Abstract: A biopsy device includes a needle extending distally from a body. The needle includes a transverse aperture, a first lumen, and a second lumen. A cutter is movable within the first lumen to sever tissue protruding through the transverse aperture. A valve assembly is operable to change the pneumatic state of the second lumen. The valve assembly includes a valve body and a translating member slidably disposed in a bore of the valve body. The valve body includes a first port and a second port. The first port is in fluid communication with the second lumen of the needle. The second port is in fluid communication with atmospheric air. The translating member selectively couples the first port with the second port based on the longitudinal position of the translating member within the bore. The translating member translates relative to the valve body based on the position of the cutter.

Abstract: A biopsy device includes a disposable unit including a needle carrier and a biopsy needle. The biopsy needle has a distal portion including a sample chamber and a hub portion located proximal to the sample chamber. The needle carrier has a holding portion. The holding portion and the hub portion are collectively configured to form a detent mechanism configured to permit the biopsy needle to rotate within needle carrier to rotationally position the sample chamber while restraining rotation of the biopsy needle at a series of rotational detent positions.

Abstract: The present invention provides for exemplary embodiments of a single-insertion, multiple sample biopsy device. Exemplary embodiments of a single-insertion, multiple sampling device with integrated marker release.

Abstract: The present invention provides for exemplary embodiments of a single-insertion, multiple sampling biopsy device. Exemplary embodiments of a single-insertion, multiple sampling device with integrated marker release.

Abstract: A self-contained hand-held biopsy needle has various features relating to automated sampling and recovery. Among the disclosed features are ones suited to fully-disposable single-use automatic biopsy devices, such as light weight, low cost, and simple design.

Abstract: A biopsy device includes a cutter defining a cutter lumen and a tissue sample holder for collecting tissue samples. In one example, the tissue sample holder has a rotatable manifold that is configured to redirect fluid from one axial direction to an opposite axial direction. The tissue sample holder also has a plurality of tissue sample trays through which fluid may be communicated. The tissue sample trays define chambers that are each configured to separately hold tissue samples. The tissue sample trays are removable relative to the manifold. A cup is configured to cover the manifold and trays. A tissue sample holder rotation mechanism is operable to rotate the manifold to successively index each chamber of the tissue sample trays with the cutter lumen. A feature may prevent rotation of the manifold when one part of the biopsy device is separated from another part of the biopsy device.

Abstract: A biopsy device comprises a handpiece, a fluid collection system, and a power transmission source. The handpiece is configured for grasping by a single hand, and is independently manipulatable by hand for movement of the instrument toward and away from the patient. An elongated piercer extends from the distal end of the handpiece. The piercer has a sharpened distal end for entering the tissue and a port located proximal to the sharpened distal end for receiving a portion of tissue mass. An elongated cutter is disposed coaxially relative to a piercer lumen of the piercer. A distal blade of the cutter slides distally past the port of the piercer to sever the tissue portion drawn into the port by vacuum. The handpiece further comprises a holster for detachably connecting a cutter rotational transmission and a cutter axial transmission to the power transmission source.

Abstract: A biopsy device is disclosed. The biopsy device includes a chamber having a body having a distal end and a proximal end, wherein the proximal end includes an inlet. The biopsy device further includes a vacuum generator for generating negative and positive pressure and at least one first recessed area and at least one second recessed area. The first recessed area extends along an inner wall of the body, proximate the proximal end of the body of the chamber. The first recessed area is configured to release pressure within the chamber. The second recessed area extends along the inner wall of the body, proximate the distal end of the body of the chamber. The second recessed area is configured to release pressure within the chamber.

Abstract: A biopsy needle system includes a cylinder with a fluid connection end, an open end and a cylinder wall. A piston is coupled to a threaded spindle shaft. The threaded spindle shaft is configured to extend from the piston and through the open end of the cylinder. The piston is inserted in the open end such that a cylinder interior volume is defined between the piston and the fluid connection end. A spindle nut is mounted to the open end of the cylinder. The spindle nut is threadably engaged with the threaded spindle shaft and configured to displace the piston via a linear translation of the threaded spindle shaft when the spindle nut is rotated. A biopsy needle is connected in fluid communication with the fluid connection end of the cylinder.

Abstract: A biopsy device comprises a body, a needle, and a cutter actuation mechanism. The needle extends distally from the body. The cutter actuation mechanism rotates and translates the cutter relative to the body and relative to the needle. The cutter has an overmold presenting a lead screw and a hex portion. The cutter actuation mechanism comprises a first gear disposed about the hex portion of the overmold and a second gear engaged with the lead screw of the overmold by a nut that is integral with the second gear. The cutter actuation mechanism is operable to simultaneously rotate the first gear relative to the body at a first rotational speed and the second gear relative to the body at a second rotational speed. With the lead screw and the nut rotating at different rotational speeds, the lead screw rotates relative to the nut at a third rotational speed.

Abstract: A needle set for a biopsy device is disclosed. The needle set includes an outer member, a cylinder lumen within said outer member, an inner member having a cannula and an inner lumen. The inner member is slidably disposed within the cylinder lumen. The biopsy device also includes a cylinder seal member that is disposed within the cylinder lumen and a cannula seal member attached to the outer surface of the cannula. The cylinder seal member and the cannula seal member define a vacuum chamber therebetween.

Abstract: A device for transcutaneous biopsy includes a casing consisting of a first half shell and a second half shell that are fixable to one another. Inside the casing there is defined a chamber into which slides a slide element to which a first cannula and a second cannula are connected. The second cannula is inserted inside the first cannula, both of them having a common longitudinal axis. The first cannula is provided with a locking element. The locking element, which is suitable for interacting with the second cannula, is provided with a pair of notches interacting with a pair of lamina elements with which the second cannula is provided.

Abstract: One embodiment of a multifunction aspiration biopsy device includes a hub having a chamber for receiving a collected specimen, a vacuum source in communication with the hub chamber, a needle detachable from the hub and having an outlet in communication with the hub chamber, and a cover extending over a portion of the needle outlet for directing a specimen collected through the needle into the hub chamber in a direction that differs from a longitudinal axis of the needle. The hub chamber with collected specimen may be separated from the vacuum source and the needle and the specimen may be triaged within the hub chamber. Various embodiments of a collection container for receiving used needles are also disclosed.

Abstract: This document provides needle biopsy systems and methods for obtaining tissue biopsies. In various embodiments, the systems and methods provided can inhibit needle contamination by unwanted tissue or cells and/or regulate a negative pressure to assist sampling of target tissue or cells.

Abstract: A biopsy device comprises a handpiece, a fluid collection system, and a power transmission source. The handpiece is configured for grasping by a single hand, and is independently manipulatable by hand for movement of the instrument toward and away from the patient. An elongated piercer extends from the distal end of the handpiece. The piercer has a sharpened distal end for entering the tissue and a port located proximal to the sharpened distal end for receiving a portion of tissue mass. An elongated cutter is disposed coaxially relative to a piercer lumen of the piercer. A distal blade of the cutter slides distally past the port of the piercer to sever the tissue portion drawn into the port by vacuum. The handpiece further comprises a holster for detachably connecting a cutter rotational transmission and a cutter axial transmission to the power transmission source.

Abstract: A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described, as well as alternative systems for tissue preservation and transport. The cutting device includes an outer cannula in which a reciprocating inner cannula is disposed. A tissue collector is also provided and is in fluid communication with the lumen of the inner cannula. A temperature control sleeve may be disposed around the tissue collector to control the temperature of the tissue samples. A preservation system may be supplied that is configured to deliver fluids to tissue samples in the tissue collector. A fluid supply sleeve may be disposed about the outer cannula and is selectively positionable along the length of the outer cannula.

Abstract: A tissue sampling, collection, and processing system including a hand-supportable power-assisted tissue aspiration device having a cannula for aspirating fat tissue from a patient's body, and a multi-pack tissue sampling, processing and collecting device, installed between the tissue aspiration device and a vacuum source, and containing multiple tissue collection tubes for collection of aspirated fat tissue samples.

Abstract: A tissue sampling, processing and collection device for connection in-line to a hand-held power-assisted tissue aspiration instrument and a vacuum source. The tissue sampling, processing and collection device includes a suction plate, mounted within a collection chamber, and having multiple hollow projections for supporting the open proximal ends of a plurality of tissue collection and processing tubes. Each of these tissue collection and processing tubes has micro-pores formed in the side walls thereof and its distal end opening is capped, thereby allowing fluid to flow and filter therethrough while the tissue collection and processing tube is mounted on the suction plate during tissue aspiration operations. The in-line tissue sampling, processing and collection device is provided with a knob for manually selecting the tissue collection and processing tube, into which a sampled of aspirated fat tissue to is be collected and processed in situ during tissue aspiration operations.

Abstract: A bone marrow aspiration assembly including an outer cannula assembly, an inner cannula assembly, and a flexible seal. The outer cannula assembly includes an outer handle and an outer cannula defining a first passageway and including a plurality of first openings between a first end and a second end of the first passageway. The inner cannula assembly includes an inner handle and an inner cannula defining a second passageway and is configured to be received within the first passageway. The inner cannula includes a plurality of second openings between a first end and a second end of the second passageway. The flexible seal is mounted to the inner handle and positioned such that the seal contacts the outer cannula assembly when the inner cannula assembly is in cooperation with the outer cannula assembly to create a substantially airtight seal therebetween.

Abstract: A puncturing device for extracting egg cells for in-vitro fertilization (IVF) includes a puncturing cannula that can be connected by means of a multiway valve to a suction line or a flushing line. The multiway valve is provided with a foot-operated, mechanical or electro-motive drive mechanism for switching the multiway valve from a suction position to a flushing position and vice versa.

Abstract: A biopsy device may be used to obtain and store multiple tissue samples. The device permits the tissue samples to be stored in a sequenced fashion within a generally transparent tissue storage chamber disposed at a proximal end of the biopsy device. The tissue samples can be stored on flexible tissue sample strips arranged around the circumference of a rotating vacuum manifold disposed within the chamber.

Abstract: A biopsy device for tissue collection having a housing and a removable element. A power source is contained within the housing and the removable unit includes a biopsy needle module and a pressure source that can be integrated into the housing such that the biopsy device is fully operational without the need for wires or cables extending from the housing to connect to external units. The biopsy needle module includes a biopsy needle and a cutting sleeve, the biopsy needle having a sharpened distal end and a distal opening for collection of tissue, the cutting sleeve having a cutting blade on its distal end and being coaxially positioned with respect to the biopsy needle.

Abstract: A medical apparatus and method useful for resecting tissue from the gastrointestinal tract are disclosed. The apparatus can include an RF tissue cutting device disposed inward of a side opening in the device. A tissue stop can be used to control the depth of tissue resected, and the tissue stop can include holes for communicating vacuum for drawing tissue into the side opening. The tissue stop can be electrically grounded with respect to the RF tissue cutting device, and the tissue stop can provide one pole of an RF electrical circuit.

Abstract: A method is provided for calibrating a surgical biopsy system. The biopsy system includes a biopsy instrument and control unit. The biopsy instrument includes a piercer, rotatable cutter, and a port for receiving tissue samples. The method comprises the steps of translating the cutter distally until the translation of the cutter is stopped at an extended position and recording the extended position. The cutter is then translated from the extended position proximally until the translation of the cutter is stopped at a retracted position proximal to the extended position. The retracted position is recorded. The method further comprises the step of rotating the cutter to a rotation speed while the cutter is located at the retracted position and, if determined that the rotation speed is within a predetermined rotation speed range, a feedback signal is provided on the display allowing the operator to progress to the next procedural step.

Abstract: A biopsy needle system includes a cylinder with an open end and a cylinder wall. A piston is inserted in the open end such that a cylinder interior volume is defined between the piston and the cylinder, the piston being movable in the cylinder. A biopsy needle is connected to the cylinder. A ventilation groove is established in the cylinder wall only to a depth of a portion of a thickness of the cylinder wall. The ventilation groove is positioned such that the cylinder interior volume of the cylinder communicates with the ambient atmosphere when the piston is displaced to a position in the cylinder so as to establish an airflow through the ventilation groove past the piston.

Abstract: A biopsy device includes a body having a cannula, a cutter positioned at least partly within the cannula, a tissue collection chamber, and a vacuum source. In one example, the biopsy device includes a cutter loader for rotating the cutter into a loaded position (e.g., open position). A trigger is engaged with a portion of the cutter loader and may be activated to allow the cutter to rotate back to a closed position. During this rotation, the cutter severs a tissue sample, which may thereafter be drawn through the cutter lumen into the tissue collection chamber under the influence of a vacuum created by the vacuum source. The vacuum source includes a piston configured to be operated by squeezing a scissors grip. A user may apply a single stroke or successive strokes to the piston to produce the vacuum.

Abstract: A biopsy apparatus includes a biopsy needle for insertion into an object to be examined in order to sample tissue of a biopsy region in the object, and a spatial range measuring section, which measures a spatial range within which the biopsy needle is capable of sampling the tissue of the biopsy region, based on an image of a phantom that simulates the object, which is captured after the biopsy needle has been inserted into the phantom and a portion of the phantom has been extracted.

Abstract: A disposable biopsy unit includes a biopsy needle unit and a pump. The biopsy needle unit includes a carrier, a biopsy needle and a cutting sheath. The carrier is configured to mount the biopsy needle and the cutting sheath. The cutting sheath is configured to move along a longitudinal axis relative to the biopsy needle. The pump has an elongate cylinder and a plunger. The plunger is configured to be movable inside the elongate cylinder in a first direction from a distal end of the elongate cylinder to a proximal end of the elongate cylinder to generate a vacuum and configured to be movable inside the elongate cylinder in a second direction from the proximal end of the elongate cylinder to the distal end of the elongate cylinder to build up pressure. The distal end of the elongate cylinder is coupled in fluid communication with the biopsy needle.

Abstract: An apparatus and method that may be used for collecting target cells or tissue and preparing a cell block are disclosed.

Abstract: A biopsy device having a stylet, an outer cannula, and a vacuum chamber is disclosed. The stylet includes a lumen with an open proximal end and a tissue receiving opening near a distal end thereof. The outer cannula is slidably disposed over the stylet and has an open distal end with a cutting edge formed thereon. The vacuum chamber is in communication with the lumen of the stylet. Actuation of the outer cannula causes a vacuum to be delivered to the tissue receiving opening through the lumen of the stylet before the outer cannula advances distally.

Abstract: An apparatus and method for accessing the bone marrow of a human's sternum is provided. The apparatus includes a tissue penetrator configured to penetrate the sternum, a trigger mechanism configured to engage when the tissue penetrator contacts the sternum and a depth control mechanism operable to limit the penetration of the tissue penetrator into the sternum to a pre-selected depth.

Abstract: A disposable tissue removal device comprises a “tube within a tube” cutting element mounted to a handpiece. The inner cannula of the cutting element defines an inner lumen and terminates in an inwardly beveled, razor-sharp cutting edge. The inner cannula is driven by both a rotary motor and a reciprocating motor. At the end of its stroke, the inner cannula makes contact with the cutting board to completely sever the tissue. An aspiration vacuum is applied to the inner lumen to aspirate excised tissue through the inner cannula and into a collection trap that is removably mounted to the handpiece. The rotary and reciprocating motors are hydraulically powered through a foot pedal operated hydraulic circuit. The entire biopsy device is configured to be disposable. In one embodiment, the cutting element includes a cannula hub that can be connected to a fluid source, such as a valve-controlled saline bag.

Abstract: A system for treating a lesion site of a patient is disclosed. The system includes a cannula having a lumen, a conduit in communication with said lumen, an introducer stylet removably disposed within said cannula, a resecting device selectively insertable within said cannula, and an adjuvant treatment device selectively insertable within said cannula.

Abstract: A biopsy device may be used to obtain and store multiple tissue samples. The device permits the tissue samples to be stored in a sequenced fashion within a generally transparent tissue storage chamber disposed at a proximal end of the biopsy device. The tissue samples can be stored on flexible tissue sample strips arranged around the circumference of a rotating vacuum manifold disposed within the chamber.

Abstract: A needle for insertion into a living body along a tortuous path comprises an elongate body extending between a proximal end which, during use, remains external to the body and a distal end which, when in an operative configuration, is positioned adjacent to a target structure within the body, a distal portion of the needle including a lumen extending therethrough to a tissue receiving opening at the distal end, the lumen having an inner diameter of at least 0.035 inches and a bending stiffness no greater than 0.08 Nm2.

Abstract: A biopsy device for taking tissue samples, includes a housing, a removable element and a control panel. The housing contains an electric power source and a tension slide connected to the power source. The tension slide may be brought into a cocked position against the action of a spring by the power source. The removable element is configured for insertion into the housing and includes a biopsy needle unit, a vacuum pressure-generating device and a control panel. The removable element may be provided as a sterile package unit. The biopsy needle unit can be arranged on the tension slide and includes a hollow biopsy needle with a sample removal chamber and a cutting sheath. The biopsy device can be held in one hand and is fully integrated with all components required to perform a vacuum biopsy such that no cables or lines are required to other external units.

Abstract: A biopsy device may include a needle, a cutter, and a handpiece. A vacuum pump in the handpiece may provide a vacuum to the needle and/or to the cutter. A pressure pump in the handpiece may also provide pressurized air to the needle and/or to the cutter. A motor in the handpiece may drive the vacuum pump, the pressure pump, and/or the cutter. A vacuum sensor may sense a vacuum level within the biopsy device, and cause initiation of operational cycles in response to sensed vacuum levels. Portions of a valving mechanism and a clutching mechanism may be integrally formed. A clutching and valving mechanism may be driven by a first battery-powered motor; and a cutter, pressure pump, and vacuum pump by a second battery-powered motor. A biopsy device may thus provide vacuum, pressurized air, and power from within a handpiece, such that the biopsy device is tetherless.

Abstract: A biopsy device includes coaxially disposed inner and outer needles in which the outer needle tip is configured for obtaining a tissue sample. The inner surface of the outer needle includes a tissue retention feature which may include a countersink and/or a feature formed in the inner surface. The device may be configured such that the inner needle does not extend past a certain point within the outer needle.

Abstract: A biopsy device includes a probe assembly and a driver unit. The probe assembly includes a first cannula having a first aperture extending to a lumen proximal to a first distal end of the first cannula. A second cannula has a second aperture extending to a lumen proximal to the second distal end of the second cannula. The second cannula is disposed co-axially with the first cannula. A least one of the first aperture and the second aperture has a cutting edge. The driver unit is configured for releasably mounting the probe assembly. The driver unit is operatively configured to simultaneously rotate the first cannula and the second cannula at different rotational velocities so that the first aperture and the second aperture periodically come into alignment to form a virtual tissue sample aperture.

Abstract: A method for extracting a tissue sample includes altering the pressure inside the lumen of a cannula to facilitate extraction of a tissue sample from the cannula. One aspect of the invention includes a biopsy apparatus comprising a valve for controlling the pressure inside the lumen of the cannula. In one variation, the pressure/vacuum generating device is connected to a cannula with a closed distal end and an orifice located on a circumferential surface of said cannula. A cutting sheath is slidably disposed over said cannula. The valve may be provided between the pressure/vacuum generating device and the cannula to control the pressure within the lumen of the cannula.

Abstract: Tissue solubilizing apparatuses are provided. The apparatuses may be useful to solubilize tissue, including skin, mucosal membrane, and other tissue. The apparatuses may be further useful to preserve and recover analytes contained within the solubilized skin, mucosal membrane, and other tissue.

Abstract: A fluid connector is provided for a biopsy system that includes a vacuum assisted biopsy device, a first fluid source and a second fluid source. In an embodiment, the fluid connector includes a body member having a first input port, a second input port and an output port. The first input port includes a first check valve in fluid communication with the first fluid source, the second input port includes a second check valve in fluid communication with the second fluid source and the output port is provided in communication with the vacuum assisted biopsy device. A biopsy system including a fluid connector of the present invention is also provided.

Abstract: A hair transplant apparatus and a method for placing hair grafts into pre-made wounds capture a hair graft into a hair graft chamber readily aligned for implantation into the human scalp. The hair graft can be placed into the hair graft chamber manually or mechanically (e.g., by vacuum). A hair transplant apparatus includes a housing and a sliding rod within the housing. When the sliding rod is away from an open distal end of the housing in a first position, a hair graft can be placed into the spacing between an end of the rod and the open distal end of the housing. In a second position, the rod is advanced so the end of the rod becomes substantially flush with the distal end of the housing, thereby pushing the hair graft out of the housing and into the pre-made wound. Advantageously, the housing is aligned with the direction of the pre-made wound allowing the hair graft to slide easily into the pre-made wound without damage.

Abstract: A dicing device dices tissue harvested from a patient. The dicing device comprises a grid cutting element and a tray to receive diced tissue. The dicing device may be integrated into an otherwise conventional biopsy device. The diced tissue specimens may be further processed, such as by being introduced into a self-expanding fistula plug creation and delivery system. The self-expanding fistula plug creation and delivery system comprises a sheet and a reinforcement tube. A scaffold material may be placed in the sheet, which may then be folded and reinforced, with the scaffold material being compressed in the sheet. The scaffold material may then be pushed into a catheter end. The catheter end may be inserted in a fistula. The scaffold material may then be flushed with a cell matrix that is based on the diced tissue to create a fistula plug, which may be left in the fistula.

Abstract: A biopsy syringe for excising tissue from skin and hair comprising a syringe for numbing the area to be excised coupled to a sleeve mounted on said syringe with a blade attached to distal edge of said sleeve. Said sleeve is manually slidable from an extended position where the needle is hidden within to a retracted potion where the needle is exposed.

Abstract: A biopsy device may include a needle, a cutter, and a handpiece. A vacuum pump in the handpiece may provide a vacuum to the needle and/or to the cutter. A pressure pump in the handpiece may also provide pressurized air to the needle and/or to the cutter. A motor in the handpiece may drive the vacuum pump, the pressure pump, and/or the cutter. A vacuum sensor may sense a vacuum level within the biopsy device, and cause initiation of operational cycles in response to sensed vacuum levels. Portions of a valving mechanism and a clutching mechanism may be integrally formed. A clutching and valving mechanism may be driven by a first battery-powered motor; and a cutter, pressure pump, and vacuum pump by a second battery-powered motor. A biopsy device may thus provide vacuum, pressurized air, and power from within a handpiece, such that the biopsy device is tetherless.

Abstract: An integrated disposable includes a test strip and a lancet packet coupled to the test strip. The lancet packet includes a sterility sheet enclosing at least a portion of a lancet to maintain the sterility of the lancet. The lancet packet and the sterility sheet, in particular, allow the lancet to be sterilized separately from the test strip. The lancet in one form is incorporated into a lancet tape that is sterilized in a continuous, reel-to-reel sterilization process. The lancet tape in one form is sterilized using an electron beam sterilization process. With electron beam sterilization, sterilization is enhanced by irradiating both sides of the tape with electron beams. Sterilization can adversely affect chemical reagents in the test strip. To alleviate this chemistry degradation issue, the lancet packet is attached to the test strip after the lancet is sterilized.

Abstract: A biopsy device includes a housing. A drive is enclosed in the housing. A biopsy needle assembly has a biopsy needle carrier that carries a biopsy needle. The biopsy needle carrier is positioned in the housing. A vacuum pump is positioned in the housing. The vacuum pump has an elongate cylinder and a piston sealed and movable inside the elongate cylinder. The piston is drivably coupled to the drive. The elongate cylinder is connected to the biopsy needle to generate a vacuum in the biopsy needle when the piston is driven by the drive. The elongate cylinder and the biopsy needle are arranged in parallel by the housing.

Abstract: A biopsy cannula and a delivery catheter are configured to deliver one or more absorbable sponge pledgets to a biopsy site after removal of one or more tissue samples from the site. The delivery catheter allows a large amount of hydrated sponge material to be delivery to the biopsy site to facilitate hemostasis. One example of the delivery catheter includes a closed distal end, a side port, a tapered section, and an enlarged proximal portion for receiving the pledget. The side port of the delivery catheter is arranged to delivery the pledget through the side port of the biopsy cannula. In order to fill a relatively large biopsy site where multiple tissue samples have been taken in a radial pattern, the biopsy cannula is rotated and additional pledgets are delivered to the biopsy site at different radial locations. The absorbable sponge pledget may also be used as a marker for location of the biopsy site at a later time.

Abstract: A biopsy device is disclosed that comprises a cutting element mounted to a handpiece and a vacuum chamber. The cutting element comprises a stylet assembly and an outer cannula assembly. The stylet assembly includes a stylet that includes an open proximal end and a tissue opening at a distal end thereof. The distal end of the stylet is blunt-shaped. The tissue receiving opening is in communication with a lumen extending through the stylet. The outer cannula assembly includes an outer cannula that is slidably mounted over the stylet and has an open distal end with a cutting edge formed thereon. The vacuum chamber is in communication with the lumen of the stylet. The stylet is selectively advanced distally outwardly with respect to outer cannula to expose the tissue opening to targeted tissue. The outer cannula is selectively advanced over the tissue opening to sever tissue, while vacuum is generated in the vacuum chamber and delivered to the tissue opening through the lumen.