# US 10,499,987 B2 · Tissue cutting systems and methods

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- Number: US 10,499,987 B2
- Document ID: US10499987B2
- Status: Granted
- Kind: B2
- Application number: 15/656,386
- Filed: 2017-07-21
- Published: 2017-11-23
- Granted: 2019-12-10
- Earliest claimed: 2011-07-06
- Assignees: Boston Scientific Scimed, Inc.
- Applicants: Boston Scientific Scimed, Inc.
- Inventors: Aaron Germain; John H. Shadduck; Michael D. Walker; Kyle Klein; Csaba Truckai
- Web page: https://patentgrep.com/patent/US10499987B2

## CPC

- A61B 18/18: by applying electromagnetic radiation, e.g. microwaves
- A61B 17/32002: {with continuously rotating, oscillating or reciprocating cutting instruments}
- A61B 18/1482: {having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy}
- A61B 1/012: characterised by internal passages or accessories therefor
- A61B 1/303: for the vagina, i.e. vaginoscopes
- A61B 18/08: by means of electrically-heated probes
- A61B 2017/320028: {with reciprocating movements}
- A61B 2017/4216: {Operations on uterus, e.g. endometrium}
- A61B 2018/00196: {reciprocating lengthwise}
- A61B 2018/00589: {Coagulation}
- A61B 2018/00601: {Cutting}
- A61B 2018/1475: {Electrodes retractable in or deployable from a housing}
- A61B 2218/002: Irrigation
- A61B 2218/007: Aspiration
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

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.

## Claims

### Claim 1

A tissue resecting device comprising:
a handle;
an elongate shaft extending from the handle, the elongate shaft including an outer sleeve and a reciprocating inner resecting sleeve disposed in the outer sleeve, wherein such reciprocation of the inner resecting sleeve moves a distal end of the inner resecting sleeve across a tissue-receiving window of the outer sleeve between window-open and window-closed positions at a reciprocation speed;
a motor drive in the handle; and
an actuator in the handle coupled between the motor drive and the inner resecting sleeve to convert rotational motion from the motor drive to reciprocation motion of the inner resecting sleeve relative to the outer sleeve for reciprocating the inner resecting sleeve at the reciprocation speed, wherein the actuator is configured to vary the reciprocation speed within one full reciprocation stroke of the inner reciprocating sleeve independent of changing rotational speed of the motor drive;
wherein the actuator includes an actuator body with an arcuate slot therein, wherein rotational motion from the motor drive rotates the actuator body; and
wherein the inner resecting sleeve extends proximal of the actuator body and reciprocates relative thereto.

### Claim 2 (depends on 1)

The tissue resecting device of claim 1, wherein the full 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-open position to the window-closed position.

### Claim 3 (depends on 2)

The tissue resecting device of claim 2, wherein the inner resecting sleeve has a faster speed during the retracting stroke and a slower speed during the extending stroke.

### Claim 4 (depends on 2)

The tissue resecting device of claim 2, 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.

### Claim 5 (depends on 4)

The tissue resecting device of claim 4, wherein the dwell time is at least 0.1 second.

### Claim 6 (depends on 1)

The tissue resecting device of claim 1, further comprising a controller for controlling reciprocation of the inner resecting sleeve.

### Claim 7 (depends on 6)

The tissue resecting device of claim 6, 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.

### Claim 8 (depends on 6)

The tissue resecting device of claim 6, wherein the controller is configured for locking the inner resecting sleeve in the window-open position.

### Claim 9 (depends on 6)

The tissue resecting device of claim 6, wherein the controller is configured for locking the inner resecting sleeve in the window-closed position.

### Claim 10 (depends on 6)

The tissue resecting device of claim 6, wherein a distal end of the inner resecting sleeve includes an RF electrode having a first polarity and the outer sleeve serves as a return electrode having an opposite, second polarity.

### Claim 11 (depends on 10)

The tissue resecting device of claim 10, wherein the RF electrode is configured to generate plasma for resecting tissue.