TISSUE EXTRACTION DEVICES AND METHODS

• US 20130103021A1
• Filed: 04/09/2012
• Published: 04/25/2013
• Est. Priority Date: 04/11/2011
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Arqos Surgical, Inc.
• Inventors: Germain, Aaron, Klein, Kyle, Walker, Michael D., Orczy-Timko, Benedek, Lesko, Balazs
• Granted Patent: US 9,254,142 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/14 Probes or electrodes 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 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00269 endoscopic mucosal resection EMR
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0072 Current
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/122 ionizing, with corona
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/142 : at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 50/10 : Furniture specially adapted for surgical or diagnostic appliances or instruments

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.

Claims

1. A tissue cutting device comprising:

an elongated structure having an axis and comprising an outer sleeve with a distal window and an inner cutting sleeve configured to move between a proximal position and a distal position relative to the window; and

wherein the inner sleeve has an interior tissue-extracting lumen with a distal lumen portion having a first diameter and a proximal lumen portion having a second diameter which is smaller than the first diameter.

2. The tissue cutting device of claim 1 wherein the distal lumen portion extends axially at least 1 mm from the distal end of the inner cutting sleeve.

3. The tissue cutting device of claim 1 wherein the distal lumen portion extends axially at least 2 mm from the distal end of the inner cutting sleeve.

4. The tissue cutting device of claim 1 wherein the cross-sectional area of the distal lumen portion is less than 95% of cross-sectional area of the proximal lumen portion.

5. The tissue cutting device of claim 1 wherein the cross-sectional area of the distal lumen portion is less than 90% of cross-sectional area of the proximal lumen portion.

6. The tissue cutting device of claim 1 wherein the proximal lumen portion extends proximally from the distal lumen portion through a proximal end of the structure.

7. The tissue cutting device of claim 1 wherein the distal lumen portion has a diameter of at least 0.105″

.

8. The tissue cutting device of claim 1 wherein the proximal lumen portion has a diameter of less than 0.100″

.

9. The tissue cutting device of claim 1 wherein a distal end portion of the inner cutting sleeve comprises has a surface comprising a first polarity electrode.

10. The tissue cutting device of claim 1 wherein a surface portion of the outer sleeve comprises a second polarity electrode.

11. The tissue cutting device of claim 9 wherein the first polarity electrode surface extends axially at least 2 mm.

12. The tissue cutting device of claim 9 further comprising a dielectric material on the exterior of the inner cutting sleeve extending proximally from the first polarity electrode surface.

13. The tissue cutting device of claim 12 wherein the dielectric material comprises in part a ceramic.

14. The tissue cutting device of claim 12 wherein the dielectric material comprises in a thin wall polymeric material.

15. The tissue cutting device of claim 1 further comprising a dielectric layer on the interior of the outer sleeve.

16. A tissue cutting device comprising:

an elongated structure having an axis and comprising an outer sleeve with a distal window and an inner cutting sleeve configured to move between a proximal position and a distal position relative to the window;

wherein the inner sleeve has an interior tissue-extracting lumen with a distal lumen portion and a proximal lumen portion having different diameters; and

wherein the perimeter of the window comprises a dielectric material.

17. The tissue cutting device of claim 16 wherein the dielectric material comprises a ceramic.

18. The tissue cutting device of claim 16 wherein the dielectric material comprises a polymeric material.

19. A tissue cutting device comprising:

an assembly comprising an outer sleeve with a distal window and an inner sleeve configured to move between a proximal position and a distal position relative to the window; and

wherein the inner sleeve has a distal tissue-contacting edge that is displaced radially inwardly from an outer diameter of said inner sleeve, said displaced edge comprising an electrode.

20. The tissue cutting device of claim 19 wherein the displaced edge is displaced radially inward at least 0.003″

.

21. The tissue cutting device of claim 19 further comprising a dielectric layer on the exterior of the inner sleeve.

22. The tissue cutting device of claim 19 further comprising a dielectric layer on the interior of the outer sleeve.

23. A tissue cutting device comprising:

an elongated assembly comprising concentric outer and inner sleeves extending along an axis;

a tissue-receiving window in the outer sleeve wherein the inner sleeve has a tissue extraction lumen extending through at least a proximal and medial region thereof;

wherein the ratio of the diameter of the extraction lumen to the outer diameter of the outer sleeve is at least 0.65;

1.

24. The tissue cutting device of claim 23 wherein the ratio of the diameter of the extraction lumen to the outer diameter of the outer sleeve is at least 0.70:

1.

25. A tissue cutting system comprising:

an elongated probe in combination with a hysteroscope;

a tissue-receiving window in a probe outer sleeve and a reciprocating inner sleeve having a extraction lumen therein;

wherein the ratio of the diameter of the extraction lumen to the outer diameter of the hysteroscope is at least 0.35;

1.

26. The tissue cutting system of claim 25 wherein the ratio of the diameter of the extraction lumen to the outer diameter of the hysteroscope is at least 0.40:

1.

27. A tissue cutting probe comprising:

first and second concentric sleeves having an axis and configured for relative axial movement between a window-open position for receiving tissue therein and a range of window-closing positions in which the second sleeve cuts tissue in a window in the first sleeve; and

a motor for providing relative movement of the sleeves;

wherein each of said sleeves comprises a tissue-contacting edge for contacting tissue, said contacting edge of one sleeve comprising an electrode and the contacting edge of the other sleeve comprising a dielectric.

28. The tissue cutting probe of claim 27 further comprising a dielectric layer on at least one interfacing surface of the first and second sleeves.

29. The tissue cutting probe of claim 27 further comprising a dielectric layer disposed the interfacing surfaces of both the first and second sleeves.

30. The tissue cutting probe of claim 27 wherein the first and second sleeves comprise opposing polarity electrodes coupled to an RF source.