Abstract: Apparatus for performing electrosurgical tissue resections, such as transurethral resection of the include motor-driven cutters which drive both a shaft of the cutter and a cutter electrode, either or selectively. The systems often include controllers which coordinate movements of the shaft, electrodes, and other external components. The apparatus may include integrated imaging and light illumination systems. The apparatus may include integrated tissue filter and collection traps.

Abstract: A tissue resecting or other medical device includes a handle coupled to an elongated shaft. A radiofrequency (RF) electrode is carried at a distal end of the elongated shaft, and the electrode is moveable across a window in a sleeve or other component of the shaft. The shaft has an interior channel connectable to a negative pressure source to remove debris from the channel. A motor is carried by the handle and operatively coupled to the electrode for moving the electrode relative to the window. An electronic image sensor and lens are disposed at a distal end of the shaft, and a plurality of conductors may extend through the shaft to the image sensor. The image sensor, lens and sensor conductors are disposed within a first tubular member, and an LED or other light source is also positioned at a distal end of the shaft with LED conductors or leads extending through a second tubular member of the shaft to the LED.

Abstract: A medical introducer includes an elongated tubular member having a proximal end, a distal portion, and a central lumen extending from the proximal end to a distal port in the distal portion. A frame structure is coupled to the distal portion of the elongated tubular member, where frame structure supports the distal portion of the elongated tubular member in a tapered shape and alternatively in a non-tapered shape. The elongated tubular member may include a rigid outer tube and a rigid inner tube carried in an interior lumen of the outer tube. The distal portion is typically a reinforced elastomeric tubular extension of the outer tube, and the reinforced elastomeric tubular extension may have a conical shape.

Abstract: A tissue resecting or other medical device includes a handle coupled to an elongated shaft. A radiofrequency (RF) electrode is carried at a distal end of the elongated shaft, and the electrode is moveable across a window in a sleeve or other component of the shaft. The shaft has an interior channel connectable to a negative pressure source to remove debris from the channel. A motor is carried by the handle and operatively coupled to the electrode for moving the electrode relative to the window. An electronic image sensor and lens are disposed at a distal end of the shaft, and a plurality of conductors may extend through the shaft to the image sensor. The image sensor, lens and sensor conductors are disposed within a first tubular member, and an LED or other light source is also positioned at a distal end of the shaft with LED conductors or leads extending through a second tubular member of the shaft to the LED.

Abstract: A medical introducer includes an elongated tubular member having a proximal end, a distal portion, and a central lumen extending from the proximal end to a distal port in the distal portion. A frame structure is coupled to the distal portion of the elongated tubular member, where frame structure supports the distal portion of the elongated tubular member in a tapered shape and alternatively in a non-tapered shape. The elongated tubular member may include a rigid outer tube and a rigid inner tube carried in an interior lumen of the outer tube. The distal portion is typically a reinforced elastomeric tubular extension of the outer tube, and the reinforced elastomeric tubular extension may have a conical shape.

Abstract: An imaging and resecting device includes a handle coupled to an elongated shaft extending about a longitudinal axis and having an interior passageway extending therethrough. A resecting component shaft extends through the interior passageway to a working end carrying an RF electrode, and a sensor sleeve at having an insulative layer extends through the interior passageway and is coupled to a distal image sensor formed from an sensor chip and a lens having an optical axis and a field of view. The image sensor is sized to fit within an open distal end of the interior passageway, and at least one co-axial sensor cable carried in an interior lumen of the sensor sleeve, each sensor cable having a shielding layer and coupled to the image sensor. The sensor sleeve is configured to shield the image sensor and each sensor cable from electrical interference caused by the RF electrode during use.

Abstract: A tissue resecting device includes an elongated shaft having a central axis, a distal end, and an outer surface. An offset housing is mounted on the distal of the shaft and has a tissue-receiving window. The tissue-receiving window is offset radially outwardly from the outer surface of the shaft, and a moveable electrode is configured to move back and forth across the window to resect tissue which extends into the window. The offset housing improves visibility of the cutting window when viewed from endoscopes and other visualization apparatus.

Abstract: A surgical system for treating targeted tissue in a fluid-filled working space includes a probe having an elongated shaft extending from a proximal end to a working end. A tissue-receiving window formed in the working end opens to a passageway in the elongated shaft, and a motor moves an electrode across the tissue-receiving window to resect tissue. A radiofrequency (RF) current source is coupled to the electrode, and a controller operatively connected to the motor and the RF source. In some instances, the controller actuates movement of the electrode in response to electrode contact with the targeted tissue. In some instances, the controller actuates movement of the electrode in a single stroke to perform biopsy.

Abstract: A distal end of an introducer sheath into a patient's urethra is advanced into a patient's urethra while flowing an irrigation fluid through a lumen and out a distal end of the introducer sheath into the urethra. The irrigation fluid is simultaneously removed from the urethra through the distal end and lumen of the introducer sheath to establish a circulation of the irrigation fluid in the urethra as the introducer sheath is advanced. The urethra may then be viewed through an endoscope positioned in the lumen of the introducer sheath as the irrigation fluid circulation is continued. A unitary connector is detachably coupled to a proximal end of the elongated sleeve, and a fluid seal is disposed between the unitary connector and the proximal end of the elongated sleeve. The unitary connector is configured to connect the first and second channels to the inflow pump and the outflow pump, respectively.

Abstract: A tissue resecting or other medical device includes a handle coupled to an elongated shaft. A radiofrequency (RF) electrode is carried at a distal end of the elongated shaft, and the electrode is moveable across a window in a sleeve or other component of the shaft. The shaft has an interior channel connectable to a negative pressure source to remove debris from the channel. A motor is carried by the handle and operatively coupled to the electrode for moving the electrode relative to the window. An electronic image sensor and lens are disposed at a distal end of the shaft, and a plurality of conductors may extend through the shaft to the image sensor. The image sensor, lens and sensor conductors are disposed within a first tubular member, and an LED or other light source is also positioned at a distal end of the shaft with LED conductors or leads extending through a second tubular member of the shaft to the LED.

Abstract: A medical introducer includes an elongated tubular member having a proximal end, a distal portion, and a central lumen extending from the proximal end to a distal port in the distal portion. A frame structure is coupled to the distal portion of the elongated tubular member, where frame structure supports the distal portion of the elongated tubular member in a tapered shape and alternatively in a non-tapered shape. The elongated tubular member may include a rigid outer tube and a rigid inner tube carried in an interior lumen of the outer tube. The distal portion is typically a reinforced elastomeric tubular extension of the outer tube, and the reinforced elastomeric tubular extension may have a conical shape.

Abstract: A tissue-resecting probe includes an elongated outer sleeve extending about an axis to a distal housing having a first window for receiving tissue. An edge of the first window has a dielectric surface. A rotatable inner sleeve has a second window, and at least a portion of an edge of the second window provides a first polarity electrode. Rotation of the inner sleeve within the outer sleeve moves the probe between window-open and window-closed configurations to resect tissue.

Abstract: A tissue resection system includes a introducer sleeve with a hub. An obturator having a shaft with a blunt tip is adapted for insertion through the introducer sleeve, and an electrosurgical resecting device with an elongated extension member is adapted for insertion through the introducer sleeve.

Abstract: A tissue-resecting probe includes an elongated outer sleeve extending about an axis to a distal housing having a first window for receiving tissue. An edge of the first window has a dielectric surface. A rotatable inner sleeve has a second window, and at least a portion of an edge of the second window provides a first polarity electrode. Rotation of the inner sleeve within the outer sleeve moves the probe between window-open and window-closed configurations to resect tissue.

Abstract: A tissue resecting device includes an elongated shaft having a central axis, a distal end, and a proximal end. A ceramic or other housing is mounted at the distal end of the shaft and has a tissue-receiving window. A movable electrode is configured to be rotationally oscillated or otherwise moved across the window. In one instance, the rotatable moveable electrode may have a dogleg configuration with a free end constrained within an arcuate slot formed near the window. In another instance, the movable electrode may have a U-shaped configuration with a distal end coupled to a pivot in the housing which is aligned with a rotational drive member.