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The invention is concerned with cauterizing and resecting tissue. A pair of electrodes are placed on opposed tissue surfaces, and radio frequency power is applied through the electrodes to cauterizing a tissue mass therebetween. After cauterization has been effected, the tissue may be resected along a plane within the cauterized region with minimum or no bleeding. The tissue mass may then be removed.
1. A method for cauterizing tissue in a patient, said method comprising the steps of:
engaging a plurality of electrodes against surfaces of a tissue mass;
selectively applying high frequency power through said electrodes to said tissue mass;
providing each electrode with a unique power and energy delivery profile based on properties of said tissue in a specific electrode location/position;
setting threshold values associated with said electrodes;
monitoring said high frequency parameters power proximate to said electrodes and/or proximate to said tissue, and modulating said high frequency power based upon any two of the following parameters:
current, voltage, impedance, energy, power, and temperature;
determining whether the threshold values are reached based on said monitoring;
when a threshold value of said threshold values is reached, continuing providing power to the associated electrode for a certain period of time such that an appropriate endpoint is reached and to assure that cauterization is complete; and
reassigning power generator channels, which are assigned to electrodes for portions of the tissue and which have reached endpoints, to those electrodes that are still actively cauterizing the tissue.
2. A method as in
3. A method as in
4. A method as in
5. A method as in
6. A method for tissue cauterization, comprising the steps of:
cauterizing said tissue in whole or in part using radio frequency energy at least along a desired resection plane within said tissue; and
resecting said tissue along said plane;
said cauterizing step further comprising the steps of:
engaging a plurality of electrodes against one or more surfaces of said tissue;
providing a power supply having a plurality of channels that are selectively connectable to said electrodes for selectively applying radio frequency energy thereto, said power supply providing multiple, selectable adjustable settings that based on a tissue to be cauterized;
providing each electrode with a unique power and energy delivery profile based on properties of said tissue in a specific electrode location/position;
setting threshold values associated with said electrodes;
providing an automatic feedback system for modulating said power supply in real time based upon any of the following parameters:
current, voltage, impedance, energy, power, and temperature;
selectively supplying radio frequency energy to said electrodes from said power supply to apply said energy to said tissue through said electrodes to selectively energize different ones of said electrodes;
determining whether the threshold values are reached based on said automatic feedback system;
when a threshold value of said threshold values is reached, continuing providing power to the associated electrode for a certain period of time such that an appropriate endpoint is reached and to assure that cauterization is complete; and
reassigning particular channels of the plurality of channels, said particular channels assigned to electrodes for portions of the tissue and having reached endpoints, to those electrodes that are still actively cauterizing the tissue.
7. The method of
8. The method of
selectively energizing said electrodes with opposite polarity to provide for application of said radio frequency energy to said tissue.
9. The method of
10. The method of
11. The method of
12. The method of
13. The method of
14. The method of
15. The method of
16. The method of
17. The method of
using opposed, bipolar electrodes to concentrate energy flux between said electrodes and to limit effects on adjacent tissue which are not confined within the opposed electrodes.
18. The method of
forming said electrodes on a plurality of locations over a conformable support structure.
19. The method of
20. The method of
directing bipolar radio frequency energy at target tissue regions which are defined by spaced-apart placement of said electrodes.
21. The method of
22. The method of
using impedance matching transformers between said power supply and said electrodes to enhance efficiency of energy delivery.
23. The method of
directing radio frequency energy to limited portions of said tissue based upon a chosen configuration of said electrodes.
24. The method of
25. The method of
providing tissue-penetrating elements on or near said electrodes to both enhance electrical contact and to increase the total surface contact area between the electrode and the tissue.
26. The method of
27. The method of
dynamically rearranging electrical connections from said power supply to power said electrodes in a pattern.
28. The method of
dynamically isolating at least one electrode to permit powering said electrodes at different polarities.
29. The method of
selectively energizing two adjacent electrodes in a bipolar fashion, while leaving all other electrodes non-energized, to cauterize a limited tissue region.
30. The method of
selectively energizing said electrodes to achieve a desired pattern of electrode surface polarity.
31. The method of
positioning said electrodes along an electrosurgical probe, comprising a pair of jaws having a distal end and a proximal end, said electrosurgical probe comprising a handle assembly attached to said proximal end of said jaws, said handle comprising a lever assembly which is connected to actuate said electrodes after they are deployed.
32. The method of
providing parallel electrodes along a support surface, wherein positive-to-negative contact is prevented if opposing jaws and electrodes are brought into contact, wherein oppositely charged electrodes that are mounted in the same jaws are mounted in a non-conductive material to prevent shorting.
33. The method of
locating multiple electrodes physically in series;
wherein said electrodes are powered any of simultaneously, in a repetitive sequential or other series, or entirely independently of each other.
34. The method of
automatically terminating energy flow to said tissue once said power supply has determined completion of a tissue sealing cycle.
35. The method of
providing a prior characterization of each tissue to determine preset power supply output limits and curves, as well as final shutdown parameters based on any of, impedance, voltage, current, power, temperature, and energy.
36. The method of
issuing a test burst through said tissue for a test period to generate tissue profile data that are automatically programmed into an algorithm that optimizes any of the following parameters:
impedance, voltage, current, temperature, energy, and power.
37. The method of
sensing contact pressure between at least one of said electrodes and said tissue.
The application claims priority to U.S. Provisional Patent Application Ser. Nos. 60/725,720, filed Oct. 11, 2005, and 60/680,937, filed May 12, 2005, the entirety of each of which is incorporated herein by this reference thereto.
1. Field of the Invention
The invention relates generally to tissue cauterization. More particularly, the invention relates to an improved electrode for tissue cauterization.
2. Description of the Background Art
Tissue and organ removal are required in a number of surgical procedures for a number of purposes. A major concern in all tissue removal procedures is hemostasis, i.e. cessation of bleeding. All blood vessels supplying an organ or a tissue segment to be removed have to be sealed, either by suturing or cauterization, to inhibit bleeding when the tissue is removed. For example, when the uterus is removed in a hysterectomy, bleeding must be inhibited in the cervical neck which is resected, as well as along the vessels which supply blood to the uterus along its sides. Similarly, blood vessels within the liver must be individually sealed when a portion of the liver is resected in connection with removal of a tumor or for other purposes. The liver is a highly vascularized organ and sealing of the blood vessels is quite time consuming. Achieving hemostasis is necessary in both open surgical procedures and in minimally invasive surgical procedures. In the latter case, however, because of the limited access through cannula and other small passages, sealing of blood vessels can be even more time consuming and problematic.
Achieving hemostasis is particularly important in laparoscopic and other limited access procedures where the organ or other tissue must be morcellated prior to removal. Most organs are too large to be removed intact through a cannula or other limited access passage, thus requiring that the tissue be morcellated, e.g. cut, ground, or otherwise broken into smaller pieces, prior to removal. It will be appreciated that morcellation of vascularized tissue can be very problematic.
For these reasons, it would be desirable to provide improved methods, systems, and apparatus, for achieving hemostasis in connection with organ and tissue removal procedures. In particular, it would be desirable to provide methods and systems which permit a surgeon to achieve hemostasis in a time-efficient manner, using readily available surgical equipment e.g. radio frequency power supplies as discussed below, while reducing risk and trauma to the patient. It would be further desirable if the methods and systems are applicable to a wide variety of tissue removal procedures, including at least hysterectomies, liver tissue resection, cholecystectomies, prostate removal, lung resection, and the like. It would be still further desirable if the methods could provide for complete or substantially complete coagulation and hemostasis of an entire volume of tissue to be removed to facilitate such procedures as a subsequent morcellation. The ability to, for example, morcelate tissue while minimizing bleeding will be of substantial benefit to the performance of laparoscopic and other minimally invasive procedures, as well as other surgical procedures.
The use of radio frequency (RF) energy to necrose body organs or portions thereof is known. U.S. Pat. No. 4,979,948 describes a balloon electrode which is inflated in the interior of a uterus and used to apply RF energy to necrose the endothelial lining of the uterus. U.S. Pat. No. 3,845,771 describes a glove having flexible electrodes on the thumb and middle finger. The glove is intended for conducting RF current to conventional forceps, scalpels, etc. U.S. Pat. No. 4,972,846 describes electrode patch pairs useful as defibrillator leads which are engaged directly on the epicardium. U.S. Pat. Nos. 5,178,618 and 5,078,736 describe stents which can be energized to apply RF energy on the interior of a body lumen. Lorentzen et al. (1996) Min. Ivas. Ther. Allied Technol. 5:511-516 describes a loop electrode that can be rotated within tissue to excuse a tissue volume.
U.S. Pat. No. 6,203,541 discloses an automatic circuit that controls a surgical instrument, having a pair of bipolar electrodes. The circuit comprises a means for measuring the current between the pair of electrodes, an impedance detection circuit that is in electrical communication with the current measuring means, a comparator that has an electrical communication with the impedance detection circuit, and a controller that is electrically connected to the comparator. The impedance detection circuit calculates the impedance between the electrodes based on the measured currents and generates a first signal indicative of the calculated impedance. The comparator processes the first signal and generates an activation signal if the calculated impedance falls within a predetermined range of impedance values and generates a deactivation signal if the calculation impedance exceeds a deactivation threshold. The controller receives the activation and deactivation signals and transmits the first control signal to a radio frequency energy output stage to activate the electrodes in response to the activation signal and transmits the second control signal to the radio frequency output stage to deactivate the electrodes in response to the deactivation signal.
U.S. Pat. No. 6,398,779 teaches a method for electrosurgically sealing a tissue that concludes the steps of applying an initial pulse of RF energy to the tissue, the pulse having characteristics selected so as not to heat the tissue appreciably; measuring the value of the impedance of the tissue and response to the applied pulse; and in accordance with the measured impedance value, determining an initial set of pulse parameters for use during a first RF energy pulse as applied to the tissue. The invention teaches varying the pulse parameters of individual ones of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs during subsequent RF energy pulses. The method terminates the generation of subsequent RF energy pulses upon a determination that the electrical transient is absent or that a minimum output voltage has been reached.
U.S. Pat. No. 5,443,463 teaches a coagulating forceps for selectively coagulating blood vessels or tissue containing blood vessels. The method taught involves the placement of the blood vessels or tissue containing blood vessels between the prongs of the forceps, with the jaws of the forceps containing a plurality of electrodes which are energized by radio frequency power. A plurality of sensors are associated with the electrodes, and in contact with the vessels or tissue, to measure the temperature rise of the tissue or blood vessels and to provide a feedback to the radio frequency power to control the heating to perform coagulation of vessels or tissue. The invention also teaches that the upper prong of the device may be split into two parts with the cutting blade between the two upper parts to provide for cutting of the coagulated vessels subsequent to the coagulation.
The invention provides methods, systems, and apparatus which facilitate tissue cauterization in connection with such procedures as tissue resection and removal from patients undergoing a wide variety of procedures. The procedures may involve removal of an entire organ, e.g. hysterectomies, cholecystectomies, prostate removal, lung resection, and the like. Alternatively, the methods may involve removal of a portion of an organ or other tissue, such as tumor removal, often from highly vascularized organs, such as the liver, lung, or the like. The methods generally involve two steps, where the tissue is first necrosed or cauterized in whole or in part using radio frequency energy. In particular, the cauterization is effected at least along a desired resection plane within the tissue. The tissue is then resected along said plane(s). Advantageously, it has been found that resection within the necrosed or cauterized tissue substantially minimizes, and in some cases eliminates, the bleeding caused by the tissue resection. Preferably, the tissue cauterization is effected over a target volume of tissue, typically an entire organ or a portion thereof, e.g. the uterus, the lobe of a liver, a lung section, the prostate, or the like. By effecting substantially complete cauterization of a target tissue volume, the bleeding capacity of that tissue is reduced or eliminated, thus facilitating subsequent morcellization and tissue removal. Thus, organ and tissue removal is greatly facilitated with a substantial reduction in bleeding and the time needed for the surgical procedure.
In a first specific aspect, methods according to the invention comprise engaging at least a first electrode structure and a second electrode structure against spaced-apart surfaces of a tissue mass, typically against opposed surfaces of the tissue mass. The first and second electrode structures may have generally similar geometries to contact tissue in a symmetric fashion. Alternatively, the electrode structures may have dissimilar geometries, e.g. one of the electrode structures may be configured as a probe for insertion into a natural body orifice with the other electrode structure being configured for engagement against an exterior tissue surface spaced-apart from said orifice. In some instances, more than two electrode structures may be employed, but at least two electrode structures (or separate regions of a single structure) are energized with opposite polarity to provide for application of the radio frequency energy to the tissue. In some other instances, the electrode structures may be different regions formed as part of a single support structure, e.g. a single elastic tube or shell which may be placed over an organ or other tissue mass and which has two or more electrode surfaces formed thereon. The different electrode surfaces are, of course, isolated from each other when they are intended to apply high frequency energy of opposite polarities. It is equally important for the electrodes not be in contact if they are of like polarity as well. In still other instances, a single electrode structure may have a plurality of electrically conductive or active regions, where the electrically conductive regions may be energized with the same or an opposite polarity. In other instances, electrode structures may be provided with tissue-penetrating elements to enhance electrode-tissue contact and increase the total available area of the electrically active region(s) on the electrode structure to deliver high frequency energy to the tissue. The use of such tissue-penetrating elements may be in addition to or in place of the use of conformable or rigid surface electrodes. In all instances, the electrode structures, or electrically active regions thereof, are configured to engage a substantially continuous segment or portion of the tissue surface having a minimum area as set forth below. When tissue-penetrating elements are used, they typically are dispersed in a general uniform matter over the electrically active area of the electrode structure.
High frequency (usually radio frequency) power is applied to the tissue mass through the electrically active regions(s) of the electrode structures, and the power is applied for a time and in an amount sufficient to cauterize or necrose tissue between said electrodes, preferably at least along a desired resection plane. Often, a volume of the tissue is resected by morcellating, e.g. grinding, comminuting, cutting into small pieces, or the like. Such morcellation is greatly facilitated by necrosis of the target tissue volume. By necrosed, it is meant that the cells of the tissue have been killed and that bleeding of the tissue, upon subsequent resection, has been substantially inhibited. The tissue are usually resected along a plane within the necrosed tissue mass, with minimal bleeding as described above.
The electrically active regions of the electrode structures have an area of at least 1 cm2, more usually at least 2 cm2, often having areas of 5 cm2 or larger, more often having areas of 10 cm2 or larger, still more often having areas of 50 cm2 or larger. The electrodes may have a wide variety of characteristics, may generally be rigid, flexible, elastic, malleable, conformable, or the like. Preferably, the electrodes flexible to facilitate engagement of the electrode against, and conformance to, a tissue surface. In at least some instances, it is desirable to provide flexible, elastic electrodes which may be conformed about the outer periphery of a tissue or organ surface, where the elastic nature of the electrode assures firm engagement and electrode contact. In other instances, however, the electrodes may be specifically configured to have a desired geometry for engaging a particular tissue surface.
The high frequency energy applied to the organ or tissue is generally provided at radio frequency typically, but not limited to the range from 100 kHz to 10 MHz, is usually from 200 kHz to 750 kHz. The power levels depend on the surface area and volume of tissue being treated, but generally fall within the range from 10 W to 500 W, usually from 25 W to 250 W, more usually from 50 W to 200 W. Power is usually applied at a level of from 1 W/cm2 to 500 W/cm2, more usually from 10 W/cm2 to 100 W/cm2. The power is applied for a time sufficient to raise the tissue temperature in the tissue mass being treated to above a threshold level required for cauterization or necrosis, usually being above at least 60� C., frequently being above 70� C., and often above 80� C., or higher. The application of energy should be limited, however, so that adjacent tissue is not significantly heated or otherwise damaged. The use of opposed, bipolar electrodes is particularly advantageous in this regard because it concentrates the energy flux between the electrodes and limits the effect on adjacent tissue which are not confined within the opposed electrodes. The resulting necrosed tissue may comprise substantially the entire organ being treated, or in other cases may comprise a more narrow region, e.g. a planar region.
In another aspect, the invention comprises systems including at least a plurality of electrodes, and a power supply that is connectable to the electrodes for applying, for example, bipolar, high frequency power therebetween. The electrodes may be configured generally as described above, and are usually carried by an electrosurgical probe to facilitate deployment. The probe may have a wide variety of configurations, but usually comprises at least a shaft and a handle for manipulating the shaft. The electrodes are mounted at a distal end of the shaft and are usually manipulable from the proximal end of the shaft so that they may be opened and closed relative to each other to engage and capture an organ or other tissue mass therebetween. The electrodes may have any of the properties described above, and may in particular comprise metallic or metallized mesh which can elastically engage and conform to tissue surfaces. The electrosurgical probes may be used in a conventional bipolar manner, i.e. where each electrode is powered at an opposite polarity. Alternatively, the electrode surfaces may be powered at the same polarity with another electrode or electrodes used for completing the high frequency circuit. Typically, the other electrode(s) are in the form of one or more probes which may be inserted into a natural body orifice or lumen or may be introduced into an organ or other tissue mass. The probe(s) may conform to a natural lumen and/or saline or other electrically conductive fluid may be introduced into the lumen to help establish the conductive path.
In a specific embodiment, an electrosurgical device may comprise a single conformable structure, such as an elastically or non-elastically expansible tubular member, e.g. an expansible tubular braid mesh. The electrodes are formed on a plurality of locations over the conformable support structure and are usually isolated from each other, e.g. either by applying insulation or by relying on the inherently non-conductive nature of the conformable support structure.
The methods, systems, and apparatus of the invention are useful for treating a variety of organs, portions of organs, or other solid tissue regions in a patient. The organ or other tissue mass have spaced-apart tissue surfaces, usually opposed tissue surfaces, which are accessible to electrode structures and which permit the application of radio frequency power between said surfaces. The tissue surfaces may be readily accessible or may require pre-treatment to gain access, e.g. blunt dissection, resection of small tissues or blood vessels using conventional surgical techniques, or the like. Organs which may be treated by the invention include the uterus, liver, prostate, kidney, bowel, pancreas, lung, breast, muscle, and the like.
The organs and other tissue are treated with bipolar radio frequency power directed at target tissue regions which are defined by spaced-apart placement of the electrode structures. The radio frequency power may be supplied by conventional general purpose electrosurgical power supplies operated at any accepted frequency, typically in the ranges set forth above. Power supplies may employ conventional sinusoidal or non-sinusoidal wave forms and may operate with fixed or controlled power levels, where the voltage, current, or both may be selected. Suitable power supplies are available from commercial suppliers, such as Valleylab, Aspen, and Bovie. In some instances, it will be desirable to use impedance matching transformers between the power supply and the electrodes to enhance the efficiency of energy delivery.
The electrodes may be configured in any manner suitable for engaging a tissue surface. Thus, the electrodes can be rigid, flexible, elastic, inelastic (non-distensible), planar, non-planar, or the like, and may optionally employ tissue-penetrating elements to enhance electrical contact between the electrode structure and the tissue, as well as to increase the electrode area. Preferred electrode configurations are either conformable so that they can be engaged against and conform to widely differing tissue surfaces (see, for example, U.S. patent application Ser. No. 11/371,988, the entirety of which is incorporated herein by this reference thereto), or they are specifically configured to have a geometry intended to engage a particular organ or tissue geometry. In both instances, the electrode structures may further be provided with tissue-penetrating elements. Examples of each are discussed hereinafter.
One electrode configuration uses a metallized mesh which is both flexible and elastic. Such meshes are suitable for use on retractable electrodes, such as retractable electrodes useful for minimally invasive procedures. The meshes may be suspended on or between more rigid frame members, where the frame members may be themselves expanded or contracted to deploy the mesh electrodes. Such meshes are also useful for fabricating elastic tubes or shells which may be placed over an organ or tissue mass like a sock. In the case of such tubular electrodes, it often desirable to form two or more discrete electrode surfaces on a single mesh, where the electrode surfaces are isolated, usually by virtue of the material properties of the mesh itself, i.e. they are polymeric and non-conductive. The elastic meshes can be in the form of a braid or other woven structure, e.g. as described in U.S. Pat. Nos. 5,431,676; 5,234,425; and 4,018,230, the full disclosures of which are incorporated herein by reference. The use of radially expansible braid structures is desirable because the diameter of the tissue-receiving lumen therein can be controlled by axial elongation. That is, the braid can be expanded by shortening its length and contracted by extending its length. All such mesh and braid structures can be metallized by conventional electroless plating techniques. Suitable for metals for plating include gold, silver, copper, stainless steel, and combinations and alloys thereof. Suitable elastomeric mesh materials include a wide variety of elastomers. Suitable braided mesh materials include nylon and other generally non-distensible polymers.
All types of electrode structures may be configured to have a conductive surface and a non-conductive surface. This is usually accomplished by leaving one surface as an exposed metallic face, while the other surface of the electrode is covered or insulated. In the case of rigid electrodes, the insulation can be laminated, coated, or otherwise applied directly to the opposed surface. In the case of flexible and elastic electrodes, it is necessary that the insulating layer also be flexible so that it can be expanded and contracted together with the electrode without loss or removal. In some cases, it is desirable to employ a separate sheet of material which is expanded together with the electrode and which covers the face which is desired to be insulated.
Referring now to
For use in cauterizing the tissue of, for example, the uterus, conformable electrodes and may be placed over opposed exterior surfaces of the uterus. Rather than applying high frequency energy of opposite polarities, as generally described above, the electrodes may be powered at a common polarity by a power supply. A probe may be inserted into the uterine cavity and powered at the opposite polarity. In this way, the opposed tissue surfaces comprise the interior lining of the uterine cavity on the one hand and the exterior surface of the uterus on the other hand. In the case of the uterus, it is generally desirable to cauterize substantially the entire tissue mass, with the possible exception of the cervical neck. In the case of other body organs and tissue masses, however, it may be desirable to cauterize only a portion of the tissue. The high frequency energy can be directed to limited portions of the tissue by choosing the configurations of the electrodes.
Preferably, the electrodes comprise a plurality of different electrically conductive regions, where the regions may be electrically isolated from each other or may be electrically coupled to each other. Single electrode structures may include three, four, five and as many as ten or more discrete electrically conductive regions thereon. Such electrically conductive regions are usually defined by electrically insulating regions or structure therebetween. When it is desired that two or more of the electrically conductive regions be electrically coupled, small electrical connections can be provided to bridge the insulation between the regions. Usually, at least some of the isolated, electrically conductive regions on the electrode structures are powered at opposite polarities, and in some instances the methods of the invention can be performed using only a single electrode structure having multiple electrically conductive regions thereon. Alternatively, isolated, electrically conductive regions on a single electrode structure may be powered at the same polarity, where a primary purpose of the different regions is to control or configure the high energy electrical flux being delivered into the tissue mass. For example, it may be desirable to deliver high frequency electrical energy into spaced-apart regions of a tissue mass without cauterizing other areas in between or adjacent to the region to be cauterized. In such cases, the electrode structures can be configured by appropriate placement of the electrically conductive regions.
To this point in the description, the electrically conducted surfaces of the electrode structures have generally comprised rigid or conformable components having continuous surface geometries, i.e. surface geometries which are selected to create an uninterrupted interface with the tissue surface against which they are engaged. In some instances, it may be desirable to provide additional structure or components on the electrode structures to enhance or increase the effective electrical contact area between the electrode structure and the tissue surface. In particular, it is often desirable to provide tissue-penetrating elements on the electrode structures to both enhance electrical contact, i.e. reduce electrical impedance between the electrode and the tissue and, more importantly, to increase the total surface contact area between the electrode and the tissue. The tissue-penetrating elements may be needles, pins, protrusions, channels, or the like, but are usually pins having sharpened distal tips so that they can penetrate through the tissue surface and into the underlying tissue mass. The pins may have depths in the rage from 1 mm to 5 cm, usually being from 3 mm to 1 cm. The diameters of the pins may be from 0.1 mm to 5 mm, usually being from 0.5 mm to 3 mm. Usually, the pins are evenly distributed over the tissue-contact area of an electrode structure, with a pin density in the range from 0.1 pin/cm2 to 10 pin/cm2, usually from 0.5 pin/cm2 to 5 pin/cm2. Usually, the pins or other tissue-penetrating elements are provided in addition to an electrically conductive conformable or rigid electrode surface, but in some instances the pins may provide the total electrically conductive or active area of an electrode structure.
A system comprising a pair plurality of electrode structures can include electrically conductive strips separated, for example, by insulating rods. In addition, however, tissue-penetrating pins can be disposed along each of the electrically conductive strips. It is appreciated that a plurality of pins are disposed along the length of each strip. The electrode structures are generally of a curved configuration so that they may be placed over a tubular body structure or tissue mass. It is appreciated, however, that the strips may be formed from conformable meshes which permit the electrode structures to be flattened out or to assume a wide variety of other configurations. Additionally, the insulating structures may also be formed from a flexible or conformable material, permitting further reconfiguration of the electrode structures.
The electrically conductive strips may be energized in an alternating polarity configuration. Most simply, adjacent strips are connected to opposite polls on a single power supply. It is a simple matter, however, to rearrange the electrical connections to power the strips in virtually any pattern. Moreover, it is also possible to isolate different regions of each strip electrically e.g. nos. 1 and 2 to permit powering those regions at different polarities.
Using the system 300, a variety of different tissue cauterization patterns can be achieved by selective energization of different ones of the electrode surfaces or regions. By selectively energizing two adjacent electrode surfaces in a bipolar fashion, while leaving all other surfaces non-energized, a limited tissue region is cauterized. In contrast, by energizing other electrode surfaces e.g. nos. 4, 5, 6, and 7, a much larger region is cauterized. Slightly different patterns are achieved depending on the precise pattern of electrode surface polarity. The electrode surfaces can be energized in an alternating pattern of polarity (+, −, +, −) to produce a tissue cauterization pattern. Patterns of (+, +, −, −); (+, −, −, +); (−, +, +, −) etc., could also be used to produce somewhat different patterns of cauterized tissue.
The electrosurgical probe 50 includes a handle assembly 62 that is attached to the proximal end 60 of the jaws 56. The handle includes a lever assembly 64 which is connected to actuate the electrodes 304 after they are deployed. The handle also includes a coaxial connector for connecting the electrodes to an electrosurgical power supply, as described herein, although the electrodes may be powered by conventional power supplies as well.
The electrosurgical probe 50 may be employed to cauterize and resect a portion of liver. For example, the probe may be introduced through a cannula, and the electrodes advanced and opened so that they can capture a portion of the liver L which is to be removed. After the electrodes are closed against opposed surfaces of is the liver, the radio frequency energy may be applied, as described above. After the tissue is fully cauterized, it may be resected along any line within the necrosed tissue mass. Optionally, the electrosurgical probe may be used to cauterize a series of tissue masses adjacent each other to cauterize and resect a larger tissue mass than would be possible using only a single application of radio frequency energy.
In one embodiment, the electrodes may be used, for example, to cauterize and resect a uterus. The uterus comprises a main body having fallopian tubes extending from each side. In addition to the fallopian tubes, several large blood vessels extend generally from the midline of the uterus. The electrodes may be placed over the anterior and posterior surfaces of the uterus with the fallopian tubes remaining attached and extending outwardly from between the electrode structures. Depending upon the procedure, in some cases the fallopian tubes would be included in the sealed, cauterized, and dissected region and, in others, the choice may be not to seal and cauterize the fallopian tubes. This decision is based upon whether the ovaries are to be removed along with the uterus or not. Radio frequency power may then be applied to the uterus, typically at a power level in the range from 10 W/cm2 to 100 W/cm2 for a time in the range from 10 sec. to 20 min., until the body of the uterus is substantially completely necrosed. Because of the geometry of the electrodes the necrosed body of the uterus terminates along a line generally at the cervical end of the uterus, as well as along lines adjacent the fallopian tubes. The uterus may then be resected along lines within the cauterized tissue region but adjacent the cervix and fallopian tubes. Resection within the cauterized regions of the uterus substantially minimizes bleeding and facilitates hemostasis. The uterus may then be removed, either intact in the case of open surgical procedures. In the case of minimally invasive procedures, the uterus may optionally be morcellated (comminuted into small pieces) prior to removal.
In one embodiment of the invention, parallel electrodes are provided along the device, thus preventing positive-to-negative contact if opposing jaws and electrodes are brought into contact. In this embodiment, the oppositely charged electrodes that are mounted in the same jaws must be mounted in a non-conductive material to prevent shorting.
The jaws can be offset by a soft compressive material, such as a foam rubber, to prevent the electrodes from contacting, while assuring secure contact with all intermediate tissue. This embodiment of the invention can accommodate variable tissue thicknesses, which are expected to be likely over 5-10 cm of tissue.
To prevent local areas of high impedance from impacting the overall system impedance along the entire electrode, and thus potentially reducing the power output of the entire system as the voltage reaches its maximal capacity, multiple electrodes could be located physically in series. These electrodes may be powered simultaneously or in a repetitive sequential or other series. The electrodes may also be powered entirely independently of each other. In this manner, if one area that has already been well sealed and has thus reached high impedance value, it does not affect other regions in which the tissue is not yet sealed, and is thus at a lower impedance, i.e. impedance goes up as sealing occurs and this can limit power transmission. Each electrode or electron pair can have unique power and energy delivery profiles, based on the properties of the tissue in a specific electrode location/position.
As should be apparent from the disclosure herein, there is a benefit to using longer electrosurgery electrodes or other high-energy sealing impedance mechanisms to save operating time in a number of surgical procedures. For example, depending on the makeup of the tissue involved and its thickness along the length of tissue to be cauterized, geometry variations of both the electrosurgical jaws and power supply may be optimized to facilitate surgical removal of part or all of particular organs.
For example, the connective tissue or ligaments of the uterus are relatively thin and of relatively low impedance, i.e. less than three Ohms in many cases before energy is delivered to the tissue, based on animal models. However, this impedance is not constant, both along the length of tissue being cauterized, and during the course of cauterization. Therefore, a power supply with a capacity of, for example, less than 100 volts is not adequate to seal and coagulate all tissue and blood vessels supporting the organ fully because it is often necessary to ramp up the voltage after initially applying power to cauterize the tissue to maintain power levels in light of increasing impedance as the sealing and cauterization process progresses. Further, for thicker tissue or organs, such as the liver, lungs, or bowel, or for longer segments of tissue, significantly higher voltages are likely to be required. For more delicate tissues or locations, high voltage power energy levels may not be safe. In addition, due to the higher impedance of some of these organs and tissues, the power supply must have sufficient cut-off for discontinuing power to the organ at the end of the sealing cycle. Thus, the power supply should automatically terminate current flow to the tissue once the power supply has determined the completion of the sealing cycle. Although manually discontinuing power delivery is an option, it is less desirable because it is subjective and it is less likely to include an accurate analysis of the condition of the tissue or organ. The automatic feedback system disclosed herein prevents excessive heating or burning of surrounding healthy tissues and organs, as well as minimizing tissue adhesion to the electrodes, while assuring adequate vessel sealing. Therefore, the power supply herein has multiple adjustable settings that the user can select based on the organ to be treated. A prior characterization of each organ determines preset voltage limits and curves, as well as final shutdown (endpoint) parameters based on time, impedance, voltage, current, temperature or energy data, or some combination of these for each specific organ. Therefore, processes that optimize safety and efficacy for the specific procedure are used. Based on the degree of vascularity and size of the blood vessels present, various tissues and organs may require different settings as well.
Another embodiment of the invention runs a test burst of current through the tissue for a short, i.e. less than five seconds, time period, at a low, safe power level. The profile data generated during this period are quickly, i.e. less than five seconds, and automatically programmed into an algorithm that optimizes the voltage, energy, time, and/or power delivery based on the conditions determined during the test period to seal the tissue or organ safely and effectively.
Likewise, the geometry of the jaws/electrodes are optimized for each indication. The length of the jaws and handle segments is optimized for the length of the tissue and location to be sealed and dissected. The force and/or minimum compression gap generated by the jaws is optimized for the tissue selected as well. A minimum force is required to ensure adequate uniform sealing among the entire length of tissue. However, excessive force may result in undesired damage to the tissue and cause significant bleeding prior to the sealing process. The optimal compression force is either predetermined for each organ or the compression handles are designed to exert a predefined force level for a particular organ. In one embodiment of the invention, this is controlled via a slip clutch-type mechanism similar to a torque wrench, or by a travel limiter for the jaws. Thus, there are separate devices designed for each application or once device that could have multiple individual settings that are adjusted to predetermined settings for the organ or thickness of organ to be operated on or removed. In some embodiments, force may be adjusted automatically and dynamically by sensing pressure along the length of one or both jaws with one or more strain gauges associated therewith.
The force exerted by the jaws in other embodiments may be limited by the materials used for the jaws themselves. In the case of an organ or a tissue where the force required to compress and seal the tissue safely is low, a material with a lower flexural modulus may be more appropriate, while in a tissue that can be safely clamped at a higher level to assure effective sealing, a higher modulus material may be used.
In another embodiment, the thickness of the jaws is adjusted by inflating a hollow chamber within the jaws with a pressurized fluid.
The angle between the handles and the jaws of the device may also be optimized to the application. This is determined mainly by the angle of attack of the procedure in the surgical environment. Rather than an abrupt angle, the device may have a gentle or gradual curve for certain applications.
The cutting or dissecting portion of the process may be optimized for specific organs as well. In the case where the cutting is performed by a sharp-edged blade, the width of the blade may vary based on the thickness of the tissue or organ to be removed. The thickness of the cutting material may also be optimized based on how readily the specific thickness/tissue cuts. More tenacious tissue may require more of a saw motion or a thicker or serrated blade or scissor mechanism, which, again, is predetermined for a specific application. If high energy systems are used to dissect the tissue, these may also be optimized for the application, as previously described in the power supply section above.
With regard to a multiple electrode algorithm as taught herein, each electrode is treated independently in terms of energy transmission and RF cycle monitoring, modulation, and termination. The parameters to be monitored in the presently preferred embodiment of the invention are current, voltage, impedance, energy, power, time, and temperature. Any combination of these parameters may be monitored, as well as the values of other parameters. These values may be monitored in a mathematical model that combines them into a single algorithm that determines the quality of the RF sealing process based on prior empirical analysis. The energy and/or power output may be modulated to optimize artery and vein sealing in the shortest time possible, preferably less than one minute, and desirable less than 30 seconds, without excessive heat transmission that could damage surrounding healthy tissue or result in excessive heat that could bond the tissue to the electrode surface. The optimization of the cycle can be based on an algorithm program into the power generator software/firmware that modulates and ultimately terminates the cycle when conditions have been met that have been empirically determined to safely and repeatedly satisfy the conditions of the surgical procedure being performed. For example, reaching a certain impedance and/or temperature value and continuing the power level for a predetermined amount of time beyond this point, or reducing (or conversely increasing) the power level once a certain impedance and pressure or temperature threshold have been reached.
Once desiccation of tissue has occurred, impedance tends to reach a plateau and becomes less of a measure of the quality of the sealing process which occurs after the point that desiccation has begun. Therefore, impedance measurement alone may not be an accurate determinant of successful vessel/tissue sealing. Thus, multiple modulations, step functions, or continuous changes in power, voltage, and/or energy, are provided to optimize the sealing cycle. The cycle changes or modulation may result in upward or downward complex variable changes to optimize the blood vessel/tissue sealing conditions. As a result, each electrode or electrode pair may have different cycle times and power, current, voltage, and energy profiles as a result of the feedback data for the specific segment of tissue is contacting the specific electrode. The modulation/determination program may be a complex algorithm based on monitoring multiple variables and responding to a combination of predetermined conditions to adjust and terminate the cycle.
With regards to these variables, the following are typical:
In a presently preferred embodiment, the power generator is comprised of a constant output power design as opposed to a constant voltage or constant current design. In the inventive design, the power output is manifested based upon the load on the system. Thus, if the system sees a very high impedance load, the voltage is maintained at a reasonable level to avoid arcing. In the application to which the power generator is put, i.e. electro-cauterization, the impedance range may vary between, for example, two ohms and 150 ohms during the cauterization of tissue. By applying constant power, the presently inventive power source provides significant current at low impedance to achieve initial desiccation when the tissue is first being cauterized and, as cauterization proceeds, to apply higher voltage to complete the tissue sealing process. Thus, the invention provides larger current and smaller voltage at the beginning of the cauterization process and a higher voltage and lower current at the sealing phase of the process. Control of such power generator only requires that the system monitor power.
In the presently preferred embodiment, the power source is provided with a mechanism for setting the desired power. This can in accordance with a profile or otherwise, as discussed below. Pulse width modulation is used in connection with a flyback transformer. The system charges a primary of the flyback transformer and produces a regulated output. The secondary may be regulated, for example 15 volts at a desired number of amperes to produce the desired power output. Based upon the period, as determined by the width of the pulse which charges the primary, the power curve is determined. Thus, the invention establishes a certain level of power in the primary of the flyback transformer and the same level of power is provided by the secondary without regard to impedance of the load, i.e. the tissue.
In the preferred embodiment invention, the power generator is a source of power for multiple electrodes in the electrical surgical appliance. Accordingly, the power generator is provided with a plurality of output channels, each of which is independently adjustable. In
The power generator 16 is comprised of a power source 335 that has multiple outputs which are controlled by control electronics 50 and thus routed to the individual electrodes in the electro-surgical appliance, as discussed above. The multiple outputs are independently operated by a microprocessor or other control mechanism 330 and are readily modulated and assignable. Thus, an output may be assigned to any one or more of the electrode elements at a certain point in operation of a cauterization cycle, and may be dynamically reassigned at other points of time. For example, if the power source were a four channel power source and the electro-surgical device had 16 electrodes, then each channel may support four electrodes in electro-surgical device. However, this arrangement may altered so that some channels support more electrodes than others.
The microprocessor 330 may be configured through a series of profiles 340 to operate the device with a power curve and power distribution amongst the various electrodes in accordance with the procedure to be performed. Thus, for a hysterectomy a certain profile may be established for the electro-surgical appliance, while for a liver procedure a different profile may be established. Additionally, a smart card reader 365 may be provided that both configures the system for a particular procedure and that provides memory for recording information as to the operation of the power generator during the procedure. For example, the application of power to each channel, impedance sensed, the temperature sensed, and the like is captured to document the procedure.
The probe (electro-surgical appliance) is positioned (405) and the power for the power source is turned on (410). The system initializes itself (415), for example by taking initial impedance readings along the various electrodes in the electro-surgical appliance to develop a profile for the tissue to be cauterized. Initialization may also include the taking of initial temperature readings, strain pressure readings which are indicative of the thickness of the tissue along the surgical appliance surface, and other readings. A pilot signal may be transferred through the electro-surgical appliance to determine these values. For example, an initial low voltage may be provided to measure impedance. In this way, a real time profile may be developed for the actual tissue to be cauterized that may be used as an adaptation to the pre-established profile for a particular procedure. Thus, the profile which is established for the procedure may be modified in accordance with measurements related to the tissue to be cauterzied.
The system then sets thresholds (420) which determine when an endpoint is approached. These thresholds may be determined by measurements such as impedance, current, voltage, energy, power, and temperature. The thresholds may also operate in connection with a time element. Thus, when a threshold is reached, the system may continue to operate for a certain period of time to assure that an appropriate endpoint is reached, such that cauterization is complete. In some embodiments, power generator channels that are assigned to electrodes for portions of the tissue that have reached an endpoint may be reassigned to those electrodes that are still actively cauterizing tissue to provide additional power to the process and thus hasten its conclusion.
Power is applied to the electro-surgical appliance (425) to commence cauterization. The system monitors two or more parameters during this process and determines when a threshold is reached (430). Once the threshold is reached, an endpoint procedure (435) is implemented. The endpoint procedure may be as simple as ramping the power down or it may also involve setting a timer. It is important to note that the application of power, while constant across a wide range of impedance may be modulated during the process of cauterization such that a power curve is applied for the procedure. Because the invention provides multiple channels of power for multiple electrodes, some electrodes may reach an endpoint before others. In this case, power to these electrodes is terminated while power is continued to be applied to the other electrodes. Thus, each electrode may have a difference power curve that is modulated in real time. If all endpoints are not reached (440), then the process continues (445); else the power to the system is turned off (450) and the procedure is complete.
The electro-surgical appliance incorporates sensors for capturing various process parameters in real time in accordance with the algorithm. Thus, impedance may be measured between selected electrode pairs or groups of electrodes; temperature may be measured in connection with one or more physical transitions along the surface of the appliance; and the effect of cauterization may be measured with local strain gauges situated along the length of one or both probe jaws (in this embodiment, strain gauges may also be used to precompute a cauterization profile). In this regard, each electrode may be thought of as a separate device which is independently operated for a particular region along the surface of tissue that is contacted by the probe jaws.
Although the invention is described herein with reference to the preferred embodiment, one skilled in the art will readily appreciate that other applications may be substituted for those set forth herein without departing from the spirit and scope of the present invention. For example, in some embodiments the power generator senses whether or not tissue is present at each electrode at the beginning of a cauterization cycle by measuring any of impedance, pressure, or any combination of these and/or other parameters. If for any electrode pair no tissue is present, then such electrode pair is idle and an indication to this effect is provided to a power generator operator. The power generator may also provide a status indicator for each electrode pair that indicates whether the sealing cycle is active or completed with regard to each electrode pair. In this embodiment, each electrode pair can comprise a mode status indicator, such as an LED for example, that indicates any of an idle, active, or complete condition, once a cauterization cycle is commenced.
Accordingly, the invention should only be limited by the Claims included below.
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PAWTUCKET — While the Red Sox are expressing confidence that the search to find the next PawSox manager will be wrapped up by Christmas, don't be surprised if official word filters out before the holidays.
Why the organization has nothing to announce at this time is likely two-fold. While all signs point to current Double-A skipper Kevin Boles moving to the front lines of the minor-league system, the 38-year-old is presently coaching a winter league team in Venezuela, Bravos de Margarita.
The Bravos' season began on Oct. 10 and concludes on Dec. 29. The team is idle Dec. 22-26 before resuming what will be the final three games of its regular season. Currently in last place in the eight-team Venezuelan league, the Bravos carried a 20-31 record into Friday's action.
Certainly the Red Sox are no strangers to announcing the next PawSox skipper while the actual person is in the midst of tending to Winter League business. Arnie Beyeler was informed three days before Christmas in 2010 that he was getting bumped up to the Triple-A ranks while in the midst of flying to his offseason home following a coaching stint in a warm climate.
Boles' familiarity with the system figures to be a major selling point with team officials – he succeeded Beyeler as Portland's bench boss in 2011 following managerial stops at Single-A Greenville (2008-09) and Single-A Salem (2010). In recent years, players such as Xander Bogaerts, Will Middlebrooks, Jackie Bradley Jr. and Bryce Brentz have benefited from Boles' guiding hand.
The likely promotion of Boles falls directly in line with the internal route that Ben Cherington talked about earlier this week at the Winter Meetings. The Red Sox general manager told reporters that Gary DiSarcina's replacement would come from within the minor-league coaching ranks, a development that not only boded well for Boles' candidacy, but for several additional coaches who are also highly perceived.
In addition to Boles, the list of possible candidates in the search to name the 16th PawSox manager in franchise history likely included Chad Epperson (minor-league catching coordinator), Bruce Crabbe (Single-A Lowell manager) and Andy Fox (minor-league infield coordinator).
You can cross Fox's name out as it was learned earlier this week that he was no longer a candidate for the Pawtucket vacancy.
The other factor that is likely keeping the Red Sox from ending Pawtucket's managerial mystery stems from the fact that they will need to find a replacement in the event that Boles departs Portland. In keeping with the "staying close to home" theme, names such as Crabbe, Carlos Febles (Greenville manager) and Billy McMillon (Salem manager) make the most sense.
Follow Brendan McGair on Twitter @BWMcGair03
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Senegal: MoD plans to acquire two additional CN235s, including MPA versions
|News - Africa
Senegalese Air-Force  plans to buy two CN235 transport aircraft from Indonesian manufacturer PTDI and use them for VIP and cargo duties. They would join its two CN235s already in service.
Senegal's intention to buy more CN235s emerged in late May this year when Senegalese Armed Forces Minister Augustine Tine expressed interest in two CN235-220 aircraft.
Senegal has also shown interest in the maritime patrol version of the aircraft, Air International reports. (The Air Force flies a smaller C212 in the maritime patrol role.) If a firm order is placed, the aircraft would be delivered in one to three years' time, depending on the contract. Indonesia may extend credit to Senegal to assist in the purchase of the aircraft.
Senegal already operates two second-hand Indonesian-built CN235-220s acquired in November 2010 and August 2012, according to Air International. They were bought under a $13 million contract.
Meanwhile, PTDI is offering its NC212 and CN235 to African countries like Uganda, as well as existing operators Senegal and Burkina Faso. PTDI has previously sold aircraft in Africa through a third party based in Belgium but may sell directly to Senegal.
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Difficulty installing Driver for GeForce4, Tecra TE2100
Redhat Advanced Server 2.1
Toshiba Tecra TE 2100
As suggested by NVchooser, I'm attempting to install the Linux Display driver using the SRPM method. When I run the command:
"rpm --rebuild NVIDIA_kernel-1.0-3123.src.rpm",
I receive a series of errors. Here is a excerpt:
"/..../linux/highmem.h:19: warning: pointer of type 'void *' used in arithmetic
nv.c: In function 'nv_kern_map':
nv.c:1305 incompatible type for argument 4 of 'remap_page_range_R1664b601' makes pointer from integer without a cast"
This is followed by a series of similar "incompatible type" errors.
Does anyone know whats causing these errors?
Is your kernel-source package installed? rpm -qa | grep source should tell you.
If it is, can you post the log.txt file that you will create when you rpmbuild --rebuild NVIDIA_kernel-whatever.src.rpm >log.txt 2>&1?
The kernel-source is installed - kernel-source-2.4.9-e.3
I'll post log.txt as soon as I can.
I'm having exactly the same problem on Tecra TE2100 & Redhat AS 2.1
I'm encountering exactly the same problem. Same machine, same OS.
I' had started a thread about a week ago under my username - GDavis.
If you get a solution, could you please respond to that thread?
Look like there are three of us with the same issue !
TE2100 + AS + Geforce 4 (Search for TE2100)
Come on NVIDIA linux experts, the challange has been set... who can help us AS + Geforce 4 owners?
same problem
I got the same problem, though my laptop is Dell.
Apparently currently NVidia driver does NOT work with RH AS 2.1 on laptop. This is for sure.
Good luck to all.
RedHat Advanced Server comes with a kernel that has changed several key interface functions that the nVidia driver needs. Obviously with these functions changed, the driver won't work!
This is according to this thread:
One workaround would be to install a Linus kernel -- one off www.kernel.org -- and recompile the nVidia drivers, if that's possible.
Another workaround would be to figure out C (if you haven't already) and patch the nVidia driver to work with your kernel.
NVIDIA's fault?
Well, I guess we should blame Nvidia. :) 'cause RH AS is just one kind of Linux distro. Since NVidia calls its drivers as Linux driver....
And probably those 'non-standard' Linux kernel features in RH AS are just what enterprise customers pay for.
Re: NVIDIA's fault?
But then, I have a personal thing against RedHat, too, so that's probably part of it.
not really....
I think RH just does a fair job, not great though.
For the same our web app for Oracle, its performance on RH AS actually outperforms Solaris 8. How much $ can customer save?
Not mention the cost saving for building RAC on Linux instead of Solaris.
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Lumbridge mine
Redirected from Lumbridge Mine
this wiki
The Lumbridge mine, also called the caved-in mine, was released during the Learning the Ropes quest update. It no longer exists due to an update of Jagex, the tutorial being replaced by Unstable Foundations. It contains tin and copper ore, and 3 anvils. The smithing tutor and mining tutor are found here. Unfortunately, after the tutorial, the mine caves in, though the tutors residing within had escaped. It is revealed later that the cave-in was caused by a three-headed Dragon, which had escaped a fight with Sir Vant underneath Lumbridge.
The mine was most likely under River Lum, as there is a small pool in it with water constantly dripping in. There were mining cart tracks there leading into unknown places. Also, after the update, a large chunk of rock appeared in Lumbridge, possibly part of the mine.
During the Battle of Lumbridge, the H.A.M.'s original base under the ruins of a house was destroyed by Saradomin and Zamorak and the cult moved to the mine, making it their new base.


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Vandalia Junior High School
Fourth Quarter
Honor Roll
The 1966 Vandalia Community High School class is busy preparing for its 45th reunion, which will be held Sept. 30, Oct. 1 and Oct. 2.
One of the activities for the weekend is a tour of the high school, where classmates can catch a glimpse of the new library, refurbished gym and new administrative addition.
After the tour, lunch will be eaten in the high school cafeteria, and there will be a chance to tell stories, look at old pictures and just catch up on the past 45 years.
June classes for the Kids in College at KC (KICK) program include:
• Starting Monday, June 27:
-Tie-dye T-Shirt making for students in grades K-8, Monday and Wednesday from 10 a.m.-noon.
-Get up, Get Out and Go Play for students in grades 1-5 is from 1-4 p.m. and for students in grades 6-8, Monday and Tuesday, 8-10 a.m.
-DNA Detective for students in sixth grade and above, Monday and Wednesday, 1-4 p.m.
The Office of Continuing/Community Education at Kaskaskia College has announced the schedule for KICK classes to be held in July at the Vandalia Campus, located at 2310 W. Fillmore St. in Vandalia.
• Storytellin' – Each day students will explore great children's books with fun and exciting activities, including puppetry, creative dramatics, movement, music and crafts.
Lincoln Land
Community College
Brooke Knebel-Renfro graduated from Lincoln Land Community College on May 13 with an associate's degree in arts and graphic design.
Illinois College
Three area residents were among the students Illinois College recognized for academic excellence on April 29 when the liberal arts college held its annual Celebration of Excellence.
• Whitney Hagy, a senior, was awarded membership into Kappa Delta Pi, the education national honors society.
Hagy is a graduate of Vandalia Community High School, and is the daughter of Elizabeth Deutsch and Mark Hagy, both of Vandalia.
Taylor Parrish, a 2011 Vandalia Community High School graduate, has been awarded a trustee scholarship from Franklin College.
Vandalia Elementary
Fourth Quarter
Honor Roll
The South Central Archery Club has moved its 3D archery range to the circle drive at Stephen A. Forbes State Park, and its next shoot is this Saturday.
Registration times for the first shoot at the new location are unchanged, 7 a.m.-3 p.m.
Cash prizes will be given to the top shooters in each of five classes.
The Brownstown Alumni Reunion will be held on Saturday, July 16, at the American Legion Home in Vandalia.
The reunion will begin with registration and a get re-aquainted time from 4-6 pm. There is no charge for the social hour.
Serving for the meal will begin at 6 pm and requires reservations by July 9 to guarantee seating with each person's graduating class. The cost of the meal is $12 per person.
Copyright © 2015
The Leader Union is your source for local news, sports, events and information in Vandalia, Il, and the surrounding area.


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Don't forget to check your spam folder if you cannot find the email. For further assistance please contact us at email@example.com .Okay
Two rows of button tufts on the inside seat back accentuate the tailored elegance of this handcrafted chair. The low curved arms and the contrast between the pale upholstery and the dark wood legs provide a sense of glamour. Handcrafted in the USA.


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Related Topics
Light Bulb Law
Bloomberg News has a news article about the House of Representatives blocking the energy department from enforcing a ban on 100-watt light-bulbs:
Bloomberg seems to think that only foreign manufacturers lack scruples. What scruples were being demonstrated when the American manufacturers of the fancy expensive lighbulbs went to Congress in the first place to ban their low-cost foreign competition?
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Unlocking the Key to Deep Sleep
By Sarah Fenske
Making the Ferguson Commission Matter
By Danny Wicentowski
My Fake Boyfriend Became a Real-Life Crush
By Lindsay Toler
Rep. Jeffrey Pogue Bill Would Ban Unisex Bathrooms
By Danny Wicentowski
Darren Wilson Gives Speech to Nonprofit
By Danny Wicentowski
Angel Stewart and Other Victims of Violence Ask for Mercy
By Jessica Lussenhop
Obama Praises St. Louis' LaunchCode
By Lindsay Toler
By Lindsay Toler
"Look," he exclaims. "There are places that franchise it now, like McDonald's." He's talking about labiaplasty, a surgical procedure that eliminates excess skin from a woman's inner or outer vaginal lips.
Young, one of the nation's pre-eminent plastic surgeons, has just emerged from a post-operative exam with a 22-year-old patient and is eager to compare her result with some cyber-erotica. "Get this," he says, clicking on a link to "Designa Vagina Lips to Die For." The doctor chuckles as he reads an entry from a commenter who calls himself "Rich48.": "So you have big lips. Or small lips. Or maybe one is longer than the other. SO WHAT? From a purely cosmetic point of view, why would you risk a medical procedure to change it? Who will ever see it besides your GYN and your lover?"
"Gotta give him credit," says Young, who, until a few years ago, tended to agree with Rich48's assessment.
Young had recently opened a private practice after 21 years in academic medicine, and he and his two partners fully expected to offer the standard bill of fare tummy tucks, breast implants, liposuction, face lifts. But labiaplasties? Never. Then, one winter morning, he was leaving a consultation with a breast-augmentation patient when the woman said, casually, "Oh, doctor? By the way: My labia really bother me. Could you do anything about it?"
Young took a step back into the room and was quiet for a moment. "Let me see here," he finally said, hunkering down to take a look through his square, oversize glasses. The woman's inner labia extended a few centimeters beyond her outer lips. "I told her she seemed normal to me, but she wouldn't buy it," Young recalls. "She kept insisting: 'It bothers me with certain pants, and when I'm intimate, and I want [the extra skin] removed.'
"I thought it was crazy," the 60-year-old physician continues. "I thought it had something to do with pornography. Maybe, you know, her boyfriend had said: 'You don't look like the pictures in the magazines.'"
Young says he's never perused an issue of Playboy in his life, and when it comes to understanding what men might expect of their lovers, the doctor considers himself no authority. He married the first girl he ever kissed and, after they divorced, he wed his second-ever girlfriend.
"In my first year of medical school, we had to do a psychiatry rotation," Young recalls. "You had a whole questionnaire of stuff you had to go through with patients. Well, there I am on my first day, and I start off with this attractive woman. I'm going down my list, and I get to the question, 'Have you ever had kinky sex?' The woman kind of pauses, and says, 'What do you mean?' I said to her, 'I was hoping you would know.'"
And so, in the name of research, the doctor went trolling through cyberspace and was quickly reassured to find a range of labia sizes and shapes described as attractive. "I even found a tribe in Africa where the women stretch their lips, because they think it's beautiful," he remembers.
Young would soon discover that functional issues drive some of the growing demand for labiaplasties. "These women feel really stressed out when they first come in. They have issues related to their clothes, particularly swimsuits, or to hygiene," Young explains. In the end, he decided to go through with his first labiaplasty, and now performs several a month, at $3,000 per surgery.
The 22-year-old patient Young saw moments ago was a timid blonde who had her inner labia trimmed in the hospital. "I think it looks awesome," Young told her. When she didn't respond, the doctor held a mirror between her legs. She glanced down and smiled.
Back in his Creve Coeur office, Young closes the "Designa Vagina" page and calls up his favorite labia-related site. "Here we go the-clitoris-dot-com. This one is really good." Young points the mouse over a wrinkly set of lips, dismissing them as "a head of cauliflower" before scrolling down the Web page to a pearly pair and pausing.
"A rosebud. It's pink; it's pretty. Yep, she could be in any magazine."
Leroy Young is a hopeless romantic. He composes love poems for his wife and dissolves into tears while watching Hoosiers. His prized possessions are his mother's petunias and the cane-bottom rocking chairs from the old family farm in Kentucky. He drinks Coors Light and sauerkraut juice and cleans his own toilets every Sunday. The doctor washes his hair with soap, gets his dress-down clothes straight off the racks at Wal-Mart.
"When I first knew him he wore blue socks with everything," says his wife, Jill.
"He would be the last person in the world to have plastic surgery himself," adds his daughter, Ann Elizabeth Mohart.
Young drives a used Ford Ranger. Before that, he drove a dented fifteen-year-old station wagon with missing hubcaps that he nicknamed "Vulva the Volvo."
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Jim Jackson (musician)
Jim Jackson (c.1884 - 1933) was an African American blues and hokum singer, songster and guitarist, whose recordings in the late 1920s were popular and influential on later artists.
Jackson was born in Hernando, Mississippi, United States,[1] and was raised on a farm, where he learned to play guitar. Around 1905 he started working as a singer, dancer, and musician in medicine shows, playing dances and parties often with other local musicians such as Gus Cannon, Frank Stokes and Robert Wilkins.[1] He soon began travelling with the Rabbit Foot Minstrels, featuring Ma Rainey and Bessie Smith, and other minstrel shows.
He also played clubs on Beale Street in Memphis, Tennessee. His popularity and proficiency secured him a residency at Memphis's prestigious Peabody Hotel in 1919. Like Lead Belly, Jackson knew hundreds of songs including blues, ballads, vaudeville numbers, and traditional tunes, and became a popular attraction.
In 1927, talent scout H. C. Speir signed him to a recording contract with Vocalion Records. On October 10, 1927, he recorded "Jim Jackson's Kansas City Blues", which became a best-seller, and in the melody and lyrics of which can be traced the outline of many later blues and rock and roll songs, including "Rock Around The Clock" and "Kansas City". Following his hit Jackson recorded a series of 'Kansas City' follow-ups and soundalikes. It also led to other artists covering and reworking the song, including Charlie Patton, who changed it to "Gonna Move To Alabama".[2] Jackson moved to Memphis in 1928, and made a series of further recordings, including the comic medicine show song "I Heard the Voice of a Pork Chop". He also appeared in King Vidor's all-black 1929 film Hallelujah!, however it is unclear what role he played.[1]
Jackson ran the Red Rose Minstrels, a travelling medicine show which toured Mississippi, Arkansas and Alabama. As a talent scout for Brunswick Records, he discovered Rufus "Speckled Red" Perryman, gaining him his first recording session.[3] Shortly afterwards, in February 1930, Jackson recorded his own last session. He later moved back to Hernando, and continued to perform until his death in 1933.
Janis Joplin later recorded a version of "Kansas City Blues", inserting the lines "Babe, I'm leavin', yeah I'm a-leavin' this mornin' / Goin' to Kansas City to bring Jim Jackson home".
Jackson was a major influence on the Chicago bluesman J. B. Lenoir, and his "Kansas City Blues" was a regular fixture of Robert Nighthawk's concert set list.[1]
The song "Wild About My Lovin'" was covered by The Lovin' Spoonful and released on their 1965 deubt album, Do You Believe In Magic.
See also[edit]
Recommended recording[edit]
- Jim Jackson Vols 1-2 (Document Records)[2]
- ^ a b c d Allmusic biography - accessed January 2008
- ^ a b Russell, Tony (1997). The Blues: From Robert Johnson to Robert Cray. Dubai: Carlton Books Limited. p. 121. ISBN 1-85868-255-X.
- ^ Peter J. Silvester, A Left Hand Like God : a history of boogie-woogie piano (1989), page 112-113.
External links[edit]


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Sometimes you have to do work with Unix/Linux machines and the differences in new line encodings can be annoying, especially when doing diffs or merges.
Luckily, Eclipse has options for this which covers a global and per-project scope.
To change the option globally:
1. Open the preferences dialog.
2. Select "General" > "Workspace".
3. Change the "New text file line delimiter" to "Other" and select your preference.
To change the option on a per-project basis:
1. Open the project.
2. View the project properties.
3. Select "Resource"
4. Change it from "Inherited from container" to "Other" and select your preference.
If your project is using UTF8, you might want to take the time to change it to UTF8 while you're at it.
Eclipse - Windows/Unix new line formatting
Posted by twig at 7:44 PM Tuesday, December 9, 2008 2 comments
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Last edited by GlowBear; 02-13-2013 at 04:53 AM.
"Guitar Party" was a band fronted by a first grade girl, one of Micheal "Eyedea" Larsen's many projects. This is their only album in its entirety, and conveniently enough the first track here is the one I was listening to just a moment ago on my iPod; 'Navy Blue Baby':
That's not even the song I meant to post but w/e. Kinda hard to do things correctly when my browser keeps freezing up.
With his birthday being 10th February I've finally revisited some Metallica and listening to Cliff's work.
Please, no thanks necessary, just doing a good deed for my fellow man.
I've been really tormented lately. Just a sour sack of shit. Been trying to turn that around and be the old me. It's work, but been making progress. Then I heard this song yesterday. Woke that mother fucker inside. I'm blessed as shit. Time to start enjoying it again.
Now excuse me. Going to talk to pretty ladies outside. It's a beautiful day.
*insert anything with Mike Patton here*
That as well. It's not on YouTube so that's the best I could do.


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Jia Foot Spa
2767 Pfingsten Rd,
With two locations to serve you, you can easily take advantage of the relaxing atmosphere and soothing treatment you will receive at Jia Foot Spa. We have several packages of services to offer. Treatments include herbal foot baths, massage for feet, head, neck shoulders and back. Our best value is a 60 minute massage for $29!! It includes a 30 minute foot massage and a 30 minute head, neck, shoulder and back massage!! Come in between the hours of 10 am and 9 pm Monday through Saturday, or 11 am to 8 pm on Sunday. We accept Visa & MasterCard. Gift certificates are also available so you can give the gift of relaxation to someone you love. Besides are location in Glenview, we also are open in the Oak Mill Mall in Niles.


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I am a cat of many, many talents. But I bet you didn't know that, among my many amazing qualities, I am a superb baker. So I put my expertise to work last night at our clinic operations manager's house.
Yes, I believe we have all the ingredients right here.
First, we will start by mixing all the ingredients together in this red bowl.
Well, hurry up now, these ingredients won't mix themselves. And I don't have thumbs.
You can use this spatula right here.
Yes, that looks good. Now let's flour the counter and roll out the dough.
I think it needs a little more flour. It's still a bit sticky.
Yes, much better. Now you can roll it out, nice and thin and even. I'll supervise.
Then we will use these great cookie cutters to make our cookie shapes.
Let's start with this one. It's my personal favorite.
Now that they are cut out, it's onto a cookie sheet to bake away. 9-11 minutes til perfection (I didn't take nearly that much time to achieve perfection.)
Out of the oven to let them cool. Then it is time for us to decorate...well, by us I mean you.
My Ninjabread Cat army!
To all my friends and fans I give you these, my mini minions to celebrate the season.
Merry Christmas and a Happy New Year!
XO Ninja Bob


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This protective upper body armor is designed in a way to provide complete protection and comfort to the adventure sports player. This gear is essential to safeguard you from any type of severe injuries in case of crash or fall. It is one of the most efficient vapor pressure suits available in the market.
This SixSixOne Vapor Pressure Suit is made up of the most durable and skin friendly fabric to provide the complete comfort to the player. It offers absolute safety to the adventure sport player by protecting their tender body parts such as shoulders, chest and back. Employ this amazing latest designed gear to ensure your safety while performing the high risky moves.
Copyright © 2011 Shock Garden. All rights reserved. ShockGarden.Com is UpFront


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The Fourth Dimension is worth attending and that too, more than once.
Zeba BakhtiyarFilm star, Producer, Director
The pioneer of Yoga, Reiki, Hypnosis, Neuro-linguistic and many such powerful technologies.
Founder of the first Yoga Institute in Pakistan, he presently conducts events, workshops and seminars in Pakistan, India, UAE, Singapore, UK and USA. He holds doctoral degree in Clinical Hypnosis. He is a faculty member of the National Guild of Hypnotists, USA and The National Federation of Neuro Linguistic Psychology (NLP), USA, Certified Reiki Grand Master and Teacher and Licensed Director of Silva Mind Control, USA.
Learn the tools to achieve your goals and improve your life with Moiz's Mind Power - The Fourth Dimension. The event is specifically designed to help you develop your mind power so you achieve your goals.
The CIA and U.S. Army developed a mind-protocol called Remote Viewing (RV) that enables the unconscious mind's inherent ability to obtain knowledge about any person, place, thing in the past, present or future. This technique was proven in real-world military operations and required a team of scientific researchers over 20 years with millions of federally funded dollars to discover the secrets behind this inhertant unconscious ability.
RV(REMOTE VIEWING) Soon in Karachi.
Subscribe to our mailing list and get updates on upcoming workshops and events


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Any deal made over the next 4 days is NOT going to fix the fiscal cliff. Face up to reality– and read the unvarnished truth about the fiscal cliff as proposed by Boston Consulting Group, a leading adviser to multinational corporations, that has to be taken damned seriously. At the very least it is food for thought– though it may give you indigestion.
BCG is proposing nothing less than a radical long term restructuring of the rules of the game for the US– and yes, the rest of the world. Consider this simple arithmetic; in the 1960s each additional dollar of debt led to a 59 cent increase in GDP. Today, each $1.00 of debt creates only 18 cents in new GDP.
And yes, governments have 4 times the debt they had in 1980; households 6 times the debt, and non-financial institutions some 3 times as much debt. You've heard this before. You're going to hear it over and over again until something– too little something perhaps– happens.
Thank you BCG for the wake-up call. "Nearly five years after t he financial crisis, the leaders of the developed world are far too complacent," the report charges. "Politicians and central bankers have continued to kick the can down the road– postponing the day of reckoning." And the reckoning, according to BCG is to "avoid telling the public the truth that a sizeable part of the debt will not be paid back in an orderly way."
Here unvarnished is the truth, the whole truth so help me BCG.
1. Creditors will have to accept losses.
2. the wealthy will have to pay more taxes.
3. wage earners will have to work longer and save more for their retirement.
4. public spending on social welfare will have to be cut.
5. government will have to get smaller.
All controversial policy issues that will require time and a sense of urgency to resolve. Could be at least a decade– maybe two decades in the working, as these are radical changes that cannot be put into effect overnight.
Who pays up and who benefits from all these changes have not been properly debated or made transparent. The White House refused to campaign on the nation's growing poverty. And it has still not presented the really hard choices to the nation in a digestible way.
Facing up to the remnants of what BCG tags "Ponzi finance" puts the spotlight on the way neither cash flow nor asset price gains have been able to absorb the amounts of public and private debt that have been created.
Ponzi finance, the multiplication of debt, must be radically reduced in order to broaden the margin of safety so that our economy will not be subject to the kind of Black Swan Long Tail that took public policy by surprise in 2008. I'd intensify my financial education by reading the Boston Consulting Group's realpolitik take on the path away from Ponzi finance.


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In the aftermath of Republican Scott Brown's victory in Massachusetts, panic has set in among the Democrats. Different factions are reacting in different ways. The Left is arguing that Obama was not liberal or aggressive enough. Moderates are saying Obama's agenda was too liberal and ambitious. Some are saying it's more imperative than ever to pass health-care legislation; others are saying that would be the worst thing to do in light of the results in the Bay State. But what they all agree on is that the Obama presidency and the Democratic Party are in a heap of trouble.
"The Republican victory in Massachusetts has sent a wave of fear through the halls of the Senate, with moderate and liberal Democrats second-guessing their party's agenda," Politico reports, "and worrying that they'll be the next victims of voters' anger… 'Every state is now in play,' said Sen. Barbara Boxer (D-Calif.)."
It is now worth asking whether, in the wake of three pulverizing electoral losses for the Democrats — the gubernatorial elections in Virginia and New Jersey and the Senate race in Massachusetts — any president has done more damage to his party in a shorter period of time than has Barack Obama.
All this wreckage from the man we were told would be the next Lincoln and FDR, a "sort of God," in the words of Newsweek's Evan Thomas. A year ago today the liberal Harold Meyerson wrote a column in the Washington Post titled "Words Made Flesh," referring to the description of Jesus in the gospel according to John.
Other presidents, having driven themselves into a ditch, have recovered. Whether or not Obama does depends on things we do not know. What we do know, and what we can assess, is what has unfolded over the course of the past year. And it has been — for Mr. Obama and his administration, his agenda and party, and liberalism itself — brutal.
Falls from grace usually are.


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Dustin Cohen
I shot this 8×10 metal wet-plate of Dustin a few weeks ago. I shot it with the intention of doing this picture, but just now getting around to it. I saw it in my head. Tonight I shot some stuff in my neighborhood, and just started combining and bleaching.
Jim Goldberg of Magnum. Fuck yes. Link here.
Nothing better than a baby's foot. From tonight at PhotoVille in Brooklyn.
Dia Beacon
Hopped the MetroNorth upstate to the Hudson Vallery area to Dia Beacon, about 80 miles north of the city. 240,000 square feet of modern art. It was an old Nabisco box-printing factory building. Only photographed part of it before security nabbed me. Missed the giant Warhol room. The whole museum was a giant meditation in white, especially the Richard Ryman area. Also passed this incredible rotting site called Bannerman's Castle, on an island in the Hudson, seen from the train window.
Someone installed these boom arms on the roof of their building, with strings attached. The vines in the flowerboxes below slowly make their way up the string. Love the colored doors. Near my apartment, this is around 43rd and 10th. My mother would love this.
Competition swimmer, and only heading into the fifth grade next week. Determined. Heart of gold. (with Alison Donalty).
Andrew Hetherington
Portrait today of my friend Andrew Hetherington. I think he wears the same model of denim jacket, and wears them out. Just buys another one once it's shot. 8×10 collodion.
Dustin Cohen
A diptych from today's portrait shoot with Dustin Cohen. I guess tattoos do show up, after all. Thanks to Tricia Scott for art direction and just a fun day, and to Abby Kraftowitz for great technical help with the process. 8″x10″ collodion on black metal.
Dumbo stairs
This morning.
"I Am", next morning
Buzzing through the train tunnel today, on the way to the Shuttle to the east side, and it's rush hour, and gazillions of people, and this guy is stopped to help out a very old Vietnamese woman, who was begging. I wanted to show the buzz of people, only got off one frame; 8 second exposure handheld, so it's blurred. But if you get a chance to see "I Am", on Netflix or whatever, you'll get it about this picture.
Julia Margaret Cameron: Met
Saw the show quickly this morning; little free time. Hopped on the 4. Nice show; small. Made me admire her even more — six children running around, and photography had just been invented. Late 1860's. Seemed to care more about feeling than exacting technique; she caught hell for that from her peers. (I give her Bonus Points). Fascinating woman. Wet-plate collodion, on clear glass, so she ended up with negatives to print somehow.
Opening room. I included some guy in there, to show scale of that opening poster print image, for the intro.
Lord Tennyson. I guess she knew him personally. The caption talked about how she put that collar on him.
Not sure who this is, but interesting that she staged and propped some of her images.
One of the few "models" that she photographed. She normally only photographed friends and family. Great face though.
Sir John Herschel.
Portrait of Julia Margaret Cameron.
Talent Casting
I photographed this interesting man today for a talent casting, for a commercial project. He's from a small town in Sicily. He told me amazing stories of being a writer as a young man, and living in Paris. I asked him to stay around for a portrait, aside from the job. Great face; great stories. I wish I could display it just like I see it, full bleed, on this 27 inch monitor. The bigger it gets, the better it gets.
August 18th
Early tests. Window light. 8×10 collodion on metal. Ninety-second exposure.
Roger's hand, and Abby's flowers. A New York crew is being trained. Early on, but satisfying.
Roger and Abby's wind machine. Strobe.
Windows at Christie's Auction
Four gigantic posters in the display windows of Christie's Auction House today, on 50th Street. You could not walk by without stopping; even printed as posters, they stopped you in your tracks.
I'm now the king of searching for wet-plate space in Brooklyn. Here's a potential studio building, today, off the Graham stop of the L. Reminds me of the electricity riggings in New Delhi, or that old Werthan building in Nashville. It's a Fire Marshall's wet dream. I found it oddly pretty, with that window light.
Everybody Street
Everybody Street Trailer from ALLDAYEVERYDAY on Vimeo.
via Rachel.
Mt Carmel Fair
I stumbled onto this Italian Street Fair on Roebling, in Williamsburg, last night. Mount Carmel festival of some type. Complete with six story portable giglio. With the drenching rainstorm, and the tattoo booth next to the statue, the whole thing was surreal biblical.
Chelsea Market
Big adventure last night on The High Line and Chelsea Market. Spices and Tease pictured below.
Stairwell leading to second floor of (hopefully) my new home, soon. Built in 1865, brownstone. Hell's Kitchen, 44th and Ninth.
Whitney: Robert Irwin
Today at The Whitney, with a massive Robert Irwin white scrim sculpture. Plus, "I You We".
Williamsburg Sunset
Manhattan in the background. Gorgeous soft light, this afternoon. And somewhere out there, a dog is in the East River, fetching a ball.
Click image for larger version.
Chelsea Hotel
Very well written article in The Times Magazine, about the Chelsea Hotel.
Bedford at Sixth
Jewelry vendor, today, on Bedford Avenue in Williamsburg. Great style, beautiful face.
No Doctor Here
Plywood sign glued to the stone doorway, at 31st and Park Avenue, today. I can only assume that, at one time, there was.
Union Square, 90 degrees
Great face, today, on the street in Union Square, at the fresh market. Striking presence.
SX-70 from the 1970's
Two frames from the first pack of SX-70 film, today, at Gus and Barbara's apartment uptown. With Andre Schneider too and his wife. Handheld, window light, Impossible Project SX-70 B/W instant film. Quirky process, but it's getting there. Camera from 1970's is still solid though. Great lens.
Gus and Barbara's son.
Andre's stepson, Gabriel.
Impossible Project: SX70
I made the trip to Mecca today, to The Impossible Project, on Broadway at Canal. The process is still a bit primitive, but it's come a long way. You still have to keep the image in the dark for the first two minutes, but they've designed this cute little black window-shade thing that cover it, right out of the camera. I sprung for a vintage metal SX-70 Sonar, with manual focus override, and some boxes of B/W film.
Anselm Kiefer
We found this jewel, out of print, in mint condition, at Dashwood. What a find. Let it rain, who cares? Just give me a cortado and a window.
Oysters and Tabasco
Rachel, at lunch, in the West Village. Step back in time. Great cafe.


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Site Feedback
Can't see the comments in the most recent Food Lab post
I can see the add comment box, and I can see what the total amount of comments are, but can't see the comments themselves. Tested it in Chrome and Safari on a Mac, as well as on my iPhone.
Talk is closed, but that doesn't mean the conversations have to stop!
Check out this post for a more thorough explanation, and jump onto our Facebook page or our Twitter feed to keep the conversations going!


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The supple silicone head on the Calphalon large silicone scraper is great for mixing and stirring. The kitchen scraper has flexible sides that help round up every last drop of batter in a mixing bowl, and it's BPA free, so it's safe for the kids to lick clean. The innovative design features slanted corners that were specially shaped to reach into pan edges and corners. The heat-resistant utensil handle has soft-touch silicone accents and a grip-anywhere construction that gives you better control without giving up comfort or having to grip too tightly. The silicone also protects the nonstick surfaces of your pots and bakeware.
- Multi-functional kitchen scraper has flexible silicone head
- Uniquely designed corners make it easy to scrape edges of cookware and bakeware
- Calphalon large silicone scraper won't scratch nonstick cookware
- Strong, textured soft-touch handle makes it sturdy for using with thick batters
- Heat resistant to 400 degrees F
- BPA free


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Our Supreme Edition Darth Vader Mask and Helmet is made in heavy injection molded ABS material, cast from the original Lucas Studios molds. The Supreme Edition Darth Vader Mask and Helmet Set is packaged in a full color display box.There is only a limited numbered being made. Don't Wait. Buy NOW!
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