# US 2013/0158546 A1 · Endoscopic systems and methods for resection of tissue > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2013/0158546 A1 - Document ID: US20130158546A1 - Status: Published application - Kind: A1 - Application number: 13/716,663 - Filed: 2012-12-17 - Published: 2013-06-20 - Earliest claimed: 2011-12-20 - Assignees: Cook Medical Technologies LLC - Inventors: Ciaran Toomey; Kieran Costello - Web page: https://patentgrep.com/patent/US20130158546A1 ## CPC - A61B 17/32002: {with continuously rotating, oscillating or reciprocating cutting instruments} - A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)} - A61B 17/32056: {Surgical snare instruments (for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26)} - A61B 18/14: Probes or electrodes therefor - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 18/1477: {Needle-like probes} - A61B 2017/00269: {endoscopic mucosal resection EMR} - A61B 2017/00296: {mounted on an endoscope} - A61B 2017/32004: {having a laterally movable cutting member at its most distal end which remains within the contours of said end} - A61B 2018/00202: {rotating} - A61B 2018/00291: {using suction} - A61B 2018/00601: {Cutting} - A61B 2018/00982: {combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes} - A61B 2018/144: {Wire} - A61B 2090/035: {preventing further rotation} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The present embodiments provide apparatus and methods for facilitating endoscopic resection of tissue. In one embodiment, the apparatus comprises a first tube having proximal and distal regions, and a working lumen disposed within at least a portion of the distal region. A second tube is disposed circumferentially around at least a portion of the distal region of the first tube. A wire has a distal end that is securely attached to a distal region of the second tube. In use, rotation of the second tube relative to the first tube causes the wire to pass circumferentially over a distal face of the first tube to incise tissue disposed within the working lumen of the first tube. ## Claims ### Claim 1 Apparatus for facilitating resection of tissue, the apparatus comprising: a first tube having proximal and distal regions, and a working lumen disposed within at least a portion of the distal region; a second tube disposed circumferentially around at least a portion of the distal region of the first tube; and a wire having a distal end securely attached to a distal region of the second tube, wherein rotation of the second tube relative to the first tube causes the wire to pass circumferentially over a distal face of the first tube to incise tissue disposed within the working lumen of the first tube. ### Claim 2 (depends on 1) The apparatus of claim 1 wherein the wire extends from the distal region of the second tube in a proximal direction through the working lumen of the first tube. ### Claim 3 (depends on 2) The apparatus of claim 2 further comprising an eyelet disposed at a distal region of the first tube, wherein the wire extends from the distal region of the second tube in a proximal direction through the eyelet and further through the working lumen of the first tube. ### Claim 4 (depends on 1) The apparatus of claim 1 wherein the second tube comprises internal threading and the first tube comprises external threading, where the internal and external threading enable selective rotation of the second tube relative to the first tube. ### Claim 5 (depends on 1) The apparatus of claim 1 wherein the wire comprises an electrocautery member configured to cauterize a segment of tissue. ### Claim 6 (depends on 1) The apparatus of claim 1 wherein at least one of the first and second tubes comprises a sharpened distal face configured to puncture tissue and cause tissue to be disposed within the working lumen of the first tube. ### Claim 7 (depends on 1) The apparatus of claim 1 wherein at least a portion of the proximal region of the first tube is adapted to be disposed over an exterior surface of an endoscope. ### Claim 8 (depends on 7) The apparatus of claim 7 wherein the portion of the proximal region of the first tube that is adapted to be disposed about the exterior surface of the endoscope comprises an elastic member having a larger diameter state adapted to be placed over the endoscope and a smaller diameter state that permits the first tube to be elastically secured about the exterior surface of the endoscope. ### Claim 9 (depends on 1) The apparatus of claim 1 wherein the first tube comprises a stepped portion disposed between the proximal and distal regions of the first tube, wherein the stepped portion reduces a diameter of the distal region of the first tube, thereby allowing the second tube to be substantially flush with an exterior surface of the proximal region of the first tube. ### Claim 10 (depends on 1) The apparatus of claim 1 further comprising an endoscope, wherein the proximal region of the first tube is disposed on a distal end of the endoscope and the distal region of the first tube is disposed distal to the endoscope. ### Claim 11 (depends on 1) The apparatus of claim 1, where at least one of the first and second tubes extend along a full length of an endoscope, where a proximal region of one of the first and second tubes can be directly manipulated by a user. ### Claim 12 A method for facilitating resection of tissue, the method comprising: providing apparatus comprising a first tube having proximal and distal regions, a second tube disposed circumferentially around at least a portion of the distal region of the first tube, and a wire having a distal end securely attached to a distal region of the second tube; positioning at least a segment of tissue within a working lumen of the first tube; and circumferentially rotating the second tube relative to the distal region of the first tube to pass the wire circumferentially over a distal face of the first tube to incise the segment of tissue disposed within the working lumen of the first tube. ### Claim 13 (depends on 12) The method of claim 12 wherein the wire extends from the distal region of the second tube in a proximal direction through an eyelet disposed at a distal region of the first tube, and then through the working lumen of the first tube. ### Claim 14 (depends on 12) The method of claim 12 wherein the second tube comprises internal threading and the first tube comprises external threading, where the internal and external threading enable selective rotation of the second tube relative to the first tube. ### Claim 15 (depends on 12) The method of claim 12 wherein the wire comprises an electrocautery member, the method further comprising cauterizing the segment of tissue disposed within the working lumen of the first tube. ### Claim 16 (depends on 12) The method of claim 12 wherein at least one of the first and second tubes comprises a sharpened distal end, the method further comprising puncturing tissue using the sharpened distal face to position the tissue within the working lumen of the first tube. ### Claim 17 Apparatus for facilitating resection of tissue, the apparatus comprising: a first tube having a working lumen; a second tube disposed circumferentially around at least a portion of the first tube; and a wire having a distal end securely attached to a distal region of the second tube, wherein at least one of the first and second tubes comprises a sharpened distal face configured to puncture tissue such that a segment of tissue is subsequently disposed within the working lumen of the first tube, and wherein rotation of the second tube relative to the first tube causes the wire to pass circumferentially over a distal face of the first tube to incise the segment of tissue disposed within the working lumen of the first tube. ### Claim 18 (depends on 17) The apparatus of claim 17 further comprising an eyelet disposed at a distal region of the first tube, wherein the wire extends from the distal region of the second tube in a proximal direction through the eyelet and further through the working lumen of the first tube. ### Claim 19 (depends on 17) The apparatus of claim 17 wherein the second tube comprises internal threading and the first tube comprises external threading, where the internal and external threading enable selective rotation of the second tube relative to the first tube. ### Claim 20 (depends on 17) The apparatus of claim 17 wherein the wire comprises an electrocautery member configured to cauterize a segment of tissue.