Patent Publication Number: US-2021169547-A1

Title: Method for cutting and hemostasis of biological tissue using high-pressure steam-based surgical tool

Description:
BACKGROUND 
     Field of the Disclosure 
     The present disclosure relates to a high-pressure steam-based surgical tool for endoscopic surgical procedures. 
     Description of the Related Art 
     Endoscopy, a procedure allowing doctors to visualize internal organs and structures of the human body without large superficial incisions, makes it possible to better investigate symptoms and diagnose disease, most commonly involving the gastrointestinal tract. This approach, however, can be further applied to other organs or structures including, but not limited to, the abdomen, cervix, and thorax. While providing visual access to internal structures without open surgery, endoscopy naturally limits the surgeon&#39;s toolkit with regard to the control of internal bleeding, an inherent complication associated with small, deep incisions made during endoscopic procedures. Traditional approaches employ heated electrical wires or freezing via liquid nitrogen, however, each approach carries with it a set of safety concerns and risk factors, including adverse heating or cooling of off-target tissues and nerve damage. Intended to address these concerns, high-pressure liquid has been proposed for cutting, dissecting, abrading and/or hemostasis. While effective in specific applications, the use of high-pressure liquids may result in tissue shearing. Further, a lack of directional control may lead to off-target application. See “Multipurpose fluid jet surgical device” by Adrian, PAZ, (WO2003096871A2). Therefore, a safe and effective endoscopic surgical tool for cutting and hemostasis need be developed. 
     The foregoing “Background” description is for the purpose of generally presenting the context of the disclosure. Work of the inventors, to the extent it is described in this background section, as well as aspects of the description which may not otherwise qualify as prior art at the time of filing, are neither expressly or impliedly admitted as prior art against the present invention. 
     SUMMARY 
     The present disclosure relates to a surgical tool for incision and hemostasis of biological tissues. The surgical tool includes a head element comprising an assisting element and an operative element. The operative element, or hollow blade, comprises a cutting implement residing within a hollow cavity configured to provide high-pressure steam through one or more ports at an apical surface. The cutting implement can operate independently or in cooperation with the provided high-pressure steam. Further, the hollow blade can operate independently or in cooperation with the assisting element, or grasping element, to hold or cut target tissues. The head element of the present disclosure is rotatable. 
     According to an embodiment, the one or more ports of the operative element allow for a controlled, directional application of the steam flow. A control unit provides temperature-controlled steam at a flow-rate determined in accordance with tissue type and intended procedure. 
     According to an embodiment, the operative element and assisting element may be shaped in a procedure-specific manner to allow improved access to hidden internal structures. 
     In an embodiment, the operative element and assistant element are fabricated into a desired shape. In another embodiment, a plurality of user-controlled wires applies a deformational force to the head element to produce a desired curvature in the operative element and the assisting element. 
     The foregoing paragraphs have been provided by way of general introduction, and are not intended to limit the scope of the following claims. The described embodiments, together with further advantages, will be best understood by reference to the following detailed description taken in conjunction with the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A more complete appreciation of the disclosure and many of the attendant advantages thereof will be readily obtained as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, wherein: 
         FIG. 1  is an exemplary illustration of a surgical tool, according to an embodiment of the present disclosure; 
         FIG. 2A  is an exemplary illustration of a handle of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 2B  is an exemplary illustration of a handle of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 3A  is an exemplary illustration of a head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 3B  is an exemplary illustration of a coupler of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 4A  is an exemplary illustration of an orientation of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 4B  is an exemplary illustration of an orientation of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 4C  is an exemplary illustration of an orientation of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 4D  is an exemplary illustration of an orientation of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 5A  is an exemplary illustration of a curvature of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 5B  is an exemplary illustration of a curvature of the head element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 6A  is an exemplary illustration of a configuration of steam ports on an operative element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 6B  is an exemplary illustration of a configuration of steam ports on an operative element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 6C  is an exemplary illustration of a configuration of steam ports on an operative element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 6D  is an exemplary illustration of a configuration of steam ports of an operative element of the surgical tool, according to an embodiment of the present disclosure; 
         FIG. 7A  is an exemplary illustration of a configuration of an assisting element of the surgical tool, according to an exemplary embodiment of the present disclosure; 
         FIG. 7B  is an exemplary illustration of a configuration of an assisting element of the surgical tool, according to an exemplary embodiment of the present disclosure; 
         FIG. 7C  is an exemplary illustration of a configuration of an assisting element of the surgical tool, according to an exemplary embodiment of the present disclosure; 
         FIG. 7D  is an exemplary illustration of a configuration of an assisting element of the surgical tool, according to an exemplary embodiment of the present disclosure; 
         FIG. 8A  is an exemplary illustration of a configuration of a control unit of a steam flow of the surgical tool, according to an exemplary embodiment of the present disclosure; 
         FIG. 8B  is an exemplary illustration of a configuration of a control unit of a steam flow of the surgical tool, according to an exemplary embodiment of the present disclosure; and 
         FIG. 9  is an exemplary illustration of a head element of the surgical tool, according to an exemplary embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The terms “a” or “an”, as used herein, are defined as one or more than one. The term “plurality”, as used herein, is defined as two or more than two. The term “another”, as used herein, is defined as at least a second or more. The terms “including” and/or “having”, as used herein, are defined as comprising (i.e., open language). Reference throughout this document to “one embodiment”, “certain embodiments”, “an embodiment”, “an implementation”, “an example” or similar terms means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present disclosure. Thus, the appearances of such phrases or in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments without limitation. 
     Currently, endoscopic surgery is complicated by the risk of uncontrollable, internal bleeding as conventional cutting implements do not directly address the consequences of an incision. Surgeons, therefore, have employed heated electric wires during surgery, or circumvented this complication entirely, with cryotherapy employing liquid nitrogen. Each approach carries with it a set of risks and limitations and creates a need for an approach with an improved efficacy and safety profile. 
     To this end, the present disclosure describes a device comprising an operative element and an assisting element. The operative element includes a cutting implement and one or more ports for the delivery of steam, wherein the steam is heated to a pre-determined temperature and delivered at a pre-determined flow strength, such that the device performs internal tissue cutting while simultaneously coagulating tissue injuries created during the incision. In this way, a controlled and localized burning of the tissue achieves hemostasis. 
       FIG. 1  is an exemplary illustration of a surgical tool, according to an embodiment of the present disclosure. The surgical tool  100  includes a handle  101 , a hollow tube  102  and a head element  103 . The handle  101  further comprises a steam canister  108  and a trigger  104  connected to a steam valve  105 . The trigger  104  is connected to the steam valve  105  via valve wire  114 . The steam canister  108  is in fluid communication with a steam tube  107  that provides pressurized steam  106  to the surgical tool  100 . The trigger  104  is further connected to an assisting element, referred to herein as a movable jaw  112 , via a jaw wire  113 . 
     Adjacent to the handle  101  is the hollow tube  102 . In another embodiment, the hollow tube  102  is a catheter. The hollow tube  102  can be telescopic or of variable fixed-lengths, according to the requirements of a procedure. The hollow tube  102  comprises the steam channel  109  and a segment of the jaw wire  113 . The diameter of the hollow tube  102 , and the steam channel  109  and jaw wire  113  therein, can be a range of sizes appropriate as determined for an intended procedure. In an embodiment, the hollow tube  102  is of sufficient size wherein the lumen further comprises complementary surgical tools, including, but not limited to, imaging tools for guided surgery. The head element  103  is disposed at a distal end of the hollow tube  102 . The head element  103  comprises a moveable jaw  112  and an operative element, referred to herein as a hollow blade  110 . The steam flow  106  travels from the steam canister  108  through the steam channel  109  to the hollow blade  110 , where it exits on opposing surfaces of a cutting implement  111  to form steam streams  115 . 
     According to an embodiment, the handle  101  of the surgical tool  100  is fabricated of a temperature resistant synthetic material such as polyetherimide, a semi-transparent high strength plastic material that can operate in high temperature environments. In other embodiments, the handle  101  may be fabricated of any suitable material that can be sterilized, including, but not limited to polypropylene, polysulfone, polyether ether ketone, stainless steel, or a combination thereof. 
     According to an embodiment, the hollow tube  102 , steam tube  107 , and steam channel  109  of the surgical tool  100  may be fabricated of elastomeric materials typical of devices used in endoscopy, including, but not limited to, polyurethanes, polyesters, or a combination thereof. 
     According to an embodiment, the head element  103  of the surgical tool  100  may be fabricated of a temperature resistant synthetic material such as polyetherimide, a semi-transparent high strength plastic material that can operate in high temperature environments. In other embodiments, the head element  103  may be fabricated of any suitable material that can be sterilized, including, but not limited to polypropylene, polysulfone, polyether ether ketone, stainless steel, or a combination thereof. 
     According to an embodiment, the cutting implement  111  of the surgical tool  100  is a blade of a type known in the art as standard for surgical incisions. In another embodiment, the cutting implement  111  is fabricated of a semi-rigid plastic, metal, or combination thereof, and is configured to bend under manual operation by a user. The cutting implement  111  and hollow blade  110  may be fabricated for one-time use or repeated use. 
     In an embodiment, each component of the surgical tool  100  is thermally insulated to provide temperature control throughout the surgical procedure and to insulate surrounding tissue from excess heating. Isolating the heat internal to the surgical tool  100  eliminates concern for off-target heating as the temperature of the exterior of the device might be elevated in accordance with the temperature of the steam in the steam tube, steam canister, and steam channel. 
     In an exemplary embodiment, the steam flow  106  is collected in the steam canister  108 . When appropriate, the trigger  104  is engaged and, simultaneously, the jaw wire  113  and valve wire  114  activate the movable jaw  112  and the valve  105 , respectively. As steam flow  106  travels from the steam canister  108  through the steam channel  109  and into the hollow blade  110  of the head element  103 , the movable jaw  112  is engaged in the direction of the cutting implement  111 . While the movable jaw  112  aids in controlling the position of a tissue of interest with respect to the cutting implement  111 , the steam flow  106  exits the hollow blade  110  and becomes at least one of a series of steam streams  116  of a pre-determined number, distribution, and shape. Following the incision of the target tissue created as the cutting implement  111  comes into contact with a surface of the movable jaw  112 , the steam streams  116  seal the open ends of the tissue left by the incision. 
       FIG. 2A  and  FIG. 2B  are exemplary illustrations of the handle of the surgical tool, according to an embodiment of the present disclosure. In an embodiment, the trigger  204  is a single trigger responsible for engaging both the movable jaw of the head element of the surgical tool and the steam valve  205  of the handle  201  simultaneously. In another embodiment, it is preferable to have independent control of the movable jaw of the head element and the steam valve of the handle. The jaw wire  213  is connected to a first trigger  204 ′ and the valve wire  214  is connected to a second trigger  204 ″. If it is desirable to only incise the tissue of interest, the first trigger  204 ′ may be engaged independently of the second trigger  204 ″. If it is desirable to only employ steam for tissue sealing, the second trigger  204 ″ may be engaged independently of the first trigger  204 ′. In both instances, a steam tube  207  supplies a steam flow to a steam canister  208  for storage. 
     According to an embodiment, the handle  201  is further modified to provide additional functionality. In an exemplary embodiment, the handle  201  includes a plurality of triggers directed to rotational control of the head element of the surgical tool. In another embodiment, the handle  201  further comprises, but is not limited to, imaging tools for guided surgery and a power supply to enhance functionality of, and user interfacing with, the handle  201 . 
       FIG. 3A  is an exemplary illustration of a head element  303  of the surgical tool, according to an embodiment of the present disclosure. Extending from the hollow tube  302 , a jaw wire  313  is functionally attached to a movable jaw  312 . A steam channel  309  also extends from the hollow tube  302  and is in fluid communication with a hollow blade  310 . The hollow blade  310  comprises a cutting implement  311  and steam ports for steam  306 . The steam  306  exits the hollow blade  310  through the steam ports as steam streams  316 . During operation, the movable jaw  312  is rotated towards the cutting implement  311 , in an action typical of scissors. Simultaneously to the implementation of the cutting implement  311 , the steam streams  316  exit the hollow blade  310  across opposing faces of the cutting implement  311 . 
     According to an embodiment, the hollow tube  302  further comprises, but is not limited to, imaging tools for guided surgery. Extending from the hollow tube  302 , the imaging tools for guided surgery may then be disposed in a variety of positions. These positions may include, but are not limited to, the face  315  of the movable jaw  312  or the exit of the hollow tube  317 , wherein the utilization of the cutting implement  311  and the steam streams  316  may be monitored. 
     In an embodiment, the head element  303  of the surgical tool is disposed on a coupler  325  that is concentric with the hollow tube  302 . The coupler  325  is of an outer diameter relatively smaller than the inner diameter of the hollow tube  302 . In an embodiment, the movable jaw  312  is attached to the coupler  325  at pin  318 , allowing for rotation about the pin  318 . 
     Further, as seen in  FIG. 3B , the coupler  325  can be rotatable via manual rotation by the user or via mechanical gears disposed near the handle of the surgical tool that controls the orientation of the coupler  325  relative to the hollow tube  302 . In an embodiment, the coupler  325  extends the length of the hollow tube  302  to the handle  301 . The proximal end of the coupler  325 , near the handle  301 , is fabricated to include a splined surface  326  or similar construct, known in the art, to function similar to a gear. A gear  327  arranged perpendicularly to the splined surface  326  and in position to drive the splined surface  326  is disposed so as to be controlled by a rotary knob  328 , or similar control knob, on the surface of the hollow tube  302 . When desired by the user, or as informed by acquired images of the surgical site, the user may rotate the head element  303  of the surgical tool by operating the rotary knob  328  on the surface of the hollow tube  302 . According to an embodiment, the rotary knob  328  is disposed on the handle  301 . The rotary knob  328  may further comprise indicia informing the user of the orientation of the head element  303  of the surgical tool. In an embodiment, the head element  303  of the surgical tool can be rotated clockwise, counter-clockwise, or in both directions as desired by the user. In another embodiment, rotational control of the coupler  325 , and head element  303  therein, can be completed with digital control according to user input via a user interface located on the handle or external to the surgical tool. 
     In an embodiment, and as seen in  FIGS. 4A-D , the head element of the surgical tool is rotatable about the long axis of the hollow tube via the coupler.  FIG. 4A  and  FIG. 4B  are exemplary illustrations of orientations of the head element of the surgical tool, according to an embodiment of the present disclosure. At a 0° orientation in  FIG. 4A , the hollow tube  402 , carrying the jaw wire and steam channel, is in line with the head element  403  of the surgical tool, disposed on the coupler  425 . In this orientation, the movable jaw  412  and the hollow blade  410  are vertically aligned with the long axis of the hollow tube  402 . The coupler  425  is rotatable about the long axis of the hollow tube as described above. 
       FIG. 4B  reflects a 90° orientation of the head element  403  with respect to the hollow tube  402 . In this orientation, following counter-clockwise rotation of the coupler  425 , the hollow blade  410  and the movable jaw  412  are perpendicular to the vertical alignment of the 0° orientation. 
       FIG. 4C  and  FIG. 4D  are additional exemplary illustrations of orientations of the head element of the surgical tool, according to an embodiment of the present disclosure.  FIG. 4C  reflects a 180° orientation of the head element  403  with respect to the hollow tube  402 . In this orientation, following counter-clockwise rotation of the coupler  245 , the hollow blade  410  and the movable jaw  412  are aligned with the vertical axis of the hollow tube  402 . 
       FIG. 4D  reflects a 270° orientation of the head element  403  with respect to the hollow tube  402 . In this orientation, following counter-clockwise rotation of the coupler  425 , the hollow blade  410  and the movable jaw  412  are perpendicular to the vertical alignment of the 0° orientation. 
     According to an embodiment, the coupler  425  is rotatable about the long axis of the hollow tube  402  in the clockwise direction, counter-clockwise direction, or a combination thereof. The ability to rotate the head element of the surgical unit provides the user with flexibility during surgical procedures. For example, with the head element in a 0° orientation, a tissue of interest may be just beyond the workable space of the surgical tool. Concurrently, there may insufficient space to maneuver the length of the hollow tube to access the tissue of interest. However, with the ability to rotate the head element of the surgical tool about the axis of the hollow tube, the previously unreachable tissue of interest may now be accessible. 
     In addition to rotation of the head element of the surgical tool about the long axis of the hollow tube,  FIG. 5A  and  FIG. 5B  are exemplary illustrations of curvatures of the head element of the surgical tool, according to an embodiment of the present disclosure. In  FIG. 5A , the movable jaw  522  and the hollow blade  520  are illustrated in a curved embodiment, wherein the curve is a right curve extending from the base of the movable jaw  522  at the pin  518 . The hollow blade  520  is curved in order to be congruent with the movable jaw  522  when in contact. In  FIG. 5B , the movable jaw  532  and the hollow blade  530  are illustrated in a curved embodiment, wherein the curve is a left curve extending from the base of the movable jaw  532  at the pin  518 . The hollow blade  530  is curved so as to be congruent with the movable jaw  532  when in contact. 
     In an embodiment, regarding  FIG. 5A  and  FIG. 5B , the head element  503  can be fabricated to impart a desired curvature. The radius of curvature can be pre-determined according to a type of procedure to be performed. For example, if a procedure is to involve resection of a polyp from the lining of the colon, wherein access to a polyp may be restricted, an approach normal to the wall of the colon may be appropriate. In this instance, a straight cutting implement is sub-optimal for efficient resection, and, therefore, a curved head element  503  may be advantageous. 
     According to an embodiment, the radius of curvature can be imparted upon the head element  503  of the surgical tool following the initialization of a procedure. In an embodiment, the head element  503 , and movable jaw  522 ,  532  and hollow blade  520 ,  530  therein, can be constructed of a semi-rigid yet flexible material that can elastically bend in accordance with the desired curvature of the head element  503 . In an embodiment, the material is a linear elastic material and has a compressive elastic modulus relatively greater than a tensile elastic modulus of the material. One or more wires can be added to the length of the hollow tube and connected to opposing internal surfaces of each component of the head element  503 , the movable jaw  522 ,  532  and the hollow blade  520 ,  530 . One or more triggers can be added to the handle of the surgical tool to operate the one or more wires connected to opposing surfaces of each component of the head element  503 . During operation, when it is desired to impart a curve in the movable jaw (and the hollow blade similarly), an engaged trigger can apply tension to a first of the one or more wires attached to an internal surface of the movable jaw. Tension induces compression in one face of the movable jaw and tension in the other, resulting in bending of the movable jaw toward the face under compression. Similarly, by applying tension to the second of the one or more wires attached to an internal surface of the movable jaw, a curvature in the opposite direction can be achieved. As the movable jaw  522 ,  532  and hollow blade  520 ,  530  are fabricated of a linear elastic material, imparted curvature in the component is dependent on the force applied to the one or more internal wires, allowing the user to control the curvature of the head element  503  according to the needs of a procedure. 
     In another embodiment, control of the curvature of the head element  503 , and movable jaw  522 ,  532  and hollow blade  520 ,  530  therein, can be completed with digital control according to user input via a user interface located on the handle or external to the surgical tool. 
     In an exemplary embodiment, a user identifies, during a procedure, a need to reposition the head element of the surgical tool to access a target tissue. Instead of removing and reinserting the tool in order to access the target tissue, introducing the risk of further injury to neighboring tissues, the user may engage a one or more triggers that impart a curvature in the head element  503  components, providing the user greater flexibility and improving outcomes in surgical procedures. 
       FIG. 6A ,  FIG. 6B ,  FIG. 6C , and  FIG. 6D  are exemplary illustrations of non-limiting configurations of steam ports of a hollow blade of the surgical tool, according to embodiments of the present disclosure. In each Figure, the centerline indicates a cutting implement  611  of the hollow blade  610 . In  FIG. 6A , the plurality of steam ports  635  are substantially rectangular and are of identical sizes along the length of the hollow blade. In  FIG. 6B , the plurality of steam ports  636  are substantially rectangular and are of identical sizes along the length of the hollow blade. Compared with  FIG. 6A , the plurality of steam ports  636  in  FIG. 6B  are of relatively increased length and relatively increased width, as might be expected in accordance with a specific procedure. The steam ports  637  in  FIG. 6C  are substantially rectangular in shape and of alternating sizes along the length of the hollow blade. In  FIG. 6D , the plurality of steam ports  638  are substantially circular and are of identical sizes along the length of the hollow blade. 
     The size, shape, number, and spatial arrangement of the steam ports are determined in accordance with the requirements of the desired procedure in order to deliver the appropriate steam flow parameters to the target tissue. 
     In another embodiment, the size and the shape of the hollow blade is modified according to the demands of the desired procedure. The length, width, and cross-sectional shape, in a non-limiting manner, may be modified as necessary. 
     According to an embodiment, the steam flow rate exiting the hollow blade is controlled by the size and the shape of the steam ports. For example, assuming a constant flow rate exiting the steam canister of the handle, a smaller aperture steam port in the hollow blade will increase the velocity at which the steam flow is exiting the hollow blade. In order to decrease the velocity of the steam flow exiting the hollow blade, a larger aperture steam port is required. In this way, steam port size and shape are determined according to tissue type and the appropriate flow parameters defined therein. The abovementioned embodiments should be considered non-limiting and are merely exemplary of a variety of possible implementations of the present disclosure. 
       FIG. 7A ,  FIG. 7B ,  FIG. 7C , and  FIG. 7D  are exemplary illustrations of configurations of a movable jaw of the surgical tool, according to an exemplary embodiment of the present disclosure. In each Figure, grips are disposed on the face of the movable jaw  715  so as to come into contact with a tissue of interest and control the motion of the tissue of interest during incision via the cutting implement of the hollow blade. In an embodiment, the grips are protrusions. In  FIG. 7A , the grips  745  are substantially hemispherical in shape and are distributed evenly along the face of the movable jaw  715 . In  FIG. 7B , the grips  746  are substantially triangular, resembling teeth, and are distributed evenly along the length of the face of the movable jaw  715 . The size and depth from the face of the movable jaw  715  of the grips can be modified to suit the desired application. According to an embodiment, in  FIG. 7C , the grips  747  are substantially rectangular and are distributed evenly along the length of the face of the movable jaw  715 . In  FIG. 7D , the grips  748  are substantially rectangular in shape and are evenly distributed along the face of the movable jaw  715 . The grips  748 , however, are at a depth relatively increased compared with the grips  747  of  FIG. 7C . 
     In another embodiment, the grips may be depressions. For example, with reference to  FIG. 7A , a trough of substantially hemispherical shape may be disposed on the face of the movable jaw, thereby providing assistance in tissue control. 
     The size, shape, number, and spatial arrangement of the grips are determined in accordance with the requirements of the desired procedure. The frequency and width of the grips, across the face of the movable jaw, may be variable and intermittent, as required. The abovementioned embodiments should be considered non-limiting and are merely exemplary of a variety of possible implementations of the present disclosure. 
     In another embodiment, the size and shape of the movable jaw can be modified according to the demands of the desired procedure. The length, width, and cross-sectional shape, in a non-limiting manner, may be modified so as to appropriately grip tissue as required by the procedure. 
     According to an embodiment, and in addition to potential modification to the abovementioned steam ports, the temperature of the steam flow may be controlled via internal or external control unit.  FIG. 8A  and  FIG. 8B  are exemplary illustrations of configurations of a control unit of a pressurized steam flow of the surgical tool, according to an exemplary embodiment of the present disclosure. In  FIG. 8A , the control unit  840  is attached to the steam canister  808  of the handle  801  which is supplied by steam flow  806  from the steam tube  807 . According to another embodiment, in  FIG. 8B , the control unit  850  is located at the steam flow source and controls the temperature of the steam prior to sending the steam flow  806  to the steam canister  808 . In each embodiment, and in a non-limiting manner, the control unit  840 ,  850  comprises a heating element and a thermostat configured to maintain temperature of a steam flow  806  in the steam canister  808 . 
     According to an embodiment, power may be supplied to the control unit  840 ,  850 , in a non-limiting manner, via rechargeable battery, conduction, induction or a combination thereof. 
     In an embodiment, the control unit  840 ,  850  includes a user interface for temperature adjustment. The user interface may include, but is not limited to, a display and a user interface mounted to the handle  801  or mounted externally at the control unit  850 . In an embodiment, the user interface further comprises a mobile device, such as a smartphone, with a processing circuitry configured to communicate with the control unit  840 ,  850  and remotely control the thermostat, setting the temperature of the steam flow  806  in the steam canister  808  as appropriate for the desired procedure. In another embodiment, the user interface comprises a computer workstation with a processing circuitry configured to communicate with the control unit  840 ,  850  and remotely control the thermostat, setting the temperature of the steam flow  806  in the steam canister  808  as appropriate for the desired procedure. 
       FIG. 9  is an exemplary illustration of a head element of a surgical tool interacting with a target tissue, or polyp, formed integrally within a tissue wall, according to an embodiment of the present disclosure. The head element  953  comprises two operative elements  910 ,  910 ′, wherein the operative element  910 ′ is rotatably connected to a jaw wire  913 . The head element  953  further comprises a filter element  956  deployable from the basal surface of the operative elements  910 ,  910 ′. The filter element  956 , when fully deployed, forms a three-dimensional cone around the target tissue and prevents the escape of large debris released from the target tissue during incision or ablation with an ablative agent. The filter element may be fabricated from a synthetic material of the kind typically used for embolic filters, such as polytetrafluoroethylene, with a pore size appropriate for the surgical procedure and ablative agent parameters. Such fabrication and use of filters for biological debris is understood in the art, as evidenced by U.S. Pat. No. 6,558,405 B1, which is incorporated herein by reference. 
     Each operative element  910 ,  910 ′ comprises a cutting implement  911 ,  911 ′ and ports  906 ,  906 ′ for delivery of the ablative agent to the target tissue. The surgical tool  900  further comprises a latching element  955  extending from the hollow tube exit  917  of the hollow tube  902 . The latching element  955  can be digitally- or manually-controlled from a user interface at the handle of the surgical tool  900 . In an embodiment, the latching element  955  is substantially helical in structure, however, the shape of the latching element  955  can be any that is suitable for grasping and holding tissue. The latching element  955  is in connection with the handle of the surgical tool  900  via a latching element shaft  954 . In an embodiment, the latching element shaft  954  is a threaded shaft with similarly threaded mating elements at the proximal end and the distal end of the surgical tool. During operation, with the filter element previously deployed, the latching element  955 , controlled by a user via latching element shaft  954 , is advanced into latching connection with the target tissue, at which time the cutting implement, ablative agent, or a combination thereof is engaged with the target tissue. Follow excision of the tissue by the operative elements, larger debris collected by the filter element  956  and the latched target tissue are removed from the surgical site with the surgical tool  900 . 
     In another embodiment, the surgical tool  900  further comprises a suction element disposed at the hollow tube exit  917  of the hollow tube  902  for expedited removal of excised tissues via vacuum. 
     Obviously, numerous modifications and variations are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described herein. 
     Thus, the foregoing discussion discloses and describes merely exemplary embodiments of the present invention. As will be understood by those skilled in the art, the present invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. Accordingly, the disclosure of the present invention is intended to be illustrative, but not limiting of the scope of the invention, as well as other claims. The disclosure, including any readily discernible variants of the teachings herein, defines, in part, the scope of the foregoing claim terminology such that no inventive subject matter is dedicated to the public.