Abstract: Provided is a medical device comprising an outer tubular member, a middle tubular member received within the outer tubular member, an inner tubular member received within the middle tubular member, and an engagement gear, wherein the inner tubular member is configured to be rotatable in one direction while the middle tubular member is configured to be simultaneously rotatable in an opposite direction through the engagement gear while the outer tubular member is configured to be stationary relative to both the middle tubular member and the inner tubular member.