Polypectomy systems, devices, and methods

Abstract

A polyp removal device comprises an outer tubular body; an inner tubular body being movable with respect to the outer tubular body; a handle; an actuation member configured to cause movement of the inner tubular body with respect to the outer tubular body when the actuation member is moved with respect to the handle; a vacuum port for coupling thereto of a vacuum source; and an opening near a distal end of the polyp removal device, the opening configured to allow fluid communication between an environment external to the polyp removal device and the lumen of the inner tubular body, wherein a size of the opening is variable based on the movement of the inner tubular body with respect to the outer tubular body.

1 .- 38 . (canceled) 
     
     
         39 . A uterine polyp removal device for use with a hysteroscope having an elongate shaft sized for insertion into a human uterus through a vaginal canal, the elongate shaft having a working channel passing therethrough, the uterine polyp removal device comprising:
 an outer tubular body having proximal and distal ends, the outer tubular body comprising an elongate cylindrical outer surface and a cylindrical lumen extending in a longitudinal direction,   wherein the elongate cylindrical outer surface of the outer tubular body comprises an outer diameter sized such that the outer tubular body is insertable into a proximal end of the working channel of the elongate shaft of the hysteroscope, the outer diameter being no greater than 0.125 inches, and   wherein the elongate cylindrical outer surface of the outer tubular body comprises a length sized such that the outer tubular body extends at least partially beyond a distal end of the hysteroscope when fully inserted into the working channel;   an inner tubular body positioned within the lumen of the outer tubular body, the inner tubular body having proximal and distal ends, the inner tubular body comprising an elongate cylindrical outer surface and a cylindrical lumen extending in the longitudinal direction from the proximal end of the inner tubular body to the distal end of the inner tubular body,   wherein the cylindrical outer surface of the inner tubular body comprises a diameter smaller than the cylindrical lumen of the outer tubular body to allow the inner tubular body to translate in the longitudinal direction with respect to the outer tubular body, and   wherein the distal end of the inner tubular body comprises a circular-shaped cutting edge;   a handle coupled to the proximal ends of the outer tubular body and inner tubular body and configured to control movement of the inner tubular body with respect to the outer tubular body, the handle comprising:
 a main body shaped to be held in a human hand; 
 a trigger rotatably coupled to the main body and configured to cause translation of the inner tubular body with respect to the outer tubular body when the trigger is rotated with respect to the main body; and 
 a spring that biases the trigger to an extended position; 
   a vacuum port for coupling thereto of a vacuum source and extraction therethrough of tissue aspirated through the lumen of the inner tubular body, the vacuum port being coupled to the handle;   an opening near the distal end of the outer tubular body, the opening comprising a longitudinal length and a transverse width, the opening configured to allow fluid communication between an environment external to the outer tubular body and the lumen of the inner tubular body,   wherein the longitudinal length of the opening is variable from a minimum length to a maximum length based on the translation of the inner tubular body with respect to the outer tubular body causing the circular-shaped cutting edge of the distal end of the inner tubular body to translate with respect to the outer tubular body,   wherein the opening is formed at least partially by a protruding member extending from the distal end of the outer tubular body, the protruding member comprising an arc-shaped cross-sectional shape, at least at a cross section taken through a transverse plane located at a midpoint of the protruding member in the longitudinal direction,   wherein the circular-shaped cutting edge of the inner tubular member is oriented parallel to the transverse plane,   wherein transverse edges of the protruding member form transverse sides of the opening and extend in the longitudinal direction for a length that is at least 150% of the outer diameter of the cylindrical outer surface of the outer tubular body, and   wherein the spring of the handle biases the circular-shaped cutting edge of the inner tubular body in a distal direction to cause the longitudinal length of the opening to be at its minimum length until a user overcomes the spring bias by operating the trigger; and   a solid cutting block affixed to the outer tubular body and positioned near a distal end of the opening, the cutting block comprising a cylindrical outer surface that extends in the longitudinal direction to a cutting edge at a proximal end of the cutting block,   wherein the cutting block is sized and positioned such that the cutting edge of the cutting block can extend at least partially into the cylindrical lumen of the inner tubular body when the inner tubular body is translated with respect to the outer tubular body, enabling the cutting edge of the cutting block and the cutting edge of the inner tubular body to separate uterine polyp tissue from the uterus, and   wherein a distal end of the uterine polyp removal device comprises a blunt rounded shape.   
     
     
         40 . The uterine polyp removal device of  claim 39 , wherein the circular-shaped cutting edge of the inner tubular body comprises a sharpened edge. 
     
     
         41 . The uterine polyp removal device of  claim 39 , wherein the trigger comprises a concave surface for engagement by one or more human fingers. 
     
     
         42 . The uterine polyp removal device of  claim 39 , wherein the inner tubular body is not rotatable with respect to the outer tubular body. 
     
     
         43 . The uterine polyp removal device of  claim 39 , wherein the inner tubular body is rotatable with respect to the outer tubular body. 
     
     
         44 . The uterine polyp removal device of  claim 39 , wherein the vacuum port is axially aligned with and in fluid communication with the proximal end of the inner tubular body. 
     
     
         45 . The uterine polyp removal device of  claim 39 , wherein the outer tubular body is rotatable with respect to the main body of the handle. 
     
     
         46 . The uterine polyp removal device of  claim 39 , wherein the minimum length of the longitudinal length of the opening is zero millimeters and the maximum length of the longitudinal length of the opening is at least five millimeters. 
     
     
         47 . The uterine polyp removal device of  claim 39 , wherein the transverse edges of the protruding member extend in the longitudinal direction for a length that is at least five millimeters. 
     
     
         48 . The uterine polyp removal device of  claim 39 , wherein the transverse width of the opening is at least 60% of the outer diameter of the cylindrical outer surface of the outer tubular body. 
     
     
         49 . A uterine polyp removal device, comprising:
 an outer tubular body having proximal and distal ends;   an inner tubular body positioned within a lumen of the outer tubular body, the inner tubular body having proximal and distal ends and being movable with respect to the outer tubular body;   a handle coupled to the proximal end of the outer tubular body;   an actuation member movably coupled to the handle, the actuation member configured to cause movement of the inner tubular body with respect to the outer tubular body when the actuation member is moved with respect to the handle,   wherein the actuation member comprises a trigger rotatably coupled to the handle, the trigger being biased to an extended position by a spring;   a vacuum port for coupling thereto of a vacuum source, the vacuum port being in fluid communication with a lumen of the inner tubular body;   an opening near a distal end of the polyp removal device, the opening comprising a longitudinal length and a transverse width, the opening configured to allow fluid communication between an environment external to the polyp removal device and the lumen of the inner tubular body,   wherein a longitudinal length of the opening is variable from a minimum length to a maximum length based on the movement of the inner tubular body with respect to the outer tubular body, the maximum length comprising a length that is at least 150% of an outer diameter of the outer tubular body; and   a solid cutting block positioned at the distal end of the outer tubular body, the cutting block having an outer diameter sized to fit within an inner diameter of the distal end of the inner tubular member.   
     
     
         50 . The uterine polyp removal device of  claim 49 , wherein the minimum length of the longitudinal length of the opening is zero millimeters and the maximum length of the longitudinal length of the opening is at least five millimeters. 
     
     
         51 . The uterine polyp removal device of  claim 49 , wherein the distal end of the inner tubular body comprises a circular-shaped cutting edge. 
     
     
         52 . The uterine polyp removal device of  claim 51 , wherein the circular-shaped cutting edge is sharpened. 
     
     
         53 . The uterine polyp removal device of  claim 49 , wherein the inner tubular body is not rotatable with respect to the outer tubular body. 
     
     
         54 . The uterine polyp removal device of  claim 49 , wherein the inner tubular body is rotatable with respect to the outer tubular body. 
     
     
         55 . The uterine polyp removal device of  claim 49 , wherein the vacuum port is axially aligned with and in fluid communication with the proximal end of the inner tubular body. 
     
     
         56 . The uterine polyp removal device of  claim 49 , wherein the outer tubular body is rotatable with respect to a main body of the handle. 
     
     
         57 . The uterine polyp removal device of  claim 49 , wherein the transverse width of the opening is at least 60% of the outer diameter of the outer tubular body. 
     
     
         58 . A method of removing a polyp from a human uterus, the method comprising:
 inserting a medical instrument into the uterus, the medical instrument comprising a working channel;   inserting a polyp removal device through the working channel of the medical instrument;   extending a distal end of the polyp removal device into the uterus beyond a distal end of the working channel of the medical device;   positioning at least a portion of a polyp through an opening in the distal end of the polyp removal device;   operating an actuation member of the polyp removal device, causing the opening in the distal end of the polyp removal device to reduce in size, separating the at least a portion of the polyp from the uterus; and   transferring the separated portion of the polyp to a proximal end of the polyp removal device via suction.