TISSUE EXTRACTION DEVICES AND METHODS

• US 20130296847A1
• Filed: 10/30/2012
• Published: 11/07/2013
• Est. Priority Date: 11/04/2011
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Arqos Surgical, Inc.
• Inventors: Germain, Aaron, Klein, Kyle, Walker, Michael D., Truckai, Csaba, Shadduck, John H.
• Granted Patent: US 9,597,149 B2
• Time in Patent Office: Days
• US Class Current: 606/39
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• 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 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00863 Fluid flow
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61B 50/13 Trolleys, e.g. carts
• CPC Class Codes: A61B 50/20 Holders specially adapted for surgical or diagnostic appliances or instruments drapes with means to hold surgical instruments A61B46/23; for catheters A61M25/02

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.

Claims

1. A method of cutting tissue from a targeted site in a space or potential space in a patient'"'"'s body, comprising the steps of:

circulating a fluid though the space with a first flow into the space and a second flow out of the space to thereby occupy or distend the space;

actuating an RF probe to perform a cutting procedure at the site; and

modulating an operating parameter of the RF probe in response to a rate of the first or second flow.

2. The method of cutting tissue of claim 1 including accessing the space with an endoscope.

3. The method of cutting tissue of claim 1 wherein the first flow into the space is provided by a peristaltic pump.

4. The method of cutting tissue of claim 1 wherein the second flow out of the space is assisted by a peristaltic pump.

5. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises power.

6. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises the movement of an RF cutting component.

7. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises rotational speed of an RF cutting component.

8. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises speed of reciprocation of an RF cutting component.

9. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises the movement of a non-RF component.

10. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises a duty cycle or pulse rate.

11. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises a position of an RF cutting component relative to a tissue-receiving window.

12. The method of cutting tissue of claim 1 wherein the space or potential space is a uterine cavity.

13. The method of cutting tissue of claim 1 wherein the space or potential space is within a joint.

14. The method of cutting tissue of claim 1 wherein an operating parameter of the RF probe comprises a position of an RF cutting component relative to a tissue-receiving window.

15. The method of cutting tissue of claim 1 wherein the first flow has a rate of at least 100 ml/min.

16. The method of cutting tissue of claim 1 wherein the first flow comprises saline.

17. The method of cutting tissue of claim 1 wherein the first flow is provided from a saline source having a volume of less than about 3 liters.

18. The method of cutting tissue of claim 1 wherein the second flow is passed through at least one filter and returned the saline source.

19. A method of cutting tissue from a targeted site in a space or potential space in a patient'"'"'s body, comprising the steps of:

circulating a fluid though the space with a fluid inflow into the space and a fluid outflow from the space to thereby occupy or distend the space;

actuating an RF probe to perform a cutting procedure at the site; and

modulating an operating parameter of an RF probe and/or the fluid management system in response to fluid pressure in the space.

20. The method of cutting tissue of claim 19 wherein an operating parameter of the RF probe is selected from the group of applied RF power, RF pulse rate, RF duty cycle, rotational and/or axial movement of an RF electrode component of the probe;

rotational and/or axial movement of a non-RF component of the probe, fluid inflow into the space, or fluid outflow from the space.

21. The method of cutting tissue of claim 19 wherein the space or potential space is a uterine cavity.

22. The method of cutting tissue of claim 19 wherein the space or potential space is within a joint.

23. The method of cutting tissue of claim 19 wherein the fluid inflow is provided through an endoscope.

24. The method of cutting tissue of claim 19 wherein the fluid outflow is provided through the RF probe.

25. A method of treating tissue in a targeted site in a space in a patient'"'"'s body, comprising the steps of:

positioning the working end of an RF probe in the space;

applying RF current to tissue from a moving RF electrode to perform a cutting procedure at the site; and

applying RF current to tissue from a non-moving RF electrode to perform a coagulation procedure at the site.

26. The method of claim 25 including utilizing a controller to selectively move or terminate movement of the RF electrode.

27. The method of claim 25 including suctioning tissue into the window of the working end to permit the moving RF electrode to cut tissue.

28. The method of claim 25 including suctioning tissue into the window of the working end to permit the non-moving RF electrode to coagulate tissue.

29. The method of claim 25 including circulating a conductive fluid though the space with a fluid inflow into the space at a rate of at least 100 ml/min.

30. The method of claim 29 wherein the conductive fluid is saline.

31. A method of cutting tissue in a targeted site in a space in a patient'"'"'s body, comprising the steps of:

positioning the cutting window of an RF probe in the space;

modulating RF current to an electrode edge of the window in response to sensing tissue contact about an RF electrode edge of the cutting window.