Tissue extraction devices and methods
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.
1. A tissue resecting device, comprising:
an outer sleeve having a tissue-receiving window opening into a lumen of the outer sleeve proximal of a distal end of the outer sleeve;
a closed distal tip positioned at the distal end of the outer sleeve;
a distal body formed of a dielectric material attached to the outer sleeve, the distal body forming at least a portion of a distal edge of the tissue-receiving window; and
an axially reciprocating inner sleeve disposed within the lumen of the outer sleeve, the inner sleeve having a lumen and a tissue-resecting distal end, the inner sleeve being configured to move longitudinally across the tissue-receiving window between an open window position and a closed window position.
2. The tissue resecting device of claim 1 , wherein the distal edge of the tissue-receiving window is entirely composed of the dielectric material of the distal body.
3. The tissue resecting device of claim 1 , wherein the distal body is semi-cylindrical in shape.
4. The tissue resecting device of claim 1 , wherein the distal body is formed of a different material than the outer sleeve.
5. The tissue resecting device of claim 4 , wherein the dielectric material is a ceramic material.
6. The tissue resecting device of claim 1 , wherein the outer sleeve includes a dielectric lining.
7. The tissue resecting device of claim 1 , wherein the outer sleeve includes a marking disposed on an outer surface of the outer sleeve.
8. The tissue resecting device of claim 7 , wherein the marking extends proximally from a proximal end of the tissue-receiving window.
9. The tissue resecting device of claim 8 , wherein the marking narrows in width towards a proximal end of the outer sleeve.
10. A tissue resecting device, comprising:
an outer sleeve having a tissue-receiving window opening into a lumen of the outer sleeve; and
an axially reciprocating inner sleeve disposed within the lumen of the outer sleeve, the inner sleeve having an extraction lumen configured to transport resected tissue and a tissue-resecting distal end, the inner sleeve being configured to move longitudinally between an open window position and a closed window position;
wherein the outer sleeve includes a closed distal tip and a proximally-extending projecting element fixedly attached to the distal tip;
wherein a proximal end of the projecting element is disposed proximal of a distal edge of the tissue-receiving window;
wherein the projecting element has a maximum cross-sectional extent at its proximal end less than an inner diameter of the inner sleeve.
11. The tissue resecting device of claim 10 , wherein the projecting member extends into the lumen of the inner sleeve in the closed window position.
12. The tissue resecting device of claim 10 , wherein at least a portion of the projecting element is disposed distal of the tissue-receiving window.
13. The tissue resecting device of claim 10 , wherein an edge of the tissue-receiving window includes a dielectric material.
14. The tissue resecting device of claim 10 , wherein the projecting element comprises a dielectric material.
15. The tissue resecting device of claim 10 , wherein the distal end of the inner sleeve comprises an RF electrode edge.
16. The tissue resecting device of claim 15 , wherein the RF electrode edge is positioned proximal of the tissue-receiving window in the open window position and the RF electrode edge is positioned distal of the tissue-receiving window in the closed window position.
17. The tissue resecting device of claim 15 , wherein the RF electrode edge surrounds the projecting element in the closed window position.
18. The tissue resecting device of claim 10 , wherein the inner sleeve includes an electrically insulative layer disposed along an exterior of the inner sleeve.
19. The tissue resecting device of claim 10 , wherein the tissue-receiving window is longitudinally asymmetrical.
20. The tissue resecting device of claim 10 , wherein the projecting element has a substantially symmetrical shape.