TISSUE EXTRACTION DEVICES AND METHODS

• US 20120330292A1
• Filed: 10/20/2011
• Published: 12/27/2012
• Est. Priority Date: 06/24/2011
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Arqos Surgical, Inc.
• Inventors: Shadduck, John H., Germain, Aaron, Klein, Kyle, Truckai, Csaba, Walker, Michael D.
• Granted Patent: US 8,512,326 B2
• Time in Patent Office: Days
• US Class Current: 606/13
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3205 Excision instruments
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00202 rotating
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00625 Vaporization
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1437 whereby the windings of the spiral touch each other such as to create a continuous surface
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

Tissue may be cut and extracted from an interior location in a patient'"'"'s body using a probe or tool which both effects cutting and causes vaporization of a liquid or other fluid to propel the cut tissue through an extraction lumen of the cutting device. The cutting may be achieved using an electrosurgical electrode assembly, including a first electrode on a cutting member and a second electrode within a cutting probe or tool. Thus, over a first cutting portion, radio frequency current may help cut the tissue and over a second or over transition region, the RF current may initiate vaporization of the fluid or other liquid to propel the tissue from the cutting device.

Claims

1. A method for extracting tissue from the interior of a patient'"'"'s body, said method comprising:

capturing a tissue volume in a distal portion of an interior passageway of an elongate probe; and

causing a phase transition in a fluid proximate to the captured tissue volume to expand the fluid to apply a proximally directed expelling force to the tissue volume.

2. The method of claim 1 wherein the fluid comprises a liquid and the phase transition comprises a liquid-to-vapor phase transition.

3. The method of claim 2 wherein causing the phase transition comprises applying electrical energy sufficient to vaporize liquid.

4. The method of claim 2 wherein causing the phase transition comprises applying RF current between first and second polarity electrodes.

5. The method of claim 1 further comprising providing fluid within a working end of the probe.

6. The method of claim 5 wherein the volume of fluid in the range of 0.004 mL to 0.080 mL.

7. The method of claim 5 wherein the fluid is provided from a fluid-filled space in the patient'"'"'s body.

8. The method of claim 7 wherein the fluid-filled space is a uterine cavity.

9. The method of claim 5 wherein the fluid is provided from a remote source through a passageway in the probe.

10. The method of claim 1 wherein the capturing step comprises resecting the tissue.

11. The method of claim 10 wherein the tissue is resected with a blade member.

12. The method of claim 10 wherein the tissue is resected with an RF electrode.

13. The method of claim 1 further applying negative pressure to a proximal end of the interior passageway.

14. A method for removing targeted tissue from the interior of a patient'"'"'s body, said method comprising:

engaging a tubular cutter with the targeted tissue;

energizing an RF electrode arrangement on the cutter to thereby electrosurgically cut tissue; and

energizing an RF electrode arrangement on the cutter to vaporize a liquid to thereby apply positive fluid pressure to move the cut tissue in a passageway in the cutter.

15. A method as in claim 14 wherein the same RF electrode arrangement is used to both electrosurgically cut the tissue and to vaporize the liquid.

16. A method as in claim 15, wherein the cutter with the RF electrode has first position to electrosurgically cut the tissue and thereafter moves to a second position to vaporize the liquid.

17. A method as in claim 16 wherein the liquid is present in a chamber having an active electrode exposed therein and wherein the RF electrode arrangement on the cutter comprises a return electrode, whereby the RF energy concentrates in the liquid to cause rapid vaporization.

18. A method for cutting and extracting tissue from the interior of a patient'"'"'s body, said method comprising:

moving a cutting member in a tubular cutter body to sever a tissue strip;

capturing the tissue strip in an extraction lumen in the tubular cutter body; and

causing a phase transition in a fluid proximate to the tissue strip to thereby apply a proximally directed expelling force to the tissue strip.

19. The method of claim 18 wherein the phase transition is caused by applied energy from at least one energy source selected from the group consisting of an ultrasound tranducer, a HIFU source, a laser source, a light energy source, a microwave or a resistive heat source.

20. The method of claim 18 wherein the cutter carries the energy source.

21. The method of claim 20 wherein the energy source of the cutter also effects cutting of the tissue.

22. The method of claim 21 wherein the cutter carries the energy source into the fluid after the tissue has been cut.

23. A method cutting and extracting tissue, comprising:

cutting tissue with a cutter member that is moveable relative to a tissue-receiving window in a sleeve between window-open and window-closed positions, wherein the movement of the cutter member cuts and captures tissue received by the window; and

causing expansive vaporization of a liquid proximate to the captured tissue with the cutter member in a window-closed position.

24. The method of claim 23 wherein the tissue is captured in a tissue extraction lumen at least partially defined by the cutter member.

25. The method of claim 24 wherein the cutter member carries a cutting electrode and a second electrode is disposed at least at a distal end of the sleeve.

26. The method of claim 25 wherein RF current is delivered to the cutting electrode and the second electrode, wherein the RF current effects cutting of the tissue as the cutter member moves from the window-open position toward the window-closed position and effects vaporization of the fluid in the window-closed position.