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A Perineal Prostatectomy Table
THE JouRNAL~OF UnoLOGY
Vol. 62, No. 4, October 1949 Printed in:U.S.A.
A PERINEAL PROSTATECTOMY TABLE ARTHUR B. CECIL
1 Any modern surgical table, by means of the accessories which I have devised, can be instantly converted into an ideal table for perineal prostatectomy. The new and basic idea which I have introduced is the sliding leg supports.
Fm. 1. Cecil's accessories for perineal prostatectomy fitted to American Sterilizer Co. table, as used in Hospital of the Good Samaritan, Los Angeles.
All tables which have heretofore been devised for perinea! prostatectomy have had fixed leg supports which necessitated the movement of the entire body of the patient down on the table for the simple purpose of flexing the thighs. The perineal prostatectomy position is brought about principally by flexion of the thighs. Flexion of the thighs causes a lifting of the buttocks and the lower part of the back. For the support of the back, I have devised a sponge rubber cushion. This cushion must be of sufficient density to give adequate support and not too easily crushed. For further adaptation of the patient to the perinea! prostatectomy position, it is sometimes valuable to slightly Trendelenburg the table. All surgical tables are equipped with slides on runners on each side. Shoulder supports come with the table. The only necessary pieces to convert the surgical table into a perineal prostatectomy table are the two leg supports which are set off at the distance of the original Halsted board supports, a distance which has been found satisfactory for thousands of patients of any build, and in addition a 492
A PERINEAL PROSTATECTOMY TABLE
493
Frn. 2. One of leg supports, showing two steps for adaption to slides of most surgical tables.
Frn. 3. A, table and sponge rubber cushion with one standard up for reception of patient. B, patient in perinea! prostatectomy position.Note that leg supports have been slid toward patient's head to support thighs in proper position. Patient's body has not been moved.
sponge rubber cushion. The leg supports are made with two steps on them so that they will fit most operating room tables, but not all. Should the hospital where the surgeon works have additional tables, another step could be easily added. The method of using the table is as follows: Drop the lower segment of the table. Have the table as low as it will go with the shoulder pieces in approximate position and the cushion on the table ·with one leg support in position. The patient is lifted onto the table, the lower part of the back and buttocks on the rubber cushion and one leg hooked over one of the
ARTHUR B. CE Cit
leg supports. The other leg support is then stuck into the slide. The operator now -flexes one thigh to the point where the perineum is in the perineal prostatectomy position, and the leg support is slid back to hold the thigh in this position. The other thigh is then flexed and the leg support is pushed back to an equal position. It is not necessary to lock the leg supports, as the eccentric position of the thighs will hold them fixed. The sponge rubber cushion requires no adjusting. The accompanying illustrations (figs. 1, 2, 3) demonstrate the table and its use. The advantages of these attachments are these: It is not necessary to have an extra table to put on top of a surgical table. Any operating room table is adaptable. The sliding leg supports permit of any position of the perineum that the operator is accustomed to or may desire. The perineal prostatectomy table is put into position with the greatest of ease in the shortest possible time and with the least trouble to the nursing staff. These leg supports and sponge rubber cushion should be standard equipment for all modern surgical tables, and it is to be hoped that the equipment which I have described will become standard with the manufacturers of surgical tables and be supplied with them. These accessories may be procured from the R. L. Scherer Co., 2206 West Seventh Street, Los Angeles 14, Calif. Please address Mr. Theodore E. Skeva.
1136 W. Sixth St., Los Angeles 14, Calif.
Vol. 62, No. 4, October 1949 Printed in:U.S.A.
A PERINEAL PROSTATECTOMY TABLE ARTHUR B. CECIL
1 Any modern surgical table, by means of the accessories which I have devised, can be instantly converted into an ideal table for perineal prostatectomy. The new and basic idea which I have introduced is the sliding leg supports.
Fm. 1. Cecil's accessories for perineal prostatectomy fitted to American Sterilizer Co. table, as used in Hospital of the Good Samaritan, Los Angeles.
All tables which have heretofore been devised for perinea! prostatectomy have had fixed leg supports which necessitated the movement of the entire body of the patient down on the table for the simple purpose of flexing the thighs. The perineal prostatectomy position is brought about principally by flexion of the thighs. Flexion of the thighs causes a lifting of the buttocks and the lower part of the back. For the support of the back, I have devised a sponge rubber cushion. This cushion must be of sufficient density to give adequate support and not too easily crushed. For further adaptation of the patient to the perinea! prostatectomy position, it is sometimes valuable to slightly Trendelenburg the table. All surgical tables are equipped with slides on runners on each side. Shoulder supports come with the table. The only necessary pieces to convert the surgical table into a perineal prostatectomy table are the two leg supports which are set off at the distance of the original Halsted board supports, a distance which has been found satisfactory for thousands of patients of any build, and in addition a 492
A PERINEAL PROSTATECTOMY TABLE
493
Frn. 2. One of leg supports, showing two steps for adaption to slides of most surgical tables.
Frn. 3. A, table and sponge rubber cushion with one standard up for reception of patient. B, patient in perinea! prostatectomy position.Note that leg supports have been slid toward patient's head to support thighs in proper position. Patient's body has not been moved.
sponge rubber cushion. The leg supports are made with two steps on them so that they will fit most operating room tables, but not all. Should the hospital where the surgeon works have additional tables, another step could be easily added. The method of using the table is as follows: Drop the lower segment of the table. Have the table as low as it will go with the shoulder pieces in approximate position and the cushion on the table ·with one leg support in position. The patient is lifted onto the table, the lower part of the back and buttocks on the rubber cushion and one leg hooked over one of the
ARTHUR B. CE Cit
leg supports. The other leg support is then stuck into the slide. The operator now -flexes one thigh to the point where the perineum is in the perineal prostatectomy position, and the leg support is slid back to hold the thigh in this position. The other thigh is then flexed and the leg support is pushed back to an equal position. It is not necessary to lock the leg supports, as the eccentric position of the thighs will hold them fixed. The sponge rubber cushion requires no adjusting. The accompanying illustrations (figs. 1, 2, 3) demonstrate the table and its use. The advantages of these attachments are these: It is not necessary to have an extra table to put on top of a surgical table. Any operating room table is adaptable. The sliding leg supports permit of any position of the perineum that the operator is accustomed to or may desire. The perineal prostatectomy table is put into position with the greatest of ease in the shortest possible time and with the least trouble to the nursing staff. These leg supports and sponge rubber cushion should be standard equipment for all modern surgical tables, and it is to be hoped that the equipment which I have described will become standard with the manufacturers of surgical tables and be supplied with them. These accessories may be procured from the R. L. Scherer Co., 2206 West Seventh Street, Los Angeles 14, Calif. Please address Mr. Theodore E. Skeva.
1136 W. Sixth St., Los Angeles 14, Calif.