TISSUE EXTRACTION DEVICES AND METHODS

• US 20130231652A1
• Filed: 08/30/2012
• Published: 09/05/2013
• Est. Priority Date: 09/01/2011
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Arqos Surgical, Inc.
• Inventors: Germain, Aaron, Klein, Kyle, Walker, Michael D., Orczy-Timko, Benedek
• Granted Patent: US 9,439,720 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• 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 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61B 90/30 Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure

Abstract

A tissue resection device comprises inner and outer coaxial sleeves. The outer sleeve has a cutting window formed therein, and the inner sleeve has a distal cutting end that can be reciprocated past the cutting window. The sleeves comprise electrodes to provide electrosurgical cutting, and an edge portion of the window includes a dielectric material.

Claims

1. An electrosurgical tissue cutting probe comprising:

an elongated assembly comprising a windowed outer sleeve and a moveable inner cutting sleeve that provides window-open and window-closed configurations adapted to electrosurgically cut tissue disposed within the window; and

wherein an edge portion of the window at least partly comprises a dielectric material.

2. The electrosurgical tissue cutting probe of claim 1 wherein the outer sleeve comprises conductive material configured as a first polarity electrode.

3. The electrosurgical tissue cutting probe of claim 1 wherein the inner cutting sleeve comprises conductive material configured as a second polarity electrode.

4. The electrosurgical tissue cutting probe of claim 1 wherein the dielectric material is configured with keys that couple to cooperating features in the outer sleeve.

5. The electrosurgical tissue cutting probe of claim 4 wherein the keys are configured to resist rotational displacement of the dielectric material relative the outer sleeve.

6. The electrosurgical tissue cutting probe of claim 4 wherein the keys are configured to resist axial displacement of the dielectric material relative the outer sleeve.

7. The electrosurgical tissue cutting probe of claim 4 wherein the keys are configured to resist radial outward displacement of the dielectric material relative the outer sleeve.

8. The electrosurgical tissue cutting probe of claim 4 wherein the keys are configured to resist radial inward displacement of the dielectric material relative the outer sleeve.

9. The electrosurgical tissue cutting probe of claim 4 wherein the dielectric material comprises at least one of a polymer, ceramic, or glass.

10. The electrosurgical tissue cutting probe of claim 4 wherein the dielectric material has a comparative tracking index value ranging from 200 volts to 800 volts.

11. The electrosurgical tissue cutting probe of claim 1 wherein the outer sleeve has a lumen with dielectric surface layer.

12. The electrosurgical tissue cutting probe of claim 1 wherein the dielectric surface layer has a thickness ranging from 0.001″

to 0.010″

.

13. The electrosurgical tissue cutting probe of claim 1 wherein an exterior surface of the outer sleeve comprises a first polarity electrode.

14. The electrosurgical tissue cutting probe of claim 1 wherein a surface portion of the lumen in the outer sleeve comprises a dielectric material.

15. The electrosurgical tissue cutting probe of claim 1 wherein a distal portion of the inner cutting sleeve comprises a second polarity electrode.

16. The electrosurgical tissue cutting probe of claim 1 wherein the inner cutting sleeve is moveable axially relative to the outer sleeve.

17. The electrosurgical tissue cutting probe of claim 1 wherein the inner cutting sleeve is moveable axially and/or rotationally relative to the outer sleeve.

18. A method of cutting tissue with electrosurgical energy, comprising:

providing an elongated probe comprising a windowed outer sleeve and an inner sleeve that is reciprocatable to cut tissue in the window, wherein a distal edge of the inner sleeve comprises a first polarity RF cutting electrode configured for plasma formation thereabout;

manipulating the window into and out of contact with tissue in a saline environment while reciprocating the inner sleeve and RF cutting electrode, and

delivering RF energy at system operational parameters such that a plasma is formed at the RF cutting electrode only when in contact with tissue.

19. The method of claim 18 wherein delivering RF energy causes current flow between the RF cutting electrode and a surface of the outer sleeve comprising a second polarity electrode.

20. The method of claim 19 further comprising actuating a negative pressure source in communication with a proximal end of a lumen in the inner sleeve thereby causing a flow of saline through the lumen.

21. The method of claim 20 wherein the negative pressure source provides a selected saline flow rate configured to prevent plasma formation about the RF cutting electrode when not in contact with tissue.

22. The method of claim 20 wherein positioning the RF cutting electrode in contact with tissue restricts the saline flow rate resulting in plasma formation about the RF cutting electrode.

23. The method of claim 20 wherein positioning the RF cutting electrode in contact with tissue increases impedance between the RF cutting electrode and the second polarity electrode resulting in plasma formation about the RF cutting electrode.

24. An electrosurgical tissue cutting probe comprising:

an elongated assembly comprising a windowed outer sleeve having a lumen carrying an inner sleeve that is reciprocatable in a stroke between window-open and window-closed positions;

wherein the inner sleeve comprises a first polarity electrode and the outer sleeve comprises second polarity electrode; and

wherein the length of the current path between the first and second polarity electrodes in any portion of the stroke is within the range of 0.010″ and

0.050″

.

25. The electrosurgical tissue cutting probe of claim 24 wherein the length of the current path is within the range of 0.015″

and 0.030″

.

26. The electrosurgical tissue cutting probe of claim 24 wherein an edge of the window in the outer sleeve comprises a dielectric material.

27. The electrosurgical tissue cutting probe of claim 26 wherein the edge has a minimum radial dimension of at least 0.005″

.

28. The electrosurgical tissue cutting probe of claim 24 wherein a surface of the lumen in the outer sleeve comprises a dielectric material.

29. The electrosurgical tissue cutting probe of claim 28 wherein the dielectric material has a thickness ranging between 0.001″

and 0.010″

.

30. The electrosurgical tissue cutting probe of claim 24 wherein an exterior surface of the inner sleeve comprises a dielectric layer.

31. The electrosurgical tissue cutting probe of claim 30 wherein the dielectric layer has a thickness ranging between 0.001″

and 0.010″

.

32. The electrosurgical tissue cutting probe of claim 24 wherein the minimum cross-sectional area of the tissue-extracting channel in the inner sleeve is at least 40% of the cross-sectional area of outer sleeve.

33. An electrosurgical tissue cutting probe comprising:

an elongated assembly extending along an axis comprising a windowed outer sleeve carrying an inner sleeve that is reciprocatable between window-open and window-closed positions, wherein the inner sleeve comprises a first polarity electrode and the outer sleeve comprises second polarity electrode; and

a thin-wall dielectric sleeve disposed around an exterior of the outer sleeve, the dielectric sleeve axially moveable to adjust the exposed surface area of the second electrode.