Instrument Insider

Table Talk

Manufacturers come up with new ways to meet the needs of surgeons and their patients.

By René Luthe, Senior Associate Editor

For 21st century ophthalmic surgery, clinicians need chairs and gurneys that can not only transport the patient into the operating room, but position themselves in ways that make the patient most accessible — and most stable. On top of these needs, surgeries such as cataract extraction require different features in a table than corneal surgeries do.

Yet while the needs of state-of-the-art eye surgeries make the old-fashioned operating table seem rather obsolete, manufacturers are managing to keep up. Recent entries to the field look at surgery from the perspectives of both physicians and patients.

Surgeon/Patient Needs

According to Kevin McWilliams, manager of VisionEquip, a quality operating table/chair for ophthalmic procedures addresses patient comfort, of course, but also relieves the staff of the burden of lifting the patient. This not only eliminates the danger of staff sustaining an injury during the lift, but means that only one person is needed to operate the lift controls. This increases OR efficiency.

The chair must also allow for plenty of leg room for the surgeon. This is particularly important for cataract surgeons who are using a phaco pedal and a scope pedal.

Another aspect practices need to consider when they are shopping for a new gurney/table/chair, says Jeff Baker, president of MTI, Inc., is whether they want their staff to try to handle larger patients on a stretcher — or in a power chair. A chair's advantage for this type of patient, Mr. Baker points out, is that they are lower in height than a gurney and allow the patient to back into them and simply sit down. He describes the power chairs as more “user-friendly” for larger patients to get in and out of, as well as for elderly patients.

Another advantage of power chairs is that they reduce the stress on the patient when the surgeon needs to adjust his position. “A power-operated chair or gurney moves the patient in a coordinated motion, so they don't feel the stress of somebody pumping up the chair and maybe trying to raise their legs and put a pillow underneath their knees,” Mr. Baker says.

Further, he points out, the headrests on gurneys usually do not offer good adjustability or stability, creating problems for both surgeon and patient.

For the Cataract Practice

In addition to room beneath for the surgeon's legs and the phaco pedal, a gurney or chair for cataract surgery must facilitate the rapid patient turnover doctors require. To accomplish this, many practices have the patient stay on one gurney, or stretcher, from the time they are prepared preopera-tively to the operating room, to postop recovery, with the patient never leaving the stretcher.

On the other hand, gurneys don't have the power option for adjusting the patient's position that chairs often do. One way around this is the chair that becomes a surgical table. This allows the patient to sit down in a chair that can then be reclined into a flat surface; after surgery, the table can be “morphed” back into a chair at the touch of a button and the patient returned to an upright position to exit the chair.

The Refractive Perspective

Practices seeking an operating table/chair for refractive surgery have their own considerations. Because operating chairs are usually used in conjunction with an instrument stand and lasers, surgeons need to be able to change the seated patient's orientation from straight up to approximately 45-degrees reclined — while the patient is still in the seated position.

Here again, motorized positioning capability allows for more precise adjustment than mechanically operated chairs do. The hand-held or foot-pedal controls some models offer enable the surgeon to reposition the patient with ease, even in the middle of a procedure.

For other corneal procedures, as well as oculoplastic and retinal procedures, battery-operated chairs may not be appropriate. Because these procedures are often of longer duration than cataract surgeries, the tables/reclining chairs need to be stable above all else, says Mr. Baker.

“A fixed power surgical table is necessary,” he says. “It can be moved from side to side for cleaning, etc., but this table is made to be in one place and operate off of a 115-volt house-type current.”

With manufacturers so attuned to the needs of contemporary surgery, shopping for a new table should be a rewarding experience. OM