Tissue extraction devices and methods
View Patent ↗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.
1. A tissue resecting device comprising:
an assembly comprising an outer sleeve with a distal window and an inner sleeve configured to longitudinally reciprocate between a proximal position and a distal position relative to the window during use; and
wherein the inner sleeve has a distally-facing distal tissue-resecting edge that is displaced radially inwardly from an outer diameter of said inner sleeve, said displaced edge comprising an annular tissue-resecting electrode.
2. The tissue resecting device of claim 1 , wherein the displaced edge is displaced radially inward at least 0.003″.
3. The tissue resecting device of claim 1 , further comprising a dielectric layer on the exterior of the inner sleeve.
4. The tissue resecting device of claim 1 , further comprising a dielectric layer on the interior of the outer sleeve.
5. The tissue resecting device of claim 1 , further comprising a dielectric material extending around a perimeter of the window.
6. The tissue resecting device of claim 5 , wherein the dielectric material comprises a polymeric material.
7. The tissue resecting device of claim 1 , wherein the inner sleeve has an interior tissue-extracting lumen with a proximal lumen portion having a first diameter and the electrode includes a lumen having a second diameter less than the first diameter.
8. The tissue resecting device of claim 1 , wherein the electrode has a first polarity and a portion of the outer sleeve forms a second electrode having a second polarity opposite the first polarity.
9. A tissue resecting device comprising:
an outer sleeve including a side window opening into a lumen of the outer sleeve; and
an inner sleeve positioned in the lumen of the outer sleeve, the inner sleeve comprising:
a tubular shaft having a tissue extraction lumen extending therethrough, and
a tubular electrode having an inner diameter and an outer diameter;
wherein the inner sleeve is configured to longitudinally reciprocate between a proximal position and a distal position relative to the window;
wherein a proximal portion of the tubular electrode extends into the lumen of the tubular shaft with a distal portion of the tubular electrode extending distally from the tubular shaft;
wherein the outer diameter of the tubular electrode is displaced radially inwardly from an outer diameter of said tubular shaft.
10. The tissue resecting device of claim 9 , wherein the tubular electrode includes an annular distal edge.
11. The tissue resecting device of claim 9 , further comprising a dielectric material extending around a perimeter of the side window.
12. The tissue resecting device of claim 9 , further comprising a dielectric layer on an exterior of the tubular shaft.
13. The tissue resecting device of claim 9 , further comprising a dielectric layer on an interior of the outer sleeve.
14. The tissue resecting device of claim 9 , wherein the tubular electrode has a first polarity and a portion of the outer sleeve forms a second electrode having a second polarity opposite the first polarity.
15. The tissue resecting device of claim 9 , wherein the inner diameter of the tubular electrode is less than a diameter of the tissue extraction lumen of the tubular shaft.
16. A tissue resecting device comprising:
an outer sleeve including a side window opening into a lumen of the outer sleeve;
an inner sleeve positioned in the lumen of the outer sleeve, the inner sleeve comprising:
a tubular shaft having a tissue extraction lumen extending therethrough, and
a tubular electrode having an inner diameter and an outer diameter;
wherein a proximal portion of the tubular electrode extends into the lumen of the tubular shaft with a distal portion of the tubular electrode extending distally from a distal end of the tubular shaft;
wherein the outer diameter of the tubular electrode is displaced radially inwardly from an outer diameter of said tubular shaft;
wherein the inner sleeve is configured to longitudinally reciprocate relative to the outer sleeve such that the tubular electrode repeatedly moves between a proximal position in which a distal end of the tubular electrode is located proximal of the window and a distal position in which the distal end of the tubular electrode is located distal of the window.
17. The tissue resecting device of claim 16 , further comprising a ceramic collar surrounding the tubular electrode distal of the distal end of the inner sleeve.
18. The tissue resecting device of claim 17 , wherein the tubular electrode includes an electrode edge located distal of the ceramic collar.
19. The tissue resecting device of claim 18 , wherein the electrode edge is a plasma forming edge configured to generate a plasma to resect tissue.
20. The tissue resecting device of claim 16 , wherein the tubular electrode is welded to the distal end of the tubular shaft.
21. The tissue resecting device of claim 16 , further comprising a dielectric material extending around a perimeter of the side window.
22. The tissue resecting device of claim 16 , further comprising a dielectric layer on an exterior of the tubular shaft.
23. The tissue resecting device of claim 16 , further comprising a dielectric layer on an interior of the outer sleeve.
24. The tissue resecting device of claim 16 , wherein the tubular electrode has a first polarity and a portion of the outer sleeve forms a second electrode having a second polarity opposite the first polarity.
25. The tissue resecting device of claim 16 , wherein the inner diameter of the tubular electrode is less than a diameter of the tissue extraction lumen of the tubular shaft.