Systems and Methods for Maintaining Patient Position

Abstract

Some of the systems, devices, and methods detailed herein provide an adjustable restraint device that maintains a person's selected position relative to a support structure to maintain a safe and customizable patient position, for example, during a surgical procedure or during medical transport. TIFF2025517015000002.tif112131

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of priority to U.S. Utility Patent Application No. 17 / 827,098, filed May 27, 2022, which is hereby incorporated by reference in its entirety.

[0002] Technical Field The present disclosure describes systems, devices, and methods for releasably and securely holding a subject, such as a patient, during a surgical procedure or during transportation to a medical site. Specific examples described herein provide improved positioning and releasable restraint of one or more limbs of a patient in a customizable and secure position while the patient is sedated during a surgical procedure.

Background Art

[0003] Background Maintaining a consistent and safe position of a patient during a surgical procedure facilitates improved surgical outcomes and reduces the potential for unintended limb movement and its consequences, such as paresthesia or ischemia of a limb that has shifted unintentionally during the course of the procedure. For example, in some situations where a patient may be under anesthesia during a surgical procedure, the patient may be unable to control or position themselves, or may be unable to alert the physician of discomfort or paresthesia in a limb. Physicians have employed several techniques to control the position of a patient during a medical procedure. For example, some medical staff may use folding or cushioning techniques of the sheet on the operating table to hold the patient in place. These techniques may include wrapping the sheet around the patient's limb and within the cushion of the operating table to hold the patient's limb in place during the procedure. Such techniques may not be effective in maintaining a consistent and safe position of the patient throughout the procedure as the sheet may loosen in some areas and allow the patient's limb to move from the initially selected position. Further, in some situations, including those involving obese or large-framed patients that occupy a larger area than the operating table, such conventional techniques may not be able to securely hold the patient's limb in a consistent and safe manner during the performance of a medical procedure. SUMMARY OF THE INVENTION

[0004] Summary The present disclosure describes, for example, systems, devices, and methods for maintaining a selected position of a person relative to a support structure to achieve a safe and customizable patient position during a surgical procedure or during medical transport of a patient. In certain embodiments, the systems, devices, and methods described herein can include at least one adjustable restraint device that achieves improved adjustability to releasably capture one or more portions of a patient in a safe position relative to an operating table or a medical transport device.

[0005] Among the advantages, some of the systems and methods described herein can advantageously provide a more efficient and customizable approach to maintaining a wide variety of patient sizes at a selected position on an operating table or a medical transport device. For example, in certain aspects, an adjustable restraint device can be made releasably lockable at a customized position along the operating table, and can be conveniently manipulated into a curved or other customized configuration (e.g., for engaging a patient's limb) prior to being releasably locked into that particular customized configuration. Further, some aspects described in more detail below can achieve a removable, reusable solution that provides additional comfort to a patient engaged with an adjustable restraint device while also achieving efficient disposal of certain components and reuse of other more complex components.

[0006] Some aspects described herein include a flexible cuff system for releasably maintaining a patient's position. The system can include a flexible cuff body adjustable from a first orientation to a customized orientation for holding a limb in a selected position relative to a medical support. Optionally, the system can also include a handle body connected to a base of the flexible cuff body, the handle body including a handle movable between a locked position and an unlocked position, the handle body defining a mating interface that slidably engages the medical support. In certain situations, in response to the handle being moved to the unlocked position, the flexible cuff body can be adjusted from the first orientation to a customized orientation so as to extend around the limb. Also, in some situations, in response to the handle being moved to the locked position while the flexible cuff body is in the customized orientation, the flexible cuff body can be locked in the customized orientation to hold the limb in a selected position relative to the medical support.

[0007] Some aspects described herein include a system that includes a plurality of adjustable limb restraints. The system may optionally include an operating table that includes one or more rails extending along one or more sides of the operating table. The plurality of adjustable limb restraints may be releasably lockable at selectable positions along one or more rails of the operating table. Each of the adjustable limb restraints may include a flexible cuff body adjustable from a first orientation to a customized orientation to hold a limb in a customized position relative to the operating table. Additionally, each of the adjustable limb restraints may include a handle body connected to a base of the flexible cuff body. The handle body can include a handle movable between a locked position and an unlocked position. Optionally, the handle body may define a mating interface for slidably engaging at least one of the one or more rails. In response to the handle being moved to the unlocked position, the flexible cuff body can be adjusted from the first orientation to a customized orientation so as to extend around the limb. Further, in response to the handle being moved to the locked position while the flexible cuff body is in the customized orientation, the flexible cuff body can be locked in the customized orientation to hold the limb in a selected position relative to the operating table.

[0008] Some aspects described herein include a method of maintaining a patient's position. The method may include releasably locking a handle body of an adjustable limb restraint to a rail of an operating table at a selected position relative to a patient's limb on the operating table. The method may further include adjusting a flexible cuff body of the adjustable limb restraint to a selected shape to engage the patient's limb. The method may also include adjusting an actuator on the handle body of the adjustable limb restraint to releasably lock the flexible cuff body in the selected shape.

[0009] Certain embodiments, in certain instances, can achieve one or more of the following advantages. The systems, devices, and methods described herein provide a safer and more consistent approach for holding a patient and the patient's limbs in a fixed position on an operating table or medical transport device that reduces the likelihood that the patient or the patient's limb can move from a desired position and maintains the initial position of the patient or the patient's limb during a procedure or transport. Further, the systems, devices, and methods described herein advantageously provide a removable and reusable solution that can be readily adjusted to capture patients and patient parts of various sizes and that can be easily adjusted to engage patients or patient limbs of different sizes and shapes.

[0010] Details of one or more embodiments are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and accompanying drawings, and from the claims.

Brief Description of the Drawings

[0011]

Figure 1

Figure 2

Figure 3

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Figure 8A

Figure 8B

Figure 9

Figure 10

[0012] Like reference numerals in the various drawings indicate like elements.

[0013] DETAILED DESCRIPTION Referring to FIG. 1, some aspects of a system 100 for releasably maintaining a subject, such as a patient 102 who is sedated or otherwise medically prepped, in a selected position can include an adjustable restraint device 104 and an operating table 106. In the illustrated aspect, the adjustable restraint device 104 is removably fitted to a portion of the operating table 106 and is an adjustable limb restraint manually adjustable to any of a variety of curved or other customized shapes for improved comfortable engagement with the limbs of the patient 102. As detailed below, the adjustable restraint device 104 of the system 100 can be releasably locked into a customized shape to securely hold the patient 102 in a selected position on the operating table 106, thereby reducing the likelihood that the patient 102 will move unintentionally from the selected location during a medical procedure.

[0014] The operating table 106 can include one or more rails 110 extending along each side of the operating table 106. The one or more rails 110 can extend from each side of the operating table 106. In some aspects, each side of the table 106 can include a plurality of rails 110 spaced along the length of the operating table 106, and in other aspects, each side of the operating table 106 can include a continuous rail 110 extending along the length of the operating table 106. For example, the left side 112 of the operating table 106 can include four rails 110 spaced along the length of the operating table 106, and the right side 114 of the operating table 106 can include four rails 110 spaced along the length of the operating table 106.

[0015] In the illustrated embodiment, system 100 includes a plurality of adjustable restraint devices 104 slidably fitted to the operating table 106. Each adjustable restraint device 104 is adjustable and can be formed as a flexible cuff system that extends around a patient's limb (e.g., the patient's arm, leg, or torso). Each adjustable restraint device 104 can be independently operable by a user, and thus each restraint device 104 can be separately controlled by the user as needed. As illustrated, system 100 includes adjustable restraint devices in the form and size of adjustable limb restraints 104 positioned and formed around the patient 102's arms and legs. In the illustrated embodiment, system 100 includes two adjustable limb restraints 104 for each arm of patient 102 and two adjustable limb restraints 104 for each leg of patient 102. In other embodiments, system 100 can include adjustable limb restraints 104 for each limb of patient 102. In other examples, system 100 can include adjustable limb restraints 104 for the arms instead of the legs, or adjustable limb restraints 104 for the legs instead of the arms.

[0016] Referring further to the illustrated embodiment of FIG. 1, a first portion of the adjustable limb restraint 104 is positioned on the right side surface 114 of the operating table 106, and a second portion of the adjustable limb restraint 104 is positioned on the left side surface 112 of the operating table 106. In this embodiment, the system 100 includes four adjustable limb restraints 104 on the right side surface 114 and four adjustable limb restraints 104 on the left side surface 112. Although four adjustable limb restraints 104 on each side of the operating table 106 are shown, the system 100 is not limited to this arrangement. The system 100 can include one adjustable limb restraint 104, two or more adjustable limb restraints 104, or a plurality of adjustable limb restraints 104. The adjustable limb restraint 104 illustrated in FIG. 1 preferably provides a padded contact portion with the patient and includes a protective outer sleeve (described in more detail below) to protect the internal mechanism of each adjustable limb restraint 104. However, in FIG. 1, one adjustable limb restraint 104a is illustrated in a state where the protective sleeve is not intentionally shown for illustrative purposes. In some embodiments, the protective sleeve is slidably removable from the adjustable limb restraint 104, so that the sleeve can be easily and hygienically discarded after its use, and the remaining components of the adjustable limb restraint 104 can receive a new protective sleeve for reuse in subsequent medical procedures.

[0017] In some embodiments, each of the adjustable limb restraints 104 can be removably connected to one of the rails 110 of the operating table 106. For example, each adjustable limb restraint 104 includes a handle body 118 that defines a recess configured to slidably engage at least one of the rails 110. In use, the adjustable limb restraint 104 is movable along the rail 110 to a customized position relative to the operating table 106 (e.g., to customize the longitudinal position of a patient of different sizes or in a different position), and the adjustable limb restraint 104 can be releasably locked at its selected position along the rail 110 during a medical procedure.

[0018] Referring now to FIGS. 2A - B, some aspects of the adjustable restraint device 104 can include a protective sleeve 130 and an internal mechanism 140 for releasably locking the restraint device 104 in a curved or other customized shape for comfortable engagement with the patient. FIG. 2A shows a perspective view of one of the adjustable limb restraints 104, which in this aspect includes a flexible cuff body 105 that extends distally from the handle body 118 towards the free end. The handle body 118 is connected to one of the rails 110 of the operating table 106 of the system 100 as previously described in connection with FIG. 1. In this aspect, the flexible cuff body 105 provides a cushioned contact portion with the patient and includes a protective sleeve 130 slidably positioned over an internal mechanism 140 (e.g., a linkage assembly in this aspect as shown in FIG. 2B with the protective sleeve 130 not intentionally shown for purposes of illustration) that covers the mechanical components of the mechanism 140. The protective sleeve 130 can include pads that can prevent pinching between a series of links 140, and the protective sleeve 130 can include a fluid - impermeable outer material to facilitate rapid washing or removal of body fluids from the adjustable limb restraint 104.

[0019] In this aspect, the flexible cuff body 105 (including the protective sleeve 130 and the mechanism 140) has an adjustable shape and can be releasably locked in a selected shape or unlocked to manually manipulate the linkage assembly 140 (and the sleeve 130 therewith) into a different shape. In the illustrated aspect, the flexible cuff body 105 is in a curved configuration configured to extend around a patient's limb (e.g., the arm, leg, or torso of patient 102). The flexible cuff body 105 can be adjusted to a customizable orientation for holding the limb of patient 102, and the customizable orientation can include several different configurations as shown and described below. As detailed below, the overall shape of the flexible cuff body 105 can be releasably locked in a customized orientation to maintain its shape for maintaining the patient's position during a surgical procedure.

[0020] The handle body 118 of the adjustable limb restraint 104 is configured to releasably lock the adjustable limb restraint 104 at a selected longitudinal position along the corresponding rail 110. The handle body 118 defines a mating interface 120 dimensioned to receive the rail 110 and slidably engage with the rail 110. In some aspects, the mating interface 120 is formed as a recess (e.g., oriented parallel to the rail 110) within the handle body 118 on the base side of the handle body such that the rail 110 extends through the recess 120 and remains in contact with the handle body 118. In some aspects, the position of the adjustable limb restraint 104 along the rail 110 can be fixed by an actuator of the handle body 118. For example, the handle body 118 can include a rotatable knob 160 (FIG. 2A), and the knob 160 can facilitate releasably locking the adjustable limb restraint 104 at a selected position along the rail 110. In this example, the adjustable limb restraint 104 can be slidably moved along the rail 110 through the interface between the rail 110 and the recess 120 to reach a selected longitudinal position along the rail 110. After reaching the position selected by the user, the knob 160 is rotated to bias a shaft (not shown) of the knob 160 into interference fit with the rail 110, thereby releasably locking the adjustable limb restraint 104 at the selected longitudinal position along the rail 110. To readjust the adjustable limb restraint 104 relative to the rail 110, the knob 160 is rotated in the opposite direction (loosening the knob 160), thereby allowing the adjustable limb restraint 104 to be slidably moved along the rail 110.

[0021] Referring further to FIGS. 2A - B, some aspects of the adjustable restraint device 104 also include another actuator that can be shifted by the user to releasably lock the mechanism 140 in a customized configuration. For example, in this aspect, the adjustable limb restraint 104 includes an actuator in the form of a handle 170 on the handle body 118, and turning this actuator can activate a mechanical lock on a series of links within the linkage assembly 140. As shown in FIG. 2B, the linkage assembly 140 extends away from the handle body 118 in a direction away from the rail 110 / recess 120 interface, and a series of links of the linkage assembly 140 are pivotally connected to each other. Thus, the entire length of the linkage assembly 140 can be manually adjusted from a first position (e.g., a vertically straight configuration like the configuration of FIG. 3, or other shapes directed away from the patient position on the operating table 106) to a second position (e.g., curved to wrap around the target portion of the patient, or other customized). Therefore, the relative rotational adjustment of adjacent links within the series of links 140 that extend away from the handle body 118 facilitates the user to change the angle of the adjustable limb restraint 104 (e.g., towards an angle non - parallel to the side of the rail 110 and the operating table 106) and change the shape of the adjustable limb restraint 104 (e.g., towards a curved configuration in the illustrated aspect). Additionally or alternatively, adjacent links within the series of links 140 can be joined together via a movable joint that provides movement beyond a hinge connection, such as a swivel point connection or a ball joint component, to provide multiple degrees of freedom between adjacent links within the series of links 140.

[0022] In the illustrated embodiment, the handle actuator 170 of the handle body 118 can be used to shift the flexible cuff body 105 between a locked position and an unlocked position. The handle 170 can be positioned on the outward-facing side of the handle body 118, such that the user can access the handle 170 while the adjustable limb restraint 104 is connected to the operating table 106. The handle 170 can control a tension element or other locking means that acts on a series of links 140 extending from the handle body 118. In some aspects, the series of links 140 are connected to the handle body 118 via a base 172 that extends upwardly away from the mating interface 120 of the handle body 118.

[0023] The handle 170 is movable between an unlocked position (see FIG. 2A) and a locked position (see FIG. 2B). For example, by gripping the handle 170 and pivoting the handle 170 downward away from the base 172 and the first link of the linkage system 140, it can be shifted from the unlocked position (FIG. 2A) to the locked position (FIG. 2B). When the handle 170 is in the unlocked position, the flexible cuff body 105 can be manually adjusted to a user-selected position, such as the curved configuration illustrated in FIG. 2B. For example, with the handle 170 in the unlocked position, the user can adjust the overall shape of the flexible cuff body 105 (and the configuration of the series of links 140) to achieve a customized configuration that fits any patient from among a variety of different patient sizes, different limb types, and different limb placements on the operating table 106 (or to release from the patient after use). In some aspects, the series of links 140 are each configured to pivot relative to one another to provide a plurality of degrees of freedom by which the user can form the series of links 140 into various shapes and sizes. When the handle 170 is shifted to the locked position, the flexible cuff body 105 is releasably locked in a customized configuration, such as the curved configuration illustrated in FIG. 2B. For example, after the flexible cuff body 105 has been manipulated or adjusted by the user (while the handle 170 is in the unlocked position) to a desired customized configuration, the flexible cuff body 105 can be locked and then fixed in that customized configuration (by shifting the handle 170 to the locked position).

[0024] Accordingly, some aspects of the adjustable limb restraint 104 can be releasably locked in a number of customizable positions as desired by the user (e.g., surgeon, nurse, physical therapist, physician, surgical technician, or other user) to achieve a safe and comfortable device for maintaining the position of a patient on the operating table 106. Examples of patient positions that can be maintained by the adjustable limb restraint 104 include, but are not limited to, supine, prone, lateral, and recumbent positions.

[0025] Referring now to FIG. 3, some embodiments of the adjustable limb restraint 104 include a protective sleeve 130 in a slidably removable form that includes an inner pocket configured to receive the free end of the linkage assembly 140. The protective sleeve 130 can be a padded sleeve that extends around a series of links 140. For example, the proximal end 180 of the protective sleeve 130 can include an opening into the inner pocket space so that the protective sleeve 130 can be pulled so as to cover the most distal end link 182 of the series of links 140. The protective sleeve 130 can be advanced over the series of links 140 until the proximal end 180 covers the base 172. As described above, the protective sleeve 130 can include a pad that provides cushioning and comfort to the patient and further can prevent pinching between the series of links 140, and the protective sleeve 130 can include a fluid-impermeable outer material to facilitate rapid cleaning of the adjustable limb restraint 104. In some situations, the protective sleeve 130 can remain on the adjustable limb restraint 104 during a cleaning or sterilization process, or in other embodiments, the protective sleeve 130 can be removed from the adjustable limb restraint 104 for cleaning or sterilization. Additionally or alternatively, the protective sleeve is slidably removable from the linkage assembly 140 so that the sleeve 130 can be hygienically and easily discarded after use on a first patient, and the remaining components of the adjustable limb restraint 104 can receive a new protective sleeve for reuse in subsequent (e.g., with different patients) medical procedures. As shown in FIG. 3, the adjustable limb restraint 104 can be arranged in a vertical configuration (extending upwardly away from the handle body 118) so that the linkage assembly 140 extends away from the operating table 106. This vertical configuration can facilitate insertion or removal of the protective sleeve 130. Further, in some situations, this vertical configuration can also be used temporarily during a medical imaging period in the region of the patient's limb near the adjustable limb restraint 104 while the patient is on the operating table, while the patient is being removed from the table.

[0026] Referring now to FIG. 4, the adjustable limb restraint 104 (shown without intentionally showing the protective sleeve for purposes of illustration) can be arranged in a horizontal configuration in which a series of links of the linkage assembly 140 extend in a direction substantially perpendicular to the configuration shown in FIG. 3. In some aspects, the horizontal position of the adjustable limb restraint 104 can be such that it enables the adjustable limb restraint 104 to be placed flat on the operating table 106, for example, while that portion of the operating table is not in use.

[0027] Referring to FIGS. 5A - B, some aspects of the adjustable limb restraint 104 can include one or more tensioners or locking devices that engage a series of links of the linkage assembly 140 and releasably lock the linkage assembly 140 in a selected position (in response to actuation of the handle 170). For example, the adjustable limb restraint 104 can include one or more cables 190 that extend from the handle body 118 through a series of links 140 of the flexible cuff body 105 and into the end link 182. In some aspects, the adjustable limb restraint 104 can include a single cable 190 that extends through the center of each link of the series of links 140. In the illustrated aspect, the adjustable limb restraint 104 can include two cables 190 (right cable 194 and left cable 196), and the two cables 190 can extend parallel to each other as they extend through the series of links 140. The right cable 194 and the left cable 196 can be equally offset from the central longitudinal axis of the linkage assembly 140 and can have the same offset from the respective left and right side edges of the linkage assembly 140.

[0028] In some aspects, each link of the series of links 140 includes one or more guide members 198 through which respective cables 190 extend. The guide members 198 can include a disk, bearing, gasket, or channel structure that facilitates the connection of the series of links 140 to each other and the extension of one or more cables 190 through the series of links. Each link of the series of links 140 can include one or more guide members 198. For example, each link of the series of links 140 can include two guide members 198, namely, a guide member 198 positioned for the right cable 194 and a guide member 198 positioned for the left cable 196.

[0029] Referring to FIGS. 5B and 2A - B, the handle 170 can be connected to one or more cables 190 such that actuation of the handle 170 adjusts the one or more cables 190. Thus, actuating the handle 170 from the unlocked position to the locked position can bias the cables 190 to apply a force to a series of links within the linkage assembly 140 that locks the links in the selected position. For example, when the handle 170 is actuated to the locked position, the handle 170 applies tension to the cables 190 to bias the series of links 140 to press against each other to form a frictional engagement, thereby holding each link within the linkage assembly 140 in a fixed position relative to each adjacent link. When the handle 170 is shifted to the unlocked position, the tension in the cables 190 is released, thereby releasing the fixation created by the frictional engagement between the links and allowing adjustment of the configuration of the linkage assembly 140.

[0030] As described above, by operating the flexible cuff body 105 at the unlocked position, the flexible cuff body 105 can be formed into various customizable shapes and sizes. For example, a series of links 140 of the flexible cuff body 105 can define an opening 210 (FIG. 5B) sized to receive a patient's limb therein. By operating the flexible cuff body 105 into various shapes and sizes, the overall shape and size of the opening 210 can be adjusted. For example, as shown in FIG. 5B, a series of links 140 of the flexible cuff body 105 can be formed into open-end hooks surrounding the opening 210. The open-end hooks can begin at a base 172 and terminate at an end link 182. The open-end hooks can extend vertically at the base 172 and can bend outward (i.e., away from the table side) to extend the opening 210 away from the table side. The series of links 140 can extend in a curved pattern terminating at the end link 182, which is positioned near or above a table (e.g., the operating table 106), and the base 172 is positioned slightly below the end link 182.

[0031] FIG. 5B shows an open-end hook configuration, but various other configurations of the flexible cuff body 105 can be formed. For example, FIG. 1 shows an adjustable limb restraint 104 formed in a closed-end loop configuration where the adjustable limb restraint 104 forms a closed-end loop with the adjustable limb restraint 104 and / or the operating table 106. The closed loop can prevent a patient's limb from slipping out of the adjustable limb restraint 104. FIGS. 3 and 4 illustrate other configurations (e.g., vertical and horizontal configurations) of the adjustable limb restraint 104. Other exemplary configurations include, but are not limited to, a conical shape where one end of the series of links 140 can have a smaller diameter than the other end. In some examples, the adjustable limb restraint 104 can include several (e.g., 4 - 6 or more) smaller, loosely connected individual connection systems that can be operated to more closely conform to a patient's limb.

[0032] FIG. 6A shows an end view of another exemplary system 600 for positioning a patient. In an exemplary aspect, system 600 includes a first adjustable limb restraint 604a on a first side of operating table 606 and a second adjustable limb restraint 604b on a second (opposite) side of operating table 606. In the illustrated aspect, the protective sleeves (described above) of each restraint device 604a, 604b are not intentionally shown for purposes of illustration. Each adjustable limb restraint 604a, 604b can share features with the adjustable limb restraint 104 described in detail above. For example, each adjustable limb restraint 604a, 604b can include handle bodies 618a, 618b that connect to corresponding rails 610 of operating table 606. As shown in FIG. 6A, the adjustable limb restraints 604a, 604b are sized and positioned to extend over operating table 606 such that their free ends meet each other. Optionally, a protective sleeve for each adjustable limb restraint 604a, 604b can also provide distal access to fasteners (see also FIGS. 6B-C) positioned on end links 682a, 682b of each adjustable limb restraint 604a, 604b. Thus, the free ends of the opposing limb restraints 604a, 604b can be fixed relative to each other, and the adjustable limb restraints 604a, 604b can extend across operating table 606 over the patient's torso to releasably secure the patient at a selected position on operating table 606.

[0033] As shown in FIGS. 6B - C, the end links 682a, 682b of the opposing adjustable limb restraints 604a, 604b can be configured to be fixed to each other via a magnetic or mechanical connection. For example, in FIG. 6B, the end links 682a, 682b are configured to be connected to each other via magnets 684a, 684b within each end link 682a, 682b. The magnets 684a, 684b provide a releasable connection between the end links 682a, 682b. Alternatively or additionally, as shown in FIG. 6C, the end links 682a, 682b are configured to be connected to each other via fasteners 686a, 686b within each end link 682a, 682b. For example, the fastener 686a can include a female receptacle, and the fastener 686b can include a male connector sized to fit within the female receptacle of the fastener 686a. The fasteners 686a, 686b provide a releasable connection between the end links 682a, 682b.

[0034] Referring now to FIG. 7, some aspects of a system 700 that uses one or more adjustable limb restraints 704 to position a patient's arm 702 on an operating arm board 706 can be used. In the illustrated system 700, the one or more adjustable limb restraints 704 can share the features of the adjustable limb restraints 104, 604a, 604b described in detail above. The handle body 718 (similar to body 118) of the adjustable limb restraint 704 can be connected to the operating arm board 706 to provide a releasable engagement with the arm board 706, and the handle body 718 can include a handle actuator (similar to actuator 170) that shifts between an unlocked position and a locked position, thereby releasably locking the linkage assembly at a selected position around the patient's limb. The adjustable limb restraint 704 extends around the patient's arm 702 and can secure the positioning of the arm 702 on the arm board 706. The adjustable limb restraint 704 can include, for illustrative purposes, a padded sleeve (e.g., similar to padded sleeve 130) in the state not intentionally shown in FIG. 7.

[0035] Referring to FIGS. 8A - B, in order to maintain the position of a patient with respect to a medical transport device, some aspects of adjustable limb restraints can be used in systems 800, 850. For example, as shown in FIG. 8A, system 800 includes a portable stretcher 806 (e.g., for transport inside and outside an ambulance or through a building of a medical institution) having one or more adjustable limb restraints 804a, 804 connected to one or more rails 810 of the portable stretcher 806. The adjustable limb restraints 804a, 804 can share the features of the adjustable limb restraints 104a, 104, 604a, 604b described in detail above, including a handle body and a connection assembly that are operable to lock releasably in a customized configuration. The adjustable limb restraint 804 includes a protective sleeve (similar to sleeve 130 described above), and the protective sleeve for the adjustable limb restraint 804a is not intentionally shown in FIG. 8A for illustrative purposes. In another example, as shown in FIG. 8B, system 850 includes a stretcher board 856 (e.g., configured to receive a patient for transport by one or more users carrying the stretcher board) having a set of adjustable limb restraints 854 connected to the side edges of the portable stretcher 856 (in a longitudinal position) between one or more handles 860. The adjustable limb restraints 854 can share the features of the adjustable limb restraints 104a, 104, 604a, 604b, 804 described in detail above, including a handle body and a connection assembly that are operable to lock releasably in a customized configuration. The adjustable limb restraint 854 can include a protective sleeve (e.g., similar to protective sleeve 130), and the protective sleeve is not intentionally shown in FIG. 8B for illustrative purposes.

[0036] Referring now to FIG. 9, some aspects of a system 900 for positioning a patient can include one or more adjustable restraint devices 904 that use a deformable internal wire structure to maintain a customized shape of the cuff body. For example, each restraint system 904 can include a deformable metal wire structure that extends longitudinally within a padded outer body, and the deformable metal wire structure can be plastically deformed by a user to assume a customized configuration that rounds or bends to engage the patient's limb. Thus, each adjustable restraint device 904 can be formed into various shapes to hold the patient in a fixed position on an operating table or surgical transport device. Each restraint system 904 can include a padded cover that shares features with the protective sleeve 130 described above. In some aspects, the restraint system 904 can include a mattress extension 909 that extends under the mattress resting on the operating table to connect the restraint systems together and to connect the restraint systems to the operating table 906.

[0037] Referring now to FIGS. 10A - B, some aspects of a system 1000 for positioning a patient can include one or more adjustable restraint devices 1004 that use a vacuum pouch structure filled with a foaming material (e.g., foaming pellets). In such aspects, the vacuum pouch structure is adjustable to a customized configuration (e.g., a rounded configuration for engaging a patient's limb), and a vacuum source can be applied inside the vacuum pouch structure to compress the foaming material inside the pouch, thereby holding the selected shape. Each of the adjustable restraint devices 1004 can include a handle body 1018 that can connect the restraint system 10004 to the operating table in a manner similar to the handle body 118 described above. The handle body 1018 can include a handle 1070 that can be actuated to apply a vacuum source inside the vacuum pouch structure. In some embodiments, the handle actuator can be configured as a manual pump handle, such that by repeatedly actuating the handle actuator, air can be manually pumped out of the vacuum pouch structure to create a vacuum therein, locking the adjustable restraint device 1004 into the selected configuration.

[0038] This specification includes many specific implementation details, but these details should not be construed as limitations on the scope of the disclosed technology or what may be claimed, but rather as descriptions of features that may be particular to specific aspects of the disclosed technology. Specific features described in the context of separate aspects herein can also be implemented, in part or in whole, in a single aspect. Conversely, various features described in the context of a single aspect can also be implemented separately in multiple aspects or as any suitable partial combination. Further, features may be described and initially claimed herein as operating in a particular combination, but one or more features from the claimed combination may in some cases be excluded from that combination, and the claimed combination may be directed to a partial combination or a variation of a partial combination. Similarly, operations may be described in a particular order, but this should not be understood as requiring that such operations be performed in that particular order or sequentially, nor as requiring that all operations be performed, whether as necessary to achieve the desired result or otherwise. Specific aspects of the subject matter have been described. Other aspects are included within the scope of the appended claims.

[0039] Accordingly, other embodiments are included within the scope of the appended claims.

Claims

**Claim 1** A flexible cuff system for releasably maintaining a body limb position, comprising: a flexible cuff body adjustable from a first orientation to a customized orientation to hold a limb in a selected position relative to a medical support; and a handle body connected to a base of the flexible cuff body, the handle body including a handle movable between a locked position and an unlocked position and defining a mating interface that slidably engages the medical support. Including in response to the handle being moved to the unlocked position, the flexible cuff body is adjustable from the first orientation to the customized orientation so as to extend around the limb; in response to the handle being moved to the locked position while the flexible cuff body is in the customized orientation, the flexible cuff body is locked in the customized orientation to hold the limb in the selected position relative to the medical support. A flexible cuff system for releasably maintaining a body limb position. **Claim 2** The flexible cuff system according to claim 1, wherein the flexible cuff body includes a series of links adjustably connected to each other; and a fluid-impermeable sleeve with a pad, defining an inner pocket open at one end for slidably attaching the fluid-impermeable sleeve with the pad over the series of links. The flexible cuff system according to claim 1. **Claim 3** The flexible cuff system according to claim 2, further comprising one or more cables extending from the handle body through the interior of the series of links of the flexible cuff body. The flexible cuff system according to claim 2. **Claim 4** The flexible cuff system according to claim 3, wherein the handle is connected to the one or more cables such that in response to the handle being moved to the locked position, the handle applies tension to the one or more cables to hold each link in the series of links in a fixed position locked relative to an adjacent link in the series of links. **Claim 5** The flexible cuff system according to any one of claims 2 to 4, wherein in response to the handle being moved to the unlocked position, the series of links are pivotable relative to each other to adjust the overall shape of the series of links. **Claim 6** The flexible cuff system according to any one of claims 2 to 5, wherein the flexible cuff body extends away from the handle body towards a free end of the flexible cuff body. **Claim 7** The flexible cuff system according to any one of claims 2 to 6, wherein the fitting interface of the handle body is configured to slidably engage with a rail of an operating table.

8. The flexible cuff system according to any one of claims 2 to 7, wherein the fitting interface of the handle body is configured to slidably engage with a side surface of a stretcher.

9. The flexible cuff system according to any one of claims 2 to 8, wherein the fitting interface of the handle body is configured to slidably engage with an arm board extending from an operating table.

10. The flexible cuff system according to claim 1, wherein the base of the flexible cuff body extends upward above the handle body, while a series of links of the flexible cuff body extend away from the handle body toward the free end of the flexible cuff body.

11. The following: The operating table including one or more rails extending along one or more sides of the operating table; A flexible cuff body adjustable from a first orientation to a customized orientation to hold a limb in a customized position relative to the operating table; A handle body including a handle connected to the base of the flexible cuff body and movable between a locked position and an unlocked position, the handle body defining a fitting interface that slidably engages at least one of the one or more rails; Each including, In response to the handle being moved to the unlocked position, the flexible cuff body is adjustable from the first orientation to the customized orientation so as to extend around the limb; In response to the handle being moved to the locked position while the flexible cuff body is in the customized orientation, the flexible cuff body is locked in the customized orientation to hold the limb in the selected position relative to the operating table; A plurality of adjustable limb restraints releasably lockable at selectable positions along the one or more rails of the operating table; A system including.

12. The flexible cuff body includes A connection assembly including a series of links adjustably connected to each other; A protective sleeve positioned on the connection assembly; The system according to claim 11 including.

13. The system of claim 12, wherein in response to the handle being moved to the unlock position, the series of links are movable relative to each other to adjust the flexible cuff body to the customized orientation that extends around the limb.

14. The system according to any one of claims 12-13, wherein in response to the handle being moved to the lock position, the series of links are mechanically fixed relative to each other to releasably lock the flexible cuff body in the customized orientation.

15. The system according to any one of claims 12-14, wherein in response to the handle being moved to the unlock position, the series of links are pivotable relative to each other to adjust the overall shape of the flexible cuff body.

16. The system according to any one of claims 11-15, wherein a first set of the plurality of adjustable limb restraints is positioned on a first side of the operating table, and a second set of the plurality of adjustable limb restraints is positioned on a second, opposing side of the operating table.

17. The system according to any one of claims 11-16, wherein each of the plurality of adjustable limb restraints operates independently of the others.

18. Each of the flexible cuff bodies of the adjustable limb restraints is positioned on an internal mechanism including at least one of a connection assembly, a deformable wire structure, and a vacuum pouch structure, and a protective outer sleeve The system of claim 11.

19. The system according to any one of claims 11-18, wherein each of the adjustable limb restraints is slidably fitted to the one or more rails and is releasably lockable to the one or more rails at a selected longitudinal position relative to the operating table.

20. A method of maintaining a position of a limb, comprising the steps of: releasably locking a handle body of an adjustable limb restraint to a rail of a medical substrate at a selected position relative to a limb on the medical substrate; adjusting a flexible cuff body of the adjustable limb restraint to a selected shape so as to wrap around and engage the limb; and adjusting an actuator on the handle body of the adjustable limb restraint to releasably lock the flexible cuff body in the selected shape.

21. the step of adjusting the flexible cuff body comprising swiveling a series of links of the flexible cuff body, which are adjustably connected to each other and disposed within a padded sleeve of the flexible cuff body The method of claim 20, comprising **Claim 22** The method of claim 21, wherein in response to the step of adjusting the actuator on the handle body, the series of links are mechanically fixed relative to each other to releasably lock the flexible cuff body in the selected shape **Claim 23** The method according to any one of claims 20 to 22, wherein the limb is an arm, a leg, or a torso **Claim 24** The step of releasably locking the handle body of the adjustable limb restraint to the rail comprises clamping the rail by adjusting a mating recess defined on a first side of the handle body and a downwardly extending clamp actuator to a grippable position below both the mating recess and the rail The method according to any one of claims 20 to 22, comprising **Claim 25** the step of adjusting the flexible cuff body comprising swiveling a series of links of the flexible cuff body, which are adjustably connected to each other and disposed within an inner pocket of a fluid-impermeable padded sleeve slidable over the series of links and open at one end The method of claim 24, comprising swiveling the series of links **Claim 26** The step of adjusting the actuator on the handle body comprises swiveling the handle from an unlocked position where a free end of the handle is received within a handle cavity defined on a second side of the handle body opposite the mating recess on the first side of the handle body to a locked position where the free end of the handle extends downwardly below the handle cavity The method of claim 25, comprising **Claim 27** The following A flexible cuff body that wraps around a limb and is adjustable from a first orientation to a user-selected orientation to hold the limb in a selected position relative to a medical support, the flexible cuff body comprising a series of links adjustably connected to each other a fluid-impermeable padded sleeve defining an inner pocket open at one end for slidably mounting the fluid-impermeable padded sleeve over the series of links and a flexible cuff body; and A handle body connected to a base of the flexible cuff body such that the base of the flexible cuff body extends upwardly above the handle body. A handle cavity defined on a first side of the handle body, and The handle movable between a locked position and an unlocked position where a free end of the handle is received within the handle cavity comprising To slidably engage the medical support, a mating interface is defined on a second side of the handle body opposite the handle cavity on the first side of the handle body; a clamp actuator extending downwardly to a grippable position below both the mating interface and the handle cavity and adjustable to releasably clamp the mating interface to a selected position along the medical support. A handle body comprising In response to the handle being moved to the unlocked position, the flexible cuff body is adjustable from the first orientation to the user-selected orientation so as to extend around the limb. In response to the handle being moved to the locked position while the flexible cuff body is in the user-selected orientation, the flexible cuff body is locked in the user-selected orientation to hold the limb in the selected position relative to the medical support. A flexible cuff system for releasably maintaining a patient's position.

28. Extending from the handle body through the series of links of the flexible cuff body and Adjusted in response to the handle being moved to the locked position such that one or more cables bias each link within the series of links to lock with an adjacent link within the series of links. Said one or more cables The flexible cuff system according to claim 27, further comprising.

29. The flexible cuff system according to claim 28, wherein the one or more cables extend through the interior of the series of links of the flexible cuff body.

30. The handle is mechanically connected to the one or more cables and In response to the handle being moved to the locked position, the handle applies tension to the one or more cables to fix the flexible cuff body in the user-selected orientation. The flexible cuff system according to any one of claims 28 to 29.

31. In response to the handle being moved to the unlock position, each link within the series of links that locks becomes rotatable about its respective pivot axis with respect to an adjacent link within the series of links, the flexible cuff system according to any one of claims 27 to 30.

32. The flexible cuff body extends away from the handle body toward the free end of the flexible cuff body, the flexible cuff system according to any one of claims 27 to 31.

33. The free end of the flexible cuff body includes a fastener configured to connect to a second flexible cuff body, the flexible cuff system according to claim 32.

34. The mating interface of the handle body is configured to slidably engage with a rail of an operating table, the flexible cuff system according to any one of claims 27 to 33.

35. The mating interface of the handle body is configured to slidably engage with a side surface of a stretcher, the flexible cuff system according to any one of claims 27 to 34.

36. The mating interface of the handle body is configured to slidably engage with an arm board extending from the operating table, the flexible cuff system according to any one of claims 27 to 34.

37. The following: The operating table including one or more rails extending along one or more sides of the operating table; A flexible cuff body extending around a limb and adjustable from a first orientation to a user-selected orientation to hold the limb in a user-selected position relative to the operating table, and A handle body connected to a base of the flexible cuff body and defining a mating interface for slidably engaging with an adjacent rail of the one or more rails, wherein the base of the flexible cuff body extends upwardly away from both the mating interface of the handle body and the adjacent rail of the operating table, and the handle body includes the handle rotatable between a locked position where the handle extends downwardly below the adjacent rail and an unlocked position where the handle extends upwardly above the adjacent rail, the handle body Each including, In response to the handle being moved to the unlock position, the flexible cuff body becomes adjustable from the first orientation to the user-selected orientation so as to extend around the limb. In response to the handle being moved to the locked position while the flexible cuff body is in the user-selected orientation, the flexible cuff body is locked in the user-selected orientation to hold the limb in the selected position relative to the operating table. A plurality of adjustable limb restraints that are releasably lockable at selectable positions along the one or more rails of the operating table comprising a system.

38. The flexible cuff body is a linkage assembly including a series of links adjustably connected to each other, an end opening sized to slidably receive the free end of the linkage assembly into an inner pocket of the fluid-impermeable pad-equipped sleeve such that the fluid-impermeable pad-equipped sleeve is slidably mounted to cover the series of links from the free end of the linkage assembly to the base of the flexible cuff body, the fluid-impermeable pad-equipped sleeve The system according to claim 37, comprising.

39. In response to the handle being moved to the unlocked position, the series of links are movable relative to each other to adjust the flexible cuff body to the user-selected orientation in a shape that extends around the limb. The system according to claim 38.

40. In response to the handle being moved to the locked position, the series of links are mechanically fixed relative to each other to releasably lock the flexible cuff body in the user-selected orientation. The system according to any one of claims 38 to 39.

41. In response to the handle being moved to the unlocked position, the series of links are pivotable relative to each other to adjust the overall shape of the flexible cuff body. The system according to any one of claims 38 to 40.

42. A first set of the plurality of adjustable limb restraints is positioned on a first side of the operating table, and a second set of the plurality of adjustable limb restraints is positioned on a second, opposite side of the operating table. The system according to any one of claims 37 to 41.

43. Each of the plurality of adjustable limb restraints operates independently of each other. The system according to any one of claims 37 to 42.

44. The flexible cuff body of each of the adjustable limb restraints is A protective outer sleeve positioned on an internal mechanism including at least one of a connection assembly, a deformable wire structure, and a vacuum pouch structure The system according to claim 37, comprising

45. The system according to any one of claims 37 to 44, wherein each of the adjustable limb restraints is slidably fitted to the one or more rails and is releasably lockable to the one or more rails at a selected longitudinal position relative to the operating table

46. The following A flexible cuff body that wraps around a body limb from a first orientation and is adjustable to a rounded orientation for engaging the body limb in a stationary position relative to the operating table The following A series of longitudinally extending links, each link in the series having a transverse link width greater than the longitudinal link length and being pivotable about a transverse axis of a respective pivot joint relative to an adjacent link in the series An inner pocket opening at a first end and having the closed end opposite the first end, such that a free end of the series of links can be slidably inserted through the inner pocket opening for housing within the closed end of the padded sleeve, the padded sleeve A flexible cuff body including; and A handle body configured to releasably clamp onto the operating table and connected to the flexible cuff body such that the series of links of the flexible cuff body extend away from the handle body A handle movable between an unlocked position in which each link in the series of links is pivotable about the transverse axis of the respective pivot joint and a locked position in which each link in the series of links is mechanically constrained from the transverse axis of the respective pivot joint A handle body including A system for releasably maintaining the position of a patient on an operating table including

47. The padded sleeve is A flat outer surface configured to at least partially wrap around and contact the body limb while the flexible cuff body is in the rounded orientation The system according to claim 46, comprising

48. The flat outer surface of the padded sleeve is Having a width greater than the transverse link width and Having a longitudinal length extending from the first end to the closed end greater than the width The system according to claim 47

49. The system according to any one of claims 47 to 48, wherein the flat outer surface of the sleeve with the pad contains a fluid-impermeable material.

50. Extending from the handle body through the interior of the series of links of the flexible cuff body, and Adjusted in response to the handle being moved to the locked position, so that one or more cables bias each link within the series of links to lock with an adjacent link within the series of links, The one or more cables The system according to any one of claims 46 to 49, further comprising.

51. The handle is mechanically connected to the one or more cables, and In response to the handle being moved to the locked position, the handle applies tension to the one or more cables to fix the flexible cuff body in the user-selected orientation. The system according to claim 50.

52. In response to the handle being moved to the unlocked position, each link within the series of links that locks becomes rotatable about the transverse axis of the respective swivel joint with respect to the adjacent link within the series of links. The system according to any one of claims 50 to 51.

53. The handle body, The handle cavity defined on a first side of the handle body and shaped to receive the handle within the handle cavity Including, The handle body defines a mating interface on a second side of the handle body opposite the handle cavity on the first side of the handle body for slidably engaging the operating table. The system according to any one of claims 46 to 52.

54. The handle body is connected to the base of the flexible cuff body such that the base of the flexible cuff body extends upwardly above the handle body, The handle body, A clamp actuator extending downwardly to a grippable position below both the mating interface and the handle cavity and adjustable to releasably tighten the mating interface to a selected position along the medical support. Including, The system according to claim 53.

55. A method of maintaining the position of a patient on an operating table, comprising the following steps: The step of releasably locking the handle body of the adjustable limb restraint to the rail of the operating table at a selected rail position with respect to the limb of the patient on the operating table; While the handle body of the adjustable limb restraint is releasably locked to the rail of the operating table, the step of rolling up the flexible cuff body of the adjustable limb restraint in a user-selected orientation, such that the flexible cuff body at least partially wraps around and engages the limb of the patient; and While the flexible cuff body of the adjustable limb restraint is in the user-selected orientation and engaged with the limb of the patient, the step of adjusting an actuator on the handle body of the adjustable limb restraint to releasably lock the flexible cuff body in the selected shape.

56. The step of releasably locking the handle body of the adjustable limb restraint to the rail, comprises clamping the rail by adjusting a fitting recess defined on a first side of the handle body and a downwardly extending clamp actuator to a position below both the fitting recess and the rail where they can be gripped. The method according to claim 55.

57. The step of adjusting the flexible cuff body, comprises adjusting a series of links of the flexible cuff body positioned within a closed pocket of a fluid-impermeable pad-attached sleeve that are pivotally connected together. The method according to any one of claims 55 to 56.

58. The series of links extend longitudinally within the fluid-impermeable pad-attached sleeve, each link within the series of links has a transverse link width greater than the longitudinal link length, and is pivotable about the transverse axis of each respective pivot joint with respect to adjacent links within the series of links. The method according to claim 57.

59. The step of adjusting the actuator on the handle body, comprises pivoting the handle from an unlocked position where the free end of the handle is received within a handle cavity defined on a second side of the handle body opposite the fitting recess on the first side of the handle body, to a locked position where the free end of the handle extends downwardly below the handle cavity. The method according to any one of claims 55 to 58.

60. The step of rolling up the flexible cuff body in the user-selected orientation, Adjusting the flat outer surface of the padded sleeve of the flexible cuff body to at least partially wrap around and contact the limb The method according to any one of claims 55 to 59, comprising:

61. The method according to claim 60, wherein the flat outer surface of the padded sleeve extends from a first end to a closed end of the padded sleeve and has a longitudinal length greater than the lateral width of the flat outer surface.

62. In response to the step of adjusting the actuator on the handle body, a series of internal mechanical links of the flexible cuff body are mechanically fixed relative to each other so as to releasably lock the flexible cuff body in the selected shape. The method according to any one of claims 55 to 61.

63. The method according to any one of claims 55 to 62, wherein the limb of the patient is the patient's arm, leg, or torso.

64. A flexible cuff body adjustable in a user-selected orientation so as to at least partially wrap around a limb; and A handle body connected to the first end of the flexible cuff body and defining a mating interface for releasably engaging a medical support A system for releasably maintaining the position of an object, comprising:

65. The flexible cuff body is A series of links adjustably connected to each other and extending away from the handle towards the free end of the flexible cuff body; and The fluid-impermeable padded sleeve defining an inner pocket open at one end for slidably attaching a fluid-impermeable padded sleeve covering the series of links The system according to 64, comprising:

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