Electrosurgical specimen-collection system

Abstract

Devices, methods and systems for obtaining biopsy tissue samples are provided. Flexible hollow tubes with a rail and a tip cutting element advance within a shaft with an aperture and a bore having a ramp, so that the cutting element emerges from the aperture and cuts tissue as it moves over the ramp. Either or both shaft and bore may have guides, which may engage each other to guide the tube along a tissue cutting pathway. A tube may have a rail and the bore a channel which engages the rail and guides the tube. Cut tissue may be acquired and transported proximally within the tube by suction to a tissue collection chamber. Multiple tissue samples may be obtained from a single insertion point by rotation and/or translation of the shaft between biopsies.

1 . (canceled)  
   
   
       2 . The tissue extraction system of  claim 77 , wherein at least part of said tissue cutting surface is an electrode.  
   
   
       3 . The tissue extraction member of  claim 2 , wherein at least part of said flexible distal portion is formed of a non-conductive material.  
   
   
       4 . The tissue extraction system of  claim 2 , wherein said tissue cutting surface is a loop-shaped electrode.  
   
   
       5 . The tissue extraction system of  claim 77 , further comprising a longitudinal bore therethrough configured to receive tissue.  
   
   
       6 . The tissue extraction system of  claim 5 , wherein said proximal portion is configured to operably connect with a vacuum source.  
   
   
       7 . The tissue extraction system of  claim 6 , wherein said longitudinal bore has an inner diameter, and said loop-shaped cutting surface has a loop diameter smaller than said inner diameter.  
   
   
       8 . The tissue extraction system of  claim 6 , wherein said elongated shaft comprises an elongated hollow tube with a tube wall comprising a strengthening filament.  
   
   
       9 . The tissue extraction system of  claim 8 , wherein said strengthening filament forms a coil.  
   
   
       10 . The tissue extraction system of  claim 8 , comprising a plurality of strengthening filaments forming a braid.  
   
   
       11 . The tissue extraction system of  claim 3 , wherein said non-conductive material is selected from the group consisting of natural and synthetic rubbers, thermoplastic elastomers, polyether block amides, NYLON®, HYTREL®, high density polyethylene (HDPE), polyvinyl chloride, poly(esters), poly(amides), poly(ester-amides), poly(carbonates), poly(urethanes), poly(ester urethanes), and copolymers, polymer alloys, polymer mixtures, and combinations thereof.  
   
   
       12 . The tissue extraction system of  claim 11 , wherein said non-conductive material comprises a thermoplastic elastomer.  
   
   
       13 . The tissue extraction system of  claim 77 , wherein said tissue cutting surface is spaced away from said distal end.  
   
   
       14 . The tissue extraction system of  claim 2 , wherein said tissue cutting surface is spaced away from said distal end.  
   
   
       15 . The tissue extraction system of  claim 77 , wherein said tissue extraction member is configured to move and said guide is configured to direct movement of said flexible distal shaft portion.  
   
   
       16 . The tissue extraction system of  claim 15 , wherein said guide is configured to engage another guide effective to direct movement of said flexible distal shaft portion.  
   
   
       17 - 43 . (canceled)  
   
   
       44 . A system for obtaining a tissue specimen from within a body, comprising: 
 a. a tissue extraction device comprising: 
 an elongated shaft having a proximal shaft portion, a distal shaft portion with a distal tip having a shaft cutting element, an inner bore, an aperture on said shaft distal portion connected with said bore; and  
 an elongated cutting member which is at least in part movably disposed within the bore of the elongated shaft and which has a proximal portion, a flexible distal portion with a distal open end, a tissue cutting member on the distal open end, a guide on the flexible distal portion configured to direct movement of the tissue cutting member out of said shaft aperture effective to cut tissue disposed about said shaft;  
   b. a vacuum source operably connected to said tissue extraction device; and    c. a source of radiofrequency energy operably connected to said tissue extraction device.    
   
   
       45 . A system for obtaining a tissue specimen from within a body, comprising: 
 a tissue extraction device comprising: 
 an elongated shaft having a proximal portion, a distal portion with a distal tip having a shaft cutting element, an inner bore, an aperture on said shaft distal portion connected with said bore, and a first guide extending along said distal portion to define a tissue cutting pathway comprising at least in part a non-axial pathway; and  
   a tissue extraction member movably disposed at least in part within said shaft inner bore, comprising an elongated hollow tube having a tube proximal portion, a flexible tube distal portion, a tube distal end having a longitudinal bore connecting with a tissue receiving port with a rim, a tissue cutting surface disposed about at least a portion of said rim, and a second guide configured to engage said first guide and follow said tissue cutting pathway;    a vacuum source operably connected to said tissue extraction device; and    a source of radiofrequency energy operably connected to said tissue extraction device.    
   
   
       46 . The system of  claim 45 , wherein said source of radiofrequency energy is effective to provide radiofrequency energy of between about 35 W and about 150 W.  
   
   
       47 . The system of  claim 46 , wherein said source of radiofrequency energy is effective to provide radiofrequency energy of between about 50 W and about 100 W.  
   
   
       48 . The system of  claim 45 , wherein said source of radiofrequency energy is effective to provide radiofrequency energy of between about 0.1 MHz and about 10 MHz.  
   
   
       49 . The system of  claim 48 , wherein said source of radiofrequency energy is effective to provide radiofrequency energy of between about 0.3 MHz and about 1.2 MHz.  
   
   
       50 . The system of  claim 45 , wherein said tissue extraction member is configured to move to at least one position wherein said tube distal end is disposed at least in part outside said aperture.  
   
   
       51 . The system of  claim 45 , wherein said elongated shaft further comprises a plurality of radial positions, and a non-axial ramp surface located at a first radial position on said inner bore within said shaft distal portion, said ramp surface having portions, said first guide being disposed on said non-axial ramp surface, said aperture being located at a second radial position along said shaft, wherein said first radial position and said second radial position are separated by about 180° effective that at least a portion of said ramp extends substantially towards said aperture.  
   
   
       52 - 75 . (canceled)  
   
   
       76 . A system for obtaining a tissue specimen from within a body, comprising: 
 a tissue extraction device comprising:    an elongated shaft having a proximal portion, a distal portion with a distal tip having a cutting means, an inner bore, an aperture on said shaft distal portion connected with said bore, and a first guide means extending along said distal portion to define a tissue cutting pathway; and    a tissue extraction member disposed at least in part within said shaft inner bore, comprising an elongated hollow tube having a longitudinal bore, a proximal portion, a flexible distal portion, a tube distal end having a tissue receiving port with a rim, a tissue cutting means disposed about at least a portion of said rim, and a second guide means configured to engage said first guide means;    a vacuum-providing means operably connected to said tissue extraction device; and    a radiofrequency energy source-means operably connected to said tissue extraction device.    
   
   
       77 . An elongated tissue extraction system, comprising: 
 a. an elongated shaft having a proximal shaft portion, a distal shaft portion and a guide on the distal shaft portion configured to define a non-axial tissue cutting pathway; and    b. an elongated cutting member which is at least in part movably disposed within the bore of the elongated shaft and which has a proximal portion, a flexible distal portion with a distal end, a tissue cutting surface on the distal end, a guide follower on the flexible distal portion configured to follow the non-axial tissue cutting pathway defined by the guide on the distal shaft portion to cut tissue disposed about said shaft;    
   
   
       78 . The extraction system of  claim 77  wherein a vacuum source is operably connected to the proximal shaft portion of the elongated shaft.