Selective tissue removal tool for use in medical applications and methods for making and using

A method of selectively removing target tissue from a body, the method comprising:

• providing a tissue cutting instrument capable of automatically distinguishing between target tissue to be removed and non-target tissue, the tissue cutting instrument comprising:
• at least two oppositely rotating cutting elements covered by a cutter housing, the at least two cutting elements each having at least one cutting surface configured to shear tissue against a cutting surface of an opposing cutting element, wherein the at least two oppositely rotating cutting elements have two separate, parallel and laterally offset axes of rotation, wherein each of the at least two oppositely rotating cutting elements is configured to rotate at least one full turn about one of the axes of rotation, wherein the cutting surfaces each comprise at least two cutting teeth and at least one trough between the teeth, the at least one trough having a nominal diameter of about 2 to about 100 microns, wherein a tip to tip distance between the teeth is at least two times the trough diameter, the cutter housing having a tissue access opening adjacent to a portion of the cutting elements through which tissue must extend to contact the cutting elements, wherein a maximum outside diameter of each of the at least two cutting elements is recessed from the tissue access opening in the cutter housing by a fixed, predetermined distance, wherein the instrument is configured to remove a maximum of about 2 to about 100 microns of target tissue at a time;
• urging the instrument against the target tissue and the non-target tissue;
• and
• allowing the instrument to cut the target tissue while automatically avoiding cutting of the non-target tissue.