb support part legs 126, The body holding part 110 has an inner edge 112 of the bracket-shaped body holding part 110 in the same direction as the long side 101 of the operating table main body, and the lower limb holding part 120 has an edge 121 of the lower limb holding part 120 in the same direction as the long side 101 of the operating table main body, which are abutted against each other and joined by a hinge 113, whereby the body holding part 110 and the lower limb holding part 120 are joined together to form the operating table main body 100 as a single unit. A lower leg support fixing device 122 is provided on the body support leg 116 below the hinge 113, The patient 2 lies supine in the center of the operating table main body 100 with the lower limb and knee 43 of the side not to be operated on along the inner edge of the bracket-shaped operating table main body long side 101 of the body holding part 110 in the same direction, and is fixed to the body holding part 110 using the fixing device 106. The lower limb of the side to be operated on 44 of the patient 2 is raised (flexed) 80 to 100 degrees above the body when the direction of the head is considered to be the upper part of the body, and rotated 80 to 100 degrees outward (external rotation), and the knee is bent 80 to 100 degrees and fixed to the lower limb holding part 120 using the fixing device 105. The skin of the superficial part of the pubic muscle 107 and pubic bone of the patient 2 is temporarily treated and cut, and then the leg 126 of the lower limb holder is removed, and then the hinge 113 is rotated downward, and the lower limb and knee 42 of the patient 2 on the side to be operated on and the other end 123 of the lower limb holder are rotated and fixed to the lower limb holder fixing device 122 provided below the hinge 113, thereby further outwardly rotating and fixing the lower limb of the side 44 to be operated on, The surgeon can approach the hip joint 5, which is the surgical field 50 for total hip replacement surgery, from the front medial side 32 of the body of the patient 2 who is lying on his back with his legs widely spread.

[0014] Furthermore, two lower limb holding sections 120, one on each side, can be installed facing each other so that surgery can be performed on both the left and right hip joints of the patient 2 simultaneously or separately.

[0015] Furthermore, it is preferable that the operating table 1 is provided with an operating table main body 200 having a body support portion 210 that is inclined so that the operated side 44 of the patient 2 is higher at an angle of 10 to 30 degrees than the non-operated side 45.

[0016] Furthermore, the operating table main body 200 is erected on an inclined body support part 210 and is characterized by being provided with an anti-slip device 240 that prevents the body of the patient 2 from moving from the body support part 210.

[0017] Here, the body holding part 210 is further provided with an anti-slip device fixing device 241 that can set the installation position of the anti-slip device 240 in the direction of the short side 202 of the operating table main body, and the anti-slip device 240 is positioned by the anti-slip device fixing device 241 when the body holding part 210 is tilted.

[0018] Then, the body holding part edge part 212 of the body holding part 210, which is perpendicular to the short side 202 of the operating table main body inside the bracket shape, and the lower limb holding part edge part 221 of the lower limb holding part 220, which is perpendicular to the short side 202 of the operating table main body, are abutted and joined by the hinge 213, and the body holding part 210 and the lower limb holding part 220 are joined and the operating table main body 200 is integrated, A lower leg support fixing device 222 is provided on the body support leg 216 below the hinge 213; The patient 2 is placed supine in the center of the operating table main body 200 with the lower limbs and knees 43 of the side not to be operated on along the inner edge of the bracket-shaped operating table main body long side 201 of the body holding part 210 in the same direction, and is fixed to the body holding part 210 using the fixing device 206, and the lower limbs of the side to be operated on 44 of the patient 2 are raised (flexed) 80 degrees to 100 degrees above the body when the direction of the head is considered to be the upper part of the body, rotated 80 degrees to 100 degrees outward (external rotation), and the knees are bent 80 degrees to 100 degrees and fixed to the lower limb holding part 220 using the fixing device 205, The skin of the superficial part of the pubic muscle 107 and pubic bone of the patient 2 is temporarily treated and cut, and then the leg part 226 of the lower limb holder is removed, and then the hinge 213 is rotated downward, and the lower limb and knee 42 of the patient 2 on the side to be operated on and the other end 223 of the lower limb holder are rotated to the lower limb holder fixing device 222 provided below the hinge 213 and fixed. As a result, the lower limb of the operated side 44 is further externally rotated and fixed, The surgeon can approach the hip joint 5, which is the surgical field 50 for total hip replacement surgery, from the anterior medial side 32 of the body of the patient 2 who is lying on his back with his legs spread wide.

[0019] On the other hand, two lower limb holding parts 220, one on each side, can be installed facing each other so that surgery can be performed on both the left and right hip joints of the patient 2 simultaneously or separately.

[0020] In addition, the operating table 1 may further include a weight support 350 that is disposed on the underside of the body support 310 of the operating table main body 300 and supports the weight of the patient 2 .

[0021] Here, it is preferable that an anti-slip device 340 is provided on the upper surface of the weight holding part 350, which is connected to the body holding part 310 by a hinge 314 and stands upright, to prevent the body of the patient 2 from moving from the inclined body holding part 310.

[0022] Furthermore, the weight support unit 350 further has an anti-slip device fixing device 341 that sets the installation position of the anti-slip device 340 in the direction of the short side 302 of the operating table main body, and it is preferable that the anti-slip device fixing device 341 positions the installation position of the anti-slip device 340 in the direction of the short side (302) of the operating table main body when the body support unit 310 is tilted.

[0023] Then, the body holding part edge part 312 of the body holding part 310, which is on the same side as the long side 301 of the operating table main body inside the bracket shape, and the lower limb holding part edge part 321 of the lower limb holding part 320, which is on the same side as the long side 301 of the operating table main body, are abutted and joined by the hinge 313, and the body holding part 310 and the lower limb holding part 320 are joined together, and the operating table main body 100 is integrated, A lower leg support fixing device 322 is provided on the body support leg 326 below the hinge 313; The patient 2 lies supine in the center of the operating table main body 300 with the lower limb and knee 43 of the side not to be operated on along the inner edge of the bracket-shaped operating table main body long side 301 of the body holding part 310 in the same direction, and is fixed to the body holding part 310 using the fixing device 306, and the lower limb 44 of the side to be operated on of the patient 2 is lifted (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation), and the knee is bent 80 to 100 degrees and fixed to the lower limb holding part 320 using the fixing device 305, The skin on the epidermal part of the pubic muscle 107 and pubic bone of the patient 2 is temporarily treated and cut, and then the leg 326 of the lower limb holder is removed. After that, the hinge 313 is rotated downward, and the lower limb and knee 42 of the patient 2 on the side to be operated on and the other end 323 of the lower limb holder are rotated and fixed to the lower limb holder fixing device 322 provided below the hinge 313, and the lower limb of the side to be operated on 44 is further outwardly rotated and fixed, thereby enabling the surgeon to approach the hip joint 5, which is the surgical field 50 for total hip replacement surgery, from the inside of the front of the body of the patient 2 who is lying on his back with his legs spread wide.

[0024] Furthermore, the lower limb holding portions 320 may be installed so that two lower limb holding portions 320, one on each side, can be opposed to each other so that surgery can be performed on both the left and right hip joints of the patient 2 simultaneously or separately.

[0025] Meanwhile, the body holding part 110 can further include a pelvis fixing device 111 that holds and fixes the pelvis of the patient 2 at a position close to the inner corner of the bracket-shaped body holding part 110.

[0026] Furthermore, the operating table used in the anterior medial approach method for total hip replacement surgery described in claim 13 is characterized in that after the hip joint 5 of the patient 2 is fixed to the pelvic fixing device 111, the hinge 113 between the body holding part edge part 112 and the lower limb holding part edge part 121 is rotated to fix the other end 123 of the lower limb holding part and the lower limb and knee 42 of the patient 2 on the side to be operated on to the lower limb holding part fixing device 122.

[0027] The method of using the operating table for the anterior medial approach method for total hip replacement surgery according to any one of claims 1 to 14 is as follows: the patient is placed supine with the lower limbs and knees of the non-operated side extended along the inner edge of the bracket-shaped body support part in the same direction as the long side of the operating table body, and fixed to the center of the operating table body using a fixing device; the lower limbs and knees of the patient on the operated side are lifted (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation). The patient's knee is bent 80 to 100 degrees and fixed to the lower limb holder using a fixing device, and the patient's pubic muscle and the skin in the relevant area are temporarily treated and cut. Next, the leg of the lower limb support part is removed, and the hinge between the end edge of the body holder and the end edge of the lower limb holder is rotated downward, and the patient's lower limb and knee on the side to be operated on and the other end of the lower limb holder are rotated and fixed to the lower limb holder fixing device provided below the hinge, and the lower limb on the side to be operated on is further rotated outward 80 to 100 degrees and fixed. A method of using an operating table for an anterior medial approach method for total hip replacement surgery as described in any one of claims 1 to 14, characterized in that the surgeon approaches the hip joint, which is the surgical field for total hip replacement surgery, from the anterior medial side of the body of a patient lying on their back with their legs spread wide. [Effects of the Invention]

[0028] The operating table 1 used in total hip replacement surgery using the anterior medial approach method according to the present invention has a patient 2 lie supine on the operating table 1, abducts the femur 20 of the patient's 2 hip joint 5 on the side 44 to be operated on by 80 to 100 degrees at the hip joint 5, externally rotates it by 80 to 100 degrees, and flexes the knee joint by 80 to 100 degrees, and then temporarily cuts the pubococcus muscle 107 of the patient (2), and rotates the lower limb and knee (42) on the side to be operated on to a lower limb holder fixing device (122) provided below, and fixes them by further externally rotating them by 80 to 100 degrees. As a result, the operating table 1 used in total hip replacement surgery according to the present invention allows the surgeon to easily approach the hip joint 5 of the patient 2 lying supine from the front and below (towards the feet), make an incision on the inside front of the hip joint 5 of the patient 2, and perform total hip replacement surgery, thereby preserving the joint capsule 30 on the posterior and lateral surfaces of the patient's 2 hip joint 5.

[0029] Although the anterior medial approach also involves cutting the joint capsule 30 and ligaments 31 from the cutting position 32, the risk of the hip joint 5 dislocating anteriorly or medially is much less than the possibility of dislocating laterally or posteriorly. As a result, the total hip replacement surgery of the present invention has the excellent feature of significantly reducing the risk of developing sequelae associated with the conventional lateral approach, in which the hip joint 5 may dislocate posteriorly after surgery.

[0030] Furthermore, in the total hip replacement surgery of the present invention, the patient 2 is stretched out in the center of the operating table body 100, lying on his back with his legs spread wide, so that the nerves and blood vessels on the front of the patient's 2 body are moved upward, making the surgery easier and reducing the burden on the patient 2. Furthermore, the total hip replacement surgery of the present invention is characterized by the ease of operation since there are no large organs other than the pubic muscle near the surgical site and the subcutaneous fat layer is thinner than in other parts.

[0031] Furthermore, the operating table 1 used in total hip replacement surgery according to the present invention has the advantage that by using an operating table 200 set up so that the operated side 44 of the patient 2 is higher at an inclination of 10 to 30 degrees than the non-operated side 45 of the patient 2, the surgeon can better observe the inside of the acetabulum 17 of the hip joint 5 of the patient 2 and the femoral head 23.

[0032] In addition, the operating table 1 of the present invention can be provided with an anti-slip device 240 that prevents the body of the patient 2 from moving from the inclined operating table main body 200, and an anti-slip device fixing device 241 that can set the installation position of the anti-slip device in the direction of the short side 202 of the operating table main body and fix it in a predetermined position. It is preferable that

[0033] Furthermore, the operating table body 100 used in the anterior medial approach method for total hip replacement surgery is characterized by the installation of a weight support part 350 that is placed on the underside of the body support part 110 and supports the weight of the patient 2. In this embodiment, an anti-slip device 340 and an anti-slip fixture 341 are provided on the weight support part 350 to support the weight of the human body, thereby making it possible to further stabilize the operating table body.

[0034] In addition, the operating table 1 of the present invention can be provided with an anti-slip device 340 that prevents the body of the patient 2 from moving from the inclined operating table body 300, and an anti-slip device fixing device 341 that can set the installation position of the anti-slip device in the direction of the short side 302 of the operating table body and fix it in a predetermined position. [Brief explanation of the drawings]

[0035] [Figure 1] 1 is a process diagram showing an outline of a total hip replacement surgery using the anterior medial approach method of the present invention. [Figure 2] FIG. 2(A) is a front view of a surgical table according to a first embodiment of the present invention, and FIG. 2(B) is a plan view thereof. [Figure 3] 3 is a perspective view of a patient lying supine on the operating table body of FIG. 2, with the lower limb and knee of the side to be operated on fixed to a lower limb holder. [Figure 4]FIG. 4 is a perspective view of the state in which the patient's lower limb and knee on the side to be operated on, and the lower limb holder, shown in FIG. 3, have been rotated and fixed below the operating table by cutting the pubococcus muscle. [Figure 5] FIG. 5 is a view of the patient and operating table in the position described in FIG. 4, seen from the patient's head. [Figure 6] 6A and 6B are diagrams showing an operating table according to a second embodiment of the present invention, in which the body holding section and the lower limb holding section are inclined so that the side of the patient undergoing surgery is higher than the side not undergoing surgery, and Fig. 6(A) is an overhead view of the operating table before the patient is placed on it, and Fig. 6(B) is an overhead view of the operating table shown in Fig. 6(A) after the patient has been placed and fixed on it, and the lower limb holding section has been rotated below the operating table body and fixed to the lower limb holding section fixing device. [Figure 7] FIG. 7 is a view of the patient and operating table in the state described in FIG. 6(B) as seen from the patient's head. [Figure 8] 8A and 8B are diagrams of an operating table body according to a third embodiment of the present invention, in which the side of the patient undergoing surgery is higher than the side not undergoing surgery and which further has a weight support section, in which Figure 8(A) is an overhead view of the operating table body before it is tilted, and Figure 8(B) is an overhead view of the operating table shown in Figure 8(A) with a patient placed and secured on it, the body support section tilted, and the lower limb support section rotated below the operating table body. [Figure 9] FIG. 8B is a view of the patient in the state described in FIG. 8B, viewed from the head of the patient. [Figure 10] This is an internal view of the right half of the main part of the hip joint seen from the front. DETAILED DESCRIPTION OF THE INVENTION

[0036] Hereinafter, the operating table used in the anterior medial approach method for total hip replacement surgery and the method of using the same according to the present invention will be described in detail with reference to the accompanying drawings. This description is for the purpose of explaining the present invention, and is not intended to limit the technical scope of the present invention. The present invention can be implemented in various modifications within the scope of the present invention.

[0037] FIG. 1 is a flow chart showing an outline of a total hip replacement surgery using the anterior medial approach method of the present invention. Here, Figure 1(A) shows a patient 2 lying supine with his / her body extended in the center of the operating table main body (100). In the present invention, the patient 2 shown in Figure 1(A) is placed in the state shown in Figure 1(B) by lifting the lower limb and knee 42 of the side to be operated on by 80 to 100 degrees above the body, rotating it 80 to 100 degrees to externally rotate it, and bending and fixing the knee by 80 to 100 degrees. Note that Figure 1(B) is a view of the same state as Figure 3.

[0038] Next, the skin of the superficial part of the pubic muscle 107 and pubic bone of the patient 2 in the state shown in Figure 1(B) is temporarily cut, and the leg part 126 of the lower limb holding part is removed. After that, the hinge 113 is rotated to rotate (X) the lower limb and knee 42 of the patient 2 on the side to be operated on, and the other end 123 of the lower limb holding part to the lower limb holding part fixing device 122 provided below the lower limb holding part 120 and fix them, thereby resulting in the state shown in Figures 1(C) to 4. Here, the surgeon approaches the hip joint 5, which is the surgical field 50 for the total hip replacement surgery, of the patient 2 lying on his back with his legs spread wide, from the anterior medial incision position 32, and can easily perform the total hip replacement surgery. Based on the above, the anterior medial approach method according to the present invention will be described in detail below.

[0039] [First embodiment] FIG. 2(A) is a front view of the operating table 1 according to the first embodiment of the present invention, and FIG. 2(B) is a plan view thereof. 2(A, B), the operating table 1 used in the anterior medial approach method for total hip arthroplasty according to the first embodiment of the present invention preferably has an operating table main body 100, which is a rectangular table with a horizontal upper surface. The operating table main body 100 has an upper surface that is a support surface against which the patient abuts, and is divided into two parts: a body support part 110 that supports most of the patient's body and weight, and a lower limb support part 120 that supports the patient's lower limbs on the side 44 to be operated on; the operating table main body 100 also has a side 44 on which the patient 2 will be operated on and a side 45 on which the patient will not be operated on.

[0040] Here, the lower limb holding part 120 is a rectangular table with a horizontal top surface and long sides in the same direction as the long sides 101 of the operating table main body, and has lower limb holding part legs 126, holds the lower limbs and knees of the patient on the side on which surgery is to be performed, and is disposed at a corner of the operating table main body 100 close to the lower limbs on the side 44 on which surgery is to be performed. In addition, the lower limb holding part legs 126 are preferably formed so as to be removable from the lower limb holding part 120 as needed by a method such as a screw-in type, a plug-in type, a movable type, or a foldable type.

[0041] On the other hand, the body holding section 110 is the remaining part of the operating table main body 100 excluding the lower limb holding section 120, and is a horizontal platform with a bracket-like shape when viewed from above, and has body holding section legs 116 of the same length as the lower limb holding section legs 126, on which most of the patient's body and weight is placed, and can abut and fit with the lower limb holding section 120 to form the operating table main body 100. Reference numeral 122 denotes a lower limb support fixing device that is fixed or movably provided below the lower limb support 120 to the body support leg 116 or the floor surface.

[0042] Figure 3 is an overhead view of patient 2 lying supine on the operating table main body 100 of Figure 2, with the lower limb and knee 42 on the side to be operated on fixed to the lower limb holding part 120, and Figure 4 is an overhead view of patient 2 shown in Figure 3, with the lower limb and knee 42 on the side to be operated on and the lower limb holding part 120 rotated downward on the operating table main body 100 and fixed.

[0043] As shown in Figure 3, the operating table 1 used in total hip replacement surgery according to the present invention is preferably designed so that the patient lies supine along the long side 101 of the operating table body 100 of the body support part 110 on the central side, and so that the lower limb and knee 43 of the patient 2 on the side not undergoing surgery are aligned with the edge 112 of the body support part in the direction of the bracket-shaped long side 101 of the operating table body of the body support part 110.

[0044] Then, it is preferable to fix or keep the abdomen 3 and upper body 4 of the patient 2 at rest, and fix the lower limb and knee 43 of the non-operated side to the body support part 110 with the fixing device 106 . Next, the lower limb and knee 42 on the side to be operated on are preferably lifted and bent 80 to 100 degrees above the body at the hip joint 5, the knee joint 5 is bent 80 to 100 degrees to make the knee stand, and then the legs are spread (externally rotated) approximately horizontally and fixed to the lower limb holding part 120 with the fixing device 105 to create the state shown in Figure 3. Here, it is preferable that the angle at which the lower limbs are lifted (bent) and the angle at which the knee joints are bent be within the range of 80 to 100 degrees. If the angle is less than 80 degrees or more than 100 degrees, it will exceed the range of motion of the body or it will be difficult to securely fix the body, so it is not preferable.

[0045] 3 and 4, reference numeral 116 denotes the leg of the body support portion, and reference numeral 113 denotes a hinge 113 that connects the body support portion edge portion 112 and the lower limb support portion edge portion 121 by abutting them together. A hinge is a joint between two members that is in a joined state so that it cannot move up and down or left and right but can rotate freely, and many types of hinges are known. A typical hinge is, for example, a hinged socket, but the hinge of the present invention is not limited to this. Also, X is the rotation direction of the lower limb holding part 120. Furthermore, the area surrounded by the dotted circle in Figures 3 and 4 is the surgical field 50 of the total hip replacement surgery, including the acetabulum 17, the femoral head 23, and the pubic muscle 107, and the pelvic fixation device 111.

[0046] In the operating table 1 used in total hip replacement surgery according to the present invention, after temporarily treating and cutting the pubococcus muscle 107 of the patient 2 shown in Figure 3 and removing the leg part 126 of the lower limb holding part, it is preferable to rotate the hinge 113 between the body holding part edge part 112 and the lower limb holding part edge part 121 in the X direction, and rotate (externally rotate) and fix the lower limb and knee 42 on the side to be operated on and the other end 123 of the lower limb holding part to the lower limb holding part fixing device 122 below the operating table main body 100, as shown in Figure 4.

[0047] That is, the present invention is characterized in that the femur 20 of the patient 2 is bent at approximately a right angle at the hip joint 5, more specifically, the femur 20 is bent at the hip joint 5 by 80 to 100 degrees, externally rotated by 80 to 100 degrees, and the knee joint 5 is bent by 80 to 100 degrees to reach the state shown in Figure 3, and then the femur 20 is further externally rotated at the hip joint 5 by 80 to 100 degrees to reach the state shown in Figure 4.

[0048] Here, FIG. 5 is a view of the patient and the operating table in the state shown in FIG. 4, seen from the head of the patient. As shown in FIG. 5, the patient 2 is positioned so that the thighs 46 and the insteps of the feet face upward and backward, and the big toes 47 face outward. This allows the practitioner to approach the hip joint 5 of the patient 2, whose legs are spread wide, at the incision position 32 (see FIG. 10) on the inside front side of the body, as shown in FIG. 4. Here, the number X is preferably within the range of 80 degrees to 100 degrees. The area enclosed by the dotted circle in Figures 3 and 4 is the surgical field 50 of the total hip replacement surgery, including the hip joint 5, acetabulum 17, femoral head 23, pubic muscle 107, and pelvic fixation device 111.

[0049] Furthermore, temporarily treating the pubic muscle 107 of the patient 2 can include an operation of cutting and moving the skin on the surface of the pubic muscle 107 of the hip joint 5 and the pubic bone, and allowing the lower limb and knee 42 on the side to be operated on to rotate downward freely. Furthermore, the temporarily treated and cut skin on the surface of the pubic muscle 107 and the pubic bone of the patient 2 can be restored by suturing after the operation. In addition, the operating table 1 can also be equipped with two lower limb holders 120 on the left and right so that the hip joints 5 on the operated side 44 and the non-operated side 45 of the patient 2 can be operated on separately, or both the left and right hip joints 5 can be operated on simultaneously.

[0050] Furthermore, it is preferable to provide a pelvis fixing device 111 for fixing the pelvis 10 of the patient 2 at the inner corner of the bracket-shaped body holding unit 110. Here, the pelvis fixing device 111 can fix the pelvis 5 at a predetermined location and at a predetermined angle, is arranged so as to firmly fix the pelvis 10 of the patient 2, has at least a part of its installation position included within a range where it does not come off the inner corner of the bracket-shaped body holding unit 110, and its installation angle is within a range of 30 degrees with respect to the upper surface of the operating table main body, and is not particularly limited as long as it meets the purpose of the present invention. Furthermore, reference numeral 50 denotes the surgical field for total hip replacement surgery of the present invention, and reference numeral 123 denotes the other end of the lower limb holding unit.

[0051] [Second embodiment] FIG. 10 is a front view of the right half of the hip joint 5 of the human body, with the top of the drawing being the front. As shown in Figure 10, the hip joint 5 is a rotatable joint in which the spherical femoral head 23, which is bent upward and inward slightly backward from the shaft 21 of the femur 20, is embedded about two-thirds into the cup-shaped acetabulum 17, which is facing downward and slightly forward on the outside of the pelvis 10, and is enclosed by a joint capsule 30 and ligaments 31. Here, in total hip replacement surgery using the anterior medial approach method of the present invention, the surgical field, particularly the interior of the acetabulum 17 and the femoral neck 22, can be better observed if the operated side 44 of the patient 2 is higher than the non-operated side 45. For this reason, the present invention further provides operating table bodies 200 and 300 in which the operated side 44 of the patient 2 is higher than the non-operated side 45.

[0052] Figure 6 is a diagram of an operating table according to a second embodiment of the present invention, in which the body holding section and lower limb holding section are inclined so that the side of the patient undergoing surgery is higher than the side not undergoing surgery, and Figure 6(A) is an overhead view of the operating table before the patient is placed on it, and Figure 6(B) is an overhead view of the operating table shown in Figure 6(A) after the patient has been placed and fixed on it, and the lower limb holding section has been rotated below the operating table body and fixed to the lower limb holding section fixing device.

[0053] As shown in FIG. 6(A), the operating table 1 according to the second embodiment of the present invention has an operating table main body 200, which is a rectangular table with an inclined upper surface. The upper surface is a support surface against which the patient 2 abuts. The operating table 1 is divided into two parts: a body support part 210 that supports most of the body and weight of the patient 2 on the non-operated side 45, and a lower limb support part 220 that supports the lower limbs and knees 42 on the operated side 44. The operating table 1 is characterized in that the operated side 44 of the body support part 210 is installed at an inclination angle of 10 to 30 degrees higher than the non-operated side 45. After the patient is placed on the horizontally installed operating table main body 200, the operating table main body 200 can also be tilted so that the operated side 44 of the body support part 210 is higher than the non-operated side 45 at an inclination angle of 10 to 30 degrees.

[0054] Here, the lower limb holding part 220 is an inclined rectangular table having a long side perpendicular to the short side 202 of the operating table main body (in the same direction as the long side of the operating table main body, not shown), and is placed at a corner of the operating table main body 200 close to the lower half of the body of the patient 2 on the side on which the surgery will be performed, and holds the lower limbs and knees of the patient on the side on which the surgery will be performed, and preferably has lower limb holding part legs 226 that can be removed as needed by methods such as screwing, inserting, moving or folding. Meanwhile, the body support unit 210 is the remaining part of the operating table main body 200 excluding the lower limb support unit 220, and is an inclined platform shaped like an angled bracket when viewed from above, and supports the body and most of the weight of the patient 2 on its upper surface using a fixing device 206, and may have multiple body support unit legs 216. The body support unit 210 and the lower limb support unit 220 are arranged in the same plane as the upper surface of the operating table main body 200, and can be fitted together to form the operating table main body 200 as a single unit.

[0055] Furthermore, the body support portion 210 may have an anti-slip device 240 that is erected at an angle of approximately 90 degrees on the inclined body support portion 210 and connected by a hinge 214 to prevent the body of the patient 2 from moving. Furthermore, the body support unit 210 may have an anti-slip device fixture 241 that fixes the anti-slip device 240. Here, the position of the anti-slip device fixture 241 in the direction of the short side 202 of the operating table main body can be freely set by operating a moving device provided on the side or back surface thereof, or by being screwed into a screw or engaged with a ratchet, and when the body support unit 210 is tilted, the non-operated side 45 of the body support unit 210 can be positioned.

[0056] Here, the operating table main body 200 is characterized in that the body holding part edge portion 212, which is perpendicular to the short side 202 of the operating table inside the bracket-shaped body of the body holding part 210 (in the same direction as the long side not shown), and the lower limb holding part edge portion 221, which is perpendicular to the short side 202 of the operating table main body of the lower limb holding part 220, are abutted and joined by hinges 213, connecting the body holding part 210 and the lower limb holding part 220 and forming an integrated operating table main body (100). It is also preferable that a lower limb support fixing device (222) for fixing the lower limb support part 220 is provided on the body support leg part (216) below the operating table main body 200 or on the floor surface.

[0057] Figure 6(B) is an overhead view of the state in which a patient is placed and fixed on the operating table 200 shown in Figure 6(A), and the lower limb holder 220 is rotated below the operating table body and fixed to the lower limb holder fixing device 220. That is, as shown in Figure 6(B), it is preferable that the patient 2 be placed supine in the center of the operating table main body 200, along a direction perpendicular to the short side 202 of the operating table main body (the same direction as the long side of the operating table main body, not shown), with the lower limb and knee 43 of the patient 2 on the side not being operated on placed along the edge 212 of the body holding part 210, which is perpendicular to the bracket-shaped short side 202 of the operating table main body 200.

[0058] Then, it is preferable to lift the lower limb and knee 42 on the side to be operated on 80 to 100 degrees above the body, bend the knee joint 80 to 100 degrees to make the knee stand, and then fix it to the lower limb holding part 220 with the fixing device 205 in a position where the legs are spread (externally rotated) approximately horizontally. Here, the angle at which the lower limb is lifted, the angle at which the leg is externally rotated at the hip joint, and the angle at which the knee joint is flexed are preferably within the range of 80 degrees to 100 degrees.

[0059] Next, the skin of the superficial part of the pubic muscle 107 and pubic bone of the patient 2 is temporarily treated and cut, and the leg 226 of the lower limb holding part is removed. After that, the hinge 213 is rotated downward, and the lower limb and knee 42 of the patient 2 on the side to be operated on and the other end 223 of the lower limb holding part are rotated and fixed to the lower limb holding part fixing device 222 provided below the hinge 213, and can be fixed in the posture of Figure 6 (B).

[0060] FIG. 7 is a side view of the patient and operating table in the state shown in FIG. 6(B), seen from the patient's head. As shown in Figure 7, the lower limb and knee 42 of the patient 2 on the side to be operated on are externally rotated a total of 160 to 230 degrees (including the tilt angle of the hip joint) and 80 to 100 degrees, so that the leg faces backward, the thigh and top of the foot face upward, and the big toe 47 faces outward from the body. This allows the surgeon to approach the hip joint 5 of the patient 2 with the lower limbs 5 widely spread, which is the surgical field 50 of the total hip replacement surgery, from the incision position 32 on the anterior medial side of the body.

[0061] Here, reference numeral 211 denotes a pelvis fixing device, and 216 denotes the legs of the body support unit. In addition, the operating table 1 can also be equipped with two lower limb holders 220, one on each side, so that the hip joints on the side 44 to be operated on and the other on the side 45 to be operated on of the patient 2, as well as both the left and right hip joints, can be operated on simultaneously.

[0062] [Third embodiment] Figure 8 is a diagram of an operating table body according to a third embodiment of the present invention, in which the side of the patient undergoing surgery is higher than the side not undergoing surgery and which further has a weight support section. Figure 8(A) is an overhead view of the operating table 1 before the operating table body is tilted, and Figure 8(B) is an overhead view of the operating table shown in (A) with a patient placed and fixed, the body support section tilted, and the lower limb support section rotated below the operating table body.

[0063] As shown in Figure 8(A), a surgical table body 300 used in an anterior medial approach method for total hip arthroplasty according to a third embodiment of the present invention is a two-tiered surgical table with a rectangular upper surface that serves as a support surface against which a patient 2 abuts. The surgical table body 300 is inclined so that the operated side 44 of the patient 2 is higher at an angle of 10 to 30 degrees than the non-operated side 45, and is characterized by having an upper tier divided into a body support part 310 that supports the body and weight of the non-operated side 45 of the patient 2 and a lower limb support part 320 that supports the lower limb and knee 42 of the operated side, and a lower tier consisting of a weight support part 350 that is provided below the body support part 310 and receives the weight from the body support part 310.

[0064] Here, the upper layer lower limb holder 320 is an inclined rectangular platform, and is arranged at a corner of the operating table main body 300 close to the lower limb and knee 42 of the patient 2 on the side to be operated on, and has removable lower limb holder legs 326, which can fix the lower limb and knee 44 on the side to be operated on with a fixing device 305. It is preferable that the lower limb holder legs 326 are arranged so that they can be removed as needed by a method such as a screw-in type, a plug-in type, a movable type, or a bendable type.

[0065] Meanwhile, the body support part 310 is the remaining part of the operating table main body 300 excluding the lower limb support part 320, and is an inclined platform shaped like an angled bracket when viewed from above, has a plurality of weight support part legs 317, and can fix the lower limb and knee 43 of the non-operated side with a fixing device 306. It is preferable that the body support part 310 and the lower limb support part 320 are arranged on the same slope as the upper surface of the operating table main body 300, and are fitted together to integrate the upper layer of the operating table main body 300. In addition, the operating table body 300 can also be equipped with two lower limb holders 320 on the left and right so that the hip joints on the operated side 44 and the non-operated side 45 of the patient 2, as well as both the left and right hip joints, can be operated on simultaneously.

[0066] As shown in FIG. 8(A), the operating table main body 300 is characterized by having a weight support part 350 provided horizontally below the body support part 310 in the lower layer to receive the weight from the body support part 310. It is also preferable to provide a lower limb support fixing device 322 for fixing the lower limb support 320 on the body support leg 317 below the operating table main body 300 or on the floor surface. It is preferable that the body support part 310 is initially set horizontally and then tilted after the patient 2 is placed thereon.

[0067] Figure 8(B) is an overhead view of the operating table body 300 shown in Figure 8(A) with the patient 2 placed and fixed, the body holding part 310 tilted, and the lower limb holding part 320 rotated downward of the operating table body 300. As shown in Figure 8(B), a detachable body support device 351 is provided between the weight support device 350 and the body support device 310 as needed by a method such as screwing, inserting, moving, or bending, and the operated side 44 of the body support device 310 is inclined at an angle of 10 to 30 degrees higher than the non-operated side 45. Here, the length of body support member 351 is preferably set in proportion to the distance between body support member 351 and hinge 314 so as to correspond to the angle between body support member 310 and weight support member 350.

[0068] 8(B), the operating table main body 300 preferably has an anti-slip device fixture 341 that fixes the anti-slip device 340 in place along the short side 302 of the operating table main body. Note that the anti-slip device fixture 341 is preferably positioned at a predetermined position on the body holding unit 310 by, for example, operating a moving device provided on the body holding unit 310 or its side or back surface, or by being screwed onto a screw or engaged with a ratchet.

[0069] Here, the operating table main body 300 preferably has a hinge 313 formed by abutting a lower limb holding part edge 321 in the same direction as the long side 301 of the operating table main body inside the bracket-shaped body holding part 310 and a body holding part edge 312 in the same direction as the long side 301 of the operating table main body of the body holding part 310, and a lower limb holding part fixing device 322 that is provided on a body holding part leg part (317) below the body holding part 310 or on the floor surface and fixes the lower limb holding part 320. Note that reference numeral 311 denotes a pelvis fixing device.

[0070] Furthermore, as shown in Figure 8(B), it is preferable to fix the patient 2 in a supine position along the long side 301 of the operating table main body 300 at the center part, with the fixing device 305 so that the lower limb and knee 43 of the patient 2 on the side not undergoing surgery are aligned with the edge 312 of the body holding part 310 in the direction of the bracket-shaped long side 301 of the operating table main body.

[0071] Then, the patient 2 is immobilized or kept at rest, and the lower limb and knee 43 of the side not undergoing surgery are fixed to the body holding part 310 by the fixing device 306, and then the lower limb and knee 42 of the side undergoing surgery are lifted upward by 80 to 100 degrees to make the knee stand, the knee joint 5 is bent by 80 to 100 degrees, and then the legs are spread horizontally and fixed to the lower limb holding part 320 by the fixing device 305.

[0072] Next, the pectineus muscle 107 is temporarily treated and severed, the leg 351 of the lower limb holding part is removed, the hinge 313 between the body holding part edge part 312 and the lower limb holding part edge part 321 is rotated in the X direction, the lower limb and knee 42 of the side to be operated on and the other end 323 of the lower limb holding part are rotated and fixed to the lower limb holding plate fixing position 322 below the operating table main body 300, and the lower limb of the side to be operated on 44 is further externally rotated by 80 degrees to 100 degrees, so that the femur 20 of the hip joint 5 of the patient 2 is abducted at the hip joint by 80 degrees to 100 degrees, externally rotated 160 degrees to 200 degrees, and flexed at the knee joint by 80 degrees to 100 degrees.

[0073] FIG. 9 is a view of the patient 2 and the operating table 1 in the state shown in FIG. 8(B) as seen from the head of the patient 2. In FIG. As shown in Figure 9, the lower limb and knee of patient 2 on the side to be operated on are externally rotated a total of 160 to 200 degrees and 80 to 100 degrees, so that the toes point backward, the thigh 46 and the top of the foot point upward, and the big toe 47 is on the outside of the body. With the patient 2 in the state shown in FIGS. 8(B) and 9, the practitioner can approach the hip joints of the patient 2 with the hip joints 5 widely spread from the front medial side 32 of the patient 2.

[0074] In this way, the surgeon can approach the hip joint 5 of the patient 2 from the anterior medial side 32 using the operating table 1 used for the anterior medial approach method of total hip replacement surgery according to the present invention, and perform total hip replacement surgery by incising the joint capsule 30, osteotomizing the femoral neck 22, removing the femoral head 23 from the acetabulum 17, preparing the inside of the acetabulum 17, installing a cup, replacing and inserting the femoral head 23 into the cup, and suturing the superficial parts of the pubic muscle 107 and pubic bone of the patient 2 that have been temporarily treated and removed, in a manner well known to those skilled in the art.

[0075] Although the preferred embodiments of the present invention have been described above, the present invention is not limited to these embodiments and includes all modifications within the scope of the technology to which the present invention pertains. [Explanation of symbols]

[0076] Symbol Name Drawing number Paragraph 1 Operating table Figure 2 0038 2 Patient Figure 3 0043 3 Abdomen Fig.3 0043 4 Upper body Figure 3 0043 5 Hip joint Fig.10 0050 10 Pelvis Fig.10 0050 17 Acetabulum Fig.10 0050 20 Femur Fig.10 0050 21 Bone body Fig.10 0050 22 Femoral neck Fig. 10 0050 23 Femoral head Fig.10 0050 29 Incision location (lateral approach) Fig. 10 0050 30 Joint capsule Fig. 10 0050 31 Ligament Fig.10 0050 32 Incision location (anterior medial approach) Fig. 10 0048 42 Lower limb and knee on the side to be operated on Figure 2 0042 43 Lower limb and knee on the non-operated side Figure 2 0043 44 The side receiving surgery Figure 2 0039 45 Non-operated side Figure 2 0039 46 Thigh Fig.9 0073 47 Thumb Figure 5 0048 50 Surgical field Figure 3 0045 100 Operating table body Figure 3 0039 101 Long side of operating table body Figure 3 0040 105 Fixation device (lower limb holding part) Figure 3 0042 106 Fixation device (body support part) Figure 3 0044 107 Pectineus muscle Figure 3 0045 110 Body support part Figure 2 0039 111 Pelvic fixation device Figure 3 0045 112 Body support edge portion Fig. 3 0045 113 Hinge Figure 3 0045 116 Body support leg part Figure 3 0041 120 Lower limb support part Figure 2 0039 121 Lower limb support edge portion Fig. 3 0042 122 Lower limb support fixing device Figure 3 0041 123 Other end of lower limb support part Figure 3 0041 126 Lower limb support leg part Figure 3 0040 200 Operating table body Figure 6 0053 202 Short side of operating table body Figure 6 0056 205 Fixation device (lower limb support part) Figure 6 0058 206 Fixation device (body support part) Figure 6 0054 210 Body support part Figure 6 0053 211 Pelvic fixation device Figure 6 0061 212 Body support edge portion Fig. 6 0056 213 Hinge Fig.6 0056 214 Hinge Fig.6 0055 216 Body support leg part Figure 6 0056 220 Lower limb support part Fig. 6 0054 221 Lower limb support edge portion Fig. 6 0056 222 Lower limb support fixing device Figure 6 0056 223 Other end of lower limb support part Figure 6 0059 226 Lower limb support leg part Figure 6 0054 240 Anti-slip device Figure 6 0055 241 Anti-slip device fixing tool Figure 6 0055 300 Operating table body Figure 8 0063 301 Long side of operating table body Figure 8 0069 302 Short side of operating table body Figure 8 0068 305 Fixation device (lower limb support part) Figure 8 0064 306 Fixation device (body support part) Figure 8 0065 310 Body support part Figure 8 0063 311 Pelvic fixation device Figure 8 0069 312 Body support edge portion Fig. 8 0069 313 Hinge Fig.8 0069 314 Hinge Fig.8 0067 317 Body support leg part Figure 8 0069 320 Lower limb support part Fig.8 0063 321 Lower limb support edge portion Fig. 8 0069 322 Lower limb support fixing device Figure 8 0069 323 Other end of lower limb support part Figure 8 0072 326 Lower limb support leg part Figure 8 0064 340 Anti-slip device Figure 8 0068 341 Anti-slip device fixing tool Figure 8 0068 350 Weight support part Figure 8 0067 351 Body support device Figure 8 0067 X Rotation direction Figure 3 0045

Claims

1. The operating table (1) used for the anterior medial approach method of total hip replacement surgery has an operating table body (100) with a rectangular upper surface, which is the working surface on which the patient abuts; The operating table body (100) is divided into a body support part (110) and a lower limb support part (120), The lower limb holder (120) is a flat table having a rectangular shape when viewed from above, and is arranged at a corner of the operating table body (100) near the lower limb and knee (42) of the patient (2) on the side on which surgery is to be performed. The patient's lower limb and knee (42) on the side on which surgery is to be performed are fixed and held on the upper surface by a fixing device (105), and the lower limb holder has removably attached lower limb holder legs (126). The body support section (110) is the remaining part of the operating table main body (100) excluding the lower limb support section (120), and is a flat platform with a hook-shaped top view, on whose top surface the lower limb and knee (43) of the patient (2) on the side not undergoing surgery are fixed by a fixing device (106), and supports most of the body and weight of the patient (2), and is provided with a plurality of body support section legs (116) having the same length as the lower limb support section legs (126); The body holding part (110) has an edge (112) of the body holding part (110) in the same direction as the long side (101) of the operating table main body inside the bracket-shaped top view, and the lower limb holding part (121) of the lower limb holding part (120) has an edge (121) of the body holding part (110) in the same direction as the long side (101) of the operating table main body, which are abutted against each other and joined by a hinge (113), thereby connecting the body holding part (110) and the lower limb holding part (120) to form an integrated operating table main body (100); a lower leg support fixing device 122 is provided on the body support leg (116) below the hinge (113); The patient (2) lies supine in the center of the operating table body (100) with the lower limbs and knees (43) of the side not to be operated on along the inner edge of the body support part (110) in the same direction as the long side (101) of the operating table body having an angled bracket shape, and is fixed to the body support part (110) using the fixing device (106). The lower limbs of the side to be operated on (44) of the patient (2) are raised (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation). The knees are bent 80 to 100 degrees and fixed to the lower limb support part (120) using the fixing device (105). The pubococcus muscle (107) and the skin of the superficial part of the pubic bone of the patient (2) are temporarily treated and cut, and then the leg (126) of the lower limb holder is removed. Then, the hinge (113) is rotated downward, and the lower limb and knee (42) of the patient (2) on the side to be operated on and the other end (123) of the lower limb holder are rotated and fixed to the lower limb holder fixing device (122) provided below the hinge (113), thereby further externally rotating and fixing the lower limb of the side to be operated on (44). The operating table is used for the anterior medial approach method for total hip replacement surgery, and is characterized in that it allows the surgeon to approach the hip joint (5), which is the surgical field (50) of the total hip replacement surgery, of the patient (2) lying on his back with his legs spread wide, from the anterior medial side (32) of the body.

2. 2. The surgical table for use in the anterior medial approach method of total hip replacement surgery according to claim 1, characterized in that the lower limb holders (120) are installed opposite each other, one on each side, so that surgery can be performed on both the left and right hip joints of the patient (2) simultaneously or separately.

3. 2. The surgical table for use in an anterior medial approach method for total hip replacement surgery according to claim 1, characterized in that the surgical table (1) comprises a surgical table body (200) having a body support portion (210) inclined so that the operated side (44) of the patient (2) is higher at an angle of 10 to 30 degrees than the non-operated side (45).

4. 4. The surgical table for use in the anterior medial approach method of total hip replacement surgery according to claim 3, characterized in that the surgical table body (200) is erected on the inclined body support portion (210) and is provided with an anti-slip device (240) to prevent the patient's body (2) from moving from the body support portion (210).

5. 5. An operating table for use in an anterior medial approach method for total hip replacement surgery, as described in claim 4, characterized in that the body support portion (210) is further provided with an anti-slip device fixing device (241) that can set the installation position of the anti-slip device (240) in the direction of the short side (202) of the operating table body, and the anti-slip device (240) is positioned by the anti-slip device fixing device (241) when the body support portion (210) is tilted.

6. The body holding part (210) has a body holding part edge (212) on the inner side of the bracket shape, which is perpendicular to the short side (202) of the operating table main body, and the lower limb holding part (221) of the lower limb holding part (220) has a lower limb holding part edge (221) on the inner side of the bracket shape, which is perpendicular to the short side (202) of the operating table main body, and are joined by a hinge (213), thereby connecting the body holding part (210) and the lower limb holding part (220) and integrating the operating table main body (200); A lower leg support fixing device 222 is provided on the body support leg (216) below the hinge (213); The patient 2 is placed supine in the center of the operating table body (200) with the lower limbs and knees (43) of the non-operated side of the patient (2) stretched along the inner edge of the body holder (210) in the same direction as the long side (201) of the operating table body having an angled bracket shape, and is fixed to the body holder (210) using a fixing device (206). The lower limbs of the patient (2) on the side to be operated on (44) are raised (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation), and the knees are bent 80 to 100 degrees and fixed to the lower limb holder (220) using a fixing device (205). The skin of the superficial part of the pubic muscle (107) and pubic bone of the patient (2) is temporarily treated and cut, and then the leg (226) of the lower limb holder is removed. Then, the hinge (213) is rotated downward, and the lower limb and knee (42) of the patient (2) on the side to be operated on and the other end (223) of the lower limb holder are rotated to the lower limb holder fixing device (222) provided below the hinge (213) and fixed thereto. As a result, the lower limb of the operated side (44) is further externally rotated and fixed, and the lower limb of the operated side (44) is further externally rotated and fixed, 6. The operating table for use in the anterior medial approach method for total hip replacement surgery according to claim 5, characterized in that the operating table enables the surgeon to approach the hip joint (5), which is the surgical field (50) of total hip replacement surgery, from the anterior medial side (32) of the body of the patient (2) who is lying on his back with his legs spread wide.

7. 7. An operating table for use in an anterior medial approach method for total hip replacement surgery, as described in claim 6, characterized in that the lower limb holding portions (220) are installed opposite each other, one on each side, so that surgery can be performed on both the left and right hip joints of the patient (2) simultaneously or separately.

8. 4. The surgical table for use in the anterior medial approach method of total hip replacement surgery according to claim 3, further comprising a weight support portion (350) disposed on the underside of the body support portion (310) of the surgical table body (300) for supporting the weight of the patient (2).

9. 9. A surgical table for use in an anterior medial approach method for total hip replacement surgery according to claim 8, characterized in that an anti-slip device (340) is provided on the upper surface of the weight support portion (350), connected to the body support portion (310) by a hinge (314) and erected to prevent the patient's (2) body from moving from the inclined body support portion (310).

10. The body weight support portion (350) further has an anti-slip device fixing device (341) that sets the installation position of the anti-slip device (340) in the direction of the short side (302) of the operating table body, and the anti-slip device fixing device (341) positions the installation position of the anti-slip device (340) in the direction of the short side (302) of the operating table body when the body support portion (310) is tilted.

11. The body holding part edge portion (312) of the body holding part (310) on the inner side of the bracket-shaped body holding part (310) in the same direction as the long side (301) of the operating table main body is abutted against the lower limb holding part edge portion (321) of the lower limb holding part (320) in the same direction as the long side (301) of the operating table main body, and they are joined by the hinge (313), and the body holding part (310) and the lower limb holding part (320) are connected to form the operating table main body 100 as a single unit; A lower leg support fixing device 322 is provided on the body support leg (326) below the hinge (313); The patient (2) lies supine in the center of the operating table body (300) with the lower limbs and knees (43) of the non-operated side along the inner edge of the bracket-shaped body support part (310) in the same direction as the long side (301) of the operating table body, and is fixed to the body support part (310) using a fixing device (306). The lower limbs of the patient (2) on the side to be operated on (44) are raised (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation). The knees are bent 80 to 100 degrees and fixed to the lower limb support part (320) using a fixing device (305).

11. The operating table for use in the anterior medial approach method for total hip replacement surgery according to claim 10, wherein the patient's pubic muscle (107) and the skin of the superficial part of the pubic bone are temporarily treated and cut, and then the leg (326) of the lower limb holder is removed. Then, the hinge (313) is rotated downward, and the lower limb and knee (42) of the patient's side to be operated on and the other end (323) of the lower limb holder are rotated to the lower limb holder fixation device (322) provided below the hinge (313) and fixed thereto, and the lower limb of the patient's side to be operated on (44) is further externally rotated and fixed thereto, thereby enabling the surgeon to approach the hip joint (5), which is the surgical field (50) of the total hip replacement surgery, from the anterior medial side of the body of the patient (2) who is lying supine with his / her legs spread wide.

12. 12. An operating table for use in an anterior medial approach method for total hip replacement surgery, as described in claim 11, characterized in that the lower limb holders (320) are installed opposite each other, one on each side, so that surgery can be performed on both the left and right hip joints of the patient (2) simultaneously or separately.

13. 2. The surgical table for use in an anterior medial approach method for total hip replacement surgery according to claim 1, characterized in that the body support portion (110) further comprises a pelvis fixation device (111) for holding and fixing the pelvis of the patient (2) at a position close to the inner corner of the bracket-shaped body support portion (110).

14. 14. The operating table for use in the anterior medial approach method for total hip replacement surgery according to claim 13, characterized in that, after the hip joint (5) of the patient (2) is fixed to the pelvis fixing device (111), a hinge (113) between the body holding portion end edge portion (112) and the lower limb holding portion end edge portion (121) is rotated to fix the other end (123) of the lower limb holding portion and the lower limb and knee (42) of the patient (2) on the side to be operated on to the lower limb holding portion fixing device (122).

15. A method of using the operating table for the anterior medial approach method for total hip replacement surgery according to any one of claims 1 to 14, comprising: The patient is placed supine with the lower limb and knee of the side not to be operated on extended along the inner edge of the bracket-shaped body support part in the same direction as the long side of the operating table body, and fixed to the center of the operating table body using a fixing device, and the lower limb and knee of the patient on the side to be operated on are raised (flexed) 80 to 100 degrees above the body with the head facing upward, and rotated 80 to 100 degrees outward (external rotation), and the knee is bent 80 to 100 degrees and fixed to the lower limb support part using a fixing device, After the patient's pubic muscle and the skin of the relevant portion are temporarily treated and cut, the legs of the lower limb support are removed, the hinge between the end edge of the body support portion and the end edge of the lower limb support portion is rotated downward, the lower limb and knee of the patient on the side to be operated on and the other end of the lower limb support portion are rotated and fixed to the lower limb support portion fixing device provided below the hinge, and the lower limb on the side to be operated on is further rotated outward by 80 to 100 degrees and fixed.

15. A method of using an operating table for an anterior medial approach method for total hip replacement surgery according to any one of claims 1 to 14, characterized in that the surgeon approaches the hip joint, which is the surgical field for total hip replacement surgery, from the anterior medial side of the body of the patient who is lying on his back with his legs spread wide.

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