Tissue cutting systems and methods
View Patent ↗A probe for resecting and coagulating tissue comprises an outer sleeve having a tissue cutting window and an inner sleeve having a tissue cutting distal end. And RF cutting region is formed at the distal end of the inner member and an RF coagulation region is formed on an exterior surface of the inner member immediately proximal to the cutting surface. A single power supply providing a single RF energy mode can be connected to both RF applicator regions to simultaneously cut and coagulate tissue.
1. A tissue resecting probe comprising:
a handle coupled to a windowed outer sleeve and a reciprocating radio-frequency (RF) inner resecting sleeve wherein such reciprocation moves the probe between window-open and window-closed positions at a reciprocation speed; and
a motor drive in the handle, and
an actuator coupled to the motor drive and rotatable therewith, the actuator configured to convert rotational motion from the motor drive to reciprocation motion of the inner resecting sleeve for reciprocating the inner resecting sleeve across a window of the outer sleeve between the window-open position and the window-closed position, the actuator including an arcuate slot shaped to vary a reciprocation speed of the inner resecting sleeve such that the reciprocation speed of the reciprocating inner resecting sleeve is variable within one complete reciprocation stroke, wherein the complete reciprocation stroke includes an extending stroke in which the inner resecting sleeve moves from the window-open position to the window-closed position and a retracting stroke in which the inner resecting sleeve moves from the window-closed position to the window-open position.
2. The tissue resecting probe of claim 1 , wherein the inner resecting sleeve has a faster speed on a retracting stroke and a slower speed during an extending stroke to increase RF resecting time when engaging tissue.
3. The tissue resecting probe of claim 1 , wherein the inner resecting sleeve has a dwell time in a fully extended stroke position to thereby allow negative and/or positive pressures to move tissue through the inner resecting sleeve.
4. The tissue resecting probe of claim 3 , wherein the dwell time is at least 0.1 second.
5. The tissue resecting probe of claim 3 , wherein the inner resecting sleeve has a peak speed range from 50 mm/s to 200 mm/s.
6. The tissue resecting probe of claim 1 , wherein a controller moves the inner resecting sleeve to the window-closed position when the motor is off.
7. The tissue resecting probe of claim 6 , wherein the controller allows the selection of at least two reciprocation rates between 1 Hz and 4 Hz.
8. The tissue resecting probe of claim 6 , wherein the controller allows the selection of locking the inner resecting sleeve in a partially extended position.
9. The tissue resecting probe of claim 8 , wherein the controller allows the selection of a low RF power delivery at least in said partially extended position for use in tissue coagulation.
10. The tissue resecting probe of claim 1 , further comprising a controller configured to allow selectable reciprocation rates of the inner resecting sleeve.
11. The tissue resecting probe of claim 10 , wherein the controller allows the selection of a single extending stroke.
12. The tissue resecting probe of claim 10 , wherein the controller allows the selection of a single retraction stroke and locking the inner resecting sleeve in the window-open position.
13. The tissue resecting probe of claim 1 , wherein the reciprocation speed of the inner resecting sleeve is greater during the retracting stroke than during the extending stroke.
14. The tissue resecting probe of claim 1 , further comprising a controller for controlling reciprocation of the inner resecting sleeve.
15. The tissue resecting probe of claim 14 , wherein the controller is configured for locking the inner resecting sleeve in a partially extended position between the window-open position and the window-closed position.
16. The tissue resecting probe of claim 14 , wherein the controller is configured for locking the inner resecting sleeve in the window-open position.
17. The tissue resecting probe of claim 14 , wherein the controller is configured for locking the inner resecting sleeve in the window-closed position.
18. The tissue resecting probe of claim 1 , wherein the inner resecting sleeve has a dwell time at the window-closed position.
19. The tissue resecting probe of claim 18 , wherein the dwell time is at least 0.1 second.
20. The tissue resecting probe of claim 1 , further comprising a tissue extraction channel extending through the inner resecting sleeve for extracting resected tissue.
21. The tissue resecting probe of claim 20 , wherein the tissue extraction channel extends through the handle.
22. The tissue resecting probe of claim 21 , further comprising a heat exchanger in the handle, wherein the tissue extraction channel extends through the heat exchanger.
23. The tissue resecting probe of claim 22 , wherein the heat exchanger is configured to cool the motor via extraction of fluid through the tissue extraction channel.
24. The tissue resecting probe of claim 1 , wherein the inner resecting sleeve includes an RF electrode at a distal end thereof.
25. The tissue resecting probe of claim 24 , wherein the RF electrode is configured to generate plasma for resecting tissue.
26. The tissue resecting probe of claim 24 , wherein the outer sleeve serves as a return electrode.
27. A tissue resecting probe comprising:
a handle;
an elongate shaft extending from the handle, the elongate shaft including:
an outer sleeve having a tissue-receiving window; and
an inner sleeve disposed in the outer sleeve;
a motor drive in the handle;
an actuator in the handle coupled between the motor drive and a pin fixed relative to the inner sleeve to convert rotational motion from the motor drive to reciprocation motion of the inner sleeve relative to the outer sleeve;
wherein the actuator includes an arcuate slot engaging the pin;
wherein the arcuate slot is configured to provide a variable reciprocation speed of the inner sleeve within a full reciprocation stroke;
wherein the full reciprocation stroke includes an extending stroke in which the inner sleeve moves from a window-open position to a window-closed position and a retracting stroke in which the inner sleeve moves from the window-closed position to the window-open position.