A tissue resection device includes an elongate shaft having a ceramic working end with a window and a wire-like electrode. A motor oscillates the electrode back and forth in an arc between opposing sides of the window. The working end is engaged against a tissue surface while radiofrequency current is delivered to the wire-like electrode to cut tissue received within the window. A negative pressure source may be connected to the window through an interior passageway in the elongate shaft to extract cut tissue from the working end.