Abstract: A tissue resection device for preferred use in an organ inflated with non-conductive optically transparent fluid under pressure is disclosed. The instrument includes a rigid shaft having a proximal end, a distal end, and defining a perfusion lumen extending therebetween. At the distal end of the shaft, the shaft is provided with a rounded blunt end having an elongate aperture exposing the lumen near the distal end. A drive tube is rotatably disposed within the shaft lumen and has a proximal end, a distal end, and a drive tube aspiration lumen extending therebetween. A cutting head is mounted on the distal end of the drive tube and has a laterally disposed cutting edge which can resection either by conventional cutting or electrocautery. This laterally disposed cutting edge is communicated to an internal passage between the cutting edge and the aspiration lumen of the drive tube so that tissue severed as the cutting head is rotated may be drawn directly into the aspiration lumen.