Patent Publication Number: US-11648048-B1

Title: Resectoscope systems and methods

Description:
This document describes devices, systems, and methods related to resectoscopes. Specifically, a device that can assist in treating patients while utilizing endoscopic or laparoscopic based therapies. For example, devices that can facilitate the examination of the anatomy of a patient using endoscopic or laparoscopic techniques, and facilitates the resection of tissues in a targeted location in the patient&#39;s body. 
     BACKGROUND 
     In general, minimally invasive medical procedures can utilize catheters, endoscopes, and other medical instruments to perform therapies and imaging to patients. Minimally invasive medical procedures can be complex and involve several medical instruments in use concurrently and/or at various times during a procedure. 
     Resectoscopes have been utilized for procedures to provide visual access to anatomy via a natural, laparoscopic, or percutaneous route. Therapeutic procedures can be performed utilizing attached instruments for cutting, ablating, and coagulating tissues. The instruments can be removable from the resectoscope so the instruments can be exchanged for a variety of purposes and for post-operative cleaning. 
     Previous approaches to reusable resectoscope systems have a larger outside diameter of the insertion shaft to accommodate the attachment of a high-frequency (HF) instrument and outer sheath. Previous approaches also utilize complex reprocessing of the resectoscope and other instruments to assure sterility, which can cause safety issues for the reusable instrument caused by sterile reprocessing of a narrow cannula. Previous resectoscope systems utilize expensive components including rod lens endoscopes that can include the addition of a camera system for viewing the anatomy on a video monitor. These expensive components are accompanied by ergonomic issues with the bulky resectoscope systems that are heavy, particularly when connected to the camera system. These systems can also include a complex assembly process performed by specialized personnel of multiple components, usually performed in the operating theater. 
     SUMMARY 
     The document generally relates to devices, systems, and methods related to resectoscopes. Specifically, a device that can assist in treating patients while utilizing endoscopic or laparoscopic based therapies. 
     One aspect includes a surgical device. The surgical device can have a shaft portion that extends along a longitudinal axis and that is configured to be inserted into a patient&#39;s body, the shaft portion may include: an outer sheath, an inner shaft provided within the outer sheath, a surgical tool provided within the outer sheath and configured to be movable along the longitudinal axis, and an optical assembly provided at a distal end of the inner shaft, the optical assembly including a light source and an imaging sensor. The device also includes a handle portion that is coupled to a proximal end of the shaft portion, the handle portion including a manipulator that is configured to be manipulated by a user to move the surgical tool along the longitudinal axis. A first channel that extends along the longitudinal axis is defined by one or both of the outer sheath and the inner shaft, the first channel providing a first flow path between the proximal end of the shaft portion and a first opening provided at a distal end of the shaft portion. A second channel that extends along the longitudinal axis is defined by one or both of the outer sheath and the inner shaft, the second channel providing a second flow path between the proximal end of the shaft portion and a second opening provided at the distal end of the shaft portion, the second flow path being distinct from the first flow path. The optical assembly is provided at a distal end of the first channel to thereby partially block and divert the first flow path around the optical assembly, and where the surgical tool is provided in the second channel and configured to be extended out of or retracted into the outer sheath via the second opening. 
     Implementations may include one or more of the following features. The optical assembly protrudes radially inward from an interior surface of the first channel. The first opening is defined between the optical assembly and the inner shaft to at least partially surround the optical assembly. The first opening is configured to direct fluid across a distal surface of the optical assembly. A cross-sectional area of the first channel is greater than a cross-sectional area of the first opening. The first channel is configured to impinge fluid against a proximal surface of the optical assembly. The first opening is configured to inject fluid to a surgical site, and the second opening is configured to suction or remove fluid and biologics from the surgical site. The handle portion includes: a first port that is in fluid connection with the first channel and that is configured to introduce fluid into the first channel, and a second port that is in fluid connection with the second channel and that is configured to extract fluid and biologics from the second channel. 
     In some implementations, the surgical tool is an electrode loop that is configured to be connected to a high-frequency power supply. The electrode loop is configured to operate in a monopolar mode based on being connected to a monopolar power supply and configured to operate in a bipolar mode based on being connected to a bipolar power supply. The electrode loop is connected to a monopolar supply cable to operate in a monopolar mode. The electrode loop is connected to a biopolar power supply cable to operate in a bipolar mode. The manipulator is a thumb loop that is configured to be manipulated by sliding along a first axis to thereby move the surgical tool along the longitudinal axis, the thumb loop being configured to freely rotate about the first axis. A distal-most end of the inner shaft includes a cap portion that protrudes distally beyond a distal-most end of the outer sheath, the first and second openings being defined in the cap portion. The outer sheath, the inner shaft, and the handle portion can be injection molded. in some aspects, the outer sheath and at least a portion of the inner shaft can be made of metal, and the proximal body can be made of plastic. In some aspects, the outer sheath, the inner shaft, and the handle portion can be made from one or more materials that cannot be sterilized at temperatures greater than 120° C. The image sensor is a CMOS sensor that is provided at the distal end of the inner shaft. The light source is a light emitting diode (LED) that is provided at the distal end of the inner shaft. The outer sheath is slidably coupled to the inner shaft. The outer sheath is integrally formed with the inner shaft. The distal end of the inner shaft may include an atraumatic tip. The optical assembly is integrally formed with the inner shaft. 
     The devices, system, and techniques described herein may provide one or more of the following advantages. For example, a disposable system is provided that incorporates a surgical device with a high frequency shielded digital imaging and illumination system with integrated high frequency instruments. The surgical device provides a hygienic, ergonomic, and economical resectoscope system with disposable components. The system advantageously improves patient safety by preventing improperly cleaned, improperly sterilized, improperly reprocessed, and improperly assembled surgical devices (e.g., resectoscopes) by providing a prepacked, preassembled, and sterilized system. The surgical device can include integrated high frequency instruments, an integrated or removable outer sheath, high frequency capability in both monopolar and bipolar modes, and can be compatible with various high frequency generators. The surgical device can include an integrated imaging system that is disposable with the surgical device and facilitates improved ergonomics of the surgical device over present rod lens designs that are expensive and heavy. 
     The details of one or more implementations are set forth in the accompanying drawings and the description below. Other features and advantages will be apparent from the description and drawings, and from the claims. 
    
    
     
       DESCRIPTION OF DRAWINGS 
         FIG.  1    shows a right-side view of an example surgical device system with a removable external sheath. 
         FIG.  2 A  shows a distal end view of the surgical device of  FIG.  1   . 
         FIG.  2 B  shows a section view of the surgical device along section  2 B- 2 B of  FIG.  2 A . 
         FIG.  3    shows a detailed section view of a distal portion  3  of  FIG.  2 B . 
         FIG.  4    shows a perspective view of a distal portion of the surgical device of  FIG.  1     
         FIG.  5    shows a right-side view of an example surgical device system with an integral external sheath 
         FIG.  6 A  shows a section view of the surgical device of  FIG.  5   . 
         FIG.  6 B  shows a detailed section view of a distal portion  6 B of  FIG.  6 A . 
         FIG.  7 A  shows a perspective view of the surgical device of  FIG.  5    with a surgical instrument in an extended position. 
         FIG.  7 B  shows a perspective view of a distal end of the surgical device of  FIG.  7 A . 
         FIG.  7 C  shows a rear perspective view of the surgical device of  FIG.  7 A . 
         FIG.  8    shows a perspective view of a surgical device of  FIG.  1    with a detachable external insertion sheath and insertable obturator 
         FIG.  9 A  shows a perspective view of an example high frequency instrument. 
         FIG.  9 B  shows a detail view of the distal end of  FIG.  9 A . 
         FIG.  10    shows a perspective view of a high frequency instrument with a bipolar connection. 
         FIG.  11    shows a perspective view of a high frequency instrument with a monopolar connection. 
     
    
    
     Like reference symbols in the various drawings indicate like elements. 
     DETAILED DESCRIPTION 
     This document generally relates to devices, systems, and methods related to surgical devices. Specifically, a surgical device that can assist in examining and treating patients while utilizing endoscopic-based or laparoscopic-based therapies. For example, surgical devices that facilitate the visualization and treatment of a target area using a disposable resectoscope system that includes a surgical tool and an optical assembly. 
     Referring to the figures,  FIGS.  1 ,  2 A, and  2 B  illustrate an example surgical device  100  as described herein. In some aspects, the surgical device  100  can be a resectoscope and/or an endoscope that has a shaft portion  102  that surrounds one or more working channels, an optical assembly at a distal end  104  of the surgical device  100 , and a proximal body  106  that has one or more ports and one or more manipulators for controlling the surgical device  100 . 
     The shaft portion  102  extends along a longitudinal axis  110  of the surgical device  100 . In some aspects, the shaft portion  102  can be configured to be inserted into a patient&#39;s body. The shaft portion  102  can include an outer sheath  112  and an inner shaft  114  that is provided within the outer sheath  112 . Each of the outer sheath  112  and the inner shaft  114  can extend distally from the proximal body  106  to the distal end  104  of the surgical device  100 . 
     The outer sheath  112  and inner shaft  114  can each define one or more channels that extend through the shaft portion  102 . For example, a first channel  116  and a second channel  118  can extend from the proximal body  106  to the distal end  104 . In some aspects, the first channel  116  and the second channel  118  can be formed in either or both of the outer sheath  112  and the inner shaft  114 . 
     The first channel  116  and the second channel  118  of the outer sheath  112  and inner shaft  114  can be configured to provide a connection between the proximal body  106  and the distal end  104  through the shaft portion  102 . In some aspects, the connection between the proximal body  106  and the distal end  104  can be configured for fluid communication through the channels in the outer sheath  112  and inner shaft  114 . In some aspects, one or more of the channels in the outer sheath  112  and inner shaft  114  can be configured to receive a surgical tool that is moveable along the longitudinal axis  110 . 
     The proximal body  106  can be connected to the shaft portion  102  and positioned proximally to the shaft portion  102 . In some aspects, the outer sheath  112  can be detachable from the proximal body  106 . For example, the outer sheath  112  can be connected to the proximal body  106  via a tapered connection  119  that facilitates attachment and detachment of the outer sheath  112  to the proximal body  106   
     The proximal body  106  can include a first port  120  that is in fluid connection with the first channel  116 . The first port  120  can be configured to introduce one or more fluids into the first channel  116 . In some aspects, the first port  120  includes a luer style connection that facilitates connection between the first port  120  and a fluid source. The first port  120  can extend outwardly from a top surface of the proximal body  106 . 
     The proximal body  106  can also include a second port  122  that is in fluid connection with the second channel  118 . The second port  122  can be configured to extract one or more fluids from the second channel  118 . The second port  122  can protrude from a bottom surface of the proximal body  106 , and can be configured to connect to one or extraction sources that can pull fluid out of the second channel  118  via the second port  122 . 
     A manipulator  130  can be positioned at the proximal end of the proximal body  106 . The manipulator  130  can be connected to a sliding connection  132  via a connection member  134 . The sliding connection  132  can connect the manipulator  130  to the proximal body  106 . The connection member  134  can connect the manipulator  130  to the sliding connection  132 , and the connection member  134  can position the manipulator  130  with respect to the sliding connection  132 . The compression spring  200  can provide force to retract the connection member  134  along the sliding connection  132  to a proximal position. For example, the manipulator  130  can be positioned below the sliding connection  132  to facilitate longitudinal movement of the manipulator  130  along the sliding connection  132  when a user moves the manipulator  130  longitudinally along the sliding connection  132 . In some aspects, the longitudinal movement of the manipulator  130  along the sliding connection  132  that can be aligned with the longitudinal axis  110 . 
     The manipulator  130  can include a loop that provides ergonomic hand positioning and control. For example, the manipulator  130  can control the longitudinal position of a surgical instrument  136  that extends through the surgical device  100  by controlling the extension and retraction of the surgical instrument  136 . In some aspects, the manipulator  130  can be rotatably connected to the connection member  134 . The rotatable connection between the manipulator  130  and the connection member  134  can facilitate the rotation of the manipulator  130  to provide a user improved ergonomics by allowing the user to adjust the rotational orientation of the manipulator  130  with respect to the connecting member  134 . 
     In some aspects, the proximal body  106  can include a grip  140  and a lever  142 . The grip  140  and lever  142  can provide the user improved ergonomics and handling options. The grip  140  can be a looped handle that extends from the bottom surface of the proximal body  106 . The lever  142  can be an arm that extends from a top surface of the proximal body  106 . The grip  140  and the lever  142  can provide stabilization to the surgical device  100  during use by providing the user additional gripping areas. 
     The components proximal to the shaft portion  102 , including at least the proximal body  106 , the manipulator  130 , the connection member  134 , the sliding connection  132 , the grip  140 , and the lever  142  can be constructed of various materials, including, but not limited to: metals or plastics, and can be produced by injection molding, machining, and additive manufacturing processes, among others. 
     Referring to  FIG.  3   , a detailed section view of the area  3  of  FIG.  2 B  is illustrated. The outer sheath  112  can surround the inner shaft  114 , and each of the outer sheath  112  and inner shaft  114  can define the first channel  116  and the second channel  118 . For example, the first channel  116  can be formed within the inner shaft  114  and the second channel  118  can be formed between the outer sheath  112  and the inner shaft  114 . 
     The first channel  116  can provide a first flow path  150  through the first channel  116  between the proximal end of the shaft portion  102  and a first opening  151  provided at a distal end  104  of the shaft portion  102 . The first flow path  150  can extend from the first port  120  to the first opening  151  through the first channel  116 . 
     The second channel  118  can provide a second flow path  152  between the proximal end of the shaft portion  102  and a second opening  153  provided at the distal end  104  of the shaft portion  102 . The second flow path  152  can extend from the second opening  153  to the second port  122  through the second channel  118 . In some aspects, the second flow path  152  is distinct from the first flow path  150 . 
     In some aspects, the distal end  104  includes a cap  160  that protrudes distally beyond a distal-most end of the outer sheath  112 . The cap  160  can extend from the distal end of the inner shaft  114 , and can extend distally beyond a distal most end of each of the outer sheath  112  and the inner shaft  114 . In some aspects, the distal most end of the inner shaft  114  is distal of the distal most end of the outer sheath  112 . The first opening  151  and the second opening  153  can be formed in the cap  160 . As illustrated in  FIGS.  3  and  4   , the surgical device  100  can include an optical assembly  170  that is provided at the distal end  104  of the inner shaft  114 . The optical assembly  170  can protrude radially inward from an interior surface of the first channel  116 . The optical assembly  170  includes a light source  174  and an imaging sensor  172 . In some aspects, the cap  160  includes a light source recess  175  and an imaging sensor recess  173  that are dimensioned to receive each of the light source  174  and the imaging sensor  172 , respectively. In some aspects, the light source  174  and the imaging sensor  172  are integral with the surgical device  100 . For example, the light source  174  and the imaging sensor  172  can be integrated into the cap  160 , the inner shaft  114 , and the outer shaft  112 . 
     In some aspects, the light source  174  is provided to illuminate a target area in a patient for imaging by the imaging sensor  172 . The light source  174  can be a light emitting diode (LED) that is provided at the distal end  104  of the inner shaft  114 . In some aspects, the light source  174  can be a proximal LED that includes a fiberoptic connection from the proximal body  106  to the light source  174 . 
     The imaging sensor  172  can be positioned at the distal end  104  of the surgical device  100  to provide imaging and guidance of the surgical device  100  in the target area of the patient to the medical operator. In some aspects, the imaging sensor  172  can be a camera, a complementary metal oxide semiconductor (CMOS) imager, active pixel sensor (APS), a charged coupled device (CCD). The distal imaging sensor can be wired to a proximal electronics located in  106  and may then communicate, either by wire or wirelessly, images, videos, and other sensed data to a medical operator. The imaging sensor  172  can include electrical shielding that rejects high frequency interference that can be present at the target area (e.g., via high-frequency surgical tools). 
     In some aspects, the first opening  151  is formed between the optical assembly  170  and the inner shaft  114  to at least partially surround the optical assembly  170 . The first opening  151  is configured to direct fluid from the first channel  116  across a distal surface  178  of the optical assembly  170 . The directed fluid through the first opening  151  across a distal surface  178  of the optical assembly can facilitate a rinsing of the optical assembly  170  to provide a clearer imaging result to the medical operator. The directed fluid can be a fluid that is chosen for rinsing the optical assembly  170 , or can be a fluid that is used for treatment in the target area, and rinses the optical assembly  170  as well. In some cases, the first opening  151  and/or the optical assembly  170  can be shaped to create and direct turbulent flow around the light source  174  and/or the imaging sensor  172  to further provide a cleaning effect. 
     In some aspects, a cross-sectional area of the first channel  116  is greater than a cross-sectional area of the first opening  151 . The first channel  116  can be configured to impinge fluid traveling along the first flow path  150  against a proximal surface  180  of the optical assembly  170 . The proximal surface  180  of the optical assembly  170  can direct fluid to the first opening  151 . The first opening  151  is configured to inject fluid to the target area (e.g., a surgical site). The second opening  153  is configured to suction fluid from the target area (e.g., the surgical site) into the second channel  118 . 
     The surgical instrument  136  can extend through the second channel  118 , and can be positioned in or near the second opening  153 . The second opening  153  can extend partially around the optical assembly  170  and the first opening  151 . In some aspects, the surgical instrument  136  and the second opening  153  can each have curved profile such that the curved profile of a distal end of the surgical instrument is compatible to extend through the curved profile of the second opening  153 . 
     In some aspects, the outer sheath  112 , the inner shaft  114 , the proximal body  106 , and the manipulator  130  can be injection molded. The outer sheath  112 , the inner shaft  114 , the proximal body  106 , and the manipulator  130  can be made from one or more materials that cannot be sterilized at high temperatures, for example at temperatures greater than around 120° C. that may be used in steam autoclaves. Such materials can include plastics that may flow, wrap, or otherwise deform at temperatures greater than 120° C. In some such cases, materials that begin to deform at temperatures greater than 140° C. may be used. In some cases, one or more of the above-mentioned parts can be made by 3D printing or other types of additive manufacturing techniques. 
       FIG.  5    illustrates the surgical device  100  that has an integral outer sheath  212 . The surgical device  100  of  FIG.  5    can share features with the surgical device  100  of  FIGS.  1 - 4   . The integral outer sheath  212  can be integral with the surgical device  100  such that the integral outer sheath  212  may not be removed from the surgical device  100 . In other aspects, the outer sheath  112  can be removed from the surgical device  100 , as shown in  FIG.  8   . 
     Referring to  FIGS.  6 A and  6 B , the surgical device  100  is shown with an integral outer sheath  212 . In some aspects, the distal end  104  includes a cap  260  that is attached to both the inner shaft  114  and the integral outer sheath  212 . The cap  260  can extend from the distal end of the inner shaft  114 , and can extend distally beyond a distal most end of each of the outer sheath  212  and the inner shaft  114 . 
     Referring to  FIGS.  7 A,  7 B, and  7 C , the surgical device  100  is shown in an extended position, where the surgical instrument  136  is extended outside of the distal end  104  of the surgical device  100 . In some aspects, the proximal body  106  includes an electrical connection  190  that can provide power to the optical assembly  170  and can transmit imaging signals including images and video from the optical assembly  170 . In some aspects, the proximal body  106  also includes an electrical connection  230  that can provide current to the surgical instrument  136 , including high-frequency current to the surgical instrument  136 . The electrical connections  190  and  230  can include an umbilical  191  and  231  that can be integral with the proximal body  106  or can be removable from the proximal body  106 . 
     The surgical instrument  136  can be extended by the medical operator. The medical operator can actuate the manipulator  130  distally, causing the connection member  134  to slide distally over sliding connection  132 . The extended position of the surgical instrument  136  includes axial motion  192  that can be along the longitudinal axis  110 . 
     The surgical instrument  136  can be retracted into the surgical device  100  (as shown in  FIGS.  1 - 6   ). The retracted position of the surgical instrument  136  provides a safe and isolated location for the surgical instrument  136  when the surgical instrument  136  is not in use. The surgical instrument  136  can be automatically retracted when the manipulator  130  is released by the medical operator. The automatic retraction of the surgical instrument  136  can be facilitated by a compression spring  200  that is positioned within the sliding connection  132 . The compression spring  200  compresses when the manipulator  130  is slid into the extended position, and the compression spring  200  releases when the operator force at the manipulator  130  is released. The release of the compression spring  200  returns the surgical device  100  to the retracted position where the surgical instrument  136  is retracted into outer sheath  112 . 
     In some aspects, the axial motion  192  of the surgical instrument  136  may have various linear travel limits to provide optimal extension of the surgical instrument  136  from the distal end  104  of the surgical device  100 . The distal end  104  of the shaft portion  102  can be designed to be atraumatic to prevent patient injury and can be composed of electrically isolative materials. 
       FIG.  8    shows that the surgical device  100  can be configured such that the outer sheath  112  is detachable from the inner shaft  114  and other components that are contained within the outer sheath  112 . The outer sheath  112  can be detachable via the tapered connection  119  to the proximal body  106 , the tapered connection  119  provides fixation and orientation of the outer sheath  112 . This feature providing two key functions: 
     The outer sheath  112  that is detached can be fitted with an internal obturator  210  and inserted into the body prior to the insertion the inner shaft  114 . The obturator  210  and outer sheath  112  can provide atraumatic access and expansion of the bodily orifice. After insertion, the obturator  210  can be removed and replaced by the inner shaft  114 . The inner shaft  114  may be removed from the outer sheath  112  at any time during the procedure thus providing a large working channel for fast extraction of fluids or biologics from the body and/or for the extraction of large material(s) to pass out of the body that otherwise would not be able to be received in a smaller channel. 
     The shaft portion  102  and the detachable outer sheath  112  can be constructed of various metals including shape memory alloys (e.g., Nitinol) or high strength plastics to provide optimal flexibility characteristics. The outer sheath  112  can be of various diameters. 
       FIGS.  9 A and  9 B  show the exemplary surgical instrument  136  removed from the surgical device  100 . In some aspects, the surgical instrument  136  can be a resecting loop that operates as a tissue resecting device via the application of high frequency current to a distal wire  220 . The surgical tool  136  can be connected to a high-frequency power supply, and the power supply can apply HF current to the proximal connections  222 ,  224 . The current applied to the proximal connections  222 ,  224  can travel along the length of the surgical instrument  136  and be delivered to the distal wire  220 , the distal wire  220  can be configured to cut, remove, coagulate, or ablate tissue. The distal wire  220  can be of various shapes and configurations to optimally cut, coagulate, or ablate tissue. 
       FIG.  10    shows a first example of a grounding path for the current supplied to the surgical instrument  136 . The grounding path of the current may be via the proximal connections  222 ,  224  exiting at a connection  230  on the proximal body  106 . The grounding path of  FIG.  10    is a bipolar grounding path that includes a positive connection  232  that connects to the proximal connection  222  and a negative connection  234  that connects to the proximal connection  224 . An electrical insulator  235  can be positioned between the positive connection  232  and the negative connection  234 . The connection  230  can interface with a power supply connection that includes a positive connection  242  and a negative connection  244  that connect to the bipolar power supply via connection line  240 . 
       FIG.  11    shows a second example of a grounding path for the current supplied to the surgical instrument  136 . The grounding path of the current may be via the proximal connections  222 ,  224  exiting through the patient body via conductive fluids and/or tissues. The patient is externally grounded. The grounding path of  FIG.  11    is a monopolar grounding path that includes two positive connections  232  that connect to the proximal connections  222 ,  224 . An electrical insulator  235  can be positioned between the positive connections  232 . The connection  230  can interface with a power supply connection that includes a positive connection  242  that connects to the monopolar power supply via connection line  240 . 
     The surgical instrument  136  and the proximal connectors  222 ,  224  are proximally attached to the connection member  134  of the proximal body  106 . In some aspects, the surgical device  100  can be configured to be both a monopolar design and a biopolar design. For example, the surgical device  100  can be configured to be connected to a monopolar power supply and to a bipolar power supply. In some aspects, the proximal connectors (e.g., proximal connectors  222 ,  224 ,  242 ,  244 ) can connect to the supply line  240 . The supply line  240  can provide either a monopolar connection or a bipolar connection. In either case, the proximal connectors can facilitate a connection to each power supply type without changes to the surgical device  100 . The surgical instrument  136  can be integrated into the surgical device  100 . 
     In operation, the surgical device  100  can be removed from sterile packaging, attached to ancillary power and control devices (e.g., Video control, HF control, and fluid control), and checked for function. The surgical device  100  can be fully disposable for hygienic reasons and ease of sterilization. The surgical device  100  can be compact, providing optimized disposal. 
     The surgical device  100  can allow extension and retraction of the surgical instrument  136 , and the surgical instrument  136  can facilitate the cutting and ablating of tissues in the target area, and the surgical device  100  includes the first opening  151  and the second opening  153  for infusion and extraction of fluids and biologics to and from the body. The surgical device  100  may allow bi-directional passage of both fluids and biological matter (i.e., continuous flow). The optical assembly  170  can provide a clear view of the procedure. The surgical device  100  can be of various lengths to accommodate different anatomies. 
     The surgical device  100  can be made to be disposable in the following versions. In one example, the surgical device  100  can include an integral outer sheath  112  that provides a slim outside diameter useful for certain anatomies and applications. In another example, the surgical device  100  can include the outer sheath  112  that is detachable, that provides the medical operator the ability for both intubating the patient and extracting large volumes of materials when the inner shaft  114  is detached from the outer sheath  112 . 
     The surgical device  100  can provide several advantages. For example, the surgical device  100  can be provided as a disposable system that incorporates a resectoscope with a high frequency shielded digital imaging and illumination system and integrated high frequency surgical instruments. The surgical device  100  provides a hygienic, ergonomic, and economical system with disposable components. The surgical device  100  can advantageously improve patient safety by preventing improperly cleaned, improperly sterilized, improperly reprocessed, and improperly assembled resectoscopes by providing a prepacked, preassembled, and sterilized system. The surgical device  100  can include integrated high frequency surgical instrument(s)  136 , an integrated or removable outer sheath  112 , high frequency capability in both monopolar and bipolar modes, and can be compatible with various high frequency generators. The surgical device  100  can include an integrated optical assembly  170  that is disposable with the surgical device  100  and facilitates improved ergonomics of the resectoscope over present rod lens designs that are expensive and heavy. 
     While this specification contains many specific implementation details, these should not be construed as limitations on the scope of the disclosed technology or of what may be claimed, but rather as descriptions of features that may be specific to particular implementations of particular disclosed technologies. Certain features that are described in this specification in the context of separate implementations can also be implemented in combination in a single implementation in part or in whole. Conversely, various features that are described in the context of a single implementation can also be implemented in multiple implementations separately or in any suitable sub combination. Moreover, although features may be described herein as acting in certain combinations and/or initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a sub combination or variation of a sub combination. Similarly, while operations may be described in a particular order, this should not be understood as requiring that such operations be performed in the particular order or in sequential order, or that all operations be performed, to achieve desirable results. Particular implementations of the subject matter have been described. Other implementations are within the scope of the following claims.