Tissue extraction devices and methods

• US 9,839,473 B2
• Filed: 03/16/2017
• Issued: 12/12/2017
• Est. Priority Date: 06/24/2011
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Inventors: Germain, Aaron, Klein, Kyle, Orczy-Timko, Benedek, Shadduck, John H., Walker, Michael D., Truckai, Csaba, Lesko, Balazs
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, Jon Eric C
• Application Number:
  US15/460,810
• Publication Number:
  US 20170181793A1
• Time in Patent Office: 271 Days
• Field of Search: 606 32, 606 41, 606 46, 606 39, 606167
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• 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 2017/320028 with reciprocating movements
• 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 2018/00601 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

Abstract

The tissue cutting device comprises an elongated assembly including both an outer sleeve and an inner sleeve. The outer sleeve has a tissue-receiving window, and the inner sleeve has a distal end which cuts tissue as the inner sleeve is advanced past the window. The tissue is received into a lumen of the inner sleeve, and the inner sleeve lumen is typically enlarged in a proximal direction to reduce the tendency of resected tissue to lodge therein. The tissue displacement member is optionally provided at a distal end of the outer sleeve to further aid in dislodging tissue which becomes captured in a distal end of the inner sleeve of the lumen.

Claims

1. An electrosurgical tissue resecting probe, comprising:

an elongated assembly comprising an outer sleeve having a tissue-receiving window open to an interior lumen thereof and a moveable inner resecting sleeve disposed within the interior lumen of the outer sleeve that provides open-window and closed-window configurations adapted to electrosurgically resect tissue disposed within the tissue-receiving window;

wherein an edge of the tissue-receiving window at least partly comprises a dielectric material.

2. The electrosurgical tissue resecting probe of claim 1, wherein the edge of the tissue-receiving window is surrounded by the dielectric material.

3. The electrosurgical tissue resecting probe of claim 2, wherein a width of the dielectric material is at least 0.005 inches.

4. The electrosurgical tissue resecting probe of claim 1, wherein the inner sleeve is arranged to longitudinally reciprocate relative to the outer sleeve.

5. The electrosurgical tissue resecting probe of claim 1, wherein the tissue-receiving window is longitudinally asymmetrical.

6. The electrosurgical tissue resecting probe of claim 1, wherein a longitudinally-extending portion of the edge of the tissue-receiving window defines a window depth from an outer surface of the outer sleeve, and the window depth varies along a length of the tissue-receiving window.

7. The electrosurgical tissue resecting probe of claim 6, wherein the window depth increases in a distal direction.

8. The electrosurgical tissue resecting probe of claim 6, wherein the window depth is defined relative to a maximum longitudinal extent of the tissue-receiving window.

9. An electrosurgical tissue resecting probe, comprising:

an outer sleeve having a closed distal tip fixedly attached thereto and a side-opening tissue-receiving window open to an interior lumen thereof; and

a longitudinally-reciprocating inner resecting sleeve disposed within the interior lumen of the outer sleeve that provides open-window and closed-window configurations adapted to electrosurgically resect tissue disposed within the tissue-receiving window;

wherein a distal end of the inner resecting sleeve comprises an RF electrode;

wherein an edge of the tissue-receiving window is defined by a dielectric material.

10. The electrosurgical tissue resecting probe of claim 9, wherein a distalmost edge of the tissue-receiving window is disposed at least 4 millimeters proximal of the closed distal tip.

11. The electrosurgical tissue resecting probe of claim 9, wherein the outer sleeve includes a projecting element extending proximally from the closed distal tip within the interior lumen.

12. The electrosurgical tissue resecting probe of claim 11, wherein the projecting element comprises a dielectric material.

13. The electrosurgical tissue resecting probe of claim 11, wherein the projecting element extends into an extraction lumen of the inner resecting sleeve in the closed-window configuration.

14. The electrosurgical tissue resecting probe of claim 13, wherein the extraction lumen has a variable cross-sectional area.

15. The electrosurgical tissue resecting probe of claim 14, wherein the extraction lumen includes:

a proximal portion having a diameter extending from a proximal end to a distal region of the inner resecting sleeve; and

a distal portion extending from the proximal portion to a distal end of the inner resecting sleeve;

wherein the distal portion has a reduced diameter relative to the proximal portion.

16. The electrosurgical tissue resecting probe of claim 15, wherein the projecting element has a maximum cross-section that occupies a majority of the reduced diameter of the distal portion.

17. The electrosurgical tissue resecting probe of claim 13, wherein the extraction lumen is fluidly coupled to a negative pressure source.

18. The electrosurgical tissue resecting probe of claim 9, wherein an inner surface of the outer sleeve is covered with dielectric material.

19. The electrosurgical tissue resecting probe of claim 9, wherein the tissue-receiving window is configured to draw a lesser volume of tissue into a proximal portion of the tissue-receiving window and a greater volume of tissue into a distal portion of the tissue-receiving window for resection with the RF electrode.

20. The electrosurgical tissue resecting probe of claim 19, wherein the distal portion of the tissue-receiving window opens to a greater radial angle about the outer sleeve relative to a longitudinal axis of the outer sleeve than the proximal portion.