TOTIM® Patient Cushions Immobilization System Ophthalmology

 Single Patient / Single Use

TOTIM Patient Cushion Immobilization System is used for positioning and immobilizing adult and pediatric patients undergoing eye surgery in order to ensure more comfort to the patient and the surgeon.

Fully sealed, its outer material is microfiber polyester cushion that contains two reagents inside which must be mixed to obtain a polyurethane foam. After a short time the polyurethane foam solidifies taking the shape of the patient's head.

It is utilized in: ocular surface surgery - limbal stem cells transplantation - corneal surgery, also by Femtosecond Laser - complex cataract surgery or in patients at risk - glaucoma surgery - anterior segment surgery - posterior segment surgery - strabismus surgery and use of Botulinum Toxin - ophthalmology surgery in children under general anesthesia

 
INDICATIONS:
The cushions allows the patient to find a more comfortable position during surgery.  

PATIENT POSITION SINGLE PATIENT and USE

PATIENT HAS AN ALTERATION OF THE SPINE OR NECK: TRENDELENBURG POSITION

  • It only works for patients who can tolerate this position, therefore it is not suitable for many older patients who may have coexistent orthopnoea
  • Because the head is lower than the rest of the body, venous engorgement can be expected
  • This may cause vitreous bulge: for cataract surgery, this can be compensated for by raising the height of the infusion bottle
MAIN MEDICAL CONDITIONS RESPONSIBLE FOR A DIFFICULT POSITION 

1. PROBLEMS CONCERNING THE PATIENT

Patient with spine alterations or neck rigidity (Kyphosis, lordosis, gibbosity)
Patients who cannot maintain the supine position for a long (obstructive pulmonary disease, heart failure, muscular dystrophies, cerebral palsy)
Patient with obesity

2. PROBLEMS CONCERNING THE SURGEON
The solidified cushion acts as a support for the surgeon, facilitating the execution of delicate maneuvers in difficult positions:

Deep sunken - Surgery in which trendelemburg or anti-trendelemburg position is required to modify IOP: custom cushion allows the head to be kept flat

3. OTHER APPLICATION

The cushion could be useful during the post-operative course, when it is necessary for the success of the surgery that the patient maintains a certain position for a long time (vitreoretinal and corneal surgery)
The patient will be more comfortable and the result will be better 

WITH SIMPLE MODIFICATIONS TO THE PATIENT'S POSITION, SURGERY COULD REMAIN COMPLICATED

PATIENT CANNOT HAVE CHEST FLAT, BUT HAS FLEXIBLE NECK: PATIENT SEATED UPRIGHT, SURGEON STANDING
  • This is the case of a patient with orthopnoea (heart failure or severe COPD), but has a flexible spine so they can extend the neck
  • The head is adjusted so that the patient can extend the neck, and look up to the overhead microscope
  • A surgeon of average height will find more comfortable to stand in vertical position
AVAILABLE OPTIONS:
PATIENT CANNOT HAVE CHEST FLAT AND CANNOT EXTEND NECK: FACE-TO-FACE UPRIGHT SEATED POSITIONING
For face-to-face surgery, the patient sits upright and comfortable on the surgical chair
The microscope is rotated forwards to face the eye and the surgeon sits (or stands) facing the patient
It is necessary to have a microscope that can be rotated forward, so it faces more horizontally than vertically
Because the eye is higher above the floor than normal, the infusion bottle height should be raised accordingly

PATIENT CANNOT HAVE CHEST FLAT, BUT HAS FLEXIBLE NECK: PATIENT SEATED UPRIGHT, SURGEON STANDING
This is the case of a patient with orthopnoea (heart failure or severe COPD), but has a flexible spine so they can extend the neck
The head is adjusted so that the patient can extend the neck, and look up to the overhead microscope
A surgeon of average height will find more comfortable to stand in vertical position

Technical Characteristics: TOTIM Patient Cushion Immobilization System is used for positioning/immobilizing adult and pediatric patients undergoing eye surgery in order to ensure more comfort to the patient and the surgeon.
Cushion with external cover in microfiber polyester comfortable and absorbent water repellent non-woven material, markable, washable/easily sanitized - temperature controlled exothermic reaction - the short window of time required for solidification allows for the correct modeling.

Materials:
Cushion in Microfiber Polyester / PU (fully sealed) and internal pouch (fully sealed) with inside the two reagents ready to be mixed.
Biocompatibility: ISO 10993-5:2009,  10993-12: 2012, ISO 10993-10: 2010


TOTIM is used in a healthcare facility / hospital. The device is intended to be used on adult and pediatric patients.  



Patent

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