Tissue extraction devices and methods

• US 8,512,326 B2
• Filed: 10/20/2011
• Issued: 08/20/2013
• 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, Walker, Michael D., Truckai, Csaba
• Primary Examiner(s): Dvorak, Linda
• Assistant Examiner(s): Ram, Jocelyn D
• Application Number:
  US13/277,913
• Publication Number:
  US 20120330292A1
• Time in Patent Office: 670 Days
• Field of Search: 606/32, 606/29, 606/41, 606/45, 606/167
• US Class Current: 606/32
• 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 the fluid within a working end of the probe.

6. The method of claim 5 wherein the volume of fluid is 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 comprising applying negative pressure to a proximal end of the interior passageway.

14. The method as in claim 1, further comprising capturing the fluid in a an interior of the elongated probe proximate a distal end of the interior passageway prior to causing the phase transition.

15. The method as in claim 14, wherein capturing the tissue volume comprises receiving the tissue volume within a tissue-receiving window and advancing an RF electrode past the tissue-receiving window.

16. The method as in claim 15, wherein advancing the RF electrode past the tissue-receiving window captures the fluid volume in the distal portion of the interior passageway of the elongate probe.

17. The method as in claim 15, wherein the RF electrode is advanced past the window to confine the fluid volume in the distal portion of the interior passageway of the elongate probe and wherein causing the phase transition comprises generating a contained electric field within the distal portion of the interior passageway of the elongate probe to instantly vaporize the fluid.

18. The method as in claim 1, further comprising engaging the captured tissue volume with a projecting element which pushes the tissue volume in a proximal direction in the distal portion of the interior passageway of the elongate probe.

19. 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 a 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, wherein the fluid is provided from a fluid-filled space in the patient'"'"'s body.