A medical apparatus , comprising: an insertion tube having a distal end and comprising: an outer tube having a proximal end and an outer tube distal end configured for insertion into a body cavity, with a radial cutting window opening through a wall of the outer tube in proximity to the distal end, and an inner tube , contained in and configured to rotate within the outer tube and comprising a cutting blade that traverses the radial cutting window opening as the inner tube rotates; a conductive element disposed over an outer surface of the outer tube distal end, wherein the conductive element is configured to inject energy into the body cavity in order to perform coagulation; and a conductor running along the insertion tube from a proximal to the distal end of the insertion tube and coupled to provide energy to the conductive element, wherein the inner tube has an inner tube distal end and an inner tube proximal end, and comprising a radial suction window opening through a wall of the inner tube in proximity to the inner tube distal end, the radial suction window opening being configured to traverse the radial cutting window opening at specific angles of rotation, and wherein the inner tube proximal end is coupled to a suction device configured to extract debris via the radial suction window opening, characterised in that the medical apparatus is configured to restrict conveyance of energy to the conductive elements to times when the radial cutting window opening and the radial suction window opening are aligned. an insertion tube having a distal end and comprising: an outer tube having a proximal end and an outer tube distal end configured for insertion into a body cavity, with a radial cutting window opening through a wall of the outer tube in proximity to the distal end, and an inner tube , contained in and configured to rotate within the outer tube and comprising a cutting blade that traverses the radial cutting window opening as the inner tube rotates; an outer tube having a proximal end and an outer tube distal end configured for insertion into a body cavity, with a radial cutting window opening through a wall of the outer tube in proximity to the distal end, and an inner tube , contained in and configured to rotate within the outer tube and comprising a cutting blade that traverses the radial cutting window opening as the inner tube rotates; a conductive element disposed over an outer surface of the outer tube distal end, wherein the conductive element is configured to inject energy into the body cavity in order to perform coagulation; and a conductor running along the insertion tube from a proximal to the distal end of the insertion tube and coupled to provide energy to the conductive element, wherein the inner tube has an inner tube distal end and an inner tube proximal end, and comprising a radial suction window opening through a wall of the inner tube in proximity to the inner tube distal end, the radial suction window opening being configured to traverse the radial cutting window opening at specific angles of rotation, and wherein the inner tube proximal end is coupled to a suction device configured to extract debris via the radial suction window opening, characterised in that the medical apparatus is configured to restrict conveyance of energy to the conductive elements to times when the radial cutting window opening and the radial suction window opening are aligned. <EOS>