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Slipping Out Of The Middle Class Can Hit Kids Hard
This is TALK OF THE NATION. I'm Neal Conan in Washington. The Department of Agriculture reports that the number of students receiving free or reduced lunch soared by 17 percent last year. That's up to 21 million. Given the state of the economy, the statistics may come as no surprise, but each new child who qualifies for free lunch means another family fallen out of the middle class.
Many of these kids are experiencing poverty for the first time, and whether the signal comes in the school cafeteria or when they see a parent struggling with the bills, they suddenly realize that they're poor.
If the economy forced you out of the middle class, how did your kids find out? Give us a call, 800-989-8255. Email email@example.com. You can also join the conversation at our website. Go to npr.org. Click on TALK OF THE NATION. The Opinion Page later in the program, the opposition in Russia finds a voice. Can it build a movement?
But first, children and poverty, and we begin with Joe Wemette, the former assistant superintendent for Roseville Schools in Minnesota, and he joins us now from his office there. Nice to have you with us today.
JOE WEMETTE: Hi, Neal.
CONAN: And this is an incremental story, a slow creep of a slipping economy, but I wonder: Was there a moment when the reality of the new poverty hit you?
WEMETTE: Oh, it has been coming gradually. Each year, we've been really aware of the consistency of the trend, but it has been more emphatic in the last five years, I would say.
CONAN: And how does it manifest?
WEMETTE: We have - when we look at our trend, we were under 20 percent free and reduced-price lunch count in '02, '03, and if you fast-forward to about six years later, we were up to 29 percent. And right now, Roseville area schools has 44 percent of the students on free and reduced-price lunch.
So it's a really steady and consistent uphill climb toward that. About three percent more kids each year, two to three percent is what we see.
CONAN: Do kids know that they're on the free lunch program?
WEMETTE: It will depend on the family circumstances. I suspect most of the time they do.
CONAN: And do other kids know that kids are on the free lunch program?
WEMETTE: Hopefully not, but again it'll depend on circumstances. It's not through the district sharing the news, of course, but it depends on kid conversations with each other.
CONAN: And so there's no tipoff when you're standing in the cafeteria line?
WEMETTE: Right. Kids don't exchange money or anything anyway. They all go through the line and enter a number. Everybody enters a number. So there's no tipoff that way to the really best we can manage that.
CONAN: This is - there's usually a relationship between poor kids and academic performance. Is that slipping in conjunction with the poverty rates?
WEMETTE: We try really hard to avert that correlation, of course, but it's there. We know it is and has been for a long time in the research. But we work really hard to avert that. We get some special resources that help in the form of Title I dollars from the federal government and in the form of compensatory ed dollars from the state of Minnesota. So we are able to do more in those pockets where the poverty is greatest.
CONAN: And describe for those of us who have not been to Roseville, can you describe what that area's like?
WEMETTE: Sure, Roseville is a first-string suburb just north of Minneapolis-St. Paul, population of some over 50,000, I believe, with a student population of about 6,700. We are 57 percent white, 43 percent students of color, and that, like the poverty rate, has been changing incrementally for at least 20 years, I know because I've tracked those statistics.
And so both poverty and diversity have been increasing in the district for quite a while.
CONAN: Do you see an effect on kids when they are - newly find themselves in poverty?
WEMETTE: You know, each of those situations has its own context. It's really hard to generalize. Sometimes it's situational poverty. Sometimes it's generational poverty. So I hate to generalize too much about kids' situations. But each one of those students has their own story.
So sometimes it'll be dramatic, and sometimes it'll be just the way it's been.
CONAN: Just the way it's been, that may be the saddest story of all.
WEMETTE: Yes it is, yeah.
CONAN: Joe Wemette, thanks very much for your time today.
WEMETTE: You're welcome.
CONAN: Joe Wemette, former assistant superintendent of Roseville Schools in Minnesota, with us today from his office there. And we'd like to hear from those of you who have seen your families drop out of the middle class. How did the kids find out? Give us a call, 800-989-8255. Email us, firstname.lastname@example.com.
Katherine Marshall Woods is a clinical psychologist with the Psychological Group of Washington. She focuses on child and adolescent psychology and been kind enough to join us here in Studio 3A. Thanks very much for coming in.
DR. KATHERINE MARSHALL WOODS: Thanks for having me.
CONAN: And I think Joe Wemette is right, it's probably a different story with each kid.
WOODS: Absolutely, everyone has their own story to tell, and each person is different and an individual. So the way they cope with the issues that they're facing is also very different.
CONAN: Well, your work focuses on kids in transition, I guess that's a kind way to describe it. What have you learned about the moment when kids first realize that their family's poor?
WOODS: Well, some kids handle it a lot better than others. Many have already developed specific coping skills that can help them through and actually want to be a very proactive participant in helping their family be able to become more successful.
Other children have a lot more difficulties handling the transition, and they begin to act out, become delinquent at school and also become very disappointed in their parents, as well.
CONAN: Yeah, so some see it as a challenge, the Horatio Algers of the world, and some see it as the latest discouragement from a life that has offered them some bad breaks to begin with.
WOODS: Yes.
CONAN: How do kids find out?
WOODS: Many times parents will sit down with their children and speak with them in age-appropriate manner. Other children begin to see a diminish in their surroundings, in their environment.
CONAN: They move from an house to an apartment to another, smaller apartment.
WOODS: Exactly, and sadly enough to say, some children find out by their peers, by being made fun of and bullied.
CONAN: That they're wearing not the right shoes or the right bag or stuff like that. It's very important to kids.
WOODS: Exactly, exactly.
CONAN: It's also - I assume there are a lot of kids in this situation, being a single parent increases the odds tremendously that a kid's going to grow up in poverty.
WOODS: Yes, actually it does. And specifically, currently right now, the statistics state that there's 8.1 million individual children who live with one parent at least who's unemployed, which then causes a lot of difficulties for that child, specifically it increases their rate of academic troubles.
Up to 15 percent of those students are then at risk of being retained, so - which also then causes issues for them long, well into their adult life.
CONAN: If this is your story, if you were one of those parents who saw your family slip out of the middle class, how did your kids find out? 800-989-8255. Email email@example.com. Angela's(ph) on the line calling from St. Louis.
ANGELA: Yes, hi. I was calling because yes, my children are on free and reduced lunch in the school district that we're in. I did have to sit them down and talk to them and explain to them that, you know, it's not a crime. It's not horrible. There's nothing wrong with it - sorry, I'm getting emotional because it was kind of two-fold why we had to do this.
I'm a full-time student myself, and my husband was transferred with his job in May of 2010, and he's been transferred again since then. So we've stayed in St. Louis, and he's gone to two different states, two different cities, just so he can have a job. And because of that, you know, we don't have that - we're having to pay for two different locations, and one of the concessions we had to do, other than cutting out all the extras, was the children actually qualified for free and reduced lunch.
Last school year, they were on reduced. This year, they're on completely free lunch. It's kind of different, I think, in our situation because we are in an economic area where it's lower-middle class to poverty is the main population of our school district. So I would have to say that maybe even 60 percent of all of our students are on some kind of free or reduced lunch program.
CONAN: And you correctly told your children there should be no stigma, but is there?
ANGELA: Oh, exactly, yeah.
CONAN: But is there a stigma?
ANGELA: There is unfortunately. There is a stigma. When I went to high school, when we moved here to St. Louis, I went to a very affluent neighborhood and a very affluent high school, and that - to have anybody on free or reduced lunch in that school district meant that you were lower class, and you were stupid, and your parents were stupid. So there is a stigma, there really is.
But I think in our situation with the district that we're in, there's not as much of a stigma because there are so many struggling families that we all understand.
CONAN: And the kids took it pretty well?
ANGELA: Yeah, the kids took it pretty well because, well, like I say, we have a high percentage. So most of their friends were on free and reduced lunch, and, you know, before 2008 or 2010, we would even pack a lunch and send it to school so that some of our children's friends, you know, knew that they were, and they were afraid that they would get picked on because they were getting free or reduced lunch.
So, you know, they would - our kids would take them an extra lunch or take them an extra pudding or something, you know, whatever we had extra. And we still have that mindset, and I think because of us bringing up our children that there's no shame in being impoverished. I was extremely impoverished when I was growing up with my parents.
We had to go to the food bank and get the - it's back in the old days where you got the giant barrel of food that lasted a month. It was a giant grab bag. You had no idea what was in that government barrel.
CONAN: Usually government cheese.
ANGELA: Yeah, usually government cheese and powdered milk, you know.
ANGELA: So, you know, my mother would try to hide the fact that it was powdered milk by putting it in a real milk carton, you know, but, you know, we knew different. And my husband, the same thing. He lived on food stamps for most of his life until he was 12 or 14. So for us, it wasn't - we grew up with it.
We knew - we know that there's a way out of it, and it just so happens that right now economically, so many people overstretched themselves for so many years thinking that the bubble was never going to pop, that there was always going to be food in the pantry, and now there's not. So you just have to learn to make concessions. I think...
CONAN: Angela, I'm just going to say we wish you the best of luck. It sounds like you're doing well, and I hope your husband can find a job in St. Louis.
ANGELA: Well, I'm hoping his company can transfer him back to St. Louis. He's got a good job, and the last thing we want to do is see it go away. But the company just announced another layoff of another 37 people.
CONAN: Ouch.
ANGELA: So yeah, so we're kind of sitting on the fence again.
CONAN: Well, good luck.
ANGELA: Yeah. Well, thank you.
CONAN: We're talking about children and poverty. If the economy forced you out of the middle class, how did your kids find out that money was suddenly tight? Give us a call, 800-989-8255. Email us, email@example.com. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.
CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan. Around the country, as layoffs and foreclosures grind on, changed families must regroup. Parents facing hardships caused by the rotten economy have to figure out how to make house payments, how to put food on the table, how to keep the car running.
As they talk with furrowed brows, kids pick up the signals and realize times have changed. If the economy forced you out of the middle class, how did your kids find out? 800-989-8255. Email us, email@example.com. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.
Our guest is Katherine Marshall Woods, clinical psychologist with the Psychological Group of Washington who focuses on child and adolescent psychology. Let's see if we can get another caller on the line. Let's go to Marcella(ph), Marcella with us from Houston.
MARCELLA: Hello, how are you doing? Thanks for having me on the call.
CONAN: I'm well, thank you.
MARCELLA: Yes, I realized that - well, my kids found out that we were kind of being pushed out when I - I mean, I work full-time, but I started not being able to have money to pay for their lunch. But I make too much to qualify for any reduced or - food. We moved to a smaller apartment, and winter came around this time, and I couldn't buy anyone winter clothes or anything. They were lacking - I mean, they (unintelligible).
CONAN: That's awful. We think of Houston as one of the warmer places, in summer yes, in winter not so much.
MARCELLA: Yeah, we're kind of having a unique time when we had cold periods that came through. I was getting by for a while because I knew I couldn't afford the coats, but it came around cold. So I was like oh gosh, I've got to figure out how we're going to do that.
CONAN: How are you going to do it?
MARCELLA: Well, my son used a coat from a cousin, and the two, the two girls kind of decided - teenagers kind of like to be cute anyway, but they decided they didn't need a coat. I think they just didn't want to bother me to try to get it. I mean, I myself have just used long sleeves and things that I had before but didn't buy anything.
CONAN: Layers also help, but...
MARCELLA: Yeah, that's what we've been - yeah, layers.
CONAN: And it sounds like the girls are doing their best to try to help you out.
MARCELLA: Well, my two older, my 19- and 17-year-old, didn't - have not been doing well with it because it's more of appearance with teenagers, and the 19-year-old, but he did find a job, but he's in college, but he had to get because I was paying for it. We didn't qualify for any aid. So he did find a job recently. So that's going to help soon.
And the 17-year-old pretty much cried a lot because she didn't have enough clothes and things for school because I couldn't replace. The 14- and the 10-year-old, I noticed that they were watching because a lot of times I would cook and feed them first, and they noticed that I wasn't eating, so then they started asking are you eating.
CONAN: And what did you tell them?
MARCELLA: Sorry, just eat when we could. And I do have a lot of family that help.
CONAN: I'm sure, Marcella. Family is a great resource in these difficult times. I wish you the best of luck. I hope that things pick up for you.
MARCELLA: Thank you.
CONAN: Thanks very much for the phone call. Katherine Marshall Woods, obviously a lot of emotion in her voice, and it's a terrible situation. The kids in that situation, obviously you don't know these individuals, but kids in situations like that, this can leave scars.
WOODS: Absolutely, and again it just is telling how she mentioned that her oldest children are having more difficulty being able to cope with it really because it's a change in what they may have known previously. And so they are hopefully relying on the idea that either things can get better and questioning what has happened.
And because they're older, they are able to question really the specifics and the details of what has happened with their finances, whereas the younger children are more of a protective role of why are you not eating and wondering whether or not that they can really take care of their mom.
CONAN: Every individual story is different, but is it more positive, do you think, for a parent to sit down with a kid and explain, age-appropriate obviously, or that kids realize it when there's no winter coat or no money for school lunch.
WOODS: Well, it's always good to prepare your children for what's happening. We even say if there's a death in the family and a child has never gone to a funeral, you want to talk to them about what they are going to see and what the experience will be like so then they have some sort of way to touch base with what you've stated and what they're experiencing.
And the same is true when it comes to financial challenges. It's a good idea to be able to sit down with your children, of course in an age-appropriate way, and talk to them about what is currently happening and what specifically may happen in the future and what difficulties the family may experience as a result of what's currently happening.
CONAN: Yeah, some parents don't want to really admit it to themselves, but it's a hard thing to do.
WOODS: True.
CONAN: Let's go next to Susan(ph). Susan's on the line with us from Medford in Oregon.
SUSAN: Hi, (unintelligible) your show.
CONAN: Hi, Susan. Thank you.
SUSAN: I am both a social worker and a school psychologist in this area. I don't - I think that people, when they think about Oregon, think about lots of green trees and lots of beauty and a national park nearby, Crater Lake National Park. We live in the southern part of the state, right on the California border, which has become pretty much a service area for retirees.
Because I worked in the schools, both in this area, in this part of southwest Oregon, and also in a remote high-desert part of Oregon - Oregon's a huge state, it's the ninth-biggest state, and it's very, very big. I'm from New England originally, and you could put New England in one corner of this state, all six states.
So I have seen not just hunger in this state, not - certainly obesity, much less obesity in schools than elsewhere, I've worked in schools on the East Coast, as well. But what you see are very thin kids and a great deal of hunger everywhere. We are one of the top hungriest states in the union, Oregon is.
And people think about Portland, it's where the jobs are, it's where most of the urban area is, but the rest of the state is very rural, and rural areas are hurting really, really seriously bad.
CONAN: And how do the kids take it when they find out?
SUSAN: Kids, in my case, my kid was always on my team. We had a team. We - I'm very proactive. I always talk with kids about money. It's a real fact of life. It's very important to know about it, how to handle it, how to help save it, and if you are a kid who gets an allowance.
You know, I work with kids daily, so I do a lot of that kind of thing with kids. You know, it's a fact of life and we mostly ignore it, I'm afraid to say, many families do.
CONAN: Susan...
SUSAN: But what happens when kids learn about it, I think the older ones particularly get extremely upset. I think it diminishes their self-esteem, their self-confidence. I mean teenage, older teenagers, high-school level. I think they get quite depressed, they can.
I think younger kids, as your guest was saying, are very protective of parents and - but they're really hurting also. I myself grew up in a very poor home that didn't have enough to eat in New England, outside of Boston, and I remember what it was like.
CONAN: Well, thanks for sharing your story, Susan, appreciate the phone call.
SUSAN: Okay, thank you.
CONAN: Taniesha Woods is a senior research associate at the National Center for Children and Poverty. She specializes in teacher development and equity in education and joins us from her office in New York City. Thanks very much for taking the time to be with us today.
TANIESHA WOODS: Thank you, thanks for having me.
CONAN: Earlier we hear Joe Wemette speak about Roseville, Minnesota. Certainly teachers and school districts have their hands full with newly poor students. And what is the best way to approach those kids in their new situation? Clearly their parents have an obligation to explain them to it, but what about the schools?
WOODS: Well, I think that there are a couple of things that can take place, and I'm going to speak to it particularly from an early childhood perspective because this is a period that's really critical for children's development and their later school success.
So there's actually a good amount of research that shows that mental health consultation, which is when a mental health expert who has expertise around children zero to six years of age actually provides support to teachers, to social workers, to health professionals that may not be knowledgeable about children's mental health.
But this individual that provides the mental health consultation, that really can help to improve children's development, their social and emotional function, their - and also their learning outcome, social and emotional function is related to learning outcomes.
So that's one of the really important things that can take place in early childhood programs in schools.
CONAN: Are those kinds of resources available at most schools?
WOODS: Well, in early childhood programs, they are available some of the time. I mean, part of the issue is funding, but there are some programs, for example Head Start programming, oftentimes they rely on mental health consultation, and there are other programs, early childhood programs, that when the funding is there, that's something that they can do.
But it actually can be done with very limited resources. I did some work in upstate New York with a community-based coalition that worked on early childhood initiatives. And what this group was really interested in doing was holding a monthly meeting or every other month, having this early childhood mental health consultant come in, and to talk to the members of their coalition, and then also to - they would invite other stakeholders to attend the meeting. And so if it's done in that manner, it's very cost-effective. But if you actually want to have someone go into a classroom, that actually does require some funding to have that person's time and effort covered.
CONAN: You were mentioning upstate New York. You're in New York City. How does this problem differ between, well, urban centers and suburbs, and upstate, that's country?
WOODS: Well, I mean, I think it's a problem regardless of geographic locale. It's something that has to be addressed. And so some of the issues in terms of urban, rural and suburban, children's mental health and social and emotional development, that's something that really needs to be addressed regardless of where they are in terms of their geographic locale.
CONAN: And are you seeing a surge in the necessity for these services?
WOODS: I would say that it's always been somewhat high, but there have been, in terms - I haven't got data that actually say that there's a surge, but I can speak to it anecdotally. And there have been some increases, as families are experiencing more economic hardship. Parents are more stressed out. So that affects their relationship. And oftentimes, that affects the interaction that parents have with children. And that manifests itself in different ways in the classroom, so you may see children acting out more and having problems in the classroom. So there is a need for the mental health consultation.
CONAN: Well, Taniesha Woods, thanks very much for your time today. We appreciate it.
WOODS: Thank you.
CONAN: Taniesha Woods, senior research associate at the National Center for Children and Poverty, joined us from her office in New York City. Still with us here in the Studio 3A is Katherine Marshall Woods, who's a clinical psychologist with the Psychological Group of Washington. And when she's talking about those people going into that situation - that's you she was talking about, right?
WOODS: It is, actually. Many times, I do go into children's classrooms to be able to provide consultation services. For five years, I actually worked for the District of Columbia Public Schools doing that exact thing, and also worked hand in hand with Head Start in being able to provide consultation services as well as being able to provide psychological testing for children who were at risk of being identified with learning disabilities and emotional disturbance.
CONAN: We're talking about children and poverty. You're listening to TALK OF THE NATION from NPR News. Let's go next to Margaret(ph). Margaret with us from Northfield in Minnesota.
MARGARET: Hi.
CONAN: Hi, Margaret.
MARGARET: My situation is kind of gone from bad to getting better. We lost our home in - last summer. And our 16-year-old was our youngest at home, really went into a dive. She took the loss of her home very personally and felt that it was something that - she felt it very personally - as if that this was being done to her. And we had wound up with issues with her attendance at school and her grades in trouble. And we moved from a moderately large area to a very, very small town. And we decided that something really serious needed to be done in our daughter's case because we felt like we were losing her. And so we took her to Minneapolis, into the more urban area and had all of us, our whole family, do some work in some of the more hard-hit areas of the - urban areas to give our daughter a little tiny bit of perspective.
She was in a really bad self-sadness area, and it was important to try to get her to stop thinking about poor me, and to look at the facts that even though she was losing her home, she still had a place to live, she still had a family that loves her. She had academics and academic opportunities. And she is doing better. And it's still hard. She doesn't like it, but she's motivated to change things. She wants to see why we can't get more schools to look at a dress code, for example. It's one of the things that she's embarrassed about, wearing the same clothes. Well, looking at - trying to look at ways that she can be a little empowered has made it a little bit better. It's still really rough, heading into Christmas. It's really tough for her.
CONAN: It's not going to get easy, but it seems like you've made a real pro-active move to get her engaged and, as you say, give her some perspective.
MARGARET: She has to have empowerment because this isn't - the job climate for us and for what businesses we are in is not improving dramatically. Things are not likely to get a whole lot better really soon.
CONAN: Margaret, thanks very much for the call. I know this is hard for you.
MARGARET: Thank you.
CONAN: Appreciate it. Katherine Marshall Woods, we heard some kids' depression - grades go down. Other kids turn into mini-adults, it seems. Yes, they cope a little bit better, but they lose that childhood too.
WOODS: Yes, they do. Unfortunately, they're placed in a very adult-like situation, and many of them cope by becoming, as you mention, mini-adults as well. Actually, the caller mentioned the idea of feeling empowered, which is really important for some children in order to be able to feel like they have some control over some situation in their life and to feel like they have some self-efficacy. And a lot of individuals who begin to go down that road are individuals who actually continue to have specific variables in place that helps them become resilient, like staying in the same academic center or like continuing to stay with their peer groups, having parents that are supportive in bringing them out, giving them perspectives and making it more of a team approach and also remaining cognitively stimulated.
CONAN: Cognitively stimulated. Do your lessons. So stay in school. Do your homework.
WOODS: Yes. Read books. Go to the library and use the resources that they have, the computers, if you are unable to keep your own.
CONAN: Mm-hmm. Well, thank you so much for your time today. Appreciate it.
WOODS: Thank you again.
CONAN: Katherine Marshall Woods, clinical psychologist with the Psychological Group of Washington, where she focuses on child and adolescent psychology. Coming up: It's the Opinion Page. After protests in Moscow, some Russians hope to end the reign of Vladimir Putin, but Kathryn Stoner-Weiss says that's highly unlikely. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News. Transcript provided by NPR, Copyright NPR.


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text:
to replicate the strategies implemented by some of the world's most sophisticated and most successful money managers. The new Top Guru Holdings Index ETF (NYSEARCA:GURU) will be linked to an index that is comprised of the publicly-disclosed equity holdings of certain hedge funds. In other words, GURU will attempt to mimic the positions and strategies implemented by hedge funds–many of whom have a proven track record of consistently generating alpha. The underlying index will include only hedge funds with concentrated top holdings, and will exclude funds that have historically exhibited high turnover.
Mimicking Gurus
The index underlying GURU will be constructed by using 13F filings made by hedge funds with the SEC. Institutional investors with $100 million or more in assets under management are required make 13F filings within 45 days of the end of each quarter, thereby shedding some light on their portfolios and strategies. As such, there exists the potential to utilize this information to replicate strategies being implemented by investors such as John Paulson, David Einhorn, and others [see ETFs To Invest Like Buffett, Paulson, & Fisher].
Some have noted that there are some potential drawbacks to implementing a "hedge fund replication" strategy through an ETF. Besides the time lag, there are potential issues with the incompleteness of these filings and the nuances of net exposure reported.
[For analysis of all new ETFs, sign up for the free ETFdb newsletter]
Under The Hood
The index to which GURU is linked consists of approximately 50 individual stocks, and is equal weighted (meaning that each security represents about 2% of the underlying portfolio). GURU will include both domestic and international securities, and will some maintain exposure to emerging markets as well. At launch, some of the GURU holdings include Apple, BHP Billiton, AIG, and America Movil.
From a sector perspective, a few biases are noticeable. Technology stocks represent about 22% of the portfolio, with financials (18%) and industrials (16%) also representing significant portions of assets. Telecom (4%) makes up the smallest sector allocation, while health care, consumer services, consumer goods, and basic materials each represent about 8% of the portfolio.
Hedge Fund ETFs In Focus
GURU's launch comes on the heels of the debut of the AlphaClone Alternative Alpha ETF (NYSEARCA:ALFA), which implements a generally similar strategy. That ETF, launched through a partnership with AlphaClone and Exchange-Traded Concepts, tracks an index consisting of stocks to which hedge funds and institutional investors have disclosed significant exposure. ALFA also has the capability to vary between a traditional long only portfolio and a market hedged strategy based on relative price targets.
GURU will charge an annual expense ratio of 0.75%; by comparison, ALFA charges 0.95%.
Written By Michael Johnston From ETF Database Disclosure: No Positions.
ETF Database is committed to giving our audience, consisting of both active traders and buy-and-hold investors, information that, to our knowledge, is truthful and non-biased. [For more ETF insights, sign up for our free ETF newsletter or try a free seven day trial of ETFdb Pro.]


text:
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Reports from men who have attempted to shave their own butts are very sad…but funny! Some who have attempted it found it impossible, noting that you have to be triple-jointed even to entertain the thought, even when using a mirror.
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text:
By BRYAN FITZGERALD
Albany Times-Union
ALBANY — An inmate caused a bizarre scene at Albany County Correctional Facility May 29 when a condom full of prescription drugs and heroin she was carrying inside her split open, spilling a cache of painkillers, anti-anxiety and sleeping pills onto the floor of a holding cell, Albany County Sheriff Craig Apple said.
Before she was to begin a six-month sentence for a probation violation, Andrea Amanatides, 38, filled a condom with 256 prescription pills — 90 pills of Lyrica, 37 Adderall pills, 50 Valiums, 43 Trazadones, 10 Ambiens, 26 Oxycontins — and four bags of heroin and put the condom in her vagina, Apple said.
As Amanatides waited in her holding cell, one of the pills fell out, Apple said. Amanatides then tried to "adjust herself," Apple said, but the 255 other pills and heroin simultaneously fell to the floor.
The entire sequence was captured on video, Apple said.
Amanatides was charged with five misdemeanor counts of criminal possession of a controlled substance and felony promotion of prison contraband. She was arraigned in Colonie Town Court and sent back to county jail.
Apple said the incident underscores the need for his jail to be able to strip search all inmates. In April, the Supreme Court ruled that jails may perform strip searches on inmates regardless of the gravity of their offenses. Jails had previously needed reasonable suspicion, a restriction Apple said made it hard to regulate drugs and weapons that came into his jail.
Drugs smuggled into the jail not only promote drug use, but violence, Apple said.
"If she's selling this stuff, people are going to find out who she is and beat her up for it," Apple said. "It leads to a whole cycle of serious problems."
email@example.com | @BFitzgeraldTU


text:
Single acting disposable laparoscopic scissors
A disposable laparoscopic single acting scissors is provided, and generally includes a hollow aluminum tube, a clevis coupled to a first end of the aluminum tube and including a pivot rod, a first scissors blade element having a pivot hole for pivotally engaging the pivot rod of the clevis, and having a through-hole in a base section of said first scissors blade element, a second scissors blade element fixedly engaging the clevis, a thin wire rod extending at least partially through the aluminum tube with a first end of the rod having a longitudinally offset terminal portion for engaging the through-hole of the base section of the first scissors blade element, and a plastic actuator engaged to the other end of the rod for imparting reciprocal motion to the rod relative to the aluminum tube which is translated at the clevis into pivotal motion of the first scissors blade element. The first scissors blade element is preferably formed from investment cast bronze.
Latest Symbiosis Corporation Patents:
The present invention broadly relates to laparoscopic surgical instruments. More particularly, the invention relates to disposable surgical instruments which include disposable end effectors such as cutters, graspers, and dissectors which are useful in a laparoscopy procedure.
The laparoscopy procedure has recently become a widely practiced surgical procedure. A laparoscopy procedure involves incising through the navel and through the abdominal wall for viewing and/or operating on the ovaries, uterus, gall bladder, bowels, appendix, or general abdominal surgery. Typically, trocars are utilized for creating the incisions. Trocar tubes ar left in place in the abdominal wall so that laparoscopic surgical tools may be inserted through the tube. A camera or magnifying lens is often inserted through the largest diameter trocar tube (e.g. 10 mm diameter) which is generally located at the navel incision, while a cutter, dissector, or other surgical instrument is inserted through a smaller diameter trocar tube (e.g. 5 mm diameter) for purposes of manipulating and/or cutting the internal organ. Sometimes it is desirable to have several trocar tubes in place at once in order to receive several surgical instruments. In this manner, organ or tissue may be grasped with one surgical instrument, and simultaneously may be cut or stitched with another surgical instrument; all under view of the surgeon via the camera in place in the navel trocar tube.
The laparoscopic tools of the prior art are primarily reusable stainless steel tools. Between each use of a stainless steel tool, the tool must be soaked, scrubbed, and disinfected. The usual procedure is then to dry the tool, wrap it, and put it in a steam autoclave. The tool is kept sterile until just prior to use when it is removed from the autoclave and unwrapped in the locale of the sterile field of use.
While reusable laparoscopic tools have functioned well for their intended purpose, the process of sterilizing the tool is problematic. Small pieces of tissue or organ often become lodged in the end effectors, and much labor is required to ensure that complete sterility is obtained and maintained. In addition, over time, sharp laparoscopic instruments such as a scissors get dull and must be discarded. However, prior to use of a particular instrument, the surgeon is not able to discern the state of the instrument and whether the instrument will satisfy the surgeon's requirements.SUMMARY OF THE INVENTION
It is therefore an object of the invention to provide disposable laparoscopic surgical instruments.
It is another object of the invention to provide disposable laparoscopic surgical instruments having investment cast end effectors.
It is a further object of the invention to provide disposable single and double-acting laparoscopic surgical instruments which utilize improved linkage systems.
It is yet another object of the invention to provide disposable laparoscopic surgical instruments which utilize a uniform push rod and handle end, to which any of a plurality of end effectors are attached.
It is even a further object of the invention to provide disposable Maryland dissector suitable for insertion in a 5 mm trocar tube.
Additional objects of the invention include providing disposable laparoscopic surgical instruments of improved design with smooth transitions from an insulating shrink wrap to the end effectors and to the handle.
In accord with the objects of the invention, a disposable laparoscopic surgery instrument generally includes, a tube, a push rod which extends through the tube, an actuating means engaging the tube and the push rod for imparting reciprocal axial motion to the push rod, end effector means coupled to the push rod by linkage means which are also coupled to the push rod, and a clevis coupled to the tube at its proximal end and to the end effector means at its distal end, wherein axial movement of the push rod effects movement of the end effector means in a plane parallel to the longitudinal axis of the push rod. Plastic shrink wrap is preferably utilized to electrically insulate the disposable instrument and extends over the aluminum tube and over at least a adjacent portion of the clevis. The tube and push rod are preferably made of aluminum, the clevis is preferably made of a high-strength aluminum alloy, the actuating means is preferably made of plastic and aluminum, and the end effector means preferably made of investment cast bronze.
The clevis of the invention is preferably a separately formed clevis having a knurled rod-like proximal end for mating with the end of the aluminum tube, and a post-supporting U-shaped distal portion for holding the end effector means. The post in the distal portion is perpendicular to the legs of the U-shaped distal portion and is arranged to extend through hole(s) in the end effector means. In this manner, the blades or prongs of the end effector means are held by, but can rotate around the post. Each leg of the U-shaped distal portion of the clevis also preferably includes a notch which serves as a terminating location for the shrink-wrap. Another aspect of the clevis relates to the forming of the post integral with one of the legs of the distal portion the clevis.
The end effector means of the invention can take any of man forms, such as, e.g., a scissors, a dissector, or a grasper. Additionally, the end effector means can be double acting or single acting. Regardless of the type of end effector utilized, the end effector is arranged with a hole to accept the post of the clevis so that the end effector can rotate around the post.
According to one aspect of the invention the push rod is flattened on its distal end, and the linkage means which couples the push rod and the end effector is a staple which extends through a hole in the flattened end of the push rod as well as another hole in the proximal end of the end effector. Because the outer tube is positioned at a fixed distance from the rotation hole in the end effector (due to the clevis), when the push rod moved axially relative to the tube, the end effector cannot move axially. However, because the push rod is also a fixed distance away from another hole in the proximal end of the end effector (due to the staple), movement of the push rod relative to the tub causes rotation of the end effector in a plane. In other words, movement of the push rod relative to the tube causes the hole through the end effector through which the staple extends to rotate along an arc centered at the rotation hole in the end effector through which the post of the clevis extends. Movement in this manner typically effects a cutting, dissecting or grasping action.
Single acting end effectors can include one hole in the flattened end of the push rod and one staple for connecting the moving prong or blade of the end effector to the push rod. A double acting end effector correspondingly includes two holes in the flattened end of the push rod and two stapes; one for each prong or blade. If desired, a single acting end effector can eliminate the staple by forming one end of the pull wire into a "dog's leg" and by inserting the dog's leg pull rod end into the hole in the proximal end of the end effector.
According to other aspects of the invention, a 5 mm Maryland Dissector with jaws which are slightly less severely curved than that of the prior art, but with more than a 5 mm tip to top offset is provided. The 5 mm Maryland dissector utilizes an identical push rod, tube, staple connector, and clevis as does the double acting scissors. The through-holes in the jaws through which the post of the clevis extends are slightly larger than the similar through-holes located in the other end effectors of the invention. With the slightly larger holes, when pushing the 5 mm Maryland dissector through a 5 mm trocar tube, the jaws of the Maryland dissector are angularly displaced relative to the clevis. Upon passing through the trocar tube to the surgery situs, the jaws ca resume their normal position.
Additional aspects of the invention include: a ferrule which is snapped onto the handle ridge for guaranteeing continuity of insulation from the tube to the handles; a knurled knob handle lever for allowing activation of the lever when the fingers of the surgeon are holding the ferrule area rather than the scissor like gripping handles of the actuator; modifications in shape to the proximal portion of the end effectors for reinforcement purposes; and a single acting scissors which utilizes a zigzag in the push rod instead of a staple connector.
A better understanding of the disposable laparoscopic surgical instruments of the invention, and additional advantages and objects of the invention will become apparent to those skilled in the art upon reference to the detailed description and accompanying drawings.BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a side elevation view, partly in section, of a disposable laparoscopic instrument prior to insertion into a trocar tube, and, in partial phantom format, after insertion into a trocar tube;
FIG. 1a-1 is a cross sectional view through the laparoscopic instrument of FIG. 1 at the indicated location;
FIG. 2a is a side elevation view, partly in section, of the clevis of the invention in conjunction with the distal end of the tube and shrink wrap of the invention;
FIG. 2b is a cross-section view of the device of FIG. 2a;
FIG. 3 is a side elevation view of an alternate clevis embodiment of the invention prior to assembly with end effectors;
FIG. 3a-1 is a side elevation view of the alternate clevis of FIG. 3 in a closed position;
FIG. 4a is a partially broken-away side elevation view of the actuating handle of the disposable laparoscopic instrument of the invention;
FIG. 4a-1 is a partial top view of the actuating handle of FIG. 4a at the indicated location;
FIG. 4b is a rear elevation view of the device of FIG. 4a;
FIG. 5a is a side elevation view, partly in section, of a double acting dissector in conjunction with the clevis and the distal ends of the rod and tube of the disposable laparoscopic instrument of the invention;
FIGS. 5a-1 and 5a-2 show a perspective view of the staple linkage means of FIG. 5a;
FIG. 5b is a plan view of the device of FIG. 5a;
FIG. 5c is an enlarged side view of the connection of the distal end of the rod and the proximal ends of the staple linkage means of FIG. 5a;
FIGS. 5d and 5e are enlarged top views of the distal end of the rod and the proximal ends of the staple linkage means when the blades of the double acting dissector are in open and closed positions respectively;
FIG. 5f is a side elevation view of a double acting dissector utilizing a crossed staple linkage means;
FIG. 5g is an enlarged top view of the distal end of the rod and the proximal end of the crossed staple linkage means FIG. 6a is a side elevation view of a first embodiment of a single acting scissors of the invention in conjunction with the clevis, and the distal ends of the rod and tube of the disposable laparoscopic instrument of the invention;
FIG. 6b is a side elevation view of a second embodiment of a single acting scissors;
FIG. 6b-1 shows a perspective view of the push-rod, end effector connection of the single acting scissors of FIG. 6a;
FIG. 7a is an elevation view in cross-section of a Maryland dissectors according to the invention;
FIGS. 7a-1, 7a-2, and 7a-3 show the relationship between the clevis post and the end effectors of the Maryland dissector of FIG. 7a when the Maryland dissector is being inserted through a trocar tube, and when the push rod of the Maryland dissector is being moved in the direction of the indicated arrows respectively;
FIG. 7b is a plan view of the Maryland dissector of FIG. 7a;
FIG. 8a is a plan view of one element of an investment cast end effector in accordance with the present invention;
FIG. 8a-1 is a perspective view of the indicated portion of the investment cast end effector of FIG. 8a;
FIG. 8b is a side elevation view of the device of FIG. 8a;
FIG. 9a is a side elevation view in section of a ferrule shielding device of the present invention engaged with the shrink wrapped aluminum tube and handle of the invention; and
FIG. 9b is a cross-section view of the device of FIG. 9a.DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
With reference to FIG. 1 (and FIG. 1A-1), a disposable laparoscopic surgical instrument is indicated at 10. The disposable laparoscopic surgical instrument 10 broadly comprises an aluminum tube 15 surrounded by a peripheral insulating shrink wrap layer or plastic 20, a clevis means 30, end effectors 40, actuating means 50, and a push rod 60. The clevis means 30 is advantageously a separately formed aluminum piece which fixedly engages aluminum tube 15 as described in more detail hereinafter. The clevis 30 also engages the end effectors 40 which are pivotally engaged to clevis 30 at pivot pin 45. The end effectors 40 are preferably formed of investment cast bronze as disclosed in copending U.S. Ser. No. 07/521,766 which was previously incorporated by reference herein. The push rod 60, which is also formed of aluminum, is engaged at its distal end 65 to the end effectors 40 as hereinafter more fully described, and is connected at 70, at its proximal end to a manually operable actuating means 50. For purposes herein, the "distal end" of the instrument 10 or any part thereof, is the end closest to the surgical site and distant from the Surgeon, while the "proximal end" of the instrument 10 or any part thereof, is the end most proximate the surgeon and distant the surgical site.
In use, the laparoscopy instrument 10 is inserted with the blades or graspers 90, 92 of the end effector 40 in the closed position, into trocar tube 80, as indicated at the arrow 85 of FIG. 1. The distal portion of the instrument 10 passes through the trocar tube 80 into body incision 100. Upon the distal portion of the laparoscopy instrument 10 exiting the trocar tube 80, the blades 90, 92 can be opened and closed as indicated at 105 by reciprocal motion of push rod 60 which results from operation of the manual actuating means 50. As is discussed more fully hereinafter, the clevis effectively translates the reciprocal motion of the push rod 60 into the end effector means action indicated at 105.
Turning to FIGS. 2a and 2b, a preferred configuration of the clevis 30 of the present invention is seen. The clevis has a knurled rod-like proximal portion 34 for mating with the end of the aluminum tube 15, and a post-supporting U-shaped distal portion 32 for holding the end effector means. The outer diameter of the distal portion 32 of the clevis is larger than the outer diameter of the proximal portion 34; shoulder 39 being formed therebetween. The proximal portion 34 of the clevis is preferably hollow, as indicated at 33, to permit the push rod 60 to extend therethrough. The distal portion 32 of the clevis 30 is provided with legs 36 and a post or pivot pin 45. The post 45 is generally perpendicular, i.e. transverse, to the legs 36 of the clevis and is arranged to extend through hole(s) 39 in the end effector means 40. In this manner, the blades or prongs of the end effector means 40 are held by, but can rotate around, i.e. are rotatably engaged with the post 45.
As seen in FIG. 2a, a recess or notch 380 is provided which extends across each leg 36 of the clevis 30. Consequently, a peripherally applied electrically insulating plastic wrap 20 can be end-cut at recess 380 and a smooth transition from the end effector means 40 via the clevis 30 to tube 15 can be achieved. Even if slight outward flaring of wrap 20 occurs at the end-cut, as is common, this flaring can be tolerated as it will be within the envelope of the normal outer surface indicated at 43.
Clevis 30 is preferably made from a high strength aluminum base alloy (e.g. 2024 alloy of Alcoa) which is preferably harder than the aluminum base alloy (e.,g. 6061 or 6063 alloys of Alcoa) from which tube 15 is fabricated. The post portion of the clevis may be made out of the identical alloy or, for added strength, out of a stainless steel nail. In assembly of the laparoscopy surgical instrument 10, serrated or knurled portion 34 of clevis 10 is fit snugly into tube 15 such that the walls of tube 15 abut the peripheral shoulder 39 of clevis 30, with the outer surface of tube 15 and the adjacent outer surface of clevis 30 having essentially the same diameter. Mechanical pressure is then applied to tube 15 peripherally at the location of knurled portion 34, thereby crimping the end portion of tube 15 onto the knurled portion 34. Mechanical pressure causes the projections of the knurls to bite into and firmly engage tube 15 as indicated at 37 due to the higher hardness of the clevis material. Once the clevis 30 and tube 15 have been properly joined, the plastic shrink wrap 20 can be applied over the tube 15 and an adjacent portion of the clevis 30 and end-cut at recess 380.
FIG. 3 shows an alternate embodiment for the clevis means of the present invention wherein the clevis 30 is formed and machined from aluminum base alloy as one integral element. As seen in FIG. 2b, the arms 36' of clevis 30 are bent outwardly away from each other. Pivot pin 45' is integral with one arm 36' as indicated at 48 and has a terminal portion 47 of reduced diameter which will engage slightly larger hole 49 when the arms 36 are bent inwardly and parallel with each other (i.e. after end effectors 40 of FIG. 2a are attached). Upon bending of the arms 36', the tip of terminal portion 47 engages and is suitably flattened in recess 59 as indicated at 53 of FIG. 3a-1.
With reference to FIGS. 4a, 4a-1 and 4b, manually operable actuating means are indicated at 50 which includes an electrically insulating housing 914 having a fixed handle portion 410 integral therewith and a lever portion 420 pivotally engaged to housing 914 at pivot pin 430. Push rod 60 passes through aluminum tube 15 (covered by shrink wrap 20) and engages cross pin 440 at 454; set screw 441 being used to extend into cross pin 440 and set push rod 60 in the cross pin 440. The cross pin 440 is fixedly positioned in lever member 420. Upon pivotal motion of lever arm 420, as indicated at 450, using a conventional hand grip as indicated at 455 to apply pressure to extended handle element 456 of lever member 420, push rod 60 will move linearly as indicated at 460 to actuate an end-effector (not shown in FIG. 4a) coupled thereto as hereinabove described. There may be occasions, in the course of certain laparoscopic procedures, that certain surgeons will prefer to hold the actuating means 50 in the manner indicated at 465 with fingers grasping housing 914 and the thumb 467 adjacent portion 470 of lever member 420 which is positioned on the opposite side of cross-pin 440 from extended handle element 456. Thus, in accord with one aspect of the invention, a roughened knurled or serrated surface 480 is provided integral with portion 470 of lever member 420 to enable a frictional engagement with thumb 467. Utilizing serrated surface 480, when thumb motion as indicated at 490 is initiated, pivotal motion of lever arm 420 is accomplished, as indicated at 450, as is the linear motion of push rod 60 as indicated at 460.
With reference to FIGS. 5a-5g, details are seen of an end effector 40 and the linkage means for linking the end effector 40 to the push rod 60. In particular, in FIGS. 5a-5g, a double acting dissector is shown with blades 90', 92' which are respectively rotatably mounted on pivot pin 45 of clevis 30'. Each blade 90', 92' of the dissector has a forwardly extending manipulating portion 94, and a rearwardly extending planar base portion 96 with a through-hole 98. Each of the through-holes 98 of planar base portions 96 is separately engaged by a separate connecting or linkage means 110, 112.
As shown in FIG. 5a, FIG. 5a-1, and FIG. 5a-2, according to one preferred embodiment, each linkage means 110, 112 is in the form of a thin metal member generally in the shape of an outwardly flared staple. Each linkage means may be generally described as having a U-shaped section 114 with a base 111 perpendicular to and bridging the arms 118 of the U, and two generally parallel spaced apart outwardly extending side or tab elements 113 which are generally parallel to base 111. Each of the linkage means 110, 112 has one of its tab elements 113 engaged in a through-hole 98 of a planar base 96, with the U-shaped section of the linkage means extending respectively in opposite directions as illustrated. The other tab element 113 of the linkage means 110, 112 engage through-holes 120 formed in a flattened plate-like terminal portion 122 of push rod 60 (as seen more clearly in FIGS. 5d-5f). As can be seen from FIG. 5a, movement of push rod 60 in the direction indicated at 124 will cause blades 90', 92' to move in the direction indicated at 127 to the position 129 without interference between the oppositely positioned staple-like linkage means 110, 112. Correspondingly, the tab elements 113 of the linkage means 110, 112 which extend through the flattened terminal portion 122 of push rod 60 will move from their position shown in FIG. 5d, to the position shown in FIG. 5e.
That manipulators (blades) 90' and 92' open and close in response to the axial movement of push rod 60 may be understood by understanding the relationship of the clevis 30' and linkage means 110, 112 to the blades 90', 92', the push rod 60, and the tube 15. In particular, due to the fact that the clevis 30' is rigidly attached to the tube 15 (as described above with reference to FIG. 2a), the tube 15 is a fixed distance from the rotation pin 45 of the clevis, and hence to the holes in the blades 90' and 92' through which rotation pin 45 extends. Thus, when the push rod 60 is moved axially relative to the tube 15 (the tube being fixed in place), the blades of the end effector cannot move axially with the push rod. However, because the push rod 60 is also a fixed distance away from holes 98 in the base portion of the end effector blades (due to staple linkage means 110, 112), movement of the push rod relative to the tube must cause movement of the holes 98 in the end effector blades. Because one part each blade is fixed, but another part must move when the push rod 60 is moved relative to the tube 15, end effector blades 110 and 112 rotate along an arc centered at the fixed rotation hole in the end effector through which the post 45 of the clevis 30' extends. Movement in this manner typically effects a cutting or grasping action.
FIGS. 5f and 5g show another embodiment of the linkage means which increases the stability of the end effector means 40. In FIGS. 5g and 5h it is seen that the linkage means 110', 112' do not respectively engage the nearest of the through-holes 120 transversely aligned in the plate-like terminal portion 122 of push rod 60, but instead cross-over as indicated at 130. With this arrangement the angle .THETA., indicated at 135, is increased. The increase in this angle affords a more stable instrument, because the amount of "shake" which results from the unavoidable clearances at the pivot 45 is reduced; i.e., as .THETA. approaches 90.degree., the amount of free movement at the end of an end-effector blade 90', 92' is minimized.
FIGS. 6a shows a single acting scissors. Essentially, the single acting scissors is identical to the double acting scissors of FIGS. 2a-2g except that blade 692 is stationary; hence no staple is used to connect blade 692 to rod 660. While blade 692 is stationary, blade 690 pivots as indicated at 627 around pin 645. To ensure rotational movement of blade 690 upon axial movement of rod 660, the end 22 of rod 660 should be supported.
FIGS. 6b and 6b-1 show a preferred embodiment of a single acting scissors where instead of utilizing a pull rod with a flattened end, pull rod 660' is a very thin wire of staple thickness (e.g. 25 mils) which has a rigid dog's-leg or Zigzagged end which extends through hole 698 of the proximal end of scissor blade 690. A similar pull rod is shown in previously incorporated U.S. Ser. No. 07/521,766, where instead of a single acting scissors, a radial jaw biopsy forceps is shown.
With reference to FIGS. 7a, 7a-1, 7a-2, 7a-3, and 7b a disposable laparoscopic Maryland dissector for use in a 5 mm diameter trocar tube 80 is shown; the actual inner diameter 720 of a "5 mm" trocar tube typically being about 6 mm). Traditionally, relatively large trocar tubes (e.g. 10 mm) are required when using Maryland dissectors, as the distance from the blade tips 701 to the top of rod (i.e., the width of the curved jaws as indicated at 710) is relatively large. Of course, larger trocar tubes inflict more trauma on the patient. Thus, it is desirable to be able to place a Maryland dissector in a smaller diameter trocar tube, e.g. a 5 mm trocar, such as indicated at 720.
In conjunction with curved jaws or blades 700, the 5 mm Maryland dissector of the invention preferably utilizes an actuator mechanism such as shown in FIGS. 4a and 4b, tube 715, push rod 760, linkage means such as shown in FIG. 5a, and clevis 730 which are substantially identical to the double acting equivalent devices seen in the double acting dissector embodiments of FIG. 1 and FIGS. 5a-5g. In the Maryland dissector of the present invention, the curve of jaws 700 is slightly less severe than a standard Maryland Dissector. However, the less severe curve does not by itself permit accommodation in a 5 mm trocar tube. Rather, the pivot holes 797 in the end effector blades of the Maryland dissector are arranged to be large enough to accommodate the required angular displacement (as indicated by angle B in an exaggerated manner) of the blades relative to the clevis and pivot axle 745. In other words, extra clearance is provided where pivot axle 745 of the clevis 730 fits into the rear portion of the end effector such that the end effectors can assume an angled position of preferably up to eight degrees (745) when the Maryland dissector is being pushed through trocar tube 80, and can assume their normal position (745') which is substantially parallel to the arms 736 of the clevis 730 when the jaws 700 have passed through the trocar tube 80 and have assumed their normal position (700'). In addition, the flexibility of the aluminum tube, which is greater than that of a stainless steel tube which is used in traditional instruments, allows freedom for the curved instrument to pass through the trocar tube as indicated at 775.
With reference to FIGS. 8a, 8a-1, and 8b, when an investment castable metal, such as bronze, is used in the making of an end effector 92', all features of the end effector are formed during casting to provide an integral end effector element. This is in contrast with the prior art practice of stainless steel end effectors which involved forging and machining to achieve the desired finished forms. While stainless steel is stronger than bronze, the use of investment cast bronze eliminates the need for forging and machining and also abrasive blasting and pickling and other treatments required in stainless steel fabrication which interfered with the achievement of close tolerances. Since investment cast bronze, while of considerable strength, is not as strong as stainless steel, it is advantageous to provide a novel configuration for the end effectors, e.g. 92', by including integral reinforcing elements in the investment cast end effector. In FIGS. 8a and 8b the extended cutting portion 94 and the base portion 96 are conventionally laterally offset as indicated at 98. In the prior art, the offset portions 94,96 join at essentially a right angle whereas in the present invention an integral mass of investment cast metal, in the form of a fillet 129, bridges the offset base and cutting portions and significantly strengthens the end effector. As shown in FIG. 8a, the flared staple linkage means 110 pivotally rotates in through-hole 98 in the base end effector portion 96, with its tab element 113 rotating through the angular segment 101 defined by radii 105, 107 extending from through-hole 98. Angular segment 101 is less than 180.degree. of arc, e.g. typically 90.degree.-120.degree.. The supplementary arc segment 108 is more than 180.degree., typically 240.degree. to 270.degree., which is the angular difference between segment 101 and 360.degree.. Segment 108 is filled with an integral mass of cast metal 119 adjacent and enveloping through-hole 98 which strengthens base 96 but does not interfere with the rotation of flared element 113. The height of the segmental metal mass 119 is preferably at least equal to the diameter of tab element 113.
With reference to FIGS. 9a and 9b, and in reference to another aspect of the invention, a ferrule type connecting means 910 is shown. Ferrule 910 provides a secure electrically insulating connection which peripherally bridges the exposed peripheral, electrically conductive, lateral portion 912 of aluminum tube 20 located between electrically insulating plastic shrink wrap 20 and the electrically insulating housing 914 of manually operable actuating means 50 which closely surrounds the aluminum tube 15. The portion of electrically insulating housing 914 adjacent the terminal portion 916 of electrically insulating shrink wrap 20 is provided with a flat-surfaces peripheral ridge 920. Ridge 920 has a substantially perpendicular wall 922 in the direction away from the shrink wrap 20. Wall 922 forms one side of a frusto-conical peripheral groove 921 which slopes upwardly away from perpendicular wall 922 until it terminates at wall 923. Ridge 920 further has a substantially frusto-conical surface 924 which slopes toward and is closely adjacent but slightly spaced from the shrink wrap 20 as indicated at 926.
Ferrule means 910 has a generally conical outer surface 929. The inner surface of ferrule means 910 is provided with a cylindrical passage 930 which is adapted to be closely adjacent to and surround a portion of shrink wrap 20, and is slidable with respect thereto Contiguous to cylindrical passage 930, and coaxial therewith, is an outwardly flaring frusto-conical passage 932 which bridges and is spaced from the peripheral electrically conductive portion 912 of aluminum tube 20. Outwardly flaring frusto-conical passage 932 is bounded at its wider flared end by a flat peripheral rim of extension 934 which is adapted to abut the flat surfaced peripheral ridge 920 of the portion 914 of the electrically insulating housing 50. An axially inwardly depending perpendicular peripheral wall 936 of the outwardly flaring frusto-conical projection 938 abuts the peripheral wall 922 of the electrically insulating housing 914 of actuating means 50. Projection 938 is matingly seated in the extended frusto-conical peripheral groove 940 of the housing 914 and causes the ferrule connecting means 910 to be secured to the housing 914 while shielding the electrically conductive peripheral portion 912 of aluminum tube 20.
Ferrule connecting means 910 is suitably made of a strong, resilient, electrically insulating plastic material such as polypropylene or polycarbonate. In a preferred embodiment, the ferrule is a colored plastic, with the color utilized to identify the type of instrument of which it is a part. For example, a blue ferrule might identify a Maryland dissector, while a red ferrule might identify a single acting scissors. Regardless of color, the ferrule is installed by being moved slidably along shrink wrap 20 in the direction indicated at 945. When the ferrule means 910 is moved in the direction indicated, at some point, the portion of the frusto-conical projection 938 located adjacent wall 936 resiliently deforms outwardly to pass over rim 934 of rigid plastic housing 914. After wall 936 passes wall 922, the frusto-conical projection 938 snaps back into a mating engagement with groove 940 of the rigid plastic housing 914. In this mated position, the electrically insulating ferrule connecting means 910 overlaps peripheral electrical conductive portion 912 of aluminum tube 20 as well as substantial portions of the electrically insulating shrink wrap 20 and the electrically insulating housing 914. In this manner, the ferrule connecting means 910 ensures that the possibility of short circuiting and electrical disruption is eliminated.
The preferred laparoscopy instruments of the invention are preferably assembled in the following fashion. The knurled portion 34 of the clevis 30 of the invention is inserted into the aluminum tube 15 which had been previously insert molded in the fixed handle portion 914, 410 of the actuating means 50. The aluminum tube 15 is crimped over the knurls 37 to effect mating. Shrink wrap 20 is then applied over the aluminum tube 15 and end-cut at grooves 380 in the arms 36 of the clevis 30. Ferrule 910 is slid over the distal end of the aluminum tube 15, up over the end of the housing 914, and snapped into place, thereby providing complete insulation. The rod 60, staples 110, 112, and end effectors (e.g. 90, 92) are assembled, with the staples coupling the rod to the end effectors. The rod is slid through the clevis and down the aluminum tube, until the end effectors are located between the arms of the clevis: When the holes in the proximal end of the end effectors (e.g. 96, 98) are lined up with the through-holes 39 in the arms of the clevis, the rotation post 45, which may either be integral with the clevis, or a separate post or nail, is inserted through the holes in the end effectors, and secured in the holes of the clevis arms such as by tapping. At this point, all that remains to be assembled is the actuating means 50. To assemble the actuating means, a cross pin 440 is inserted in handle 420. Handle 420 is then arranged such that the push rod 60 which extends out of the fixed handle portion will extend through the cross pin 440. With rod 60 in the cross pin 440, handle 420 is lined up with handle 410 such that the handle rotation pivot pin 430 can be inserted. With pivot pin 430 in place, and with the end effectors in the closed position, set screw 441 is tightened into the cross pin until it bits into rod 60, thereby holding rod 60 in place relative to cross pin 440.
There has been described and illustrated herein a disposable laparoscopic instrument. While particular embodiments of the invention have been described, it is not intended that the invention be limited exactly thereto, as it is intended that the invention be as broad in scope as the art will permit. Thus, while particular end effectors were disclosed, it will be appreciated that other end effectors such as, e.g., duck-bill graspers, duck-bill dissectors, a traumatic graspers, and traumatic (rat-tooth) graspers, could be utilized. Also, while various materials were described as being preferred for various parts, it will be appreciated that other materials could be utilized. By way of example only, and not by way of limitation, while the tube and clevis are preferably made from aluminum alloys, with the clevis being harder than the tube, if desired, the tube could be harder than the clevis. In such a situation, rather than crimping the tube over the clevis, the clevis could be welded or press fit into the tube. Therefore, it will be apparent to those skilled in the art that other changes and modifications may be made to the invention as described in the specification without departing from the spirit and scope of the invention as so claimed.
1. A single acting scissors for insertion through a trocar tube, comprising:
- a) a hollow tube having a first end and a second end, and a longitudinal axis;
- b) a clevis means coupled to said first end of said tube, said clevis means including a pivot rod means;
- c) a first scissors blade element having a base section, said base section having a pivot hole pivotally engaging said pivot rod means of said clevis means, and a second through-hole in said base section of said first scissors blade element;
- d) a second scissors blade element fixedly engaging said clevis means;
- e) a thin wire rod extending through said hollow tube and having a first end and second end, the first end of said rod having a terminal portion angled relative to said longitudinal axis and engaging said second through-hole of said base section of said first scissors blade element; and
- f) actuating means engaging said second end of said rod for imparting reciprocal motion to said rod relative to said tube which is translated at said clevis means to pivotal motion of said first scissors blade element.
2. A scissors in accordance with claim 1, wherein:
- said hollow tube and said clevis are comprised of aluminum, and said actuating means is comprised of plastic.
3. A scissors in accordance with claim 2, wherein:
- said first scissors blade element is formed of investment cast bronze.
4. A scissors in accordance with claim 1, wherein:
- said terminal portion of said thin wire rod has first and second approximately ninety degree bends.
5. A scissors in accordance with claim 1, further comprising:
- g) shrink wrap plastic covering substantially all of said hollow tube, and a portion of said clevis means adjacent the first end of the hollow tube.
6. A scissors in accordance with claim 5, wherein:
- said hollow tube has uniform inner and outer diameters, and
- said clevis means includes a hollow first portion having an outer diameter slightly smaller than the inner diameter of the hollow tube, said hollow first portion fitting closely within the hollow tue and fixedly engaging the hollow tube, said hollow first portion having an inner diameter, and a second portion having a base section having an outer diameter substantially the same as the outer diameter of the hollow tube and a bore corresponding to the inner diameter of the hollow first portion of the clevis means, and a pair of parallel, spaced apart, opposed arm members having respective first and second ends and integrally joined to said base portion of said clevis means at respective said first ends of said opposed arm members, said pair of arm members extending away from said hollow first portion of said clevis means, each said opposed arm member having an undercut groove therein along an outer surface of said arm member and substantially transverse said longitudinal axis, wherein said shrink wrap plastic covering terminates in the undercut grooves of the arm members, and said pivot rod means extending transversely between said opposed arm members.
7. A scissors in accordance with claim 6, wherein:
- said hollow tube, clevis means, and push rod means are formed of aluminum or aluminum base alloys, and said actuating means is formed substantially of plastic, said instrument further comprising,
- h) a ferrule means for surrounding and covering a terminal portion of said shrink wrap plastic covering and an adjacent portion of said actuating means.
8. A scissors in accordance with claim 7, wherein:
- said actuating means comprises a housing means fixedly engaging said aluminum tube, wherein said ferrule means surrounds and covers at least a portion of said housing means, and a lever means fixedly engaging said push rod and pivotally engaging said housing means, wherein upon pivotal movement of said lever means reciprocal motion is imparted to said push rod.
9. A scissors in accordance with claim 8, wherein:
- said actuating means further comprises a handle means fixedly attached to said housing means and cooperating with said lever means in providing pivotal movement of said lever means when said handle and lever means are squeezed by a human hand.
10. A scissors in accordance with claim 9, wherein:
- said lever means has an external surface, and a portion of said external surface of said lever means has a serration means for being frictionally engaged by a digit of a human hand and imparting pivotal motion to said lever means, wherein said serration means run substantially transverse said longitudinal axis and parallel said pivot pin.
11. A scissors in accordance with claim 7, wherein:
- said first scissors blade element is formed of investment cast bronze.
12. A scissors in accordance with claim 11, wherein:
- said terminal portion of said thin wire rod has first and second approximately ninety degree bends.
13. A scissors in accordance with claim 10, wherein:
- said first scissors blade element is formed of investment cast bronze.
14. A scissors in accordance with claim 13, wherein:
- said terminal portion of said thin wire rod has first and second approximately ninety degree bends.
|June 1880
|September 1874
|September 1912
|October 1927
|August 1950
|August 1972
|July 1975
|August 2, 1988
|November 21, 1989
|January 30, 1990
|August 21, 1990
|June 25, 1991
|Rydell et al.
Type: Grant
Filed: Apr 4, 1991
Date of Patent: Dec 15, 1992
Assignee: Symbiosis Corporation (Miami, FL)
Inventors: Kevin W. Smith (Miami, FL), Charles R. Slater (Fort Lauderdale, FL), Thomas O. Bales, Jr. (Coral Gables, FL)
Primary Examiner: Kyle L. Howell
Assistant Examiner: Scott N. Akers
Attorney: David P. Gordon
Application Number: 7/680,381
International Classification: A61B 1700;


text:
Life is frustratingly unfair. Jobs are lost, the body grows ill, good people turn out to be evil, friends fail, enemies win, ideals disappoint, and faith grows weak. It is so discouraging to see people who never have a difficulty and never suffer. Always on the mountaintop, they leave many feeling inadequate wondering, "What's wrong with me?" The storms of life threaten to overwhelm us with a hurricane's relentless fury. If you have ever lost your zeal to serve, ever felt so tired you wanted to quit, ever doubted why you should keep trying, then you know the paralyzing aftermath of life's storms that conceal the joy for which God created you. You know the humdrum existence to which this world has succumbed. It seems like you are just drifting along in an unfamiliar wilderness. Wandering is tolerable; it requires minimal effort and it's relatively comfortable. You offend no one and you keep your distance. You are lost but you are moving, so why add anything more to your plate? Busy and preoccupied, you go through the motions day after day after exhausting day. Jesus changes all that. He is faithful, walking where you have walked. He cries your tears. He understands your regret. He smiles at every effort and heals your wounds, rebuking the raging storms of life. He has called to you as you hid in the bushes, ashamed of your nakedness. He searches for you when you were lost, alone, and shivering in the dark. He rescues you from those in the world who would devour you. He can restore your zeal and your desire to serve. In these accounts, you will experience the joy, the fear, the delight, and especially the wonder of walking with Jesus on your journey back to Paradise.
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text:
What's New
Bug fixes and support for iOS7.
App Description
Weather Motion takes mobile weather apps to a whole new level with stunning High Definition (HD) graphics and sound effects!
◉ "See And Hear The Weather Indoors Before Heading Outdoors." - AppAdvice.com
◉ Featured by Macworld (AppGuide).
◉ "If you're in need of a soothing alarm clock or a way to listen and watch the weather without going outside, Weather Motion is another way to experience the weather." - Padvance.com
◉ "Weather information in style!" - StylishiPadApps.tumblr.com
Weather Motion is the most beautiful way to check for weather information on your iPhone or iPod Touch. This application shows you the local condition report on top of a soothing video representation of the current weather condition.
◉ See the current and forecast weather in gorgeous HD videos.
◉ High quality video footage of different weather conditions.
◉ Completely optimized for the iPhone 4's amazing Retina Display.
◉ Real time weather information based on your current location (GPS or WiFi) wherever you are in the world.
◉ Local condition report, temperature, high & low, wind speed & direction, and humidity level.
◉ 6-day local weather forecast for every city. Slide your finger on the screen to see the forecast.
◉ The temperature is displayed in Celsius or Fahrenheit.
◉ You can check the weather for other cities. Choose the city you want to see weather for by scrolling through your saved cities. You can add or delete cities, and reorder your list. PLEASE, ENTER THE CITY AND THE COUNTRY.
◉ Two display modes are available.
◉ The most accurate weather application on the AppStore.
◉ The application is available in English, French, Spanish, Italian, German and Japanese.
◉ We have added sound (nature ambiences) for each weather condition to make everything even more real! We hope you will like this new feature as we do!
IMPORTANT: This application requires an active Internet connection to retrieve data. You also need to turn on "Location Services" option in the settings of your iPhone.
If you like Weather Motion, please leave us a review on iTunes. Your support would greatly help.
Thank you for taking the time to report any bugs or to request an enhancement to Weather Motion application. Feedback is very important to us. We will do our best to answer queries. Email us at [email protected]
App Changes
- February 12, 2012 New version 1.1
- April 14, 2012 New version 1.2
- September 02, 2012 New version 1.3
- July 31, 2013 New version 1.6
- August 10, 2013 New version 1.7
- November 10, 2013 New version 1.8


text:
White Tanuki
Metal Material: Titanium Steel
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Hearts Chain Belt
Regular price $15.97
Metal Material: Titanium Steel
Length of Belt: Adjustable; from 115cm to 120cm
(45.27 inches to 47.24 inches)
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