Abstract: A platform device for material excision or removal from vascular structures for either handheld or stereotactic table use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous beak or scoopula closing under rotation may be incorporated.

Abstract: A tri-point tissue-collection needle configured similarly to a fine-needle-aspiration needle is configured to excise intact tissue cores for collection. The distal tip is configured with three beveled points separated by cutting edges, where a single longer/more distal point is trailed by and circumferentially separated from a symmetrical pair of points, providing a bilaterally symmetrical needle cannula distal end. A stylet may be provided through a lumen of the needle during introduction into a patient body, where the distal end surface of the stylet may be configured to complement the tri-point needle end configuration.

Abstract: A battery control method comprising detecting whether a current value of N battery systems is greater than a safe current, where the safe current is a safe current of a target battery system, and the target battery system has a largest resistance difference of parallel branch circuits respectively corresponding to M battery cells in the target battery system, and adjusting the current value of the N battery systems when the current value of the N battery systems is greater than the safe current.

Abstract: An impedance measuring probe for use in a biopsy apparatus includes a metal elongate member having an elongate surface, a proximal end portion, and a distal end portion. The elongate surface has a recessed longitudinal channel having a depth that longitudinally extends from the proximal end portion into the distal end portion. A conductive wire electrode, having a connection end and a sensing end, is located in and extends along the recessed longitudinal channel. The connection end extends from the proximal end portion of the elongate member and the sensing end is located at the distal end portion of the elongate member. An insulation material is disposed in the recessed longitudinal channel of the elongate member and around the conductive wire electrode so as to electrically insulate the conductive wire electrode, and with the sensing end of the conductive wire electrode being exposed.

Abstract: A concept for facilitating a user interface for interacting with interventional medical devices depicted in an image. The positions of one or more features of at least one interventional medical device are identified. A size and shape of an interactive zone is determined for each feature, where an interactive zone (when provided on a display of a user interface) facilitates interaction with the corresponding feature and/or interventional medical device. The size of the interactive zone is chosen to be larger than the size of the feature. A position for the interactive zone is selected based on the position/position of the corresponding feature in the image. Zone information is then output to define the size, shape and position of the interactive zones with respect to the image.

Abstract: A bone marrow aspiration device and associated method includes an introducer needle assembly and an aspiration needle assembly. The introducer needle assembly includes an introducer cannula having proximal and distal ends, each end including an opening, and a screw assembly coupled to the introducer handle. The screw assembly includes a threaded tube and a lead screw receivable in the threaded tube. An outer cover is disposed around and in sealing engagement with the threaded tube and the lead screw. The aspiration needle assembly is receivable in the introducer cannula and includes an aspiration cannula forming a channel for aspirating bone marrow and including a flexible portion that extends from a distal end along a length of the aspiration cannula. A length of the aspiration cannula that extends beyond the distal end of the introducer cannula is adjustable by advancing the lead screw into or reversing the lead screw out of the threaded tube.

Abstract: A handle device is provided comprising a first wing and a second wing. The first wing and the second wing are configured to pivot about a common axis to one another. The first wing has one or more first ridge, and a first one or more clearance spaces. The second wing has one or more second ridges and a second one or more clearance spaces. The one or more first ridges is configured to be received within the second one or more clearance spaces and the one or more second ridges is configured to be received within the first one or more clearance spaces when the first wing is pivoted about the common axis to the second wing in a folded configuration.

Abstract: A device may comprise a work element, an outer tube co-axially disposed around a portion of the work element and a collar assembly. The work element may be configured to rotate and define proximal and distal ends, and may comprise a body portion, one or more articulable beak(s) configured to cut tissue, and a beak actuation portion. The collar assembly may be coupled to the work element away from the articulable beak(s), and may comprise a distal collar element coupled to the body portion, a middle collar element coupled to the outer tube and a proximal collar element coupled to the beak actuation portion. The distal collar element may comprise a first peripheral surface that extends around the distal collar element and that faces the proximal end and the middle collar element may comprise a second peripheral surface that that extends around the middle collar element, faces the distal end and at least partially contacts the first peripheral surface.

Abstract: A device for soft tissue biopsy or excision for either handheld or stereotactic table use may comprise a work element configured to selectively open and close at least one articulable beak configured to penetrate tissue, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks and provisions for simultaneous beak closing under rotation may be incorporated.

Abstract: An intraosseous access system can include a needle that defines a lumen and a longitudinal axis about which the needle can be rotated during an insertion event. The needle can include a proximal end that remains at an exterior of a patient during use, a distal end that can be inserted through the skin of the patient into contact with a bone of the patient, and a distal tip at a distalmost point of the distal end of the needle that is positioned at the longitudinal axis of the needle. The system can further include an obturator sized to be received within the lumen of the needle that can inhibit material from entering the needle as the system is inserted into the bone.

Abstract: A puncture device guide includes a body member configured to fixedly attach to an ultrasound probe, a slide member slidingly received within the body member; and a cradle member slidingly received within the slide member and longitudinally fixed relative to the body member. The cradle member is configured to receive a puncture device therein. Longitudinal movement of the slide member causes radial movement of the cradle member relative to the body member.

Abstract: A soft tissue biopsy device including: an elongated handle including a gripping member; an elongated flexible shaft mechanically comprising a hollow distal sampling portion with an internal lumen and a distal opening facing a soft tissue; a driving unit configured to rotate the sampling portion with a speed in a range of 100 rounds-per-minute (RPM) to 10,000 RPM while the sampling portion axially advances into said soft tissue.

Abstract: A bone biopsy system can include a cutting cannula that is coupled to a powered drill. The powered drill can be actuated to rotate the cutting cannula and cut through a cortical layer of a bone. The powered drill can be decoupled from the cutting cannula while the cutting cannula extends through the cortical layer of the bone. A handle may then be used to manually advance the cutting cannula to a greater depth within the bone to core a sample.

Abstract: The present disclosure relates generally to medical imaging devices, such as a real-time visualization and diagnostic and/or therapeutic tool assembly, which may include an ergonomic handle and catheter configured for dual-function use during a medical procedure. By way of non-limiting example, the medical device may be configured for use with a probe, such as one disposed at the distal end of the catheter, and delivered within a bronchoscope working channel to provide real-time visualization (e.g., radial ultrasound imaging) and manipulation (e.g., diagnostic biopsy sampling) of pulmonary nodules in peripheral regions of the lung. As disclosed herein, in various embodiments, one or more components of the medical imaging device may be configured to position a catheter with a first tool/instrument (e.g., a biopsy needle) within a peripheral region of the lung while maintaining real-time visualization of the pulmonary nodule (e.g., with a second tool/instrument, such as a radial ultrasound probe).

Abstract: A hysteroscopy system includes a scope having an internal channel, a sheath removably coupled to the scope, and an outflow channel. The sheath has a distal flange extending internally towards an outer surface of the scope. The outflow channel is formed between an inner surface of the sheath and an outer surface of the scope. The distal flange forms a distal end of the outflow channel and is generally located between the scope and the sheath.

Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: An intraosseous access device can include a device body, a trocar needle, and an intraosseous catheter removably disposed on the trocar needle. The device body can be configured to enable a user of the access device to manually insert a distal tip of the trocar needle through a skin surface of a body of a patient to an external surface of a bone of the patient. The intraosseous access device can include a first advancement member configured to provide a first distal advancement force sufficient to distally advance a distal tip of the trocar needle and the catheter through a skin surface to an external surface of a bone of a patient, and a second advancement member configured to provide a second distal advancement force sufficient to distally advance the distal tip of the trocar needle and the catheter through the external surface of the bone.

Abstract: A telescoping assembly such as an endobronchial ultrasound needle (EBUS) assembly includes a motor coupled to a biopsy needle within a telescoping housing to rotate (such as to oscillate) the needle during tissue harvest to improve harvesting.

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 includes a countersink having a predetermined length from the distal cutting edge of the outer needle.

Abstract: A cannula-stylet assembly for piercing tissues of a subject's body includes a stylet that is significantly longer than the cannula. The length of the stylet enables introduction of the stylet through the length of both the cannula and a gripping device that has been coupled to a proximal end of the cannula. A medical piercing system may include a cannula-stylet assembly with a long stylet and a gripping device that may remain assembled with the cannula when the stylet is removed from the cannula or a gripping device that remains assembled with a stylet of a conventionally configured cannula-stylet assembly when the stylet is removed from the cannula.

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 introduced to a biopsy site through an introducer in which the introducer is vented and/or a certain ratio of introducer inner diameter and biopsy device outer diameter is maintained.

Abstract: A specimen collector for gathering tissue specimens includes a housing extending along a first axis between a first opening and a second opening to define a hollow interior. An inlet port and an outlet port are located axially between the first and second openings. A specimen tray defines a first specimen well and a second specimen well and is slideably disposed within the housing and axially slideable between a first position to dispose the first specimen well in fluid communication with the inlet and outlet ports and a second position to dispose the second specimen well in fluid communication with the inlet and outlet ports. The specimen tray comprises a pair of tray components each defining a respective one of the first and second wells and jointly slideable. The pair of tray components are separable from one another and each individually removable from the housing.

Abstract: Provided are an ultrasound imaging apparatus and a method of controlling the same. The ultrasound imaging apparatus includes: a probe configured to transmit ultrasound signals to an object and receive echo signals corresponding to the ultrasound signals; a display; and at least one processor configured to detect a reference region of a medical tool inserted into the object in an ultrasound image generated based on the echo signals, control the display to display at least one distance-indicating line arranged with respect to the reference region in the ultrasound image, and update a position of the at least one distance-indicating line according to movement of the medical tool.

Abstract: A telescoping assembly such as an endobronchial ultrasound needle (EBUS) assembly includes a motor coupled to a biopsy needle within a telescoping housing to rotate (such as to oscillate) the needle during tissue harvest to improve harvesting.

Abstract: The disclosed technology is directed to a puncture needle access system for introducing guide wire into an interior of a tubular organ. The puncture needle access system includes an endoscope having an insertion portion. An endoscopic puncture needle is configured to be engaged with the insertion portion and includes an elongated tubular sheath having a lumen that extends in a longitudinal direction through the elongated tubular sheath. A tubular needle tube is inserted movably in the longitudinal direction into the lumen of the elongated tubular sheath. The tubular needle tube includes an inclined cutting-edge face formed at a distal end. The elongated tubular sheath includes an inclined surface oriented toward a distal end of the sheath so that the inclined surface comes closer to the elongated tubular sheath. The distal end of the sheath is located on a proximal end side of the sheath relative to a distal end of the inclined surface.

Abstract: A surgical instrument includes an end effector having a first jaw, a second jaw movable relative to the first jaw to grasp tissue therebetween, an anvil, a staple cartridge comprising staples deployable into the tissue, wherein the staples are deformable by the anvil, and a sensor configured to provide a sensor signal according to a physiological parameter of the tissue. The surgical instrument further includes a control circuit coupled to the sensor, wherein the control circuit is configured to receive the sensor signal, and assess proximity of the sensor to cancerous tissue based on the sensor signal.

Abstract: A handle for a medical device includes a proximal segment defining a proximal lumen extending therethrough and sized and shaped to receive an endoscopic medical device therein. A medial segment is received within a distal portion of the proximal segment and has an outer diameter smaller than an inner diameter thereof. A medial lumen extends through the proximal segment and is open to the proximal lumen. A distal segment is received within a distal portion of the medial segment and defines a distal lumen extending therethrough open to the medial lumen. The distal segment has an outer diameter smaller than an inner diameter of the medial segment. The medial segment includes a first movement limiting mechanism limiting movement of an endoscopic medical device inserted therethrough along an axis of the distal lumen and a second movement limiting mechanism limiting advancement of an endoscope attached to the distal body portion.

Abstract: A core needle biopsy device including a needle assembly, a cutter drive assembly, a piercer drive assembly and a piercer retraction assembly. The needle assembly includes a piercer and a hollow cutter. The piercer includes a sharp distal tip and a notch proximal to the distal tip. The piercer is slidably disposed within the cutter to sever a tissue sample into the notch. The cutter drive assembly is configured to selectively fire the cutter. The piercer drive assembly is configured to selectively fire the piercer. The piercer retraction assembly is configured to retract the piercer independently of the cutter while the needle assembly is disposed within a patient to expose the notch of the piercer to an exterior of a patient.

Abstract: A biopsy device includes a disposable elongated probe component having a coaxial arrangement of an elongated tubular section and an elongated tissue cutting member, and having a coaxial arrangement of a first driven gear, a second driven gear, and a third driven gear. The first driven gear is configured to rotate the elongated tubular section. The second driven gear is configured to rotate to longitudinally move the elongated tissue cutting member. The third driven gear is configured to rotate or oscillate the elongated tissue cutting member. A driver component has a coaxial arrangement of a first drive gear, a second drive gear, and a third drive gear. The first drive gear is drivably engaged with the first driven gear. The second drive gear is drivably engaged with the second driven gear. The third drive gear is drivably engaged with the third driven gear.

Abstract: A core biopsy system includes a core biopsy needle device and biopsy sample collection device, wherein the core biopsy needle device is positionable within and movable with respect to the biopsy sample collection device. Systems and methods for obtaining multiple biopsy samples with a single insertion of a needle of the biopsy needle device include obtaining sequential samples and storage in a multi-cell cartridge. Additional features and methods of the invention include obtaining two sample portions from each sample acquisition, wherein each of the two sample portions can be separately preserved and analyzed.

Abstract: Methods and devices are provided for preparing and implanting tissue scaffolds. Various embodiments of scribing tools are provided that are configured to mark one or more predetermined shapes around a defect site in tissue. The shape or shapes marked in tissue can be used to cut a tissue scaffold having a shape that matches the shape or shapes marked in tissue. In one embodiment, the scribing tool used to mark a shape in tissue can also be used to cut the tissue scaffold.

Abstract: The present invention relates to a tip for use with delivery devices, particularly for use in implanting retinal implants into the retinal space of an eye. The tip includes a flexible envelope and an internal sliding member. Further, the invention relates to an inserter attachment and a delivery device including said tip.

Abstract: A combined system for diagnostic and therapeutic procedures includes a needle extending longitudinally from a proximal end to a distal end and including a lumen extending therethrough, the distal end including a sharp grind for cutting a tissue sample to be collected in the lumen of the needle and a protective sheath sized and shaped to be inserted through the lumen of the needle such that a distal end of the protective sheath extends distally past the distal end of the needle, the protective sheath extending longitudinally from a proximal end to the distal end and including a lumen extending therethrough.

Abstract: A marker delivery device is described and claims. The marker delivery device is used to implant a detectable marker after a biopsy procedure is performed. The marker delivery device includes a cannula comprising a distal end and a marker exit positioned proximate the distal end; a rod extending within the cannula; and a flexible deployer operatively coupled with the rod and positioned proximate the marker exit.

Abstract: A surgical visualization system is disclosed. The surgical visualization system is configured to identify one or more structure(s) and/or determine one or more distances with respect to obscuring tissue and/or the identified structure(s). The surgical visualization system can facilitate avoidance of the identified structure(s) by a surgical device. The surgical visualization system can comprise a first emitter configured to emit a plurality of tissue-penetrating light waves and a second emitter configured to emit structured light onto the surface of tissue. The surgical visualization system can also include an image sensor configured to detect reflected visible light, tissue-penetrating light, and/or structured light. The surgical visualization system can convey information to one or more clinicians regarding the position of one or more hidden identified structures and/or provide one or more proximity indicators.

Abstract: A full core biopsy device includes a needle assembly having stylet, spoon, and at least one coring cannula. A window is located in at least one of the spoon and coring cannula. A excising finger is configured to prolapse through the window into a lumen of the inner spoon or cannula to sever a tissue sample upon translation or axial advancement of the excising finger.

Abstract: The present invention relates to deep learning implementations for medical imaging. More particularly, the present invention relates to a method and system for indicating whether additional medical tests are required after analysing an initial medical screening, in substantially real-time. Aspects and/or embodiments seek to provide a method and system for recommending additional medical tests, in substantially real-time, based on analysing an initial medical scan, with the use of deep learning.

Abstract: A fiber optic tracking sensor includes at least three optical fibers, each optical fiber having a plurality of fiber optic sensors along a length of a sensing portion of the sensor. A shape-memory member is coupled to the three optical fibers and provides support to the sensor. The at least three optical fibers are arranged in a spaced apart relationship, each offset from a central longitudinal axis of the sensor.

Abstract: An automatic biopsy gun is described, the gun comprising a body and a needle cantileverly extending from the body. The needle comprises a stylet provided with a collecting hollow to collect a tissue sample, and a cannula in which the stylet is slidingly housed so that the collecting hollow can come out of the cannula and go back in it with a guillotine effect. The gun further comprises a pushing member to push the cannula and a pushing member to push the stylet, both being movable in the body between a forward position and a rearward position in order to slide the stylet with respect to the cannula. Elastic countering means counter the pushing members which are loaded by driving means operable by the user. Advantageously, pushing members are guided by inner guides that are inside the gun body and the guide of the cannula is closer to the needle than the guide of the stylet.

Abstract: A biopsy device comprising: a cannula comprising an elongate cannula body extending between a cannula distal end and a cannula proximal end to define a lumen, wherein the cannula comprises a cutting portion at the cannula distal end; a stylet comprising an elongate body having a stylet distal end and a stylet proximal end, the stylet being slidably disposed within the lumen, wherein the stylet comprises a tissue sampling portion. The tissue sampling portion is formed by a notch in the body of the stylet at or near the stylet distal end. The biopsy device further comprises an actuator assembly, the actuator assembly arranged to move the cannula relative to the stylet between a retracted position in which at least part of the tissue sampling portion is exposed and an extended position in which the cannula at least partly surrounds the tissue sampling portion.

Abstract: An endoscopic device for biportal endoscopic spinal surgery is proposed. The device includes: a guide tube as a hollow tubular member extending in a longitudinal direction and having a front end thereof reaching a target site in a patient's body when being used, the guide tube accommodating a probe of an endoscope inserted therein; a saline solution guide part mounted on a rear end of the guide tube and guiding a saline solution injected from an outside to an inside of the guide tube; and an adapter part positioned at the rear end of the guide tube and guiding the probe of the endoscope to use to the guide tube.

Abstract: The disclosed embodiments include a computer-implemented method for improving efficacy of diabetes self-management with automated personalized computer engagement that reliably obtains a measurement message and/or contextual information used to determine a suitable insulin dosage of an insulin titration process to treat the diabetic patient. The method includes causing display of a messaging interface that couples the user of the computing device to a chat bot simulating a health coach in a natural conversation to obtain a measurement of the diabetic patient's blood-glucose level. The method includes determining an insulin dosage recommendation to treat the diabetic patient by processing the measured blood-glucose level with an insulin titration algorithm that is personalized for the diabetic patient, and generating an electronic signal configured to cause a corresponding action to be performed by a computing device (e.g., display message of recommended insulin dosage).

Abstract: A system including includes an intraosseous needle and a handle. The intraosseous needle includes a distal end configured for insertion into a bone and a proximal end configured to extend from the bone. The handle is configured to releasably engage the intraosseous needle. The handle includes a cylindrical body portion, a handle portion, and a channel. The cylindrical body portion includes a distal end configured to receive the proximal end of the intraosseous needle. The handle portion extends from the cylindrical body portion and has a bulb-like cross-sectional shape and opposing first and second substantially planar surfaces. The channel is configured to receive the proximal end of the intraosseous needle.

Abstract: Exemplary embodiments of an apparatus can be provided for obtaining portions or samples of tissue from a target region of a biological tissue. One or more needles can be provided that have a small internal diameter, e.g., about 1 mm or less, and the needles can be configured to extract the tissue portions when the needles are inserted into and withdrawn from the tissue. Windows and/or markings can be provided on the wall of the needles to facilitate access to the sample. The needles can be provided in an enclosure, and an actuator can be provided to direct the needles into the tissue and/or withdraw them. A plurality of tissue portions having known relative locations in the target region can be obtained, and extraction of the tissue portions can be well-tolerated by the tissue as compared with conventional punch biopsies or the like.

Abstract: An exemplary biopsy device includes (i) an elongated body, (ii) a hollow needle coupled to the distal end of the elongated body, the hollow needle having a channel that spans the length of the hollow needle, (iii) a trigger associated with the elongated body, (iv) a stylet having or associated with a biopsy element, the stylet being disposed within the channel of the hollow needle, operably connected to the trigger, and configured to extend beyond the distal end of the hollow needle and subsequently retract within the channel of the hollow needle, and (v) a spring mechanism operably connected to the trigger such that the spring mechanism compresses in response to operation of the trigger, extending the biopsy element, and is configured to rebound following compression, the rebound causing the biopsy element to retract toward or within the hollow needle.

Abstract: A biopsy device (100), comprising: a cannula (102) comprising an elongate cannula body (106) extending between a cannula distal end (108) and a cannula proximal end (110) to define a lumen (112), wherein the cannula comprises a cutting portion at the cannula distal end (108); a stylet (104) comprising an elongate body (116) having a stylet distal end (118) and a stylet proximal end (120), the stylet (104) being slidably disposed within the lumen (112), wherein the stylet (104) comprises a tissue sampling portion (122); and an alignment means (126) arranged to maintain a preferred alignment between the stylet (104) and the cannula (102), wherein the alignment means (126) is arranged to align one or more of: i) relative rotation between the stylet distal end and the cannula distal end; ii) relative flexing between the stylet distal end and the cannula distal end; and iii) relative axial translation between the stylet distal end and the cannula distal end.

Abstract: According to an aspect of the present disclosure, an end effector for use with a surgical device is provided. The end effector includes a driver, a clip assembly, a needle assembly, and biasing element. The clip assembly is disposed in mechanical cooperation with the driver. Rotation of the driver results in longitudinal translation of the clip assembly. The needle assembly is selectively engaged with the clip assembly. The biasing element is disposed in mechanical cooperation with the needle assembly and is configured to bias the needle assembly proximally.

Abstract: An approach is provided for delivering therapeutic materials to an intervertebral disc via a sub-ligamentous space. The approach includes positioning a tool at an interface of a longitudinal ligament and an outer surface of the intervertebral disc, in which the interface is the sub-ligamentous space. The tool may include a first needle and a second needle housed within the first needle. An insertion end of the first needle may include a shallow beveled end. The approach includes inserting the insertion end of the first needle into the sub-ligamentous space. The approach includes deploying the second needle from within the first needle into at least one of an annulus and a nucleus of the intervertebral disc. The approach includes delivering the therapeutic materials to the at least one of the annulus and the nucleus.

Abstract: A bone fragment and osteomedullary tissue harvesting system that includes a harvesting device, a collection vessel and tubing. The harvesting device includes a needle portion and a handle portion. The needle portion that has a needle bore that extends through at least part of the needle portion. The handle portion is operably attached to the needle portion. The handle portion includes a connection port and a vacuum control mechanism that are in communication with a handle bore that extends through the handle portion. The needle bore is in communication with the handle bore. The vacuum control mechanism includes a vacuum aperture that extends through a surface of the handle portion and is in communication with the handle bore. The collection vessel is capable of receiving aspirated bone fragments and tissue. The tubing operably connects the connection port and the collection vessel.

Abstract: Methods and apparatus are provided to facilitate the minimally invasive removal of tissue biopsies and to facilitate the direct approach to anesthetizing the chest wall, in accordance with embodiments of the present invention. A pull-type cutting device 1 comprises two coaxially nested tubes, each extending from a proximal end 21 to a distal end 22. The first tube 61 defines a guide wire lumen 23 for slidingly receiving a guide wire. The second tube 63 extends over the first tube 60 and coupled thereto at the distal end 22 defining an expandable portion 13 adjacent the distal end 22. The second tube 63 defines an inflation lumen 25 extending from the shaft proximal end 21 to the expandable portion 13. The inflation lumen 25 communicates inflation fluid from the proximal end 21 to the expandable portion 13 so as to inflate and deploy the expandable portion 13.