Tissue extraction devices and methods

Patent metadata

Field	Value
Publication number	US-9827037-B2
Application number	US-201514982593-A
Country	US
Kind code	B2
Filing date	Dec 29, 2015
Priority date	Apr 11, 2011
Publication date	Nov 28, 2017
Grant date	Nov 28, 2017

Abstract

A tissue cutting device has an outer sleeve with a distal window and an inner cutting sleeve which moves past the window to cut tissue. The inner cutting sleeve has a lumen which may have a larger proximal diameter than distal diameter. A perimeter of the window may comprise a dielectric material. A distal edge of the inner sleeve may be displaced inwardly.

First claim

What is claimed is:

1. A method of resecting tissue, comprising:
advancing a tissue resecting device to a treatment site, the tissue resecting device comprising:
an outer sleeve including a tissue-receiving window opening into a lumen of the outer sleeve, the outer sleeve including a return electrode; and
an inner sleeve positioned in the lumen of the outer sleeve, the inner sleeve including an active electrode;

longitudinally reciprocating the inner sleeve relative to the outer sleeve such that the active electrode repeatedly moves across the tissue-receiving window from a proximal position to a distal position and back to the proximal position from the distal position;
applying an RF current between the active electrode and the return electrode as the active electrode moves across the tissue-receiving window from the proximal position to the distal position; and
terminating the RF current between the active electrode and the return electrode as the active electrode moves across the tissue-receiving window from the distal position to the proximal position.

2. The method of claim 1 , further comprising:
forming plasma at a distal edge of the inner sleeve as the active electrode moves across the tissue-receiving window from the proximal position to the distal position.

3. The method of claim 2 , wherein the plasma resects tissue extending into the tissue-receiving window as the active electrode moves across the tissue-receiving window from the proximal position to the distal position.

4. The method of claim 3 , further comprising:
aspirating resected tissue proximally through an extraction lumen of the inner sleeve.

5. The method of claim 1 , wherein the return electrode is an exposed surface portion of the outer sleeve.

6. The method of claim 5 , wherein the tissue resecting device includes a dielectric layer on an exterior of the outer sleeve.

7. The method of claim 1 , wherein the tissue resecting device includes a dielectric material extending around a perimeter of the tissue-receiving window.

8. The method of claim 1 , wherein the active electrode is a ring electrode having a distal annular edge.

9. The method of claim 8 , further comprising:
forming plasma at the annular edge as the active electrode moves across the tissue-receiving window from the proximal position to the distal position.

10. A method of resecting tissue, comprising:
advancing a tissue resecting device to a treatment site, the tissue resecting device comprising:
an outer sleeve including a tissue-receiving window opening into a lumen of the outer sleeve; and
an inner sleeve positioned in the lumen of the outer sleeve;
wherein the inner sleeve includes a first electrode having a first polarity and the outer sleeve includes a second electrode having a second polarity opposite the first polarity;

longitudinally reciprocating the inner sleeve relative to the outer sleeve such that the first electrode repeatedly moves across the tissue-receiving window in a distal direction during a forward stroke and in a proximal direction during a retracting stroke;
applying an RF current between the first electrode and the second electrode during at least a portion of the forward stroke; and
terminating the RF current between the first electrode and the second electrode during at least a portion of the retracting stroke.

11. The method of claim 10 , further comprising:
forming plasma at a distal edge of the inner sleeve during the forward stroke.

12. The method of claim 11 , wherein the plasma resects tissue extending into the tissue-receiving window during the forward stroke.

13. The method of claim 12 , further comprising:
aspirating resected tissue proximally through an extraction lumen of the inner sleeve.

14. The method of claim 10 , wherein the second electrode is an exposed surface portion of the outer sleeve.

15. The method of claim 14 , wherein the tissue resecting device includes a dielectric layer on an exterior of the outer sleeve.

16. The method of claim 10 , wherein the tissue resecting device includes a dielectric material extending around a perimeter of the tissue-receiving window.

17. The method of claim 10 , wherein the first is an annular distal edge of the inner sleeve.

18. A system for resecting tissue, comprising:
a tissue resecting device comprising:
an outer sleeve including a tissue-receiving window opening into a lumen of the outer sleeve; and
an inner sleeve positioned in the lumen of the outer sleeve;
wherein the inner sleeve includes a first electrode having a first polarity and the outer sleeve includes a second electrode having a second polarity opposite the first polarity;
wherein the inner sleeve is configured to longitudinally reciprocate relative to the outer sleeve such that the first electrode repeatedly moves across the tissue-receiving window in a distal direction during a forward stroke and in a proximal direction during a retracting stroke;

a controller configured to apply RF current between the first electrode and the second electrode during at least a portion of the forward stroke, and terminate the RF current between the first electrode and the second electrode during at least a portion of the retracting stroke.

19. The system of claim 18 , wherein the first electrode is an annular distal edge of the inner sleeve.

20. The system of claim 19 , wherein the second electrode is an exposed surface portion of the outer sleeve.

Assignees

• Boston Scient Scimed Inc

Inventors

• Germain Aaron
• Klein Kyle
• Walker Michael D
• Orczy-Timko Benedek
• Lesko Balazs

Classifications

• A61B17/320016

  Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence) · CPC title

• A61B2018/00196

  reciprocating lengthwise · CPC title

• A61B2018/122

  ionizing, with corona · CPC title

• A61B2018/1412

  Blade · CPC title

• A61B18/18

  by applying electromagnetic radiation, e.g. microwaves · CPC title