Insertable endoscopic instrument for tissue removal

Abstract

An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

What is claimed is: 
     
         1 . An instrument for removing material from a subject, comprising:
 an outer cutter having an outer opening;   an inner cutter disposed in the outer cutter, the inner cutter having an inner opening;   an outer tubing coupled with the outer cutter;   a flexible shaft at least partially disposed in the outer tubing, the flexible shaft comprising at least one of a torque coil, a torque rope, or a torque cable, the flexible shaft having a distal end coupled with the inner cutter such that rotation of the flexible shaft causes rotation of the inner cutter to remove the material;   an aspiration channel extending from the inner opening to an aspiration port; and   an irrigation channel extending between the outer tubing and the aspiration channel.   
     
     
         2 . The instrument of  claim 1 , wherein the flexible outer tubing is sized to fit within an instrument channel of an endoscope. 
     
     
         3 . The instrument of  claim 1 , wherein the outer tubing comprises a braided member. 
     
     
         4 . The instrument of  claim 1 , wherein the irrigation channel extends from a proximal port to the outer opening of the outer cutter. 
     
     
         5 . The instrument of  claim 1 , further comprising a lining between the outer tubing and the flexible shaft. 
     
     
         6 . The instrument of  claim 1 , wherein a length of a cutting assembly comprising the inner cutter and the outer cutter is less than one percent of a length of the instrument. 
     
     
         7 . The instrument of  claim 1 , further comprising a proximal connector coupled with a proximal end of the flexible shaft and configured to engage with a drive assembly to cause the proximal connector, the flexible shaft, and the inner cutter to rotate. 
     
     
         8 . The instrument of  claim 7 , wherein the proximal connector is a rigid cylinder. 
     
     
         9 . The instrument of  claim 1 , further comprising a tensioning spring coupled with the inner cutter to bias the inner cutter towards a distal end of the outer cutter. 
     
     
         10 . The instrument of  claim 1 , further comprising a rotational coupler connecting the outer tubing with a tubular member proximal from the outer tubing. 
     
     
         11 . The instrument of  claim 1 , further comprising a lavage connector coupled with the irrigational channel. 
     
     
         12 . The instrument of  claim 1 , wherein at least one of (i) a length of the outer tubing is at least forty times greater than a length of the outer cutter or (ii) the length of the outer tubing is at least one hundred times greater than a diameter of the outer tubing. 
     
     
         13 . The instrument of  claim 1 , wherein an outer diameter of the outer tubing is less than 5 millimeters. 
     
     
         14 . The instrument of  claim 1 , wherein the outer tubing has a length of at least 36 inches. 
     
     
         15 . An endoscopic tool, comprising:
 a cutting assembly comprising an outer cutter having an outer opening and an inner cutter disposed in the outer cutter, the inner cutter having an inner opening;   an outer tubing coupled with the outer cutter;   a flexible shaft at least partially disposed in the outer tubing, the flexible shaft comprising at least one of a torque coil, a torque rope, or a torque cable, the flexible shaft having a distal end coupled with the inner cutter such that rotation of the flexible shaft causes rotation of the inner cutter to remove the material;   an aspiration channel extending from the inner opening to an aspiration port; and   an irrigation channel extending between the outer tubing and the aspiration channel.   
     
     
         16 . The endoscopic tool of  claim 15 , wherein the outer tubing comprises a braided member. 
     
     
         17 . The endoscopic tool of  claim 15 , wherein a length of the cutting assembly is less than one percent of a length of the instrument. 
     
     
         18 . The endoscopic tool of  claim 15 , further comprising a proximal connector coupled with a proximal end of the flexible shaft and configured to engage with a drive assembly to cause the proximal connector, the flexible shaft, and the inner cutter to rotate. 
     
     
         19 . The endoscopic tool of  claim 15 , further comprising a rotational coupler connecting the outer tubing with a tubular member proximal from the outer tubing. 
     
     
         20 . The endoscopic tool of  claim 15 , wherein at least one of (i) a length of the outer tubing is at least forty times greater than a length of the outer cutter or (ii) the length of the outer tubing is at least one hundred times greater than a diameter of the outer tubing.