Tissue extraction devices and methods

An electrosurgical system for resecting tissue, comprising:

• an elongated probe including:
• an outer sleeve having a tissue receiving window extending through a side wall of the outer sleeve to a lumen disposed within the outer sleeve;
• and
• an inner sleeve movably disposed within the lumen of the outer sleeve and including a tissue extraction lumen disposed within the inner sleeve;
• wherein the inner sleeve is configured to axially reciprocate across the tissue receiving window to resect tissue extending into the tissue receiving window;
• wherein the inner sleeve includes a first polarity electrode disposed at a distal end of the inner sleeve;
• wherein the outer sleeve comprises a second polarity electrode proximate a distal end region of the outer sleeve;
• wherein during distal strokes of the inner sleeve:
• the first polarity electrode and the second polarity electrode are configured to operate in a first mode to resect tissue extending into the tissue receiving window with RF energy during a first stroke portion of the distal strokes, and
• the first polarity electrode and the second polarity electrode are configured to operate in a second mode to vaporize a fluid volume within the lumen of the outer sleeve with RF energy to expel tissue proximally through the tissue extraction lumen of the inner sleeve during a second stroke portion of the distal strokes.