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|Número de publicación
|Tipo de publicación
|Número de solicitud
|Fecha de publicación
|9 May 2006
|Fecha de presentación
|30 Jul 2003
|Fecha de prioridad
|27 Dic 1999
|También publicado como
|Número de publicación
|Philip E. Eggers
|Cesionario original
|Neothermia Corporation
|Exportar cita
|BiBTeX, EndNote, RefMan
|Citas de patentes (45), Otras citas (6), Citada por (17), Clasificaciones (16), Eventos legales (5)
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet
The present application is a continuation-in-part of application Ser. No. 10/235,131, filed Sep. 5, 2002 (now abandoned) entitled "Method and Apparatus for Positioning a Tissue Recovery Instrument in Confronting Adjacency With a Target Tissue Volume" by Eggers, et al., which, in turn, is a continuation-in-part of application Ser. No. 09/904,396 filed Jul. 12, 2001 now U.S. Pat. No. 6,471,659, entitled "Minimally Invasive Intact Recovery of Tissue", by Eggers, et al., which, in turn, is a continuation-in-part of application of Ser. No. 09/472,673, filed Dec. 27, 1999, now U.S. Pat. No. 6,277,083 by Eggers, et al., issued Aug. 21, 2001 and entitled "Minimally Invasive Intact Recovery of Tissue".
Not applicable.
The employment of high frequency current for the purpose of carrying out surgical cutting and/or coagulation has represented a significant surgical modality since its promotion in the 1920's by Cushing and Bovie. Electrosurgical cutting is achieved by disrupting or ablating tissue in immediate apposition to an excited cutting electrode, i.e., slightly spaced before it so as to permit the formation of a cutting arc. Continuous sine waveforms generally are employed to carry out the cutting function wherein tissue cells encountered by the electrode arc are vaporized. An advantage of this electrosurgical cutting procedure over the use of a cold scalpel, at least below the skin layer, resides both in an ease of cutting and a confinement of tissue damage, in the absence of collateral thermal phenomena, to very small and shallow regions. In this regard, cells adjacent the cutting electrode arc are vaporized and cells only a few layers deeper essentially are undamaged.
Inasmuch as these electrosurgical cutting and coagulation systems, for the most part, have been utilized in conjunction with what may be deemed "open" surgical procedures, the noted collateral thermal damage essentially has been dismissible. For instance, elevated temperature fluid including gases, liquid and steam generated by tissue cell vaporization immediately is disseminated to atmosphere, or in the case of abdominal laparoscopy, to an artificially developed inert atmospheric volume.
These cutting systems typically are employed in a monopolar manner wherein the cutting electrode is considered the active one and surgical current is returned from a large, dual component dispersive electrode coupled with the skin of the patient at a remote location. Other electrosurgical modalities typically are available with the generators employed with these systems. For example, various forms of coagulation employing discontinuous current waveforms may be carried out, including the use of a "blend" waveform devised for providing a combined cutting and coagulation electrode-carrying output. The generators also may perform in bipolar fashion, a return electrode being located at an instrument working end region.
The electrosurgical cutting reaction has been the subject of study. Some investigators have observed and thus contemplated a model wherein cutting is achieved as the electrical conduction of current heats the tissue up to boiling temperatures and, as noted above, the involved cells basically are exploded as a result of phase change. That phase change involves a generation of the noted elevated temperature fluid including steam with attendant latent heat of vaporization, a thermal attribute heretofore deemed to be of no physiological significance.
Another, parallel model has been described wherein, as an intense electromagnetic field impinges on absorbing tissue, an acoustic wave is generated by the thermal elastic properties of the tissue. The origin of the pressure wave lies in the inability of the tissue to maintain thermodynamic equilibrium when rapidly heated. As with the initial model described, a consequence of the reaction is the generation of elevated temperature fluid and attendant thermal phenomena. See generally:
Electrosurgical systems have somewhat recently been introduced to what may be described as "embedded interstitial" surgical procedures. Important interest in such procedures has been manifested in achieving a minimally invasive access to potentially neoplastic lesions of the breast. These minimally invasive endeavors perhaps have been stimulated in consequence of estimates that one out of eight women will face a breast involved potentially cancerous lesion at some point in her life.
Access to these breast-involved lesions historically has been achieved through open surgery where the target tumor is removed along with a margin of healthy surrounding tissue. Over the somewhat recent past, non-electrosurgical preliminary minimally invasive biopsy procedures have been carried out to distinguished benign lesions from neoplastic ones. These preliminary approaches have involved: fine needle aspiration biopsy, vacuum assisted large core needle biopsies, Advanced Breast Biopsy Instrumentation (ABBI), and Minimally Invasive Breast Biopsy (MIBB). See generally:
Relatively early as well as concurrent activities employing electrosurgical cutting implements in accessing breast born lesions generally involve an elongate probe, the distal or working end of which carries an electrosurgically excitable cutting edge. That cutting edge is sought to be excited when embedded in tissue, i.e., when positioned within or in adjacency with the lesion. Investigators have encountered serious difficulties in creating the necessary arc for carrying out a cutting maneuver. However, when such requisite arc formation is achieved, a variety of cutting electrode configurations have been and continue to be promulgated. For instance, the distal tip of the probe has been positioned in adjacency with the lesion, whereupon a wire-form cutting electrode is deployed while excited from a retracted orientation into a curvilinear shape which then is manipulated about the lesion in a circumscriptive maneuver, whereupon the electrode is retracted back into the probe structure. Where the thus vascularly isolated and compromised lesion is to be left in place, a barrier fluid may be introduced from the probe to enhance its isolation from adjacent healthy tissue. See, for example, U.S. Pat. No. 6,514,248 by Eggers, et al, entitled "Accurate Cutting About and Into Tissue Volumes With Electrosurgically Deployed Electrodes" issued Feb. 4, 2003.
A minimally invasive approach to accessing breast lesions wherein the lesion is removed in its entirety for diagnostic as well as therapeutic purposes has been described in U.S. Pat. No. 6,277,083 by Eggers, et al., entitled "Minimally Invasive Intact Recovery of Tissue", issued Aug. 21, 2001. This electrosurgically based instrumentation is of a variety wherein the active cutting electrodes, inter alia, move in a highly elaborate locus configuration with a geometry which alters active surface areas in the course of a circumscription procedure which initially isolates the target lesion and then captures it for submittal to analysis by pathology. The instrument employs an expandable metal capture component supporting forwardly disposed, arc sustaining electrosurgical cutting cables. Those cutting cables, upon passing over a target lesion, carry out a pursing activity to close about the target tissue establishing a configuration sometimes referred to as a "basket". To initially position the forward tip of the involved instrument in confronting adjacency apposite the targeted tissue volume, an assembly referred to as a "precursor electrode" assembly is employed. In the latter regard, the forwardmost portion of the instrument tip supports the precursor electrode assembly. That electrode assembly is initially positioned within a small incision at the commencement of the procedure, whereupon it is electrosurgically excited and the instrument tip then is advanced to a target confronting position. The utilization of such precursor electrodes as opposed to a sharpened tip cold trocar-like arrangement serves to avoid displacement of the target lesion by the instrument itself as it is maneuvered into confronting position.
An improved design for the instrument, now marketed under the trade designation EN-BLOC® by Neothermia Corporation of Natick Mass. is described in U.S. Pat. No. 6,471,659 by Eggers, et al., entitled "Minimally Invasive Intact Recovery of Tissue", issued Oct. 29, 2002. That patent also describes an electrosurgical generator which is, inter alia, configured to provide accommodation for the necessity of initially creating or "striking" an arc while the involved electrode is embedded within tissue. This initial creation of an arc is called for both at the commencement of probe or instrument positioning by creating an arc at the precursor electrode assembly and with respect to the capture component cutting and pursing cables both at the onset of the procedure and, for example, during an intermittent operation of the system as the capture component envelopes the targeted lesion. Because these electrodes are embedded or in direct contact with tissue, conventional surgical techniques for spacing the cutting electrode from the tissue to start an arc do not represent a practical approach to arc formation. To create such an arc at procedure commencement or for purposes of restarting during intermittent operation, the attending electrosurgical generator elevates a control voltage to an extent effecting arc creation at an elevated power level for a boost interval of time which is of that minimum duration necessary to assure development of an arc. Such a generator is marketed as a "Model 3000 Controller" by Neothermia Corporation (supra).
The "EN-BLOC®" instrumentation as discussed above further is characterized in the utilization of an evacuation system extending from a vacuum device to the instrument and thence through the elongate cannula or probe component thereof to four ingress ports located adjacent its tip or distal end. This evacuation system is activated during the utilization of the device for the purpose of collecting and removing liquids, for instance, which may be of such low resistance as to defeat arc formation, as well as smoke and steam.
Experience and a modeling form of analysis of the systems incorporating imbedded electrosurgical electrodes have revealed that the necessary confinement of the active electrodes within tissue during their excitation may lead to a substantial evocation of higher temperature thermal phenomena. The mechanism of electrosurgical cutting, involving arc generated steam vapor and other elevated temperature fluids for the duration required for target tissue volume circumscription may lead to collateral thermal damage to adjacent healthy tissue. Latent heat of vaporization of arc/cell generated fluids such as steam also may be conveyed through the surface of the elongate probe instrument itself into healthy tissue adjacent the path of insertion and removal.
Because the active cutting electrodes and associated elongate support components are located subcutaneously during a procedure, the anatomically and physiologically specialized boundary lamina protection barrier to external thermal attack represented by the skin is compromised by an interior heat attack. That same skin developed barrier to external phenomena may also be subject to the thermal (burn) damage occasion by a contact of proximal portions of the probe cannula with skin to induce burn or erythema. Skin contact with the steam/fluid heated probe cannula has been observed to be a particular possibility where guidance of the working end of the probe is assisted by ultrasound-based systems.
The present invention is addressed to method, system and apparatus for carrying out interstitially located electrosurgical cutting while avoiding collateral thermal trauma to healthy tissue, as well as thermal damage to any target tissue specimen sought to be retrieved for biopsy.
As tissue is severed by application of an interstitially positioned electrosurgical cutting arc, elevated temperature fluids including steam, any heated gases and liquids including blood and anesthetic solution, are contemporaneously removed through an intake port located in the vicinity of tissue severance. These hot fluids are directed along a transfer channel for external disposition. As the elevated temperature fluids traverse the cannula component of an involved electrosurgical instrument, external surfaces of that instrument itself may be heated to tissue damaging temperatures. Such damage is avoided under the precepts of the instant invention by a variety of thermal insulation approaches, the selection of which may be predicated upon the ultimately developed physical size extent of the cutting electrode utilized and an attendant duration of the cutting procedure. In one instrument arrangement, a cannula component internally incorporating a heated fluid transfer channel is externally insulated by a thermal barrier configured as a thermal insulator sheath. That sheath may be provided as a tube having an inner wall surface spaced from the exterior surface of the cannula component. With such spacing, there is defined an insulation gap or space. Standoffs are employed to support the tube away from the cannula component surface, one such standoff being fashioned by rolling the ends of a stainless steel sheath tube.
In another embodiment the insulator sheath is formed as an extruded polymeric tube having an array of internally depending rib-form standoffs aligned in parallel with the axis of the cannular instrument.
As another feature, the invention provides a method for carrying out an electrosurgical cutting procedure at the subcutaneous situs of a target tissue volume situate within healthy tissue, comprising the steps of:
Other objects of the invention will, in part, be obvious and will, in part, appear hereinafter. The invention, accordingly, comprises the method, system and apparatus possessing the construction, combination of elements, arrangement of parts and steps which are exemplified in the following detailed description.
For a fuller understanding of the nature and objects of the invention, reference should be made to the following detailed description taken in connection with the accompanying drawings.
In the discourse to follow the thermal consequences of utilizing an electrosurgical cutting arc in an embedded, interstitial tissue environment are addressed. These consequence are, in effect, collateral to the generation of a cutting arc within a confined tissue environment. Accordingly, the system and method at hand looks both to the need for evacuating steam generated by boiling cell fluids heated gas or liquids (collectively "elevated temperature fluid") in order to avoid or at least minimize thermally induced trauma to surrounding healthy tissue, and looks to the consequences of instrument-born heat resulting from this process of evacuating generated steam and other fluids. Thermal data is provided which has been compiled from investigations carried out with the noted tissue retrieval system marketed under the trade designation "EN-BLOC®". Accordingly, that system is described along with modifications to it. The discourse then turns to applications concerning diverse electrosurgical cutting instruments having working end or forward regions which are utilized at interstitially embedded sites.
Referring to
Disposable component 16 includes an elongate cannula assembly represented generally at 22 which extends along a longitudinal cannula or instrument axis 24. The proximal end of cannula assembly 22 extends through a rotatable, externally threaded connector 26. Connector 26 is threadably engaged within the housing 18. Cannula assembly 22 further extends through a suction manifold 28 which is a component of an evacuation system. Manifold 28 is retained in position on cannula assembly 22 by a ferrule or collar 30 which is mounted over the outward surface of a cannula component, a portion of which is represented generally at 32. Most of the outward surface of the cannula assembly 22 will be seen to be covered with an electrically insulative thin black colored polyolefin shrink wrap or tube. The forward region or working end region of the cannula assembly 22, as represented generally at 34 extends to a distal end or tip represented generally at 36. Suction or vacuum manifold 28 is in vacuum conveying and fluid (steam/gas or smoke/liquid), receiving relationship through cannula assembly 22 with four intake ports, two of which are shown at 38 located at the forward region 34. Vacuum is conveyed to and fluid/steam/gas is received from suction manifold 28 via a flexible transparent polymeric tube 40. Tube 40 extends from an evacuation outlet (not shown) at manifold 28 into press fit connection with connectors 42 and 44, whereupon it is coupled with a flexible tube or hose of larger diametric extent shown at 46. Hose 46 extends to a fluid trap and filter assemblage 48 which is in vacuum communication via flexible hose 50 with the suction input of a suction pump assembly represented generally at 52. Vacuum or suction pump assembly 52 can be of a type marketed under the trade designation "VersaVac 2" by Stackhouse, Inc. of Palm Springs, Calif. Pump assembly 52 may be actuated into operation from a switch arrangement shown at 54 or through utilization of a footswitch 56 coupled to the pump assembly 52 via a cable 58.
Connectors as at 42 are positioned on each side of the housing 18 and function additionally to support a stabilizer handgrip, for example, the annulus-shaped grip represented at 60. Connectors as at 42 also may be employed to support the instrument 12 for stereotactic manipulation. Positioned at the forward portion of the housing 18 are three button switches 62–64 which function, respectively as an arm/disarm switch; an energize/position switch; and a start tissue capture switch. Immediately above the switches 62–64 on each side of housing 18 are linear arrays of light emitting diode (LED) based indicator or cueing lights, one such array being represented generally at 66. The visual cues provided by the indicators at 66, from the forward region of housing 18 toward the rear region thereof, provide a start/reset cue as a green light; a tissue capture complete cue provided as a green light; a start tissue capture cue (above switch 64) provided as a yellow light; an energize/position cue (above switch 63) provided as a yellow light; and an arm/disarm cue (above switch 62) provided as a green light. Energization and control is provided to the instrument 12 via a multi-strand cable 68 which connects with a combined control assembly and electrosurgical generator represented generally at 70 and incorporated within a console 72. Connection of the cable 68 with the console 72 is shown at a multi-lead connector 74 which is coupled to a console connector 76. The electrosurgically active electrode assembly of the instrument 12 performs in monopolar fashion. Thus, a conventional, relatively large, dispersive return electrode assembly, as shown in general at 80, is positioned against the skin surface of the patient. Assembly 80 is configured as having two electrode components 82 and 84 which are connected via cable 86 and connector 88 to console connector 90. Alternately, a return electrode may be positioned at the surface of cannula assembly 14 near its distal end in place of the illustrated use of a dispersive return 80.
Power is supplied to the circuitry at console 72 upon actuation of an on/off switch 92. When switch 92 is in an "on" orientation, a green visual indicator LED 94 located above the switch is energized. Proper connection of the cable 68 and connector 74 with console connector 76 is indicated by an illuminated green LED 96 positioned above connector 76. This connection test is carried out by directing current to a coding resistor within housing 18. A three-pedal footswitch represented generally at 98 is coupled via a cable 100 to the rear panel of console 72. The three pedals, 98 a–98 c of switch 98 emulate and provide alternative switching with respect to button switches 62–64.
Visual cueing corresponding with that at housing 18 LED arrays as at 66 also is provided at the console 72. In this regard, a start/reset switch 102 is operationally associated with an LED indicator 104 which illuminates in a green color upon actuation of that switch. An energize/position mode visual cue LED representing an energization of a precursor electrode at tip 36 is shown at 106. This LED provides a yellow output during the electrosurgical advancement of cannula assembly tip 36 into confronting adjacency with a targeted tissue volume. Next, a green, arm/capture mode visual cue is provided by an LED 108 to represent an arming of the tissue capture feature of instrument 12. Once an arm/disarm switch as at 62 or 98 a is depressed, the energize/position switches as at 63 or 98 b are no longer activatable. However, the practitioner may return to the positioning mode by again depressing an arm/disarm switch. A yellow capture mode visual cue is provided by an LED 110 to represent the start of and carrying out of a tissue capture procedure and upon completion of such capture, a green capture complete mode visual cue is provided by a green LED 112. A pause mode condition is represented by the energization of a green LED 114. In general, the pause mode is entered during a procedure by releasing capture switch 64 or footswitch 98 c. When in a pause mode, the active capture electrodes of the instrument 12 are not energized and deployment of its capture component is halted. However, the evacuation function carried out by the suction pump assembly 52 continues to perform. To reenter the capture mode, the practitioner again depresses footswitch 98 c or capture switch 64. Upon such re-actuation of the chosen switch, the capture mode continues, in effect, from the orientation where it left off. This pause mode of operation of the system may be employed by the practitioner during a capture mode of operation to permit, for example, the evacuation of fluids encountered by arc-based cutting components. Such fluids, may for example, be accumulations of local anesthetic solution, blood or the like.
An assurance that the vacuum system, at least to the extent that the vacuum pump assembly 52 is active, can be accomplished with a vacuum actuated switch (not shown) attached within the conduiting extending between the pump assembly 52 and the instrument 12. For example, unless such a switch is actuated, the commencement of a procedure can be logically blocked by the control assembly 70. In addition to the removal of smoke and such fluids as above discussed, the evacuation system including pump assembly 52, conduiting defining a transfer channel extending to the intake ports 38, functions to remove steam which is generated by the encounter of an electrosurgical cutting arc with the fluid of tissue cells. This removal of steam (as a component of elevated temperature fluid) serves, inter alia, to protect healthy tissue surrounding the region of cutting from thermal trauma. As such steam is evacuated, for example, along a transfer channel within cannula component 32 and into conduiting as at 40, it will tend to condense, releasing heat associated with the latent heat of vaporization of water. Accordingly, heat within the transfer channel of the cannula component 32 may, for certain orientations of the probe, cause an external surface burn to skin or erythema, notwithstanding potential damage to internally disposed healthy tissue. Accordingly, a thermal insulator sheath or shield assembly, shown generally at 120 is seen to be located over the cannula component 32. The performance of this shield and others is discussed later herein. Not seen in the instant figure is a very thin electrically insulative and biocompatible covering of the sheath assembly 120 and adjacent portions of the cannula component 22.
At the time the connector 88 of the return electrode 80 is coupled to console connector 90 and switch 92 is in a power-on condition, a patient circuit safety monitor (PCSM) carries out a self test. On subsequent actuation of the start/reset switch 102, a fault test with respect to the two electrode components 82 and 84 is performed. In the event the later test fails, then both visual and aural pulsating warning cues are activated, the visual cue being provided at a red LED 122 located adjacent connector 90.
The protectional functioning of the thermal insulator sheath assembly 120 is demonstrated in connection with
Referring to
Positioned opposite indexing pin 146 on support housing 140 are two, spaced apart electrical contacts 154 and 156 which are oriented to make wiping contact with corresponding electrical terminals disposed within housing 18 upon insertion of support housing 140 within the receiving cavity 150. Contacts 154 and 156 selectively receive electrosurgical cutting current which is applied respectively to a precursor electrode assembly at tip 36 and the electrosurgical cutting and pursing cables associated with a capture component retained within cannula assembly 22. Those pursing cables extend from the capture component within cannula component 32 to a cable terminator component having guidance tabs or ears, one of which is revealed at 158 slidably mounted within an elongate stabilizer slot 162 arranged in parallel with axis 24. A corresponding guidance tab and slot combination is found at the opposite side of support housing 140. Located forwardly of the slots as at 162 are two, additional elongate drive slots, one of which is shown at 166 similarly arranged in parallel with axis 24. The outwardly extending ears or guide tabs of a drive assembly drive member extend from these slots and are seen at 170 and 172. These ears or tabs 170 and 172 support rearwardly disposed driven surfaces which are used to impart forward movement to the drive assembly. This forward movement functions to deploy a capture component from cannula component 32. When the support housing 140 is installed within the receiving cavity 150 of housing 18, these tabs 170 and 172 pass through oppositely disposed notches shown respectively at 174 and 176 provided at a forward portion of housing 18. Similarly, a notch 178 is located forwardly within housing 18 to permit passage of the electrical terminals 154 and 156.
The procedure for installing the disposable component 16 within the reusable component 14 involves the sliding of disposable support housing 140 within the receiving cavity 150 and rotating knurled portion 144 of connector 26 to provide for the engagement of threads 142 with threads 152. Upon completing the assembly, the flexible transparent tube 40 of the evacuation assembly may be attached to an evacuation outlet 180 depending outwardly and in fluid and suction or vacuum communication with suction manifold 28. Finally, a tab at 182 is seen extending through a forward portion of the drive slot 166. This tab may be a component of a drive assembly safety stop functioning to limit the extent of forward travel permitted by a drive member component of the ears 170 and 172. It is located in accordance with a pre-selected capture component maximum effective diametric extent. Such a tab also may function as a capture complete stop which functions in the derivation of a capture complete signal conveyed to the control assembly 70. Further details of the system 10 including control assembly 70 are provided in the above-referenced U.S. Pat. No. 6,471,659 which is incorporated herein by reference.
Referring to
Cannula component 32 has a relatively small diametric extent, for example, about 5 mm. Within forward region 34 there is disposed an earlier-noted capture component comprised of a pentagonally-shaped stainless steel elongate leaf structure with a leaf leading edge formed with dual apertures or eyelets which carry a five pursing cable assembly.
Referring momentarily to
Returning to
Located inside support tube 242 is an electrosurgical precursor electrode tube 248 which also extends to the rearward portion of support housing 140 for purposes of both support and receiving electrosurgical cutting energy transmitted through electrical contact 154 (
The precursor electrodes are mounted as a subassembly of four stainless steel electrode wires having the noted generally elongate L-shape as seen, in particular, at 190 and 191 in the instant figure. Elongate components of the precursor electrodes, for example, as identified at 252 and 253 with respect to electrodes 190 and 191 extend into a subassembly tube 254. Four such electrode assemblies are crimped inside of this tube 254 and that tube, 254, in turn is crimped within the forward portion of the precursor electrode tube 248. It has been found that the utilization of four cutting surfaces for the precursor electrodes, arranged in the cross-shaped pattern, provides preferable instrument positioning results. The resultant arrangement of confronting electrode surfaces is revealed, for example, in connection with
In the procedure initiation orientation of
In general, within about three seconds following the commencement of the electrosurgical cutting procedure with either the precursor electrodes or the capture component, heat released, for instance, from the steam as steam condensation, consequent latent heat of vaporization within the transfer channel 246 will elevate the temperature of the external surface of the wall of cannula component 32 to excessive levels. Returning to
Looking momentarily to
Looking to
In general, the thermally insulative air gap for the stainless steel thermal shield embodiment will range from about 0.005 inch to about 0.200 inch in extent and the stainless steel cylinders will exhibit thicknesses ranging from about 0.001 inch to about 0.020 inch.
Referring to
Looking additionally to
Thermal insulation of the cannula component also can be accomplished employing sufficiently rigid thermally insulative materials such as cross-linked foamed polyethylene marketed by Hitachi Chemical Co. America, Ltd of Cupertino, Calif.; Silicone fiberglass sleeving, or Polyurethane-fiber sleeving, both marketed by CNACC Import & Export Co., Ltd, Zhejiang, China. Other thermally insulative materials include sleeving materials which are air entrained (foamed) such as foamed polyurethane and foamed silicone rubber. In addition low thermal conductivity plastic materials such as urethane and polyimide may be used. Such a thermally insulative sheath assembly is represented generally at 320 in
The extent of caloric involvement associated with interstitially embedded electrosurgical cutting arcs will vary with the size variations of the arc carrying electrode and the duration of arc cutting. For instance, for the capture component structuring described above, where a target tissue volume of about 10 mm maximum diametric extent is involved, the time of the procedure involved for cutting subsequent to precursor electrode energization and positioning will be about seven seconds. Where the maximum diametric extent of the target tissue volume is about 15 mm, then the extent of pursing cable carrying an electrosurgical cutting arc will expand as well as the time interval for completing a capture. That time interval will be about 10 seconds. Correspondingly, where the maximum diametric extent of the target tissue volume is about 20 mm, then the extent of pursing cable play-out to form an electrosurgical cutting arc will expand still further and the time required for completing a capture will increase to about 12 seconds.
Surface heating characteristics of two of the above-described cannula components with associated thermal shields and polyolefin coverings were analyzed utilizing a finite-differencing heat transfer computer program identified as "TRUMP". The TRUMP program was originally authored by the Lawrence Livermore Laboratory, (Los Alamos National Laboratory) and subsequently became available through the Oak Ridge National Laboratory (ORNL). Those cannula structures evaluated are described in conjunctions with
The TRUMP program provides a transient (temporal) analysis where the instrument structure is modeled using parameters having thermal effects. For example, the instruments (probes) are surrounded by room air and may be in partial contact with skin, exhibit mass, material densities, specific heat, thermal conductivity, exhibit air gaps which are open or are combined with ribbing (276–312) will exhibit emittance coefficients such as that of the black shrink wrap (e=0.95), emittance coefficient of stainless steel (e=0.3) and combined or effective emittances. With respect to partial cannula assembly contact, the program-based analysis also accounts for the heat sinking effects envisioned with the black polyolefin covered shield being in contact with exposed skin as discussed in conjunction with
The results of an analysis with respect to the rolled end stainless steel thermal shield structure are revealed in connection with
Now looking to the conditions described in connection with
Looking to
Training involving a simulation of clinical experience with the system 10 is, in part, carried out by prospective practitioners utilizing a breast phantom block or mass which is positioned over a dispersive return electrode. For training purposes, the cannula assembly with excited precursor electrodes then is inserted into this phantom breast to a pre-designated location, whereupon a capture procedure is undertaken. The phantom material is a substantially transparent, jell-like material functioning to emulate the physical and electrical characteristics of the human female breast. The material is marketed under the trade designation "Ultrasonic BP Breast Phantom" by Pharmaceutical Innovations, Inc. of Newark, N.J. In general, the phantom mass exhibits a resistance of about 300 ohms.
Using this phantom breast material, an in vitro study was undertaken to further assess the instrument probe or cannula component surface temperature with and without a thermal shield as described in conjunction with
Referring to
Where the disposable component 16 was configured for capturing a target tissue volume of 15 mm maximum diametric extent and with a configuration wherein no thermal shield was employed, then the surface temperatures represented at curve 356 were encountered. Note that at about 10 seconds or the completion of capture for this configuration, surface temperatures exceeded 80° Celsius. Correspondingly, where the heat shield described in connection with
Where the disposable component 16 was configured for capturing target tissue volumes having a maximum diametric extent of 20 mm and no thermal shield was employed, then the results represented at curve 360 were encountered. Capture completion for this test was at the termination of an interval of about 12 seconds and it may be observed that a cannula component surface temperature of greater than 90° Celsius was encountered. However, as represented at curve 362, where the thermal shield represented at
Referring to
Disposable component 376 of instrument 372 is threadably engageable with the handle or reusable component 374 just behind manifold 382. Handle 374 is formed of a polymeric material and includes a polymeric housing 398 having a slot 400 formed therein through which a hand manipulated slidable tab 402 protrudes. The practitioner manually moves this tab 402 forwardly to cause the wire electrode 396 to be compressibly urged against its connection with the forward region of slot 394 to move from a position retracted within the slot to a deployed arch-like orientation as shown. Correspondingly, the electrode is retracted by moving tab 402 rearwardly. Also located upon housing 398 is a button switch 404 manually depressable to cause electrosurgical energy to be applied to the electrode 396. Also shown as being located forwardly of the switch 404 are two LED cueing lights represented generally at 406. Electrical energy for electrosurgical activity is applied to the handle 374 and thence to the cutting electrode 396 via a flexible cable 408 having a cable connector 410 which is inserted within a console connector 412 forming a part of an electrosurgical generator represented generally at 414.
The electrosurgical generator 414 includes a console 416 which, in addition to connector 412, includes a console connector 417 to which is coupled a cable connector 418 and associated control cable 420 extending, in turn, to a footswitch assembly represented generally at 422. Switch assembly 422 includes a footswitch 422 a actuable to create a cutting arc at electrode 396 and a footswitch 422 b which may be employed, for example, to apply a coagulating electrosurgical current to the electrode.
Electrode 396 performs in a monopolar fashion. Accordingly, a dispersive electrode assembly represented generally at 424 is positioned against the skin of the patient at a location remote from the electrode region of influence. As before, the electrode 424 includes two electrode components 424 a and 424 b and is connected to a return cable 426 which extends in turn to a cable connector 428. Connector 428 is coupled with console connector 430.
Manifold 382 as well as the cannula component 386 are portions of an evacuation system for removal of elevated temperature fluid. In this regard, the evacuation system includes an inlet port at the entrance of slot 394, a transfer channel formed within the cannula component 386, manifold 382 and an evacuation outlet (not shown) extending from the manifold. Attached to that outlet is a transparent flexible evacuation tube 432 which extends, in turn, to a flexible hose 434. Hose 434 extends to a fluid collection and filtering component 436 of a suction assembly represented generally at 438. Vacuum is applied to the component 436 from a vacuum pump 440 via flexible hose 442. Pump 440 may be activated from a hand switch as at 444. Alternately, the pump 440 may be activated from a footswitch 446 coupled thereto via a cable 448 at a connector assembly 450.
The assembly 378 also provides a second transfer channel feature to the system 370 permitting the expression of a barrier fluid into the cut formed by electrode 396 subsequent to its cutting activity. Such an arrangement is described in the above-noted U.S. Pat. No. 6,514,248. For this purpose, manifold 382 is further formed with a fluid input (not shown) coupled to a flexible delivery tube 452 which extends, in turn, to a barrier fluid reservoir and pump assembly 454. Assembly 454 is activated from a footswitch 456 which is coupled thereto from a cable assembly 458.
Visual cueing is provided to the practitioner at the console 416 as represented at the LED array 460. Such cueing will include, for example, the indication of an actively energized electrode 396 as well as any fault detected by a patient circuit safety monitor (PCSM) check as above-described in connection with the dispersive electrode 424.
Looking to
Referring to
Electrode 396 may be formed, for example, of type 304 stainless steel titanium or the like. In general, the electrode 396 will have a diameter within a range of from about 0.1 mm to about 1.0 mm and the cannula component 386 will have a diameter ranging from about 1 mm to about 5 mm. To facilitate deployment of the electrode 396 in the arch-shape shown, a deflector guide component 480 may be positioned within the slot 394. Because the entire instrument 372 (
The thermal shield component of assembly 378 is represented at 482. Shield 482 may assume a variety of configurations including the extruded polymeric design described in connection with
Looking to
Reusable handles similar to that shown at 374 in
Looking additionally to
The disposable probe structure 500 may be provided with a different tip structuring. Such an arrangement is revealed in
Looking additionally to
Another disposable probe configuration which may be employed with the system described in
Looking additionally to
Since certain changes may be made in the above system, method and apparatus without departing from the scope of the invention herein involved, it is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.
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|Electrosurgery with cooled electrodes
|6 Jun 1995
|17 Feb 1998
|Considine; John
|Apparatus for removing tumours from hollow organs of the body
|11 Ene 1996
|24 Mar 1998
|Alto Development Corporation
|Inclined, flared, thermally-insulated, anti-clog tip for electrocautery suction tubes
|29 Ago 1996
|22 Sep 1998
|Ethicon Endo-Surgery
|Methods and devices for collection of soft tissue
|10 Feb 1995
|29 Sep 1998
|Enable Medical Corporation
|Apparatus and method for morselating and removing tissue from a patient
|3 Sep 1998
|8 Feb 2000
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|14 Jul 1997
|13 Jun 2000
|Seedling Enterprises, Llc
|Electrosurgery with cooled electrodes
|27 Dic 1999
|21 Ago 2001
|Neothermia Corporation
|Minimally invasive intact recovery of tissue
|28 May 1998
|2 Oct 2001
|Link Technology, Inc.
|Electrosurgical electrode and methods for its use
|8 Abr 1998
|18 Dic 2001
|Senorx, Inc.
|Breast biopsy system and method
|4 May 2000
|27 Ago 2002
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|12 Jul 2001
|29 Oct 2002
|Neothermia Corporation
|Minimally invasive intact recovery of tissue
|4 Ene 2000
|29 Oct 2002
|Senorx, Inc.
|Apparatus and method for accessing biopsy site
|15 Oct 1999
|4 Feb 2003
|Neothermia Corporation
|Accurate cutting about and into tissue volumes with electrosurgically deployed electrodes
|31 Ene 2002
|9 Mar 2004
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|14 Mar 2002
|20 Jul 2004
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|22 May 2002
|24 Ago 2004
|Rubicor Medical, Inc.
|Methods and systems for in situ tissue marking and orientation stabilization
|21 Jun 2001
|7 Feb 2002
|Seedling Enterprises, Llc
|Cooled electrosurgical forceps
|27 Abr 2001
|14 Feb 2002
|Dubrul William R.
|Intraoperative tissue treatment methods
|7 Dic 2000
|13 Jun 2002
|Roberta Lee
|Methods and devices for radiofrequency electrosurgery
|31 Ene 2002
|20 Jun 2002
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|14 Mar 2002
|18 Jul 2002
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|31 Ene 2002
|25 Jul 2002
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|31 Ene 2002
|25 Jul 2002
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|16 Oct 2001
|15 Ago 2002
|Senorx, Inc.
|Tissue acquisition system and method of use
|31 Ene 2002
|5 Sep 2002
|Rubicor Medical, Inc.
|Excisional biopsy device and methods
|23 Jul 2002
|19 Dic 2002
|Senorx, Inc.
|Tissue acquisition system and method of use
|21 Jun 2002
|30 Ene 2003
|Senorx, Inc.
|Apparatus and method for accessing a body site
|23 Ene 2003
|12 Jun 2003
|Rubicor Medical, Inc.
|Methods and devices for radiofrequency electrosurgery
|12 Mar 2002
|28 Ago 2003
|Manoa Medical, Inc.
|Devices and methods for tissue severing and removal
|22 May 2002
|27 Nov 2003
|Rubicor Medical , Inc.
|Methods and systems for in situ tissue marking and orientation stabilization
|16 Oct 2002
|8 Ene 2004
|Rubicor Medical, Inc.
|Methods and devices for cutting and collecting soft tissue
|3 Jul 2002
|8 Ene 2004
|Rubicor Medical, Inc.
|Methods and devices for cutting and collecting soft tissue
|16 Oct 2002
|22 Abr 2004
|Rubicor Medical, Inc.
|Devices and methods for performing procedures on a breast
|6 Nov 2002
|6 May 2004
|Rubicor Medical, Inc.
|Excisional devices having selective cutting and atraumatic configurations and methods of using same
|8 Mar 2004
|9 Sep 2004
|Rubicor Medical, Inc.
|Excisional biopsy devices and methods
|18 Jun 2003
|23 Dic 2004
|Rubicor Medical, Inc.
|Methods and devices for cutting and collecting soft tissue
|17 Jun 2004
|3 Feb 2005
|Rubicor Medical, Inc.
|Methods and systems for in situ tissue marking and orientation stabilization
|20 Ago 2004
|2 Jun 2005
|Rubicor Medical, Inc.
|Devices and methods for performing procedures on a breast
|9 Dic 2003
|9 Jun 2005
|Rubicor Medical, Inc.
|Suction sleeve and interventional devices having such a suction sleeve
|26 Ene 2005
|18 Ago 2005
|Roberta Lee
|Excisional biopsy devices and methods
|6 Jun 2005
|6 Oct 2005
|Rubicor Medical, Inc.
|Devices and methods for performing procedures on a breast
|D'Angelo, Philip C., et al. "Stereotactic Excisional Breast Biopsies Utilizing the Advanced Breast Biopsy Instrumentation System" Am J Surg. 174: 297-302 (1997).
|Ferzli, George S., et al. "Advanced Breast Biopsy Instrumentation: A Critique", J Am Coll Surg. 185: 145-151 (1997).
|Parker, Steve H. "Stereotactic Large-Core Breast Biopsy," Percutaneous Breast Biopsy Eds. Parker, et al, Raven Press, new York, pp. 61-79 (1993.
|Parker, Steve H. "The Advanced Breast Biopsy Instrumentation: Another Trojan Horse?" Am. J. Radiology 171: 61-53 (1998).
|Parker, Steve H., Needle,) Percutaneous Breast Biopsy Eds. Parker, et al, Raven Press, new York, pp. 7-14 (1993.
|Rosen, Paul Peter, Rosen's Breast Pathology, Philadelphia: Lippincott-Raven Publishers, pp. 837-858 (1997).
|Patente citante
|Fecha de presentación
|Fecha de publicación
|12 Ene 2010
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical device
|26 Ene 2010
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical device
|11 Sep 2008
|20 Abr 2010
|Covidien Ag
|Three-dimensional finite-element code for electrosurgery and thermal ablation simulations
|4 Feb 2005
|1 Jun 2010
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical devices and methods
|12 Oct 2010
|Salient Surgical Technologies, Inc.
|Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
|19 Oct 2010
|Salient Surgical Technologies, Inc.
|Fluid delivery system and controller for electrosurgical devices
|6 Feb 2004
|31 May 2011
|Salient Surgical Technologies, Inc.
|Electrosurgical device having a tissue reduction sensor
|30 Mar 2004
|16 Ago 2011
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical devices, systems and methods
|18 Oct 2011
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical devices, systems and methods
|1 Nov 2011
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical devices, systems and methods
|30 Oct 2007
|13 Dic 2011
|Salient Surgical Technologies, Inc.
|Fluid-assisted medical devices and methods
|12 Oct 2010
|29 Ene 2013
|Medtronic Advanced Energy Llc
|Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
|23 Ene 2012
|11 Jun 2013
|Covidien Ag
|Electrode with rotatably deployable sheath
|28 Oct 2003
|2 Jul 2013
|Medtronic Advanced Energy Llc
|Fluid-assisted electrosurgical scissors and methods
|1 May 2007
|12 Nov 2013
|Covidien Lp
|Accordion style cable stand-off
|1 May 2007
|6 Nov 2008
|Vivant Medical, Inc.
|Accordion style cable stand-off
|11 Sep 2008
|12 Mar 2009
|Stanley Humphries
|Three-Dimensional Finite-Element Code for Electerosurgery and Thermal Ablation Simulations
|Clasificación de EE.UU.
|606/46, 606/41, 606/47
|Clasificación internacional
|Clasificación cooperativa
|Clasificación europea
|30 Jul 2003
Owner name: NEOTHERMIA CORPORATION, MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:EGGERS, PHILIP E.;REEL/FRAME:014349/0942
Effective date: 20030724
|15 Nov 2005
Owner name: INTACT MEDICAL CORPORATION, MASSACHUSETTS
Free format text: CHANGE OF NAME;ASSIGNOR:NEOTHERMIA CORPORATION;REEL/FRAME:016769/0772
Effective date: 20051027
|14 Dic 2009
|Maintenance fee reminder mailed
|9 May 2010
|Lapse for failure to pay maintenance fees
|29 Jun 2010
|Expired due to failure to pay maintenance fee
Effective date: 20100509


text:
Mixed feelings – three key take-outs for Russia at the World Championship
Altogether for the 8-Ball. KHL 2015-16 Closing Ceremony
Repeat gold for Canada, Laine gets MVP
Migration Patterns. Transfer news 21-27 May
Foreign Flavor. May 12-20 Transfer Highlights
Prodigal Sons and New Arrivals: early May transfer highlights
Ufa to Host 2017 All-Star Game
Hail the Justice Department! The Finest Referees, Linesmen of 2015-16
Museum, Hall of Fame and Much, Much More at the Park of Legends
Presenting Hockey in 360 Video Format
KHL.ru is the official Web site of the Kontinental Hockey League. All KHL logos and marks as well as all other proprietary materials depicted herein are the property of the KHL and may not be reproduced without the prior written consent of KHL, ltd
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text:
First-year UW SOM students 2015-16 - Shadowing opportunities
Beginning in the Fall of 2015, we will offer shadowing experiences in the HMC and UWMC EDs for 1st year students. This is meant to complement the revised curriclum, as formal preceptorships will no longer be offered. Students will be able to shadow a maximum of 16 hours per quarter.
More information to come in mid-to-late August, please check back for updates!
The Emergency Medicine Preceptorship provides opportunities for second-year medical students to gain experience working in an emergency setting. Students shadow faculty in Emergency Medicine during faculty shifts.
Preceptorships are offered at Harborview Medical Center, UW Medical Center and occasional openings at Seattle Children's Hospital.
We have limited availability each quarter. Please e-mail Alexis Rush at email@example.com to put your name on a wait list for your preferred quarter.
You must be a 2nd year student at the University of Washington. We do not accept non-UW medical students at this time.
Objectives for the Preceptorships
By the end of the preceptorship, students will:
- Have an increased knowledge of the practice of Emergency Medicine
- Be more comfortable in patient encounters through early patient contact
- An opportunity for students to observe and possibly practice doctor-patient communication skills
- Have an increased knowledge of the basics of doctor/patient communication
Preceptorship Requirements
Students must:
- Complete 32 hours of shadowing with their assigned preceptor
- Complete precept hours within the UW upper campus quarter dates
- Complete an online preceptorship experience evaluation (students will receive an email with a link to a Catalyst evaluation survey upon completion of the course)
- Wear UW issued student ID in the ED at all times.


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When it was (unofficially) announced that NBC was looking to get back into the Xena: Warrior Princess game with a reboot, fans understandably went apeshit. Then Lucy Lawless shot the rumors down. But wait! Maybe she spoke too soon.
Depending on who you ask, Xena: Warrior Princess might be fighting its way back into the back half of the forefront of popular culture, as NBC has possibly given the show a second chance. Here are 7 actresses we think would be perfect for the role, should it indeed exist.
Well, hell. That was fast. Less than a week after Lucy Lawless re-publicized her desire to return to the world of Xena: Warrior Princess, it looks like that universe is almost definitely coming back to the small screen.
Every show has a strong a dedicated fandom. Some series are lucky enough to have really dedicated fans. Nearly 15 years after it ended Xena: Warrior Princess is one of those shows. Those fans would love to see the Warrior Princess return. So, is there any chance that Xena fans might see her again one day?
Fans of The Evil Dead franchise will no doubt be aware by now that Campbell is dusting off the old chainsaw for the new series, but recently, Lawless revealed that her character, Ruby, will have a signature weapon to defeat the Deadites, too.
Xena: The Warrior Princess star Lucy Lawless has most recently signed on for a role in Starzs highly anticipated horror series Ash vs. Evil Dead. All is right with the world except for all those Deadites, of course.
Lucy Lawless' anticipated arrival on Agents of S.H.I.E.L.D. is one more reason to look forward to the series, and today Marvel has given us our first look at the Xena: Warrior Princess star in her role in Agents of S.H.I.E.L.D.. Vague spoiler alert (or big spoiler alert if you're not caught up through Season 1!)
Lucy Lawless is what you might call a geek-friendly actress. While she got her start on the fantasy series Xena: Warrior Princess, she has followed it with great appearances in genre shows like Battlestar Galactica and Spartacus. Because of these credits, the Marvel Cinematic Universe is certainly something that fans would expect her to eventually become a part of, and now that idea is actually becoming a reality.
In what is most definitely an awesome bit of casting news, Lucy Lawless (Battlestar Galactica, Xena: Warrior Princess, Spartacus) is headed to Parks and Recreation. What's more, her role sounds especially fantastic, as she's set to play a love interest to one of the lead characters in the series' upcoming fifth season.
Lucy Lawless has made a name for herself in genre programming, which has likely earned her a healthy-sized crop of fans who love her from her days in Xena: Warrior Princess, Battlestar Galactica, and the currently airing Starz series Spartacus: Vengeance (see also Blood and Sand, and Gods of the Arena). While we may associate her with her roles as a warrior, a Cylon, or the crafty Lucretia, I expect shes just as capable of bringing her talents to series that dont have her dressed for another era or reality.
TV Stories 1 to 10 of 10


text: I have a issue in programming for the graphics Card. I write a shader for Image processing (I use DirectX 11 in combination with SharpDX), but the Transfer from the CPU to the GPU is really slow (sometime about 0.5 seconds), but I think there should be a faster way than using Texture2D.FromStream, because when playing a video, also every image of the Video has to be transfered to the GPU (or am I wrong at this Point?). How can I Speed up this process?


text:
"The Great War is never far away . . ." Top 5 Page for this destination Ieper by filipdebont
Ieper Travel Guide: 539 reviews and 1,598 photos
Mostly, for me Ieper is the gateway towards the hill area (towards Heuvelland, Kemmelberg, Rode- and Zwarteberg) for my tours with my bicycle.
But I think that is a common fact that one travels around the world and that way we forget to visit the beautiful places nearby our home.
But thanks to VT, I have learned to visit and to revisit the nearby places. As being a member of VT, you learn to look with different eyes; you start to look around as a tourist even in your own region, and that way you discover beautiful gems in your own neighborhood.
A perfect opportunity to do that was the Meeting we (Jean Pierre - wandeljp - , Frans - northsea - and I) organised in Ieper on Saturday April 21st 2007.
We had organised a great welcome, with our own VT-bar, with 4 flavours of Jenever and of course the typical Flemish cakes (named "Lukken" from Destropere) and some delicious Belgium Pralines (chocolates).
We started with a walk along the Ramparts (with the great guiding by Patje), along the way we passed a war cemetery, the Rijsel gate, the wooden house and we finally reached the imposing Menin gate.
Then we continued our journey towards the Grote Markt. Here we could amire the imposing Cloth Hall and Bellfry.
After lunch we continued our journey, via the Celtic Cross we passed St Martin's cathedral (unfortunately we could not visit the Cathedral as there was a wedding ceremony going on, then we visited the St. George's Memorial Church and via the Fish market we arrived back at the Grote Markt.
Now it was time to visit the In Flanders Fields Museum, an interactive museum on the Great War. I a bit a shamed, but I must admit that I had never visited this museum before, so now thanks to this VT meeting it finally happened.
After the visit at the museum everyone was (very) thirsty, so time for some local beers on the terrace of the Old Tom.
After a delicious diner we headed for the Menin Gate for the Last Post Ceremony.
And then it was time to say goodbye, . . of course with a local beer.
It was a fine day with a wonderful group of (old and new) friends.
Reviews (34)
Beware of the Ypres wildlife . . . No, No, this is not a joke . . . Especially when you are walking around the... more travel advice
In the utterly ruined "Cat Town"of Ieper the allied forces were our only source of hope ! Hope to give our Youth a... more travel advice
At the corner Jules Coomansstraat and Boterstraat (across the street coming from the Grote Markt, along the Cloth hall),... more travel advice
Potyze : the word comes from the French word Potiche. Which is a long earthen or chinaware vase or vessel. Nearby there... more travel advice
Comments (7)
Dag Philip. Uitstekend commentaar na een zo goede VT meeting. Wat was die "Iepers Fury"?
Indeed, it was a great meeting, which started with a hearty welcome. Thanks to all organisers for the job done. Een heel mooie page is dit geworden. Proficiat !!!
Toch wel wat gemist. Zeker de bar moet door iedereen geweldig gevonden zijn. Volgende meeting zijn wij er bij :) Tom en Gonnie
Nogmaals hartstikke bedankt :)
Zullen volgend jaar moeten herdoen zeker? Locatie zien we wel later! Lille is een goed idee. Jean-Pierre
Hi there filip I heard about the great succesful VT meeting you all had and I am looking for pictures I love the VT signs and the VT Bar Looks like you guys did a great kob organizing this VT meeting Prima gedaan hoor
I also missed a VT bar! Ciao!
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text:
Lion Entry0 Comments Published by Marketing Team May 19th, 2016 in Architecture, Buzz, Cast Stone, Community, Culture, Design, Starbucks, Stone Legends, Uptown.
Cast Stone Lions –
Lions by Stone Legends greet me with a peace
only strength could offer.
A classic style, and one of our popular pieces of cast stone art. This prone lion looks as natural and as detailed as the real thing, all it's missing is the roar.
Even an understated entrance can make a statement.
Anything you can imagine0 Comments Published by Marketing Team August 28th, 2015 in Announcements.
Can You See The Signs0 Comments Published by Marketing Team July 1st, 2015 in Architecture, Cast Stone, Community, CSCS, Culture, Design, Industry, Stone Legends, Uptown.
We produced stone for the Life Sciences Building on the University of North Texas Denton campus. We built the main entry for the building, including the curved sign above the door, and a sculpted sign for the plaza at the corner.
The entry has several parts to it, The curved banding that caps the brick columns, a surround for the door and window above, and the lettering that runs along many panels as well as a wide radius curve.
This is the sculpted sign they put in the plaza between several buildings
Here is a young couple taking photos, with our sign as the background
Closeups of the details.
And a high resolution shot of the sign
The Hero Lives On (and plays a mean round of golf)0 Comments Published by Marketing Team June 24th, 2015 in Announcements, Buzz, Community, Culture, Events, Uptown.
You never know, I guess little boys reside in us forever.
As an adult I might not so willingly admit how many episodes, much less reruns of the TV program Hercules I've seen. You never in a million years think you will meet him in person much less spend the day with him playing golf. Recently, at a celebrity charity sponsored by Bob's Steak and Chop House I did just that. Much to my surprise he was the same pleasant spirit, with the same gentleness only real inner strength portrays, and with all that he had the humility he portrayed as my hero Hercules.
Well maybe the humility waned a little on hole number two when Kevin knocked a 250 yard # 3 wood stiff, leaving less than a 10 foot putt, He had the honor of sinking for the second eagle of the day.
For many, Kevin Sorbo's run on Hercules: The Legendary Journeys And Xena is untouchable, and made him a household name to fans both young and old. He also starred in the adventure movie "Kull the Conqueror", a story from the author and world of "Conan the Barbarian". Sorbo's next major role on the sci-fi series Andromeda made him one of the few nerd icons capable of leaping from swords to spaceships, but the son of Zeus he will forever be. He even reprised the Hercules role in the video game, God of War III – not quite the same character.
In life we suffer many disappointments especially when we elevate people in status and admiration. You know it is nice when your boyhood hero really does turn out to be a hero. He was our team's hero on the second hole, but it was his role in the low budget film "God Is Dead" that had won me over. His wife and he were on a talk show promoting the movie when I first realized he was a real life hero, the kind of hero that faces such things as a brain aneurysm. To me it was the same as looking death in the eye and smiling only to go on to do even greater things.
I can honestly say if ever there was a fan club I wanted to join it would be Kevin's. God bless him and thank you for the time, past, present, and by grace the future.
Richard Carey
A classic style, all in cast stone0 Comments Published by Marketing Team June 5th, 2015 in Architecture, Cast Stone, Community, CSCS, Culture, Design, Stone Legends, Uptown.
This is a project we producted stone for many years ago, but we just received some photos we wanted to share with everyone.
This home is 100% stone, top to bottom. It has a paneling pattern often used in Italianate and other architectural styles architecture. It creates an impression of horizontal bands and surrounds on the windows and doors.
This pool are shows the paneling pattern up close.
The pattern continues in this veranda area.
A view of the ocean out the window. No actual stone in the shot, just a lovely interior.
Architectural Banding in Cast Stone – Pg 1 – Cornice and Entablature0 Comments Published by Marketing Team May 28th, 2015 in Architecture, Cast Stone, CSCS, Design, Industry, Stone Legends.
Horizontal banding is a common decorative architectural feature. It goes at the top of a wall, at the bottom, or somewhere in between.
At the bottom it is called watertable (originally it was for deflecting rain away from the foundation. The top of the watertable projected a few inches away from the building materials below.
Midline banding is located in the middle of a wall. It may run at any height, but is often aligned with the top or bottom of a set of windows or the front entry, or a visual upper level floorline.
At the top it can be called cornice, which is banding directly beneath the roofline, or entablature, which runs between a set of columns and a roof, pediment or balcony. Entablature commonly has a support beam (architrave) that rests on the top of the columns, a frieze, a wide band that may or may not have ornamental art panels, and the upper cornice just below the roofline.
Two examples of Entablature, banding running above a set of columns and below a triangular pediment on the first and below a small balcony on the second.
This example shows a double banding course running under the roofline.
This example shows a cornice with decorative brackets. This is a very common feature in certain architectural styles, and we produce several designs of corbels and brackets for this purpose. We also make profiles that have this visual appearance in one piece. This style of profile is called Dentil.
This example has a band running across the top edge of the portico, a different cornice at the roofline of the main building (interrupted by a dormer window), and a sloped cap along the edge of the lower roof / balcony.
Architectural Banding in Cast Stone – Pg 2 – Midline Banding0 Comments Published by Marketing Team May 28th, 2015 in Architecture, Cast Stone, CSCS, Design, Industry, Stone Legends.
Midline banding is generally, any band that isn't at the bottom or the top. The styles and profiles usable for midline are nearly infinite, the options are less constrained that Cornice or Watertable. The band will usually run aligned with the top of a window surround or entry, or the visual position of a second level floorline, but can go about anywhere.
Many banding applications are rather wide, sometimes more than a foot across. Using multiple profiles makes the individual pieces lighter and easier to install. Several profiles are often stacked together as a single course, (a set of profiles installed together as a single band)
See the attachment hardware and the airspace between in this drawing of a profile family on a brick wall.
This profile family cross-section shows two profiles forming a single wide band. The setting line makes them form a continuous shape that rises from the top and fades back into the brick at the bottom.
These two examples show a midline running at the middle of the wall, at the floorline of the second floor. The lower image shows a narrow profile band running into a wider band, made of two identical profiles, with one reversed and a flat panel between them.
This home uses two midline banding courses, (the lower could be defined as a watertable) . This home also shows one other style of banding. While it is seldom called banding, Quoins can be considered a VERTICAL banding. This home uses fluted square columns as quoins, see the first midline example photo to see a more typical set of quoins running up a corner.
Architectural Banding in Cast Stone – Pg 3 – Watertable0 Comments Published by Marketing Team May 28th, 2015 in Architecture, Cast Stone, CSCS, Design, Industry, Stone Legends.
Many banding applications are wide, sometimes more than a foot across. Using multiple profiles makes the individual pieces lighter and easier to install. Several profiles are often stacked together as a single course, (a set of profiles installed together as a single band) Two identical profiles are often used that way, one reversed.
The watertable uses two profiles, and serves as a window sill when under a window.
A close up of a similar watertable.
Here the profile forms the top of the watertable with the stucco below. The profile runs under the window sill here. This corner uses a outside cope to eliminate the need for fragile miter cuts. The photo above uses an inside cope for each profile.
This watertable has a cast stone band running across the top, with stone blocks below.
These are preselected families of profiles we often produce for watertables, there are many other options. The same profiles can even be used in other configurations, varying the setting line, and the materials surrounding the stone.
Borden Dairy Factory – Cast Stone Sign0 Comments Published by Marketing Team May 21st, 2015 in Announcements, Architecture, Buzz, Cast Stone, Community, CSCS, Culture, Design, Events, Stone Legends.
We produce many types of signage. For Borden we produced custom art that was cast into the tooling, so it came out in relief, with lettering sandblasted into the panel, then all was painted.
The sign is complete, and ready for packing and shipping
The sign was installed at their front factory entrance.
The artwork, lettering and logo for the sign.
Several Close ups of the cast stone artwork.
An extreme close up of one character on the sign.
Style and Cast Stone – Italianate0 Comments Published by Marketing Team May 13th, 2015 in Architecture, Cast Stone, Culture, Design, Stone Legends.
Italianate Style
Italianate Style is a rebellion against previous formal classical ideals fashionable since the 1600's. It developed first in Britain about 1802.
Some of the styles strongest characteristics include low-pitched or flat roofs on two-to-four story tall homes, with wide eaves, decorative paired brackets and cornices. An emphasis on vertical proportions, including tall, narrow windows, the use of columns and quoins, and arches above doors and windows with keystones are also key features of this style. Italianate is also called Tuscan, Bracketed, Italian Villa or High Victorian Italianate Style.
In the late 1840s to 1890 it became popular in the USA, promoted by the architect Alexander Jackson Davis. The style lost popularity in the late 1870s, superceded by Queen Anne and Colonial Revival styles.
Elements of the style
As with any building it may contain elements of a different style, and some elements of the style may be missing on any particular building
Key visual components of this style include:
– Low-pitched or flat roofs; roof often hipped
– Projecting eaves supported by corbels, and cornice structures
– Pedimented windows and doors
– Tall first floor windows
– Angled bay windows
– Attics with a row of awning windows between the eave brackets
– Cupolas or domes
– Quoins
– Loggias (covered exterior hall, usually on an upper level, open on one side with a series of columns or arches)
– Balconies with wrought-iron railings, or Renaissance balustrading
– Balustrades concealing the roof-scape
About 15% of Italianate houses in the United States include a tower


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