Operating table
An operating table ( operating table ) is the table on which a patient comes to lie during a surgical procedure, the operation . It is used for the special positioning of this patient so that the surgeon has good access for the respective procedure. A modern operating table can be moved on a carriage and is attached to a column in the middle of the operating room for the procedure .
properties
The positioning of the operating table and thus the positioning of the patient in the center of the operating room are also based on the locations of other devices such as operating lights and other ceiling-mounted devices.
Operating tables can be moved and adjusted not only in height, but also in a variety of ways using a remote control. The lying surface is divided into segments that can be adjusted independently of each other. Basic functions are the height adjustability, the rotation of the table in the room, the raising or lowering of the head end and the raising of the upper body. Lateral inclination of the table top and the positioning of the arms and legs are added.
For decubitus prophylaxis when sedated or anesthetized patients and to other storage to prevent damage, operating tables are padded with mats or gel pads. The patient is secured against falling off with straps or fixing straps with Velcro . Head shells, armrests and more are available as accessories. Operating tables can be expanded and changed using the standard medical rails used in the European Union in accordance with DIN EN 19054, so that their equipment can be adapted to the respective procedure. For example, a retractor system can be attached to the rail. With other aids, such as the Ulm wheel , the supply and discharge lines for the monitoring and anesthesia guidance are securely attached. Operating tables for children are adapted in their dimensions to the smaller body size. You can work on them while sitting.
Operating tables are related to the dentist's chair and the gynecological chair , which are also used to position patients for interventions.
Requirements for operating tables
The requirements for the safety of operating tables are formulated in the European standard EN 60601-2-46 . They are medical devices and are therefore subject to the relevant legislation.
Operating tables must be resistant to liquids and disinfectants and can ideally also be cleaned and disinfected mechanically in a decontamination machine . You must also ensure electrical safety in a high-tech environment . When the patient is on a dry and non-conductive surface, this is the case when using electrosurgery and defibrillation . In the case of very overweight patients , it is taken into account that not every operating table is approved for a high body weight. Operating tables can, for example, be approved for 150 kg or for up to 225 or even 360 kg. In order to enable x-ray controls or fluoroscopy during the operation , the bed surface must be transparent to x-rays. Electrically heated operating tables were already known at the beginning of the 20th century. Warming up the patient is intended to counteract the cooling down during the operation or anesthesia, and thus prevent postoperative tremors . Warming mats on the table or warming up the patient with warm air perform this task today.
Mors in tabula
The Latin expression Mors in tabula , also Exitus in tabula , stands for the death of the patient on the operating table and found its way into medical terminology. Such an event can lead to the question whether the patient died of an illness, a fateful surgical complication or as a result of a treatment error.
history
In the 19th century, after patients were initially operated on in bed, there was a development from the hospital bed furniture to a special table based on human joints. The patient was not stable in a bed and the low working height was unsatisfactory for the surgeons. With the advancement of surgical techniques, asepsis and anesthesia, the demands on the equipment used increased. Operating tables were initially made of wood and were only fitted with castors and thus mobile from the end of the century. At the same time, steel established itself as a material. Friedrich Trendelenburg introduced the surgical positioning named after him in 1880 and in 1890 presented a segmented, adjustable operating table that made this positioning possible without the assistance of an assistant. The handwheels for operation were shifted towards the head end in order not to impair the sterility of the operating field. From the beginning of the 20th century, operating tables were also hydraulically adjustable, and from the end of the 1950s by electric motors. The system of the fixed column in the operating room with a separate table top has existed since the 1960s and made it easier for the patient to move around by saving weight. The development towards a microprocessor-controlled high-tech product was then driven forward by the medical technology industry.
The challenge of turning a simple table into the most functional device possible was described by Carl Emmert in 1850:
“Special tables and chairs have been constructed for the convenient positioning of the sick during operations. These devices are suitable for hospitals and are found there of very different properties. The most well-known operating tables designed according to various ideas include the one invented by Graefe and improved by Kluge on the one hand and the French or Parisian operating table on the other. […] We have succeeded in constructing and executing an operating table which, with the greatest possible simplicity and proper strength, does not merely combine the various advantages […], but also grants essential new ones. The tabletop of our operating table cannot simply be made higher and lower and rotated in one plane , but can also be inclined in the direction of its ends . […] In addition, the table can be made longer and shorter, not just giving the patient one on it movable backrest, but if necessary also a footrest and can be set up as a chair. "
literature
- Christian Krettek, Dirk Aschemann: Positioning techniques in the operating area . Springer, 2004, ISBN 978-3-540-65948-8 .
Web links
Individual evidence
- ↑ Gertraud Luce-Wunderle: Clinical Guide for OP Care, p. 76 . Elsevier, Urban & FischerVerlag, 2006, ISBN 978-3-437-26691-1 .
- ^ Rüdiger Kramme: Medical technology: procedures - systems - information processing, p. 838 ff. Springer, 2006, ISBN 978-3-540-34102-4 .
- ↑ Thomas Carus: Atlas of Laparoscopic Surgery . Springer, 2006, ISBN 978-3-540-33673-0 .
- ↑ Krettek, Aschemann, p. 77
- ↑ Albert Döderlein : Operative Gynäkologie, p. 103 . Published by Georg Thieme, 1907.
- ↑ B. Krönig: About electrically heated operating tables. in: Archives of Gynecology and Obstetrics, Springer Berlin / Heidelberg 1904, online: doi : 10.1007 / BF02058542
- ↑ tuwien.ac.at: Physiology and Basics of Pathology VD (MU / Sedivy) Lecture notes ( page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.
- ^ Wilhelm Holczabek : Mors in Tabula , in: German journal for judicial medicine, Vol. 42, pp. 385-389 (1953).
- ↑ Preuss, Dettmeyer, Madea: assessment alleged lethal and non-lethal medical malpractice specialist Forensic Medicine (nationwide multicenter study); Consequences for coordinated medical damage research . From the Institute for Forensic Medicine of the Rheinische Friedrich-Wilhelms-Universität Bonn On behalf of the Federal Ministry for Health and Social Security, 2005. Archived copy ( memento of the original from October 29, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. .
- ↑ Dirk Aschemann: OP bearings for specialist staff, p. 52 ff. Springer, 2008, ISBN 978-3-540-79316-8 .
- ↑ Krettek, Aschemann, pp. 74 ff.
- ^ Carl Emmert: Textbook of surgery: Textbook of general surgery, Volume 1 , Franckh Verlag, 1850, p. 137 [1]
