Abstract: This document provides medical device systems and methods for obtaining tissue samples. For example, this document provides medical device systems and methods for transbronchial needle biopsy tissue acquisition. In some cases, a needle biopsy system includes an actuator device, an outer needle with a lumen therethrough, and an inner needle at least partially disposed within the lumen. The outer needle can extend distally from the actuator device. A distal tip of the inner needle can be capable of being fully disposed within the lumen. The inner needle can extend distally from the actuator device. The actuator device can be configured to translate the outer needle proximally and distally. The actuator device can be configured to translate the inner needle proximally and distally independently of the outer needle.