Removing Tissue

Abstract

Tissue can be removed from a patient with a catheter or other medical device having a cutting member. A source of suction can be coupled to the device for suctioning removed tissue through a lumen in the device and out of the patient's body.

1 . A medical device, comprising: 
 a) an outer catheter including a distal end and defining a lumen; and    b) a tubular member defining a lumen and an opening for cutting tissue within the body of a patient, the lumen of the tubular member being couplable to a suction source to provide suction through the opening, the tubular member disposed movably within the lumen of the outer catheter such that at least a portion of the tubular member is extendable beyond the distal end of the outer catheter to engage tissue within the opening, the tubular member being configured to cut the engaged tissue when the tubular member is moved with respect to the outer catheter, the cut tissue being transported through the lumen of the tubular member when the suction source is coupled to lumen of the tubular member.    
   
   
       2 . The medical device of  claim 1 , wherein the opening is elongate and is defined at least in part by two substantially parallel edges.  
   
   
       3 . The medical device of  claim 2 , wherein at least one of the edges defines a cutting member for cutting the engaged tissue.  
   
   
       4 . The medical device of  claim 3 , wherein the cutting member is configured to cut the engaged tissue when the tubular member is rotated about a longitudinal axis of the outer catheter.  
   
   
       5 . The medical device of  claim 3 , wherein the cutting member is configured to cut the engaged tissue when the tubular member is moved along a longitudinal axis of the outer catheter.  
   
   
       6 . The medical device of  claim 3 , further comprising an ultrasound device operably coupled to the cutting member and being adapted to facilitate cutting tissue.  
   
   
       7 . The medical device of  claim 3 , wherein the cutting member includes an active cord cautery device.  
   
   
       8 . The medical device of  claim 3 , wherein the cutting member includes a bipolar cautery device.  
   
   
       9 . The medical device of  claim 3 , wherein the cutting member is a monopolar cautery device.  
   
   
       10 . The medical device of  claim 1 , further including a light source configured to facilitate determining the location of the opening while inside of a patient.  
   
   
       11 . The medical device of  claim 10 , wherein the light source includes a fiber optic element.  
   
   
       12 . The medical device of  claim 10 , wherein the light source includes a light emitting diode.  
   
   
       13 . A system, comprising: 
 a) a medical device, comprising 
 an outer catheter including a distal end and defining a lumen; and  
 a tubular member defining a lumen and an opening for cutting tissue within the body of a patient, the lumen of the tubular member being couplable to a suction source to provide suction through the opening, the tubular member disposed movably within the lumen of the outer catheter such that at least a portion of the tubular member is extendable beyond the distal end of the outer catheter to engage tissue within the opening, the tubular member being configured to cut the engaged tissue when the tubular member is moved with respect to the outer catheter, the cut tissue being transported through the lumen of the tubular member when the suction source is coupled to lumen of the tubular member; and  
   b) a computer interface coupled to the medical device and capable of providing signals representative of a visual image of an internal portion of the body of the patient.    
   
   
       14 . The system of  claim 13 , further including a bag coupled to the medical device for collecting a tissue sample.  
   
   
       15 . A system, comprising: 
 a) a medical device, comprising 
 an outer catheter including a distal end and defining a lumen; and  
 a tubular member defining a lumen and an opening for cutting tissue within the body of a patient, the lumen of the tubular member being couplable to a suction source to provide suction through the opening, the tubular member disposed movably within the lumen of the outer catheter such that at least a portion of the tubular member is extendable beyond the distal end of the outer catheter to engage tissue within the opening, the tubular member being configured to cut the engaged tissue when the tubular member is moved with respect to the outer catheter, the cut tissue being transported through the lumen of the tubular member when the suction source is coupled to lumen of the tubular member; and  
   b) a suction source adapted and configured to provide suction through the lumen.    
   
   
       16 . A medical device comprising: 
 a main body portion including a distal end, the main body portion defining a longitudinal axis;    a cutting member operably coupled to the distal end of the main body portion, the cutting member being configured to rotate about an axis transverse to the longitudinal axis from a first position to a second position when performing a cutting operation.    
   
   
       17 . The medical device of  claim 16 , wherein the main body portion defines a lumen along at least a portion of its length, a distal port at the distal end, and a proximal port proximal to the distal end.  
   
   
       18 . The medical device of  claim 17 , wherein the proximal port is in fluid communication with a suction source for removing tissue cut by the cutting member through the distal port and the lumen.  
   
   
       19 . The medical device of  claim 16 , wherein the cutting member has a substantially arcuate shape and circumscribes a volume when moved from the first position to the second position.  
   
   
       20 . The medical device of  claim 19 , further including an actuator for moving the cutting member from the first position to the second position.  
   
   
       21 . The medical device of  claim 20 , wherein the actuator includes a wire having a distal end, the distal end of the wire being operably coupled to the cutting member and being configured to circumscribe an arcuate path when the wire is moved along the longitudinal axis.  
   
   
       22 . The medical device of  claim 21 , wherein the main body portion defines a lumen and the wire is disposed within the lumen.  
   
   
       23 . The medical device of  claim 21 , wherein the wire is made from spring steel.  
   
   
       24 . The medical device of  claim 21 , wherein the wire is made from a shape memory material.  
   
   
       25 . The medical device of  claim 24 , wherein the wire is made from a nickel-titanium alloy.  
   
   
       26 . The medical device of  claim 21 , wherein the cutting member moves from the first position to the second position when the wire is advanced in a distal direction with respect to the main body portion.  
   
   
       27 . The medical device of  claim 21 , wherein the cutting member moves from the first position to the second position when the wire is advanced in a proximal direction with respect to the main body portion.  
   
   
       28 . The medical device of  claim 20 , wherein the actuator moves the cutting member from the first position to the second position by applying an electromagnetic force thereto.  
   
   
       29 . The medical device of  claim 28 , wherein the actuator and the cutting member are configured to carry electrical currents in opposing paths.  
   
   
       30 . The medical device of  claim 29 , further including a switching mechanism, a power supply and a controller operably associated with the switching mechanism and power supply, the controller adapted to operate the switching mechanism to alternate electrical current flowing through the actuator and cutting member to cause the cutting member to oscillate between the first position and the second position.  
   
   
       31 . A medical device comprising: 
 a main body portion defining a lumen therethrough and including a distal end;    a shaft rotatably disposed in the lumen of the main body portion, the shaft including a proximal end and a distal end, the shaft being capable of rotation with respect to the main body portion about a longitudinal axis;    a rotational drive source operably coupled to the proximal end of the shaft;    a substantially arcuate cutting member attached to the distal end of the shaft, the cutting member configured to circumscribe a volume about the longitudinal axis when the shaft is rotated; and    a compartment affixed to the distal end of the main body portion, the compartment configured to house the cutting member.    
   
   
       32 . The medical device of  claim 31 , wherein the main body portion defines a second lumen therethrough, the second lumen having a distal port proximate the cutting member and a proximal opening proximal to the distal end of the main body portion.  
   
   
       33 . The medical device of  claim 32 , further comprising a suction source operably coupled to the compartment by way of the second lumen to facilitate removal of tissue from a patient.  
   
   
       34 . A medical device comprising: 
 a main body portion including a distal end and defining a lumen therethrough;    a rotatable cutting member disposed in the lumen, the cutting member defined by at least one helical cutting edge and defining at least one helical channel therethrough, the cutting member being capable of being disposed beyond the distal end of the main body portion.    
   
   
       35 . The medical device of  claim 34 , wherein the cutting member can be moved in a rotational direction with respect to the main body portion.  
   
   
       36 . The medical device of  claim 34 , wherein the cutting member can be moved in a longitudinal direction with respect to the main body portion.  
   
   
       37 . The medical device of  claim 34 , wherein the cutting member can be moved in a longitudinal direction and in a rotational direction with respect to the main body portion.  
   
   
       38 . A medical device comprising: 
 a main body portion including a distal end and defining a lumen therethrough;    a shaft slidably disposed through the lumen of the main body portion, the shaft including a distal end and a cup shaped cutting member attached to the distal end of the shaft, the cutting member including a cutting edge disposed proximate to a rim of the cup shaped cutting member, the cutting member configured to cut tissue when advanced in a proximal direction with respect to the main body portion of the medical device.    
   
   
       39 . The medical device of  claim 38 , wherein the cutting member protrudes from the distal end of the main body portion.  
   
   
       40 . The medical device of  claim 38 , wherein the main body portion includes a closed end and defines a tissue entry port through a sidewall of the main body portion suitable to permit entry of tissue to be removed from a patient.  
   
   
       41 . A method of removing tissue from a patient, comprising; 
 providing a medical device including a main body portion and a cutting member slidably coupled thereto;    introducing the medical device through the urethra of a patient;    removing tissue from the patient by advancing the cutting member in a proximal direction with respect to the main body portion; and    withdrawing the medical device from the patient.    
   
   
       42 . The method of  claim 41 , wherein the removing step comprises removing tissue from the bladder of the patient.  
   
   
       43 . The method of  claim 42 , wherein the removing step comprises removing tissue from the prostate gland of the patient.