Patent Description:
Endoscopic surgery of a distensible organ, such as a uterus, may be performed with an endoscope that is insertable into an organ such as the uterus and a resector that passes through the endoscope to cut or otherwise treat tissue in the organ. During surgery, it often is desirable to distend the organ, such as the uterus, with a fluid, such as saline, sorbitol, or glycine, in order provide a visible working space. Fluid can be infused into the uterus and removed from the uterus through the endoscope and/or the resector. Patents <CIT> and <CIT> are examples of known similar devices in the field.

The scope of the invention is defined in appended claim <NUM>, preferred embodiments are disclosed in the dependent claims. According to implementations of the present concepts, tissue resecting systems include easy-to-handle handsets that compactly integrate a pump and other components for extracting fluid/tissue from an organ. In an example implementation, a tissue resecting system includes a handset that includes a disposable portion including a pump, a first fluid line, and a second fluid line. The pump draws fluid, with suction, from an organ through the first fluid line and moves the fluid into the second fluid line for further processing. The handset also includes a reusable portion that is detachably coupled to the disposable portion to define a single housing for the handset. The reusable portion includes one or more drive components that drive the pump. The system also includes a cutting element that extends from the handset to cut tissue from the organ. This cutting element may also be driven by the one or more drive components in the reusable portion. The fluid drawn from the organ by the pump carries tissue that the cutting element cuts from the organ.

In some cases, the disposable portion may include a filtration system that filters the fluid drawn from the organ, where the pump moves the fluid through the filtration system and into the second fluid line, which delivers the filtered fluid back to the organ. The tissue resecting system may include an endoscope that is configured to be inserted into the organ and to guide the cutting element into the organ. The endoscope includes a passageway that is configured to extend into the organ, and the passageway is coupled to the second fluid line to deliver the filtered fluid to the organ. In other cases, the second fluid line may simply deliver the fluid to an external receptacle, for example, for disposal.

In another example implementation, a tissue resecting system includes a handset that includes a disposable housing including a pump, a first fluid line, a second fluid line, and one or more drive components that drive the pump. The pump draws fluid, with suction, from an organ through the first fluid line and moves the fluid into the second fluid line for further processing. The tissue resecting system includes a cutting element that extends from the handset to cut tissue from the organ. The fluid drawn from the organ by the pump carries tissue cut from the organ by the cutting element. The housing may include more than one section. For example, the housing may include a first section and a second section, where the first section includes the pump, the first fluid line, and the second fluid line, and the second section includes the one or more drive components.

The one or more drive components in the reusable portion may include a motor that drives the pump and optionally the cutting element. The motor may be powered by an external power source and/or by a battery in the handset.

According to additional aspects of the present disclosure, implementations structurally integrate various functions of a tissue resecting system into a footswitch. Such integration results in a smaller footprint for the tissue resecting system and makes the system more portable and easier to set up and operate.

In an example implementations, a tissue resecting system includes a resector and a footswitch. The resector includes a handset and a cutting element that extends from the handset to cut tissue from the organ. The footswitch is coupled to the resector and is selectively operated to activate the cutting element. The footswitch includes one or more control elements that control the operation of the cutting element according to selected parameters. The footswitch may include a motor that is coupled to and drives the cutting element via a flexible drive shaft, where the one or more control elements control the motor to drive the cutting element.

The handset may include a pump and a filtration system that recirculates and filters fluid through the organ through fluid lines that pass into the handset. The motor of the footswitch also drives the pump with the flexible drive shaft to move the fluid through the recirculation path. In alternative implementations, the pump and filtration system may be disposed externally from the handset. In some cases, the pump and the filtration system are integrated into the footswitch.

Other aspects a tissue resecting system may be further integrated into the footswitch. For example, the footswitch may include a user interface with a display and user inputs. The user inputs receive the selected parameters employed by the one or more control elements in the footswitch.

In an preferred embodiment of the invention, as defined in claim <NUM>, a tissue resecting system, comprising: a disposable portion comprising: a handle portion that defines a hub section and a mating section, the handle defines a fluid path that extends through the hub section and the mating section; an elongated shaft coupled to the hub section of the handle portion, the elongated shaft defines an internal flow channel fluidly coupled to the fluid path, and a central axis; an aperture through a distal end of the elongated shaft; a cutting blade within the elongated shaft and in operational relationship to the aperture; a rotating hub disposed within hub section and in operational relationship to a portion of the fluid path within the hub section, the rotating hub defines a drive connector exposed at a transition between the hub section and the mating section; a blade drive shaft that mechanically couples the cutting blade to the rotating hub, the blade drive shaft disposed within the internal flow channel of the elongated shaft and also disposed in the portion of the fluid path in the hub section; a seal in operational relationship to the rotating hub and the hub section, the seal fluidly isolates the fluid channel from drive connector exposed at the transition between the hub section and the mating section; and a reusable portion comprising: an exterior case detachably coupled to the mating section of the of the disposable portion, the exterior case defines an internal volume; a plurality of drive components disposed at least partially within the internal volume of the reusable portion, and wherein the plurality of drive components are configured to rotate the rotating hub when the tissue resecting device is in use; a power source coupled to the reusable portion.

In an embodiment, according to the main embodiment of the invention as defined in claim <NUM>, a disposable handset component comprising: a handle portion that defines a hub section and a mating section, the handle defines a fluid path that extends through the hub section and the mating section; an elongated shaft coupled to the hub section of the handle portion, the elongated shaft defines an internal flow channel fluidly coupled to the fluid path, and a central axis; an aperture through a distal end of the elongated shaft; a cutting blade within the elongated shaft and in operational relationship to the aperture; a rotating hub disposed within hub section and in operational relationship to a portion of the fluid path within the hub section, the rotating hub defines a drive connector exposed at a transition between the hub section and the mating section; a drive shaft that mechanically couples the cutting blade to the rotating hub, the drive shaft disposed within the internal flow channel of the elongated shaft and also disposed in the portion of the fluid path in the hub section; a seal in operational relationship to the rotating hub and the hub section, the seal fluidly isolates the fluid channel from drive connector exposed at the transition between the hub section and the mating section.

In an embodiment, a method, not forming part of the claimed invention, comprising: disposing a cutting element in proximity to an organ, wherein the cutting element is disposed on a distal end of an elongated shaft being part of a handset that comprises a reusable portion and a disposable portion, wherein the handset is coupled to a power source, a footswitch, a filtration system, and a pump; activating the cutting element by applying power from the power source to the handset, wherein the reusable portion comprises a motor that drives the cutting element; removing, from the organ, fluid and tissue by way a fluid path extending through the disposable portion, wherein the motor is fluidly isolated from the fluid path by a seal and the removed fluid and tissue does not contact with the reusable portion, the removing creates removed fluid; recirculating the removed fluid by: transferring the removed fluid and tissue to the filtration system by way of an outflow line coupled to the handset; filtering the tissue from the removed fluid using the filtration system; and returning to the organ at least some of the removed fluid after filtering.

While the disclosure is susceptible to various modifications and alternative forms, specific implementations thereof have been shown by way of example in the drawings and will be described in detail herein. It should be understood, however, that it is not intended to limit the disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit of the present disclosure.

Certain terms are used throughout the following description and claims to refer to particular system components. As one skilled in the art will appreciate, different companies may refer to a component by different names. This document does not intend to distinguish between components that differ in name but not function. In the following discussion and in the claims, the terms "including" and "comprising" are used in an open-ended fashion, and thus should be interpreted to mean "including, but not limited to. " Also, the term "couple" or "couples" is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

"Drive shaft" shall mean a device that transmits energy from a first point (e.g., a rotational hub) to a second point (e.g., a cutting blade). The terms "drive shaft" shall not be read to imply any particular structure unless expressly so limited. Thus, a drive shaft may be implemented as a solid rod, a tube with hollow central axis, an elongated spring, and the like.

"Detachably coupled" shall mean that two components are designed and constructed to be selectively coupled to each other, and also selectively decoupled from each other, without damage to or destroying either component. Thus, if a first device must be broken, destroyed, or rendered fully or partially inoperable as part of decoupling from the second device, then such devices shall not be considered "detachably coupled" within the meaning of this specification and claims.

An "elliptical feature" shall mean a feature that defines a closed curve on a plane surrounding two focal points such that the sum of the distances to the two focal points is constant for every point on the curve. A circular feature is a special case of the elliptical feature where the two focal points are collocated.

The following discussion is directed to various embodiments. Although one or more of these embodiments may be preferred, the embodiments disclosed should not be interpreted, or otherwise used, as limiting the scope of the disclosure. In addition, one skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is meant only to be exemplary of that embodiment, and not intended to intimate that the scope of the disclosure, is limited to that embodiment.

Operating rooms (OR) may have limited space due to the number of personnel and the amount of equipment that may be employed for some procedures. As such, the systems, apparatuses, and methods discussed herein are directed towards instrumentation designed to reduce clutter in the OR during procedures and to reduce the cross-contamination potential among and between patients using disposable and reusable components as discussed herein. In an embodiment, a footswitch of a device such as a tissue resecting device comprises components enabling device control, device power, and tissue extraction in a foot unit (foot switch) that may be used as an on/off switch in similar devices. In another embodiment, a handset of the device may comprise a pump (miniature pump), in contrast to other devices that may rely on a pump or other suction source situated in a control unit or otherwise supplied by OR services as a separate unit from the device. In various embodiments, the pump in the handset may be coupled to a filtration system to recirculate the carrying medium to the body and to capture the removed materials, and in other embodiments the pump may be coupled to an open ended extraction pass where the carrying medium is not recovered (recirculated). In some embodiments, the device may not operate on a mechanical cutting principle that employs power, in which case a drive motor may be employed for the pump.

In an embodiment, the footswitch may comprise a printed circuit board (PCB) and a transformer, and the controls for the removal process may be housed in a separate display unit that may be located inside or outside of the sterile field. In another embodiment, the footswitch may include a graphical user display that may be a touch screen and may include control buttons for the display, a motor to drive at least the cutting action may also be included in some embodiments, as may a means of extracting and/or transporting medium. The footswitch may further include a means of separating the products of tissue removal from the carrying medium (fluid), and may be configured to return the separated carrying medium to the body and/or contain the tissue or other removal products for further analysis. The battery in the footswitch may be configured to carry enough power for procedures within a predetermined time period without recharging, which decreases or eliminates the use of a power cord during the procedure.

In an embodiment, a tissue resecting device comprises a handset that comprises a motor but not a pump and is made up of a disposable part and a reusable part which are fluidly isolated from each other so that the reusable portion is not in contact with the fluid path, or in some embodiments, so that only a portion separate and fluidly isolated from the motor, heat sink, and electronics of the reusable portion is in contact with the fluid. In an embodiment, the handset comprises the motor to activate the tissue resecting device, a plurality of electronics including a PCB to control the motor, a flow path to transfer fluid from the tissue removal device to external collection containers, a tissue resecting device (e.g., a cutting blade) that simultaneously resects and removes tissue from a target area. In an embodiment, a vacuum/power unit, which may be referred to generically as a control box or external source, comprises a vacuum generator (pump) employed to move fluid from the organ through the tissue resecting device and the disposable part of the handset and into the external collection device, where the power source used to power the motor in the handset is also located. In an embodiment, the control box may comprise a graphical user interface, which may display various statistics and information regarding the device, the current procedures, and historical procedural information, such as the time that has passed since a procedure began. A footswitch may also be coupled to the device, the footswitch may comprise a single pedal for handset motor activation as well as other components as discussed herein.

In an embodiment, the handset may comprise a reusable portion and a disposable portion. In example systems the reusable portion shares a central axis with the disposable portion, along which they are aligned in order to provide power to a cutting element and establish a fluid path from the target organ to a container for collection and/or disposal. In an embodiment, the reusable portion of the handset may comprise an outer casing comprising a distal end and a proximal end, the distal end configured to engage with a proximal portion of a connector of the disposable portion. The outer casing may also comprise a plurality of mating features including rails that are intended to mate with a guide track of the disposable portion along a shared (common) central axis. In an embodiment, the outer casing of the reusable portion may comprise a plurality of tabs or other features located on the distal end and on a first and a second side, these tabs may be configured to mate with features of the disposable portion. In an embodiment, disposed in the outer casing of the reusable portion are a motor and a heat sink (which may be collectively referred to herein as the motor), as well as a plurality of electronics. The disposable portion may comprise a distal end comprising a housing coupled to a cutting element or other instrument and a proximal end configured to be coupled to a sample collection, filtration, or other fluid and/or tissue receptor or fluid recirculation device. The disposable portion comprises a fluid path that moves fluid and/or tissue from the organ through the handset and on to the sample collection, filtration, or other fluid and/or tissue receptor or fluid recirculation device without contacting the reusable portion.

In an embodiment, the fluid path in the disposable portion is fluidly isolated from the reusable portion and extends from the distal end of the handset through a rotating hub to a proximal end of the disposable portion. In an embodiment, the seal separates the fluid flow from the motor and heat sink and electronics, which may eliminate the need for an autoclaving procedure in between surgical procedures. For example, a disposable portion may be attached to the reusable portion, a procedure performed, the disposable portion may be removed, disposed, and the reusable portion may be cleaned by spraying, wiping, or other means, and the reusable portion is prepared (cleaned) for a subsequent surgery with a new disposable portion without being sterilized (by autoclave or otherwise), since the non-sterile fluid and tissue in the disposable portion do not come in contact with the reusable portion.

In another embodiment, the fluid path comprises a first portion extending from the distal end of the disposable portion to a rotating hub of the reusable portion, where a seal is disposed as discussed above. In this embodiment, the fluid path does not take a <NUM> degree turn with respect to the central axis, but rather comprises a second portion disposed before the end of the first portion and comprising a smooth angled transition. After the transition, the second portion extends parallel to the central axis towards the proximal end of the disposable portion where the fluid and/or tissue are collected/disposed/recirculated, depending upon the embodiment.

Referring to <FIG>, a tissue resecting system <NUM> includes an endoscope <NUM> (e.g., a hysteroscope), which includes an endoscope body <NUM> and an insert portion <NUM> that extends from the endoscope body <NUM> to a distal end thereof. The endoscope insert portion <NUM> is insertable into an organ, (e.g., a uterus) of a patient to enable a tissue resecting procedure in the organ. The tissue resecting system <NUM> also includes a resector <NUM> that is received by the endoscope <NUM> to resect tissue from the organ. The resector <NUM> includes a handset <NUM> that is disposed at a proximal end of the endoscope body <NUM>. The resector <NUM> also includes a shaft <NUM> that extends from the handset <NUM> and passes correspondingly through the endoscope body <NUM> and the endoscope insert portion <NUM>. At the distal end of the shaft <NUM>, the shaft <NUM> includes a cutting element <NUM>, (e.g., a hysteroscopic tissue removal device). The cutting element <NUM> is disposed beyond the distal end of the endoscope insert portion <NUM> to access tissue in the organ. The handset <NUM> includes a motor (not shown) that is coupled to and drives the cutting element <NUM> to cut tissue from the organ. A motor, discussed below in <FIG>, may actuate/rotate and/or linearly move the cutting element <NUM> in a back-and-forth motion to generate a cutting action.

The endoscope <NUM> includes an inlet port <NUM> that is coupled to a main inflow line <NUM>, which delivers fluid, (e.g., saline, sorbitol, glycine, etc.) to the endoscope <NUM>. An endoscope inflow passageway <NUM> is formed in the endoscope <NUM> and extends from the inlet port <NUM> to an inflow opening <NUM> at the distal end of the endoscope insert portion <NUM>. As shown in <FIG>, the main inflow line <NUM> receives fluid from a fluid source <NUM> (e.g., a syringe or other device) that provides the fluid under some pressure, through a source inflow line <NUM>. The fluid then flows from the main inflow line <NUM>, through the inlet port <NUM>, the inflow passageway <NUM>, and the inflow opening <NUM>, and into the organ at the distal end. In some implementations, the endoscope <NUM> may include a seal (e.g., a cervix seal) disposed about the endoscope insert portion <NUM> to close the opening to the organ when the endoscope insert portion <NUM> is inserted into the organ and to minimize the amount of fluid loss from the organ and the closed loop of the tissue resecting system <NUM>.

The resector <NUM> includes an outflow opening <NUM> at the cutting element <NUM>. An outflow passageway <NUM> extends from the outflow opening <NUM>, through the shaft <NUM>, and into the handset <NUM>. The handset <NUM> applies suction through the outflow passageway <NUM>. As the cutting element <NUM> cuts tissue from the organ, the suction draws fluid as well as cut tissue and other byproducts (e.g., blood, etc.) from the cutting process through the outflow opening <NUM>. The fluid, tissue, and byproducts then flow through the outflow passageway <NUM> and into the handset <NUM>. In other implementations, the handset <NUM> may be coupled to an outflow passageway formed in the endoscope insert portion <NUM> (rather than the shaft <NUM>) and the suction extracts the fluid, tissue, and other byproducts through this alternative outflow passageway formed in the endoscope insert portion <NUM>.

After receiving the fluid, tissue, and other byproducts from the organ through the outflow passageway <NUM>, the handset <NUM> filters the fluid to remove the tissue and other byproducts. The handset <NUM> includes an inflow line <NUM> that is coupled to the main inflow line <NUM> to deliver the filtered fluid back to the main inflow line <NUM>. Thus, the main inflow line <NUM> receives fluid from the handset <NUM> as well as the fluid source <NUM>. The filtered fluid flows through the inflow passageway <NUM> of the endoscope <NUM> and into the organ.

The handset <NUM> includes a pump that recirculates the fluid through the tissue resecting system <NUM> and the organ. In addition, the handset <NUM> includes a filtration system that removes tissue and other byproducts from the recirculating fluid. Furthermore, the handset <NUM> includes a control switch/button <NUM> that activates the pump and/or the cutting element <NUM>. In some implementations, the handset <NUM> may also include a battery. In other embodiments, the pump and/or the cutting element <NUM> may be activated by an external footswitch coupled to the handset <NUM>.

To summarize the fluid path in the tissue resecting system <NUM>, fluid is introduced into the system through the source inflow line <NUM> from the fluid source <NUM>. The fluid from the source inflow line <NUM> flows through the main inflow line <NUM>, the inlet port <NUM>, the inflow passageway <NUM>, and the inflow opening <NUM> and into the organ. The fluid, tissue, and other byproducts produced by the cutting element <NUM> are then drawn from the organ through the outflow opening <NUM>, the outflow passageway <NUM>, and into the handset <NUM>. The fluid is filtered in the handset <NUM> and flows through the inflow line <NUM> and back into the main inflow line <NUM>. Thus, the handset <NUM> illustrated in <FIG> is configured to extract fluid from an organ and filter the fluid for delivery back into the organ. Recirculating the fluid in this manner minimizes the amount of working fluid required for a procedure. Fluid from the fluid source <NUM> can also be subsequently introduced to the tissue resecting system <NUM> to maintain an amount of fluid in the system, for example, in the event of some leakage.

In contrast to other tissue resecting systems that require many separate components to be organized, the handset <NUM> integrates many of the components required for recirculating fluid through an organ as well as cutting and extracting tissue from the organ. Advantageously, the configuration of the handset <NUM> makes the tissue resecting system <NUM> highly portable and easier to set up. Additionally, due to the compact nature of the tissue resecting system <NUM>, less fluid is required to create the necessary flow through the endoscope <NUM> and the resector <NUM>. As such, the fluid can be more easily managed to maintain fluid pressure inside the organ, for example, for distension. In addition, the amount of fluid can be more easily monitored to ensure undesired/excessive absorption of fluid into the body does not occur.

As shown in <FIG>, the endoscope <NUM> may also accommodate other devices for various procedures. For example, the endoscope <NUM> includes a camera port <NUM> and a light port <NUM> that may be coupled to a camera (not shown) and an illumination source (not shown), respectively. Together, the camera and the illumination source allow the operator to visualize and capture images from the area around the distal end of the tissue resecting system <NUM>. It is understood, however, that the endoscope <NUM> is shown as an example, and that other similar devices (with fewer or more features) can be employed according to aspects of the present disclosure, for example, to accommodate the resector <NUM>.

Referring to <FIG>, an example handset <NUM> is illustrated. The handset <NUM>, for instance, may be employed in the tissue resecting system <NUM> (e.g., in some implementations the handset <NUM> is the handset <NUM> shown in <FIG>). The handset <NUM> includes a housing <NUM> that contains many of the components required for cutting and extracting tissue from an organ and recirculating fluid through the organ. The housing <NUM> is defined by a disposable portion 310A and a reusable portion 310B. The disposable portion 310A and the reusable portion 310B may be detachably coupled to each other by threaded engagement, snap-fit, frictional engagement, pins, fasteners, tape (adhesive), etc. The disposable portion 310A is intended to be discarded after only one use. Meanwhile, the reusable portion 310B includes components that can be used more than one time. After each use, the disposable portion 310A is detached from the reusable portion 310B and discarded, but the same reusable portion 310B can be coupled to a new disposable portion similar to 310A for another use. Each disposable portion 310A may be individually and sterilely packaged. Allowing the section 310A to be disposable promotes hygienic use of the tissue resecting system <NUM> (e.g., including the handset <NUM>), because it eliminates any need to clean and sterilize the disposable portion 310A after it has been contaminated, for example, by contact with fluid and tissue from a patient. In addition, allowing the reusable portion 310B to be reused reduces cost, because it does not require all components of the tissue resecting system <NUM> to be discarded after only one use. Advantageously, the tissue resecting system <NUM> provides the convenience of disposable components while avoiding the costs of a completely disposable handset, thus increasing efficiency and safety in the OR without increasing cost.

The handset <NUM> includes a shaft <NUM> that has a cutting element at a distal end. Similar to the implementation shown in <FIG>, the handset <NUM> in <FIG> receives fluid from the organ and then returns filtered fluid to the organ through an inflow line <NUM>. As shown in <FIG>, the shaft <NUM> extends from the housing <NUM> of the handset <NUM>. Like the shaft <NUM> described above, the shaft <NUM> provides an outflow passageway <NUM> that delivers the fluid, tissue, and other byproducts into the handset <NUM>. The shaft <NUM> is coupled to a chamber <NUM> where the fluid, tissue, and other byproducts are drawn from the outflow passageway <NUM>.

The handset <NUM> includes a pump <NUM> inside the housing <NUM>. The pump <NUM> is coupled to the chamber <NUM> via an outflow line <NUM>. The pump <NUM> is capable of producing sufficient suction at the distal end of the resector to draw the fluid from the organ and through the outflow passageway <NUM>, the chamber <NUM>, and the outflow line <NUM>. The pump is sufficiently compact to permit the handset <NUM> to have a convenient size and an ergonomic shape for easy handling. The pump <NUM> may be a positive displacement pump, such as a gear pump, a diaphragm pump, a peristaltic pump, a cavity pump, a lobe pump, a piston pump, or the like. The magnitude of suction depends on the cutting device, the nature of tissue being cut, and the hydraulic resistance in the extraction path. The suction, for example, may be produced with a vacuum of approximately <NUM> mmHg to approximately <NUM> mmHg. It is understood, however, that the vacuum may be provided according to a range, for example, with a maximum greater than <NUM> mmHg, as required by the operation of the tissue resecting system.

The handset <NUM> also includes a filtration system <NUM>. The pump <NUM> is coupled to the filtration system <NUM> via a connecting line <NUM>. Accordingly, the fluid from the outflow line <NUM> is drawn through the pump <NUM> and to the filtration system <NUM> via the connecting line <NUM>. The filtration system <NUM> includes a filter/tissue trap that removes the tissue and other byproducts from the fluid received by the handset <NUM>. The filter/tissue trap may be removable or otherwise accessible to allow the tissue from the organ to be collected and examined. The filtration system <NUM> is coupled to the inflow line <NUM> which allows filtered fluid to be returned to the organ via an endoscope (e.g., endoscope <NUM>) as described above. Although the pump <NUM> shown in <FIG> is upstream of the filtration system <NUM>, it is understood that in other implementations, the components inside the housing <NUM> may be configured differently so that the pump <NUM> is downstream of the filtration system <NUM> and pulls, rather than pushes, the fluid through the filtration system <NUM>.

As shown in <FIG>, the outflow line <NUM>, the pump <NUM>, the connecting line <NUM>, the filtration system <NUM>, and the inflow line <NUM> are contained in the disposable portion 310A. These components are contaminated by contact with fluid and tissue from the body. As such, the ability to dispose of them after a single use enhances the convenience of using the handset <NUM>. Because the shaft <NUM> (with the outflow passageway <NUM> and the cutting element) also comes into direct contact with the fluid and tissue from the body, it is also conveniently disposable with the other components in the disposable portion 310A.

Additionally, the handset <NUM> includes a motor <NUM> to drive the pump <NUM>. In this implementation, the motor <NUM> is electrically coupled to an external power source, for example, a DC power, via a cable <NUM>. Typically, the tissue extraction and fluid recirculation by the pump <NUM> and the cutting operation occur at the same time, so the same motor <NUM> can be used for the pump <NUM> and the cutting element. Thus, the motor <NUM> drives the shaft <NUM> to generate cutting action with the cutting element (e.g., rotating and/or linearly moving the cutting element in a back-and-forth motion to generate the cutting action). Even if a common motor is employed, however, the fluid flow from the pump can be controlled independently from the cutting operation with the cutting element. The handset <NUM> can include a gear box and clutch <NUM> that divides the drive from the motor <NUM> between the pump <NUM> and the shaft <NUM>.

The handset <NUM> includes a control switch/button <NUM> that activates the pump <NUM> and/or the shaft <NUM> (and the attached cutting element). In some implementations, the motor <NUM> runs and drives the pump <NUM> constantly whenever the cable <NUM> is coupled to the external power source. Meanwhile, the control switch/button <NUM> is selectively operated by the user to engage a clutch that delivers drive from the motor <NUM> to the shaft <NUM>. For example, in some such implementations, the handset <NUM> constantly recirculates fluid through the organ, while the user selectively presses the control switch/button <NUM> to cut tissue from the organ. In other implementations, one control switch/button may be employed to activate fluid recirculation with the pump <NUM>, while another control switch/button may be employed to independently and selectively activate the cutting element. In further implementations, the user presses the control switch/button <NUM> to activate the pump <NUM> and the cutting element simultaneously. In some embodiments, other controls and user interfaces may be provided to control other aspects of the tissue resecting system <NUM>.

Because the motor <NUM> and the gear box and clutch <NUM> are not contaminated by contact with fluid and tissue drawn from the organ, these components can be reused more easily. As such, the motor <NUM> and the gear box and clutch <NUM> are positioned in the reusable portion 310B. In some cases, these components may be more costly than those in the disposable portion 310A. As such, reusing the motor <NUM> and the gear box and clutch <NUM> reduces the marginal cost of using the tissue resecting system <NUM>. The reusable portion 310B may be cleaned and/or sterilized before it is used again.

Referring to <FIG>, another example handset <NUM> is illustrated having a disposable portion 410A and a reusable portion 410B. The handset <NUM> is similar to the handset <NUM> described above and includes many of the same components, where like reference numerals indicate like elements across the Figures. Indeed, like the handset <NUM> in <FIG>, the handset <NUM> may be employed in the tissue resecting system <NUM>. The handset <NUM>, however, does not receive power from an external power source. As shown in <FIG>, the handset <NUM> does not include a cable that extends outwardly to an external power source. Rather, the handset <NUM> includes a battery <NUM> that is coupled to and powers a motor <NUM>, which in turn drives the pump <NUM> and the shaft <NUM> via the gear box and clutch <NUM>, as described above. In an embodiment, the battery <NUM> may be a non-rechargeable battery that must be replaced once its power has been depleted. In other embodiments, the battery <NUM> may be a rechargeable battery that can be coupled to another power source to be replenished.

As shown in <FIG>, the battery <NUM> is conveniently and removably attached to the proximal end of the reusable portion 410B of the handset <NUM>. As such, the handset <NUM> has a housing <NUM> that is defined by a differently configured reusable portion 410B. In some aspects, the handset <NUM> is easier to use as compared with the handset <NUM> because the motion of the handset <NUM> is not restricted by a cable that is connected to an external power source.

Referring to <FIG>, another example handset <NUM> is illustrated having a disposable portion 510A and a reusable portion 510B. The handset <NUM> includes many of the same components of the handsets <NUM> and <NUM>, where like reference numerals indicate like elements across the Figures. Unlike the handsets <NUM> and <NUM>, however, the handset <NUM> does not filter and/or recycle the fluid received from the organ.

As shown in <FIG>, the handset <NUM> includes a pump <NUM> that draws fluid/tissue from the organ through the outflow line <NUM>, but the pump <NUM> does not direct the fluid/tissue to a filtration system and back to the organ. Rather, the fluid/tissue is directed from the handset <NUM> through an external line <NUM> to an external receptacle where the fluid/tissue can be collected for disposal, examination, etc. Thus, the handset <NUM> provides open-ended extraction. With the external line <NUM>, the handset <NUM> includes a housing <NUM> that is defined in part by the disposable portion 510A, which has a different configuration as compared with the handsets <NUM>, <NUM>.

According to aspects of the present disclosure, the implementations provide examples of tissue resecting systems that include easy-to-handle handsets that compactly integrate a pump and other components for extracting fluid/tissue from an organ. In some implementations, the handsets include a filtration system to allow fluid to be recirculated through the organ. The handsets include a disposable portion that allows components that contact the fluid/tissue (e.g., the pump) to be easily disposed, thereby promoting hygienic use of the tissue resecting system. Meanwhile, the handsets include a reusable portion that allows other components (e.g., drive components) to be used more than once, thereby achieving cost savings.

Although the implementations described above may include a first section that is disposable and a second section that is reusable, it is understood that the second section in alternative implementations may also be disposable. Thus, the handset may include a housing that is defined by more than one disposable portion.

It is also understood that other implementations may employ a single disposable housing. Referring to <FIG>, for example, another example handset <NUM> is illustrated. The handset <NUM> includes a housing <NUM> that houses the chamber <NUM>, the outflow passageway <NUM>, the pump <NUM>, the gear box and clutch <NUM>, the motor <NUM>, and a battery <NUM>. Like the handset <NUM> described above, the handset <NUM> does not filter and recirculate fluid drawn from the organ. In other words, the handset <NUM> provides open-ended extraction. Driven by the motor <NUM> via the gear box and clutch <NUM>, the pump <NUM> draws the fluid, tissue, and other byproducts from the organ into the handset <NUM> through the outflow passageway <NUM> and out of the handset <NUM> through the external line <NUM>. Unlike the handset <NUM>, however, the housing <NUM> of the handset <NUM> is not divided into a disposable portion and a reusable portion. Rather, the handset <NUM> is configured to be completely disposable. The motor <NUM> and the battery <NUM> are disposable with the other components of the handset <NUM>. For example, handset <NUM> may include a low-cost motor and a low-cost battery that make single or limited use of the handset <NUM> less prohibitive. Therefore, the handset <NUM> is configured for limited, for example, single, use and convenient disposal. Advantageously, the handset <NUM> promotes hygienic use of the tissue resecting system <NUM>, because it eliminates any need to clean and sterilize any of its components after it has been contaminated, for example, by contact with fluid and tissue from the patient.

It is understood that aspects of the present disclosure are not limited to the implementations described above. For example, in alternative implementations where the cutting element does not require power or the drive of a motor, the motor in the handset only drives the pump. In other implementations, separate motors may be employed to drive the pump and the cutting element, respectively. In yet other implementations, the motor may be disposed externally and coupled to the handset via a rigid or flexible drive shaft, where the handset includes drive components (e.g., gear box and clutch) that deliver the driving force from the motor to the pump, etc..

It is also contemplated that additional implementations according to aspects of the present disclosure may combine any number of features from any of the implementations described herein. For example, referring to <FIG> and <FIG>, an operator may have the option of selectively coupling the same disposable portion 310A with either the reusable portion 310B (external power source) or the reusable portion 410B (onboard battery power). Or referring to <FIG> and <FIG>, an operator may have the option of selectively coupling the same reusable portion 310B with either the disposable portion 310A (fluid filtration/recirculation) or the disposable portion 510A (open-ended extraction, no fluid filtration/recirculation).

Although the implementations described herein may include an endoscope through which a resector passes, it is contemplated that, in other applications, resectors according to aspects of the present disclosure do not pass through a working channel of an endoscope and instead may be employed outside an endoscope (e.g., work along with the endoscope).

Referring to <FIG>, a tissue resecting system <NUM> includes an endoscope <NUM> (e.g., a hysteroscope), which includes an endoscope body <NUM> and an insert portion <NUM> that extends from the endoscope body <NUM> to a distal end. The endoscope insert portion <NUM> is insertable into an organ (e.g., a uterus, a prostate, etc.) of a patient to enable a tissue resecting procedure in the organ. The tissue resecting system <NUM> also includes a resector <NUM> that is received by the endoscope <NUM> to resect tissue from the organ. The resector <NUM> includes a handset <NUM> that is disposed at a proximal end of the endoscope body <NUM>. The resector <NUM> also includes a cutting shaft <NUM> that extends from the handset <NUM> and passes correspondingly through the endoscope body <NUM> and the endoscope insert portion <NUM>. At its distal end, the cutting shaft <NUM> includes a cutting element <NUM> that performs tissue resection. The cutting element <NUM> is disposed beyond the distal end of the endoscope insert portion <NUM> to access tissue in the organ. The handset <NUM> transmits a driving force to the cutting element <NUM> to cut tissue from the organ. The cutting shaft <NUM> may cause the cutting element <NUM> to translate, reciprocate, actuate, rotate, or any combination thereof, thereby generating a cutting action.

As shown in <FIG>, the endoscope <NUM> may also accommodate other devices for the procedure. For example, the endoscope <NUM> includes a camera port <NUM> and a light port <NUM> that may be coupled to a camera (not shown) and an illumination source (not shown), respectively. Together, the camera and the illumination source allow the operator to visualize and capture images from the area around the distal end of the tissue resecting system <NUM>. It is understood, however, that the endoscope <NUM> is shown as an example, and that other similar devices (with fewer or more features) can be employed according to aspects of the present disclosure (e.g., to accommodate the resector <NUM>).

The endoscope <NUM> includes an inlet port <NUM> that is coupled to a main inflow line <NUM>, which delivers fluid (e.g., saline, sorbitol, glycine, etc.) to the endoscope <NUM>. An endoscope inflow passageway <NUM> is formed in the endoscope <NUM> and extends from the inlet port <NUM> to an inflow opening <NUM> at the distal end of the endoscope insert portion <NUM>. As shown in <FIG>, the main inflow line <NUM> receives fluid from a fluid source <NUM> (e.g., a syringe) through a source inflow line <NUM>. The fluid then flows from the main inflow line <NUM>, through the inlet port <NUM>, the inflow passageway <NUM>, and the inflow opening <NUM>, and into the organ at the distal end of the endoscope <NUM>.

The resector <NUM> includes an outflow opening <NUM> at the cutting element <NUM>. An outflow passageway <NUM> extends from the outflow opening <NUM> and through the cutting shaft <NUM>. The handset <NUM> includes an outflow line <NUM> that is coupled to a proximal portion of the outflow passageway <NUM>. The handset <NUM> delivers suction through the outflow line <NUM> and the outflow passageway <NUM>. As the cutting element <NUM> cuts tissue from the organ, the suction draws loose tissue as well as fluid from the organ through the outflow opening <NUM> at the cutting element <NUM>. The fluid/tissue then flows through the outflow passageway <NUM> and the outflow line <NUM> into the handset <NUM>. In other implementations, the outflow line <NUM> of the handset <NUM> may be coupled to an outflow passageway formed in the endoscope insert portion <NUM> (rather than the cutting shaft <NUM>) and the suction extracts the fluid/tissue and through the alternative outflow passageway formed in the endoscope insert portion <NUM>.

The tissue resecting system <NUM> includes a pump that recirculates the fluid through the tissue resecting system <NUM> and the organ. In addition, the tissue resecting system <NUM> includes a filtration system that removes tissue and other material from the recirculating fluid. After receiving the fluid/tissue from the organ through the outflow line <NUM>, the tissue resecting system <NUM> filters the tissue from the fluid. The handset <NUM> includes an inflow line <NUM> that is coupled to the main inflow line <NUM> to deliver the filtered fluid back to the main inflow line <NUM>. Thus, the main inflow line <NUM> receives fluid from the handset <NUM> as well as the fluid source <NUM>. The filtered fluid flows through the inflow passageway <NUM> of the endoscope <NUM> and into the organ.

To summarize the fluid path in the tissue resecting system <NUM>, fluid is introduced into the tissue resecting system <NUM> through the source inflow line <NUM>. The fluid from the source inflow line <NUM> flows through the main inflow line <NUM>, the inlet port <NUM>, the inflow passageway <NUM>, and the inflow opening <NUM> and into the organ. The fluid and tissue is then drawn from the organ through the outflow opening <NUM>, the outflow passageway <NUM>, the outflow line <NUM>, and into the handset <NUM>. The fluid is filtered and flows through the inflow line <NUM> and back into the main inflow line <NUM>. Thus, the tissue resecting system <NUM> illustrated in <FIG> is configured to extract fluid from an organ and filter the fluid for delivery back into the organ. Recirculating the fluid in this manner minimizes the amount of working fluid required for a procedure.

As shown in <FIG>, the tissue resecting system <NUM> includes a footswitch <NUM> that activates and controls aspects of the tissue resecting system <NUM>. For example, the footswitch <NUM> is coupled to the handset <NUM>, via a flexible drive shaft <NUM>, to drive the pump and/or the cutting element <NUM> (e.g., via the cutting shaft <NUM>). The footswitch <NUM> may be positioned relative to the endoscope <NUM> and resector <NUM> so that the user can manipulate the endoscope <NUM> and the resector <NUM> with his/her hands while operating the footswitch <NUM> with his/her feet. For example, the footswitch <NUM> may be placed on the floor while the endoscope <NUM> and the resector <NUM> are used on a patient disposed above on an operating/examination table. The footswitch <NUM> includes a body <NUM> with an upper surface <NUM>. To operate the footswitch <NUM>, the user applies a force against the upper surface <NUM> (e.g., with his/her foot). For example, the force may cause the upper surface <NUM> to pivot or to move or otherwise deform mechanically relative to the rest of the body <NUM>, and the mechanical action generates an electrical signal that activates and controls aspects of the tissue resecting system <NUM>. The mechanical action may close an electrical circuit that in turn sends the electrical signal. Or the mechanical action may be otherwise converted into the electrical signal by an appropriate transducer.

The footswitch <NUM> is configured to minimize the footprint of the tissue resecting system <NUM>. Rather than employing a separate controller device (e.g., computer) to control the pump (e.g., pump <NUM> in <FIG>) and/or the cutting element <NUM>, the tissue resecting system <NUM> houses control elements <NUM> in the footswitch <NUM>. The control elements <NUM> may include one or more printed circuit board (PCB) assemblies with one or more processors that control aspects of the tissue resecting system <NUM> according to stored program instructions and input parameters. When the footswitch <NUM> is activated, for example, by the application of a force on the upper surface <NUM>, the resulting electrical signal is delivered to the control elements <NUM> in the footswitch <NUM>, which in turn activate aspects of the tissue resecting system <NUM> according to desired parameters. In some implementations, the control elements <NUM> may cause the cutting element <NUM> to operate according to a selected cutting speed and/or may cause the pump to recirculate the fluid in the tissue resecting system <NUM> according to a selected flow rate.

The footswitch <NUM>, as shown in <FIG>, also contains a suitably rated electrical transformer <NUM> to convert the main electrical supply into suitable voltages for powering and controlling aspects of the tissue resecting system <NUM>. The footswitch <NUM> may receive electrical power from an external source via an electrical cable <NUM>. However, the footswitch <NUM> (and the other implementations described herein) may house a battery of sufficient capacity (e.g., a rechargeable battery) to remove the need for an electrical connection to an external source.

As shown further in <FIG>, the tissue resecting system <NUM> includes a separate user interface <NUM> that allows the user to monitor the operation of the tissue resecting system <NUM> and to enter any information required for the tissue resecting process. The user may employ the user interface <NUM> to set parameters for the control elements <NUM> housed in the footswitch <NUM>. The user interface <NUM> includes a display screen <NUM> as well as user inputs <NUM> (e.g., pushbuttons, switches, etc.). Alternatively or additionally, the user interface <NUM> may include a touch screen. For example, the user may set a cutting speed for the cutting element <NUM> and/or set a flow rate for the recirculation of fluid through the tissue resecting system <NUM>. The parameter settings and other input information are communicated to the footswitch <NUM> for use by the control elements <NUM>. The selected parameters are displayed on the user interface <NUM> along with any feedback information from the control elements <NUM>.

As shown in <FIG>, the communication between the footswitch <NUM> and the user interface <NUM> occurs over a wireless connection (e.g., via radio frequency (RF) technology, such as BLUETOOTH®, etc.). Using a wireless connection, the user interface <NUM> can be easily positioned in a desired location, for example, within reach of the surgeon in the sterile field or within reach of an assistant outside the sterile field, without needing to arrange inconvenient cables or wires. However, in alternative implementations, the footswitch <NUM> and the user interface <NUM> may communicate over a wired connection.

In contrast to other tissue resecting systems that require many separate components to be assembled and organized, features of the resecting system <NUM> are compactly integrated into relatively fewer components. As described above, for example, the implementation of <FIG> incorporates the control elements <NUM> into the footswitch <NUM>, thereby eliminating the need for a separate controller device. Reducing the number of separate components in the system saves significant space in the operating room or office environment and minimizes or eliminates the number of trailing hazards posed by tubes and cables. In general, according to aspects of the present disclosure, a footswitch can integrate many of the components required for recirculating fluid through an organ as well as cutting and extracting tissue from the organ. Advantageously, the configuration of the footswitch makes the tissue resecting system <NUM> highly compact, portable, and easy to set up and operate.

Referring to <FIG>, another implementation of a tissue resecting system <NUM> is illustrated. The tissue resecting system <NUM> includes a resector <NUM>, which may be combined with an endoscope (not shown) that is the same as, or similar to, the endoscope <NUM> of <FIG>. The resector <NUM> includes a handset <NUM> with a housing <NUM> that contains many of the components required for cutting and extracting tissue from an organ and recirculating fluid through the organ. The resector <NUM> also includes a cutting shaft <NUM> that extends distally from the handset <NUM> and through the endoscope. The cutting shaft <NUM> is employed to generate a cutting action (e.g., translating, rotating, reciprocating, or any combination thereof) with a distal cutting element (not shown), which is positioned within an organ by the endoscope.

Similar to the embodiment shown in <FIG>, the handset <NUM> includes an outflow line <NUM> that receives fluid from the organ and an inflow line <NUM> that returns filtered fluid to the organ. As shown in <FIG>, the handset <NUM> includes a pump <NUM> inside the housing <NUM>. The pump <NUM> is coupled to the outflow line <NUM> which extends into the housing <NUM>. The pump <NUM> is capable of producing sufficient suction at the distal end of the resector to draw the fluid from the organ and through the outflow line <NUM>. The pump <NUM> is sufficiently compact to permit the handset <NUM> to have a convenient size and an ergonomic shape for easy handling. The pump <NUM> may be a positive displacement pump, such as a gear pump, a diaphragm pump, a peristaltic pump, a cavity pump, a lobe pump, a piston pump, or the like. The magnitude of suction depends on the cutting device, tissue nature, and the hydraulic resistance in the extraction path. The suction, for example, may be produced with a vacuum of approximately <NUM> mmHg to approximately <NUM> mmHg.

The handset <NUM> also includes a filtration system <NUM>. The pump <NUM> is coupled to the filtration system <NUM> via a connecting line <NUM>. Accordingly, the fluid from the outflow line <NUM> is drawn through the pump <NUM> and to the filtration system <NUM> via the connecting line <NUM>. The filtration system <NUM> includes a filter/tissue trap that removes the tissue and other material from the fluid received by the handset <NUM>. The filter/tissue trap may be removable or otherwise accessible to allow the tissue from the organ to be collected and examined. The filtration system <NUM> is coupled to the inflow line <NUM>, which allows filtered fluid to be returned to the organ via an endoscope as described herein. While the filtration system <NUM> is shown as being downstream from the pump <NUM>, in alternative implementations, the filtration system <NUM> can be positioned upstream of the pump <NUM>, such that the fluid is filtered prior to reaching the pump <NUM>.

Additionally, the tissue resecting system <NUM> includes a footswitch <NUM>. The footswitch includes a motor <NUM> to drive the pump <NUM>. Typically, the tissue extraction and fluid recirculation by the pump <NUM> and the cutting operation occur at the same time, so the same motor <NUM> can be used for the pump <NUM> and the cutting element. Thus, the motor <NUM> drives the cutting shaft <NUM> to generate the cutting action with the cutting element. Even if a common motor is employed, however, the fluid flow from the pump <NUM> can be controlled independently from the cutting operation with the cutting shaft <NUM>. Thus, the handset <NUM> includes a gear box and clutch <NUM> that divides the drive from the motor <NUM> between the pump <NUM> and the cutting shaft <NUM>. The motor <NUM> is coupled to a proximal end of the handset <NUM> and drives the gear box and clutch <NUM> via a flexible drive shaft <NUM>. The flexible drive shaft <NUM> is coupled to the gear box and clutch <NUM> via a connecting drive shaft <NUM>. The flexibility of the drive shaft <NUM> provides sufficient freedom of motion to permit the resector <NUM> to be freely manipulated.

The footswitch <NUM> includes a body <NUM> with an upper surface <NUM>. Similar to the footswitch <NUM> of <FIG>, the user applies a force against the upper surface <NUM> (e.g., with his/her foot) to operate the footswitch <NUM>. Mechanical action resulting from the force against the upper surface <NUM> generates an electrical signal that delivers power to and drives the motor <NUM>, which in turn drives the flexible drive shaft <NUM>. In some implementations, the user must apply continuous pressure to the upper surface <NUM> to drive the motor <NUM> continuously. In other implementations, the user applies a force to turn on the power that continuously drives the motor <NUM>, and the user subsequently applies a separate force to turn off the power to and stop the motor <NUM>.

The footswitch <NUM> also includes control elements <NUM> (e.g., PCB assemblies with one or more processors). In particular, the control elements <NUM> allow the motor <NUM> and thus the flexible drive shaft <NUM> to be driven according to selected parameters, such as revolutions per minute (RPM), which in turn determine how the pump <NUM> and the cutting element operate.

The handset <NUM> includes a control switch/button <NUM> that activates the pump and/or the cutting shaft <NUM> while the flexible drive shaft <NUM> is being driven by the motor <NUM>. The control switch/button <NUM> is selectively operated by the user to engage the gear box and clutch <NUM> to deliver drive from the flexible drive shaft <NUM> to the cutting shaft <NUM> and to the pump <NUM>. In other implementations, one control switch/button may be employed to activate fluid recirculation with the pump <NUM>, while another control switch/button may be employed to independently and selectively activate the cutting shaft <NUM>. Other controls may be provided on the handset <NUM> to control other aspects of the tissue resecting system.

Because the motor <NUM> is disposed in the footswitch <NUM>, it can be reused with the footswitch <NUM>. The flexible drive shaft <NUM> can be decoupled from the handset <NUM>, and because it does not become contaminated by direct contact with fluid and tissue from the patient, it too can be reused. In some cases, the motor <NUM> and the flexible drive shaft <NUM> may be more costly than the other components of the resector <NUM>. As such, reusing the motor <NUM> and the flexible drive shaft <NUM> advantageously reduces the marginal cost of using the tissue resecting system <NUM>. In some implementations, the footswitch <NUM> and/or the flexible drive shaft <NUM> may require cleaning/sterilization before they are used again.

Meanwhile, the resector <NUM> includes components that come into direct contact with fluid and tissue from the patient. Such components include the cutting element, the cutting shaft <NUM>, the outflow line <NUM>, the pump <NUM>, the connecting line <NUM>, the filtration system <NUM>, and the inflow line <NUM>. After each use, the resector <NUM> can be conveniently decoupled from the flexible drive shaft <NUM> and discarded, while the same flexible drive shaft <NUM> and footswitch <NUM> can be coupled to a new resector <NUM> for another use. Allowing the resector <NUM> to be disposable promotes hygienic use of the tissue resecting system <NUM>, because it eliminates the need to sterilize the resector <NUM> after it has been contaminated. However, allowing the motor <NUM> and the flexible drive shaft <NUM> to be reused reduces cost, because it does not require all components of the tissue resecting system <NUM> to be discarded after only one use. Advantageously, the tissue resecting system <NUM> provides the convenience of disposable components while avoiding the costs of a system that requires disposal of more costly components that do not come into direct contact with fluid and tissue from the patient.

As shown in <FIG>, the footswitch <NUM> also includes a user interface <NUM> that eliminates the need for a separate user interface, such as the user interface <NUM> shown in <FIG>. Like the user interface <NUM>, however, the user interface <NUM> allows the user to monitor the operation of the tissue resecting system <NUM> and to enter any information required for the tissue resecting process. The user interface <NUM> includes a display screen <NUM> as well as user inputs <NUM> (e.g., pushbuttons, switches, etc.). Alternatively or additionally, the user interface <NUM> may include a touch screen. The user may employ the user interface <NUM> to set parameters for the control elements <NUM> housed in the footswitch <NUM>. For example, the user may set a cutting speed for the cutting element and/or set a flow rate for the recirculation of fluid through the tissue resecting system <NUM>. The selected parameters are displayed on the user interface <NUM> along with any feedback from the control elements <NUM>. The information displayed on the user interface <NUM> is sufficiently visible even when the footswitch <NUM> is placed on the floor for operating the tissue resecting system <NUM>. Additionally, in some implementations, the user inputs <NUM> are designed to be readily operated by the foot of the user. By incorporating the user interface <NUM> into the footswitch <NUM>, even fewer separate components are required for the tissue resecting system <NUM>. Again, the configuration of the footswitch <NUM> makes the tissue resecting system <NUM> highly compact, portable, and easy to deploy and operate.

Referring to <FIG>, yet another example tissue resecting system <NUM> is illustrated. The tissue resecting system <NUM> includes a resector <NUM>, which may be combined with an endoscope (not shown) that is, the same as, or similar to, the endoscope <NUM> of <FIG>. The resector <NUM> includes a handset <NUM> with a housing <NUM>. The resector <NUM> also includes a cutting shaft <NUM> that extends distally from the handset <NUM> and through the endoscope. The cutting shaft <NUM> is employed to generate a cutting action (e.g., translating, rotating, reciprocating, or any combination thereof) with a distal cutting element (not shown), which is positioned within an organ by the endoscope.

Similar to the implementations shown in <FIG> and <FIG>, the handset <NUM> includes an outflow line <NUM> that receives fluid from the organ and an inflow line <NUM> that returns filtered fluid to the organ. As shown in <FIG>, however, the handset <NUM> does not includes a pump or filtration system in the housing <NUM>. Instead, the tissue resecting system <NUM> includes a pump <NUM> and a filtration system <NUM> that are separate components disposed outside the housing <NUM>. The pump <NUM> is coupled to the handset <NUM> via a pump line <NUM>. The pump line <NUM> is removably coupled to a proximal end of the handset <NUM> where it is connected to the outflow line <NUM>, which extends through the housing <NUM> of the handset <NUM>. The pump <NUM> is capable of producing sufficient suction to draw the fluid from the organ and through the outflow line <NUM> and the pump line <NUM>. The pump <NUM> may be a positive displacement pump, such as a gear pump, a diaphragm pump, a peristaltic pump, a cavity pump, a lobe pump, a piston pump, or the like. The magnitude of suction depends on the cutting device, tissue nature, and the hydraulic resistance in the extraction path.

The pump <NUM> is coupled to the filtration system <NUM>. Accordingly, the fluid from the outflow line <NUM> is drawn through the pump line <NUM> by the pump <NUM> and to the filtration system <NUM>. The filtration system <NUM> includes a filter/tissue trap that removes the tissue and other material from the fluid received by the handset <NUM>. The filter/tissue trap may be removable or otherwise accessible to allow the tissue from the organ to be collected and examined. The filtration system <NUM> is coupled to the handset <NUM> via a filtration system line <NUM>. The filtration system line <NUM> is removably coupled to the proximal end of the handset <NUM> where it is connected to the inflow line <NUM>, which also extends through the handset <NUM>. The filtration system line <NUM> allows filtered fluid to be returned to the inflow line <NUM> and to the organ via an endoscope as described above.

Additionally, the tissue resecting system <NUM> includes a footswitch <NUM>. The footswitch includes a motor <NUM> to drive the pump <NUM> as well as the cutting shaft <NUM> to generate the cutting action with the cutting element. The fluid flow from the pump <NUM> can be controlled independently from the cutting operation with the cutting shaft <NUM>. Thus, the footswitch <NUM> includes a gear box and clutch <NUM> that divides the drive from the motor <NUM> between the pump <NUM> and the cutting shaft <NUM>. The gear box and clutch <NUM> is coupled to and drives the pump <NUM> via a flexible pump drive shaft <NUM>. The flexibility of the pump drive shaft <NUM> provides sufficient freedom of motion to permit the pump <NUM> to be conveniently positioned relative to the footswitch <NUM>.

The gear box and clutch <NUM> is coupled to and drives the cutting shaft <NUM> via a flexible cutting drive shaft <NUM>. The flexible cutting drive shaft <NUM> is removably coupled to the proximal end of the handset <NUM> where it is connected to the cutting shaft <NUM>, which extends through the housing <NUM> of the handset <NUM>. The flexibility of the drive shaft <NUM> provides sufficient freedom of motion to permit the resector <NUM> to be freely manipulated.

The footswitch <NUM> includes a body <NUM> with an upper surface <NUM>. The user applies a force against the upper surface <NUM> (e.g., with his/her foot) to operate the footswitch <NUM>. Mechanical action resulting from the force against the upper surface <NUM> generates an electrical signal that delivers power to and drives the motor <NUM>, which in turn drives the flexible cutting drive shaft <NUM> and the flexible pump drive shaft <NUM>. The footswitch <NUM> also includes control elements <NUM> (e.g., one or more PCB assemblies with one or more processors). In particular, the control elements <NUM> allow the motor <NUM> and thus the flexible cutting drive shaft <NUM> and the flexible pump drive shaft <NUM> to be driven according to selected parameters, such as revolutions per minute (RPM), which in turn determine how the cutting shaft <NUM> and the pump <NUM> operate. The footswitch <NUM> is selectively operated by the user to engage the gear box and clutch <NUM> to deliver drive to the flexible cutting drive shaft <NUM> and the flexible pump drive shaft <NUM>. As shown in <FIG>, the footswitch <NUM> receives electrical power from an external source via an electrical cable <NUM> and includes an electrical transformer <NUM> to convert the main electrical supply into suitable voltages for powering and controlling aspects of the tissue resecting system <NUM>.

The footswitch <NUM> also includes a user interface <NUM> that eliminates the need for a separate user interface, such as the user interface <NUM> shown in <FIG>. Like the user interface <NUM> described above, the user interface <NUM> allows the user to monitor the operation of the tissue resecting system <NUM> and to enter any information required for the tissue resecting process (e.g., set parameters for the control elements <NUM> housed in the footswitch <NUM>). The user interface <NUM> includes a display screen <NUM> as well as user inputs <NUM> (e.g., pushbuttons, switches, etc.). Alternatively or additionally, the user interface <NUM> may include a touch screen.

Like the motor <NUM> and the flexible drive shaft <NUM> described above, the motor <NUM>, the flexible drive shaft <NUM>, and the flexible pump drive shaft <NUM> can be reused, while other components that come into direct contact with fluid and tissue from the patient can be conveniently discarded after a single use. Such disposable components include the resector <NUM>, the pump <NUM>, the pump line <NUM>, the filtration system <NUM>, and the filtration system line <NUM>. Allowing these components to be disposable promotes hygienic use of the tissue resecting system <NUM>, because it eliminates the need to sterilize the components after they have been contaminated. After each use of the tissue resecting system <NUM>, the resector <NUM>, and the pump <NUM> can be conveniently decoupled from the flexible cutting drive shaft <NUM> and the flexible pump drive shaft <NUM> and discarded along with the pump line <NUM>, the filtration system <NUM>, and the filtration system line <NUM>. Meanwhile, the same footswitch <NUM>, the flexible cutting drive shaft <NUM>, and the flexible pump drive shaft <NUM> can be coupled to a new resector <NUM>, pump <NUM>, filtration system <NUM>, etc., for another use. Allowing the motor <NUM>, the flexible cutting drive shaft <NUM>, and the flexible pump drive shaft <NUM> to be reused reduces the marginal cost of using the tissue resecting system <NUM>.

Because the pump <NUM> and the filtration system <NUM> are not included in the housing <NUM> of the handset <NUM>, the tissue resecting system <NUM> may include more separate components than, for example, the tissue resecting system <NUM> described above. The configuration of the resector <NUM> is simplified, however, because the handset <NUM> only houses the inflow line <NUM>, the outflow line <NUM>, and the cutting shaft <NUM>. The disadvantages of having more separate components in the tissue resecting system <NUM> may be offset by the simpler configuration for the resector <NUM>, which is simpler and less expensive to manufacture. Moreover, with fewer components included in the resector <NUM>, the resector <NUM> is relatively lighter and easier to hold and operate, and further can be completely and thus conveniently discarded after a single use.

Referring to <FIG>, a further example tissue resecting system <NUM> is illustrated. The tissue resecting system <NUM> includes a resector <NUM>, which may be combined with an endoscope (not shown) that is the same as, or similar to, the endoscope <NUM> of <FIG>. The resector <NUM> includes a handset <NUM> with a housing <NUM>. The resector <NUM> also includes a cutting shaft <NUM> that extends distally from the handset <NUM> and through the endoscope. The cutting shaft <NUM> is employed to generate a cutting action (e.g., translating, rotating, reciprocating, or any combination thereof) with a distal cutting element (not shown), which is positioned within an organ by the endoscope.

The handset <NUM> includes an outflow line <NUM> that receives fluid from the organ and an inflow line <NUM> that returns filtered fluid to the organ. Similar to the handset <NUM> shown in <FIG>, the handset <NUM> does not include a pump or filtration system in the housing <NUM>. Instead, the tissue resecting system <NUM> includes a footswitch <NUM> that houses a pump <NUM> and a filtration system <NUM> separately from the handset <NUM>.

The pump <NUM> is coupled to the handset <NUM> via a pump line <NUM>. The pump line <NUM> is removably coupled to a proximal end of the handset <NUM> where it is connected to the outflow line <NUM>, which extends through the housing <NUM> of the handset <NUM>. The pump <NUM> is capable of producing sufficient suction to draw the fluid from the organ and through the outflow line <NUM> and the pump line <NUM>. The pump <NUM> is sufficiently compact to permit the footswitch <NUM> to have a convenient size and shape for easy operation. The pump <NUM> may be a positive displacement pump, such as a gear pump, a diaphragm pump, a peristaltic pump, a cavity pump, a lobe pump, a piston pump, or the like. The magnitude of suction depends on the cutting device, tissue nature, and the hydraulic resistance in the extraction path.

The pump <NUM> is coupled to the filtration system <NUM>. Accordingly, the fluid from the outflow line <NUM> is drawn through the pump line <NUM> by the pump <NUM> and to the filtration system <NUM>. The filtration system <NUM> includes a filter/tissue trap that removes the tissue and other material from the fluid received through the handset <NUM>. The filter/tissue trap may be removable or otherwise accessible to allow the tissue from the organ to be collected and examined. The filtration system <NUM> is coupled to the handset <NUM> via a filtration system line <NUM>. The filtration system line <NUM> is removably coupled to the proximal end of the handset <NUM> where it is connected to the inflow line <NUM> which also extends through the housing <NUM> of the handset <NUM>. The filtration system line <NUM> allows filtered fluid to be returned to the inflow line <NUM> and to the organ via an endoscope as described above.

The footswitch <NUM> also includes a motor <NUM> to drive the pump <NUM> and the cutting shaft <NUM> to generate the cutting action with the cutting element. The fluid flow from the pump <NUM> can be controlled independently from the cutting operation with the cutting element. Thus, the footswitch <NUM> includes a gear box and clutch <NUM> that divides the drive from the motor <NUM> between the pump <NUM> and the cutting shaft <NUM>. The gear box and clutch <NUM> is coupled to and drives the pump <NUM> via a pump drive coupling <NUM>. As shown in <FIG>, the drive coupling <NUM> may be a flexible drive shaft to allow the components in the footswitch <NUM> to be compactly arranged, but it is understood that other structures for transmitting the drive from the motor <NUM> to the pump <NUM> may be employed.

The gear box and clutch <NUM> is also coupled to and drives the cutting shaft <NUM> via a flexible cutting drive shaft <NUM>. The flexible cutting drive shaft <NUM> is removably coupled to the proximal end of the handset <NUM> where it is connected to the cutting shaft <NUM> which extends through the housing <NUM> of the handset <NUM>. The flexibility of the drive shaft <NUM> provides sufficient freedom of motion to permit the resector <NUM> to be freely manipulated.

The footswitch <NUM> includes a body <NUM> with an upper surface <NUM>. The user applies a force against the upper surface <NUM> (e.g., with his/her foot) to operate the footswitch <NUM>. Mechanical action resulting from the force against the upper surface <NUM> generates an electrical signal that delivers power to and drives the motor <NUM>, which in turn drives the flexible drive shaft <NUM> and the pump drive coupling <NUM>. The footswitch <NUM> includes control elements <NUM> (e.g., one or more PCB assemblies with one or more processors). In particular, the control elements <NUM> allow the motor <NUM> and thus the flexible drive shaft <NUM> and the pump drive coupling <NUM> to be driven according to selected parameters, such as revolutions per minute (RPM), which in turn determine how the cutting shaft <NUM> and the pump <NUM> operate. The footswitch <NUM> is selectively operated by the user to engage the gear box and clutch <NUM> to drive the flexible drive shaft <NUM> and the pump drive coupling <NUM>. As shown in <FIG>, the footswitch <NUM> receives electrical power from an external source via an electrical cable <NUM> and includes an electrical transformer <NUM> to convert the main electrical supply into suitable voltages for powering and controlling of aspects of the tissue resecting system <NUM>.

The footswitch <NUM> also includes a user interface <NUM> that eliminates the need for a separate user interface, such as the user interface <NUM> shown in <FIG>. Like the user interfaces <NUM> and <NUM> described above, the user interface <NUM> allows the user to monitor the operation of the tissue resecting system <NUM> and to enter any information required for the tissue resecting process (e.g., set parameters for the control elements <NUM> housed in the footswitch <NUM>). The user interface <NUM> includes a display screen <NUM> as well as user inputs <NUM> (e.g., pushbuttons, switches, etc.). Alternatively or additionally, the user interface <NUM> may include a touch screen.

The resector <NUM>, the pump <NUM>, the pump line <NUM>, the filtration system <NUM>, and the filtration system line <NUM> come into direct contact with fluid and tissue from the patient. Conveniently, the resector <NUM>, the pump line <NUM>, and the filtration system line <NUM> can be decoupled from the footswitch <NUM> and completely discarded after a single use. The footswitch <NUM>, however, houses the pump <NUM> and the filtration system <NUM> with other components that do not come into direct contact with fluid and tissue from the patient. Thus, the footswitch <NUM> is configured to allow the pump <NUM> and the filtration system <NUM> to be removed and discarded after single use, while the rest of the footswitch <NUM> can be reused with a new pump <NUM> and a new filtration system <NUM>.

The footswitch <NUM> may be defined by separable disposable and reusable portions. The disposable portion includes the pump <NUM> and the filtration system <NUM>. Meanwhile, the reusable portion includes the control elements <NUM>, the electrical transformer <NUM>, the motor <NUM>, the gear box and clutch <NUM>, the user interface <NUM>, etc., which can be used more than one time. These reusable components are sometimes more costly. In some implementations, the disposable portion may be configured as a removable cartridge intended to be discarded after only one use. The removable cartridge may be detachably coupled to the rest of the footswitch <NUM>. After each use, the disposable cartridge is detached and discarded. Each disposable cartridge may be individually and sterilely packaged.

Allowing components, such as the pump <NUM> and the filtration system <NUM>, to be easily removed for disposal promotes hygienic use of the tissue resecting system <NUM>, because it eliminates the need to sterilize such components after they have been contaminated. Meanwhile, allowing other components to be reused reduces cost, because it does not require all components of the tissue resecting system <NUM> to be discarded after only one use. Advantageously, the tissue resecting system <NUM> provides the convenience of disposable components while avoiding the costs of a completely disposable system. Accordingly, the footswitch <NUM> contains many of the components required for cutting and extracting tissue from an organ and recirculating fluid through the organ. By incorporating the control elements <NUM>, the user interface <NUM>, the pump <NUM>, the filtration system <NUM>, etc., into the footswitch <NUM>, the tissue resecting system <NUM> reduces the number of separate components that would have to be assembled and organized for a procedure. In general, the tissue resecting system <NUM> can perform a procedure with three basic components: an endoscope (e.g., the endoscope <NUM> shown in <FIG>), the resector <NUM>, and the footswitch <NUM>.

In addition, by incorporating many components into the footswitch <NUM>, the configuration of the resector <NUM> is simplified as the handset <NUM> only houses the inflow line <NUM>, the outflow line <NUM>, and the cutting shaft <NUM>. The simplified resector <NUM> may be simpler and less expensive to manufacture. Moreover, with fewer components included in the resector <NUM>, the resector <NUM> is relatively lighter and easier to hold and operate, and further can be completely and thus conveniently discarded after a single use.

<FIG> is a perspective view of a tissue resecting handset <NUM> that comprises a reusable portion <NUM> and a disposable portion <NUM> in accordance with yet still other embodiments. The handset <NUM> may be coupled to a plurality of peripheral devices including a power source, fluid source, filtration device, and pump, as discussed below in detail in <FIG>. The handset <NUM> is configured so that the reusable portion <NUM> and the disposable portion <NUM> are engaged along a plurality of locking features on each portion and disengaged after use, at which point the disposable portion is disposed and the reusable portion is either cleaned but not sterilized, or cleaned and sterilized, depending upon the embodiment and configuration of the handset <NUM>. The handset may comprise an elongated shaft <NUM> having an aperture <NUM> at a distal end <NUM> of the elongated shaft <NUM>. A cutting element <NUM> is disposed within the elongated shaft <NUM> in operational relationship to the aperture <NUM>.

<FIG> is a partial perspective view of a disposable portion <NUM> of a handset. In an embodiment, the disposable portion <NUM> comprises a central axis <NUM>, a tapered distal end of the handle portion <NUM> and a proximal end <NUM>. The disposable portion <NUM> further comprises an overall length <NUM> comprising a first portion <NUM> and a second portion <NUM>, the first portion <NUM> comprising a length <NUM>, the first portion <NUM> may also be referred to as the hub section <NUM> since a rotational hub is disposed in the hub section (the rotational hub is illustrated and discussed below in at least <FIG>). The distal end of the hub section <NUM> comprises an instrument engagement feature <NUM> where an elongated shaft comprising a cutting element may be disposed (only a portion of the elongated shaft is visible). The tapered distal end of the handle portion <NUM> is defined by a first elliptical feature <NUM> comprising a largest outer diameter <NUM> and a second elliptical feature <NUM> comprising a largest outer diameter <NUM>, a length <NUM>, and a smooth transition surface <NUM> between the first <NUM> and the second elliptical feature <NUM> circumferentially around the hub section <NUM>. The distal end of the hub section <NUM> may be defined in various configurations and geometries. In an embodiment, the distal end of the hub section <NUM> may be further defined by an apex <NUM> and a bottom smoothly curved surface <NUM>, both along the second elliptical feature <NUM>, and an apex <NUM>, and an elongated shaft <NUM> that is in communication with a fluid path within the hub portion <NUM>, not shown here. The hub section <NUM> comprises a proximal portion length <NUM> and a proximal end <NUM> configured to mate with a reusable portion (not pictured) via a plurality of locking features. The second portion <NUM> comprises a length <NUM>, a first surface <NUM>, and a second surface <NUM>, and may also be referred to as the mating section <NUM>. The first <NUM> and second <NUM> surfaces extend from the proximal end <NUM> of the hub section <NUM> to the proximal end <NUM> of the disposable portion <NUM> parallel to the central axis <NUM>. While the mating section <NUM> is illustrated here in one embodiment, in alternate embodiments, it may be different in length or otherwise vary as appropriate for the design of the disposable portion <NUM>.

In an embodiment, a channel <NUM> extends for at least a portion of the mating section <NUM>. The mating section <NUM> may comprise a plurality of locking features <NUM>, which may be formed and/or disposed on any or all of the first surface <NUM>, the second surface <NUM>, and/or an interior surface <NUM> of the channel <NUM>. The plurality of locking features <NUM> may be disposed in various patterns, configurations using varying geometries and styles. The plurality of locking features <NUM> may comprise guide tracks (as shown in <FIG>), rails, press-fit features, snap-fit features, pins, fasteners, frictional engagement, threads, or combinations thereof as appropriate. The elongated shaft <NUM> may extend beyond that shown in <FIG> and may comprise the cutting element <NUM> (<FIG>), and in some embodiments as shown above the elongated shaft <NUM> may be telescoped through the working channel of an endoscope. The elongated shaft <NUM> engages with a fluid channel (not shown here) that extends through both the hub section and the mating section of the disposable portion <NUM>, and fluid and/or tissue are resected and drawn from an organ through the elongated shaft <NUM>, into the fluid channel through the disposable portion <NUM> to the proximal end <NUM>. The proximal end <NUM> may be configured to fluidly couple at least to a waste, collection, filtration, or other apparatus configured to receive at least one of fluid and/or tissue removed from the organ.

<FIG> is a cross sectional view 800A taken along line 11B-11B in <FIG>. In particular, <FIG> illustrates the central axis <NUM>, fluid path <NUM> through the hub section. The fluid path <NUM> may comprise a consistent diameter throughout, or may be tapered, depending upon the embodiment. <FIG> also illustrates a driver connector <NUM>, in some embodiment in the form of a counter-bore into the rotating hub 814into which a hub drive shaft of the reusable portion (discussed below) telescopes as part of being detachably connected. Also visible is the rotating hub <NUM>, which may be fluidly isolated from the reusable portion by a seal <NUM>, which may comprise an o-ring, a shaft seal, or a spring seal.

<FIG> is a perspective view <NUM> of the disposable portion <NUM>, illustrated from the proximal end <NUM> looking towards the distal end in order to illustrate the locking and other mating features. The view <NUM> illustrates the central axis <NUM>, and a rotating hub <NUM> is disposed in the hub portion <NUM> exposed to the mating section. The rotating hub <NUM> defines the driver connector <NUM>, in some embodiment in the form of a counter-bore into the rotating hub <NUM>. Also illustrated in the view <NUM> are a third flat surface <NUM> located on the proximal end <NUM> of the hub section <NUM>, and the third flat surface <NUM> may comprise a plurality of locking features <NUM> as discussed above. The seal <NUM> is not illustrated in this view, as the rotating hub <NUM> is only partially exposed in this embodiment. Also illustrated are the additional locations for locking features <NUM>, including the interior surface <NUM> of the channel <NUM>, the first surface <NUM> extending from the proximal end <NUM> of the hub portion <NUM> to the proximal end <NUM> on the first side <NUM> and comprising a width <NUM>, and the second surface <NUM> extending from the proximal end <NUM> of the hub portion <NUM> to the proximal end <NUM> on a second side <NUM> and comprising a width <NUM>.

<FIG> and13B are schematic illustrations of a perspective view 1700A (<FIG>) and an end elevation view 1700B (<FIG>) of a reusable portion of a handset. <FIG> illustrates the perspective view 1700A of the reusable portion, which comprises an outer casing defined by a smoothly curved upper surface <NUM>, a first side <NUM> and a second side <NUM> that are parallel to the central axis <NUM>. The smoothly curved upper surface <NUM> joins the first side <NUM> and the second side <NUM> by way of shelves <NUM> (the shelves <NUM> are perpendicular to their respective sides <NUM> and <NUM>). In an embodiment, the example reusable portion also comprises a bottom feature that may be a flat bottom feature <NUM> perpendicular to the sides <NUM> and <NUM>. The outer casing extends along a length from a distal end <NUM> to a proximal end <NUM> along a central axis <NUM>. The reusable portion 1700A comprises a motor and a heat sink <NUM> as well as a plurality of electronic components <NUM> and at least one connection port <NUM> that may be used to supply power to the reusable portion and/or to connect to peripheral devices. The motor <NUM> and the plurality of electronic components <NUM> may be in various configurations disposed adjacent to one another or spaced a predetermined distance from each other, depending upon the embodiment. The motor <NUM> may comprise a hub drive shaft <NUM> that extends from the motor <NUM> at the distal end <NUM>, parallel to the central axis <NUM>. When the reusable portion is coupled to the mating section of disposable portion, the hub drive shaft <NUM> couples to the rotating hub of the disposable portion, as illustrated in <FIG>. The reusable portion shown in view 1700A may further comprise a plurality of locking features <NUM> formed on at least one of the sides <NUM> and <NUM>. In some embodiments, the shelves <NUM> are parallel to both the central axis <NUM> and perpendicular to the sides <NUM> and <NUM>, and may comprise locking features (which are not visible in the view of <FIG>). The locking features <NUM> may comprise tabs (such as shown in <FIG>), guide rails, press-fit features, snap-fit features, pins, fasteners, frictional engagement, threads, or combinations thereof as appropriate, and are configured to mate with some or all of the plurality of locking features <NUM> discussed in <FIG>.

<FIG> is the end-elevation view 1700B of the distal end <NUM> of 1700A from <FIG>, and illustrates the outer casing's curved top surface <NUM>, flat bottom <NUM>, the hub drive shaft <NUM> of the motor (not pictured in <FIG>), the first and second sides <NUM> and <NUM> where the locking features <NUM> may be located.

<FIG> illustrate different schematic cross sectional views of the disposable portion of a handset detachably coupled to a reusable portion of the handset according to embodiments of the present disclosure. In particular, <FIG> is an illustration of a partial cross section 1400A of an embodiment of the disposable portion of a handset detachably coupled to a reusable portion of the handset. The cross section 1400A illustrates a disposable portion <NUM> and a reusable portion <NUM>. The disposable portion <NUM> comprises the fluid path <NUM> which begins in an instrument, partially shown in <FIG> as elongated shaft <NUM> (as also shown in <FIG>), and, as discussed above, has an inflow location <NUM> and an outflow location <NUM>. In the example embodiment shown, the fluid path <NUM> extends into and through the rotating hub <NUM> and continues through the disposable portion <NUM>. The fluid path <NUM> in <FIG> extends into the rotating hub to enable the blade drive shaft (not specifically shown) to access the fluid path, and the rotating hub is designed and constructed to enable the fluid and/or resected tissue to travel through the hub. The seal <NUM> may comprise an O-ring or another type of seal, which may be a flexible or a rigid seal, or comprise multiple components, may be disposed on an outside surface of the rotating hub <NUM>, and particularly on the proximal side of the rotating hub <NUM>. The seal <NUM> fluidly isolates the rotating hub <NUM> (and the disposable portion <NUM>) from the motor <NUM>, electronics <NUM>, and other components in the reusable portion <NUM>, which may also comprise at least one connection port <NUM> for power and other connections. The reusable portion <NUM> may be detachably coupled to the detachable portion <NUM> by multiple means including the locking features <NUM> discussed above, which are engaged but not illustrated in this view, as well as through the coupling of the hub drive shaft <NUM> extending from the motor <NUM> that mates with a drive connector defined in the rotating hub <NUM> as illustrated.

<FIG> is an illustration of a partial cross section 1400B of an embodiment of the disposable portion of a handset detachably coupled to a reusable portion of the handset. The cross section 1400B illustrates a disposable portion <NUM> and a reusable portion <NUM>. The disposable portion <NUM> comprises the fluid path <NUM> which begins in an instrument, partially shown in <FIG> as the elongated shaft <NUM>, and, as discussed above, has an inflow location <NUM> and an outflow location <NUM>. The fluid path <NUM> extends to but not through the rotating hub <NUM>, and fluid path also extends through the disposable portion <NUM>. The fluid path <NUM> in <FIG> extends to the rotating hub to enable the blade drive shaft (not specifically shown) to access the fluid path. However, in the example system of <FIG> the fluid path <NUM> does not extend through the rotating hub <NUM>. The portion <NUM> of the fluid path is illustrated as being oriented perpendicular to the central axis <NUM>, but in some embodiments, it may be angled towards the outflow location <NUM>. As discussed above in <FIG>, seal <NUM>, which may comprise an O-ring or another type of seal, which may be a flexible or a rigid seal, or comprise multiple components, may be in operational relationship to the rotating hub <NUM> and fluidly isolates the rotating hub <NUM> (and the disposable portion <NUM>) from the motor <NUM>, electronics <NUM>, and other components in the reusable portion <NUM>, which may also comprise at least one connection port <NUM> for power and other connections. The reusable portion <NUM> may be detachably coupled to the detachable portion <NUM> by multiple means including the locking features <NUM> discussed above, which are engaged but not illustrated in this view, as well as through the coupling of the hub drive shaft <NUM> from the motor <NUM> that mates with the rotating hub <NUM> as illustrated.

<FIG> illustrates a system diagram for a tissue resecting system <NUM> according to certain embodiments of the present disclosure. The system <NUM> comprises a foot switch <NUM> coupled to a power source <NUM> that is also coupled to a pump/suction device <NUM>, a filtration device <NUM>, and a fluid source <NUM>. The power source <NUM> is also coupled to the handset <NUM> that comprises the disposable portion discussed above and, in some cases, an endoscope <NUM>. The handset <NUM> may also be coupled to the filtration device <NUM> by way of tubing, and the filtration device <NUM> may be connected to a sample collection station which the handset <NUM> may in some cases directly access without filtration using <NUM>. The power source <NUM> may supply power to the handset <NUM> for at least the motor to activate the cutting device, which may also be coupled to the pump/suction device <NUM> to provide suction through the fluid channel while cutting tissue and removing fluid. The handset <NUM> may be connected to one or both of the filtration <NUM> and sample collection <NUM> devices and may use one or both depending upon the embodiment (as indicated by the arrows) in order to collect tissue samples and recirculate the fluid as illustrated, where the fluid is removed by the handset <NUM>, sent through the filtration device <NUM>, where the tissue is separated out, and then the fluid may be returned (recirculated) to the body, for example, by way of the endoscope <NUM>. After the procedure is finished, the disposable portion of the handset <NUM> may be disengaged from the reusable portion and disposed of, while the reusable portion is wiped manually or otherwise cleaned, in some embodiments the reusable portion is not sterilized, for example, using an autoclave, and in other embodiments sterilization may be employed. In an embodiment, the endoscope <NUM> may be in fluid communication with the sample collection device <NUM>, and in other embodiments (not illustrated here), the endoscope may be connected to the filtration device <NUM> directly, e.g., not through the handset portion, in addition to or instead of the connection to the sample collection device <NUM>.

In an embodiment, tissue resecting system, comprising: a resector including a handset and a cutting element that extends from the handset to cut tissue from an organ; and a footswitch coupled to the resector, the footswitch being selectively operated to activate the cutting element, and the footswitch including one or more control elements that control the operation of the cutting element according to selected parameters. The tissue resecting system wherein the footswitch includes a motor that is coupled to and drives the cutting element via a flexible drive shaft, the one or more control elements controlling the motor to drive the cutting element. The tissue resecting system further comprising wherein the handset includes a pump, a first fluid line, and a second fluid line, the pump drawing fluid, with suction, from the organ through the first fluid line and pushing the fluid into the second fluid line for further processing, and the fluid drawn from the organ by the pump carries tissue cut from the organ by the cutting element, the footswitch being selectively operated to activate the pump, the one or more control elements controlling the operation of the pump according to the selected parameters. The tissue resecting system further comprising wherein the handset includes a filtration system that filters the fluid from the organ, the pump pushing the fluid through the filtration system and into the second fluid line, the second fluid line delivering the filtered fluid to the organ. The tissue resecting system further comprising an endoscope that is configured to be inserted into the organ and to guide the cutting element into the organ, the endoscope including a passageway that is configured to extend into the organ, the passageway being coupled to the second fluid line, the passageway delivering the filtered fluid to the organ. In an embodiment, the footswitch includes a motor that is coupled to a gear box and clutch component via a flexible drive shaft, the gear box and clutch component driving the cutting element and the pump, the one or more control elements controlling the motor to drive the cutting element and the pump according to the selected parameters. In an embodiment, a pump may be disposed externally from the handset, wherein the handset include a first fluid line and a second fluid line, the pump drawing fluid, with suction, from the organ through the first fluid line and pushing the fluid into the second fluid line for further processing, the fluid drawn from the organ by the pump carrying tissue cut from the organ by the cutting element, the footswitch being selectively operated to activate the pump, the one or more control elements controlling the operation of the pump according to the selected parameters, and in some embodiments, the pump is housed in the footswitch. The footswitch includes a motor that is coupled to a gear box and clutch component via a flexible drive shaft, the gear box and clutch component driving the cutting element and the pump, the one or more control elements controlling the motor to drive the cutting element and the pump according to selected parameters.

In an embodiment, filtration system may be disposed externally from the handset, the filtration system filtering the fluid from the organ, the pump pushing the fluid through the filtration system and into the second fluid line, the second fluid line delivering the filtered fluid to the organ, and in some embodiments, the filtration system is housed in the footswitch. The footswitch includes a user interface, the user interface including a display and user inputs, the user inputs receiving the selected parameters from a user. In an embodiment, a first pump is disposed externally from the handset and a second pump disposed externally from the handset, wherein the handset include a first fluid line and a second fluid line, the first pump drawing fluid, with suction, from the organ through the first fluid line and pushing the fluid towards the second pump, the second pump drawing the fluid from the first pump and pushing the fluid into the second fluid line. The fluid is drawn from the organ by the first pump carrying tissue cut from the organ by the cutting element, the footswitch is selectively operated to activate the first pump and the second pump, the one or more control elements controlling the operation of the first and the second pumps according to the selected parameters. The first and the second pumps are housed in the footswitch which further includes a motor that is coupled to a gear box and clutch component via a flexible drive shaft, the gear box and clutch component driving the cutting element and the first and the second pumps, the one or more control elements controlling the motor to drive the cutting element and the first and the second pumps according to selected parameters. In an embodiment, a filtration system is disposed externally from the handset and operatively between the first and the second pumps such that the filtration system is configured to filter the fluid sucked from the organ by the first pump, the first pump pushing the fluid through the filtration system and the second pump pulling the filter fluid from the filtration system and pushing the filter fluid into the second fluid line, the second fluid line delivering the filtered fluid to the organ.

In an embodiment, a tissue resecting system, comprising: a handset including: a disposable portion including a pump, a first fluid line, and a second fluid line, the pump drawing fluid, with suction, from an organ through the first fluid line and moving the fluid into the second fluid line for further processing; and a reusable portion that is detachably coupled to the disposable portion to define a single housing for the handset, the reusable portion including one or more drive components that drive the pump; and a cutting element that extends from the handset to cut tissue from the organ, wherein the fluid drawn from the organ by the pump carries tissue cut from the organ by the cutting element. The disposable portion includes a filtration system that filters the fluid from the organ, the pump moving the fluid through the filtration system and into the second fluid line, the second fluid line delivering the filtered fluid to the organ. In alternate embodiments, the second fluid line delivers the fluid to an external receptacle. The one or more drive components in the reusable portion include a motor and drive the cutting element. In an embodiment, the one or more drive components drive the shaft to cause a cutting action with the cutting element and the one or more drive components may include a gearbox and clutch component that divides drive between the pump and the cutting element.

In some embodiments, the system further comprises an endoscope that is configured to be inserted into the organ and to guide the cutting element into the organ, the endoscope including an inflow passageway that is configured to extend into the organ, the passageway being coupled to the second fluid line, the passageway delivering the filtered fluid to the organ. In an embodiment, the reusable portion includes a battery that powers the motor and a cable that electrically couples the motor to an external power source. In an embodiment, the handset includes a control element that is configured to be selectively operated by a user to cause the one or more drive components to engage the cutting element to cause a cutting action, while the one or more drive components continue to drive the pump. In an embodiment, the system further comprises a shaft that extends from the handset and into the endoscope, the cutting element being disposed at an end of the shaft, which comprises an outflow passageway that extends from an opening at the cutting element and into the handset, the outflow passageway being coupled to the first fluid line, the pump drawing the fluid from the organ through the opening and into the outflow passageway via the first fluid line.

In another embodiment, a tissue resecting system, comprising: a handset including a disposable housing including a pump, a first fluid line, a second fluid line, and one or more drive components that drive the pump, the pump drawing fluid, with suction, from an organ through the first fluid line and moving the fluid into the second fluid line for further processing; and a cutting element that extends from the handset to cut tissue from the organ, wherein the fluid drawn from the organ by the pump carries tissue cut from the organ by the cutting element. In an embodiment, the housing includes a filtration system that filters the fluid from the organ, the pump pumping the fluid through the filtration system and into the second fluid line, the second fluid line delivering the filtered fluid to the organ. The system may further comprise an endoscope that is configured to be inserted into the organ and to guide the cutting element into the organ, the endoscope including an inflow passageway that is configured to extend into the organ, the passageway being coupled to the second fluid line, the passageway delivering the filtered fluid to the organ. In an embodiment, the housing comprises a plurality of sections and includes a disposable battery that powers the motor, and the one or more drive components drive the cutting element. In an embodiment, the housing includes a first section and a second section, the first section including the pump, the first fluid line, and the second fluid line, and the second section including the one or more drive components.

In some the one or more drive components include a gear box and clutch component that divides drive between the pump and the cutting element, and the handset includes a control element that is configured to be selectively operated by a user to cause the one or more drive components to engage the cutting element to cause a cutting action, while the one or more drive components continue to drive the pump. In some example, the second fluid line delivers the fluid to an external receptacle. In an embodiment, the system further comprising an endoscope that is configured to be inserted into the organ and to guide the cutting element into the organ and a shaft that extends from the handset and into the endoscope, the cutting element being disposed at an end of the shaft, wherein the shaft includes an outflow passageway that extends from an opening at the cutting element and into the housing, the outflow passageway being coupled to the first fluid line, the pump drawing the fluid from the organ through the opening and into the outflow passageway via the first fluid line, wherein the one or more drive components drive the shaft to cause a cutting action with the cutting element.

According to aspects of the present disclosure, the implementations provide tissue-resecting systems that include footswitches that compactly integrate components for extracting fluid/tissue from an organ. In some implementations, the footswitches include one or more control elements and a motor to drive the pump and the cutting element of a resector according to selected parameters. In other implementations, the footswitches include the pump and the filtration system in addition to the one or more control elements and the motor. The footswitches may include a disposable portion that allows components that contact the fluid/tissue (e.g., the pump, the filtration system, etc.) to be easily disposed, thereby promoting hygienic use of the tissue resecting system. Meanwhile, the footswitches may include a reusable portion that allows other components (e.g., drive components like the motor.

Claim 1:
A disposable handset component (<NUM>, 310A) comprising:
a handle portion that defines a hub section and a mating section, the handle defines a fluid path that extends through the hub section and the mating section;
an elongated shaft (<NUM>) coupled to the hub section of the handle portion, the elongated shaft (<NUM>) defines an internal flow channel (<NUM>) fluidly coupled to the fluid path, and a central axis;
an aperture through a distal end of the elongated shaft (<NUM>);
a cutting blade within the elongated shaft (<NUM>) and in operational relationship to the aperture;
a rotating hub disposed within hub section and in operational relationship to a portion of the fluid path within the hub section, the rotating hub defines a drive connector exposed at a transition between the hub section and the mating section;
a drive shaft that mechanically couples the cutting blade to the rotating hub, the drive shaft disposed within the internal flow channel (<NUM>) of the elongated shaft and also disposed in the portion of the fluid path in the hub section; and
a seal in operational relationship to the rotating hub and the hub section, the seal fluidly isolates the fluid channel from drive connector exposed at the transition between the hub section and the mating section.