A tissue removal device includes a cannula that can aspirate tissue, and a thermal element located at a tip of the cannula that can apply localized heat to the tissue to be aspirated. The tissue removal device may also include a device for applying a vacuum in the cannula, which may be configured for applying vacuum pulses according to a controlled pulse rate and vacuum level. The tissue removal device may also include a device for applying the heat at the tip according to a controllable pulse rate and power level.