Patent Publication Number: US-2021186545-A1

Title: Microforceps

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims benefits and priority to U.S. Provisional Patent Application No. 62/951,170, filed on Dec. 20, 2019, the entire disclosure of which is incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     The present disclosure generally relates to the field of biopsy and, more specifically, to forceps deployable through a needle. 
     BACKGROUND 
     Endoscopes are well-known in the medical arts and are commonly used for numerous medical procedures. One such procedure is removing objects from the inside of a human subject, such as for example, foreign bodies, excised human tissues from the wall of the gastrointestinal tract, and previously inserted medical objects, such as stents. One conventional technique for removing objects is using a grasping tool in an endoscopic procedure. Conventional endoscopic grasping devices have one or two jaws which pivot relative to a base. The jaw or jaws at the distal end of the device may be pivoted by a user operating a handle at a proximal end of the device and at a proximal location outside of the endoscope. The object may be held by the jaws while the endoscope, grasping device, and object are removed from the patient. The success of the user to grasp and retain objects during the procedure is dependent on several factors, including the shape and structure of the jaws (and the jaw teeth). 
     SUMMARY 
     In one exemplary embodiment, an endoscopy device is provided. The endoscopy device includes at least a fork defining a guide channel, a pair of control arms pivotally mounted about the fork at a proximal end of the guide channel, and a pair of jaws movable between a closed position and open position. Each jaw includes a grasping portion having a plurality of teeth and a connection portion. The grasping portion includes at least a front tooth formed at a distal end of the grasping portion, and a plurality of rear teeth formed between the front tooth and a proximal end of the grasping portion. The connection portion includes a first opening at a distal end of the connection portion and a second opening at a proximal end of the connection portion. The first opening is elongated and each jaw is pivotally mount at a distal end of the guide channel via the first opening, and each jaw is pivotally mounted to one of the pair of control arms via the second opening. 
     In another exemplary embodiment, a microforceps assembly is provided. The microforceps assembly includes at least a fork and two jaws pivotally mounted about a pivot point at a distal end of the fork and movable between an open position and a closed position. Each jaw includes a connection portion and a grasping portion. The connection portion of each jaw is mounted at the pivot point at the distal end. The grasping portion includes at least a front tooth, an intermediate tooth, and a rear tooth. One or more of the intermediate tooth and the rear tooth are curved in a proximal direction towards the connection portion. 
     In yet a further exemplary embodiment, a microforceps jaw is provided. The microforceps jaw includes at least a jaw body having a grasping portion and a connection portion. The grasping portion is wider than the connection portion and includes a plurality of teeth extending from the jaw body. The connection portion includes a pair of differently shaped recessed areas or openings for connecting the jaw to parts of an endoscopy device. At least one of the differently shaped recessed area or opening is elongated. 
     These and other objects, features and advantages of the present disclosure will become apparent from the following detailed description of illustrative embodiments thereof, which is to be read in connection with the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       These and other features of the present disclosure will become better understood with regard to the following description and accompanying drawings in which: 
         FIG. 1A  illustrates an exemplary embodiment of an endoscopic grasping device in a closed position, and in accordance with the disclosure provided herein; 
         FIG. 1B  illustrates an exemplary embodiment of the endoscopic grasping device of  FIG. 1A  in an open position; 
         FIG. 2  illustrates an exemplary embodiment of a handle assembly in accordance with the disclosure provided herein; 
         FIG. 3  illustrates an exemplary embodiment of a microforceps assembly in accordance with the disclosure provided herein; 
         FIG. 4  illustrates an exploded view of an exemplary embodiment of a microforceps assembly in accordance with the disclosure provided herein; 
         FIG. 5  illustrates an exemplary embodiment of a fork in accordance with the disclosure provided herein; 
         FIG. 6A  illustrates a side view of an exemplary embodiment of a fork in accordance with the disclosure provided herein; 
         FIG. 6B  illustrates a top view of an exemplary embodiment of a fork in accordance with the disclosure provided herein; 
         FIG. 6C  illustrates a perspective view of a distal end of an exemplary embodiment of a fork in accordance with the disclosure provided herein; 
         FIG. 6D  illustrates a perspective view of a proximal end of an exemplary embodiment of a fork in accordance with the disclosure provided herein; 
         FIG. 7A  illustrates a perspective view of an exemplary embodiment of a pusher in accordance with the disclosure provided herein; 
         FIG. 7B  illustrates a top view and bottom view of an exemplary embodiment of a pusher in accordance with the disclosure provided herein; 
         FIG. 8A  illustrates a side view of an exemplary embodiment of a pusher in accordance with the disclosure provided herein; 
         FIG. 8B  illustrates a perspective view of a distal end of an exemplary embodiment of a pusher in accordance with the disclosure provided herein; 
         FIG. 8C  illustrates a perspective view of a proximal end of an exemplary embodiment of a pusher in accordance with the disclosure provided herein; 
         FIG. 9A  illustrates a perspective view of an exemplary embodiment of a pair of arms of a microforceps assembly in accordance with the disclosure provided herein; 
         FIG. 9B  illustrates a side view of an exemplary embodiment of the pair of arms of  FIG. 9A . 
         FIG. 10A  illustrates a perspective view of an exemplary embodiment of an arm in accordance with the disclosure provided herein; 
         FIG. 10B  illustrates side views of an exemplary embodiment of the arm of  FIG. 10A ; 
         FIG. 11A  illustrates a top view of an exemplary embodiment of the arm of  FIG. 10A ; 
         FIG. 11B  illustrates a front view of an exemplary embodiment of the arm of  FIG. 10A ; 
         FIG. 12A  illustrates a perspective view of an exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 12B  illustrates a second perspective view of the jaw of  FIG. 12A ; 
         FIG. 13A  illustrates a perspective view of an exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 13B  illustrates an underside view of an exemplary embodiment of the jaw of  FIG. 13A ; 
         FIG. 14A  illustrates a side view of another exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 14B  illustrates a second side view of the jaw of  FIG. 14A ; 
         FIG. 15A  illustrates a perspective view of another exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 15B  illustrates an underside view of an exemplary embodiment of the jaw of  FIG. 15A ; 
         FIG. 16A  illustrates a side view of an embodiment of a microforceps assembly in a closed position, and in accordance with the disclosure provided herein; 
         FIG. 16B  illustrates a top view of an embodiment of a microforceps assembly in an open position, and in accordance with the disclosure provided herein; 
         FIG. 17A  illustrates a side view of another exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 17B  illustrates a perspective view of the jaw of  FIG. 17A ; 
         FIG. 18  illustrates a side view of another exemplary embodiment of a jaw in accordance with the disclosure provided herein; 
         FIG. 19  illustrates a side view of yet another exemplary embodiment of a microforceps assembly in accordance with the disclosure provided herein; and 
         FIG. 20  illustrates a side view of yet a further exemplary embodiment of a microforceps assembly in accordance with the disclosure provided herein. 
     
    
    
     DETAILED DESCRIPTION 
     Aspects and implementations of the present disclosure will be understood more fully from the detailed description given below and from the accompanying drawings of the various aspects and implementations of the disclosure. This should not be taken to limit the disclosure to the specific aspects or implementations, but explanation and understanding only. 
     In discussing the exemplary embodiments herein, the terms “proximal” and “distal” are often used. These terms are used to describe a position or a direction with reference to the operator of the device. For example, the proximal position or proximal direction is toward the user or operator of the tool, and the distal position or direction is away from the user or operator of the tool, i.e., position or direction toward the object which the operator is attempting to grasp and retain. 
     Referring now to the drawings, which are for purposes of illustrating exemplary embodiments of the subject matter herein only, and not for limiting the same,  FIG. 1A  and  FIG. 1B  show an exemplary embodiment of an endoscopic grasping device  10  which may be used during an endoscopy ultrasound (EUS) procedure. 
     As shown in the figures, the endoscopic grasping device  10  may include at least a forceps assembly (e.g., a microforceps assembly  100 ), a sheath  12 , and a needle  14 . In the embodiment of  FIG. 1A  and  FIG. 1B , the endoscopic grasping device  10  is shown with at least one embodiment of the microforceps assembly  100  in a closed position ( FIG. 1A ) and an open position ( FIG. 1B ). 
     In some embodiments, the jaws of the microforceps assembly  100  may open between 0°-120°. In a further embodiment, a diameter of the microforceps assembly  100  may be between 0.013 to 0.160 inches when the jaws of the microforceps assembly  100  are in the closed position. Additionally, or alternatively, the diameter of the microforceps assembly  100  may be between 0.013 to 0.023 inches, for example, when used with a 22 gauge needle. 
     With continued reference to  FIG. 1A  and  FIG. 1B , the microforceps assembly  100  is shown extending in a distal direction from the sheath  12  of the needle  14 . In some embodiments, the endoscopic grasping device  10  may further include one or more control wires or drive wires (not shown). The drive wires may be operably connected to one or more jaws of the microforceps assembly  100 , for example, through the sheath  12  and towards the proximal end of the endoscopic grasping device  10 , for facilitating the opening and closing of the jaws. For example, a movement of the drive wire(s) in the distal direction may open the jaws as shown in  FIG. 1B , while a movement of the drive wire(s) in the proximal direction may close the jaws as shown in  FIG. 1A . The drive wire may be formed from stainless steel materials and/or other materials suitable for performing the functions of the drive wire and connectable to parts of the microforceps assembly  100  (e.g., a nickel titanium such as Nitinol). In some embodiments, the suitable materials may include any medical grade materials (i.e., materials safe for use in a medical application). 
     In some embodiments, the sheath  12  may be a spring sheath catheter, a solid tube, or a tube with laser cuts. The sheath  12  may run the length of the endoscopic grasping device  10 , for example, from the microforceps assembly  100  (or portions thereof (e.g., a fork)) to a handle assembly  20  of the endoscopic grasping device  10 . The sheath  12  may be formed of a coil wire and may be a variety of shapes, such as for example, a circular cross section or a rectangular cross section. In some embodiments, the sheath  12  may be PTFE (Teflon) coated or a heat shrink coated (e.g., on its outside). The diameter of the sheath  12  may vary and be based on a diameter of the needle  14 . In some embodiments, an outside diameter range of the sheath  12  may be between 0.013 to 0.160 inches. Additionally, or alternatively, the diameter may be between 0.013 to 0.023 inches, for example, when used with a 22 gauge needle. 
     It should be appreciated that the sheath  12  may be long enough to allow for a reasonable length beyond the proximal end and/or beyond the distal end of an endoscope. It should be further appreciated that the length of the sheath  12  may be based on a total working length of the endoscopic grasping device  10 . In some embodiments, for example, a length of the sheath  12  may be between 43 to 138 inches. In some embodiments, the drive wire within the sheath  12  may run the length of the endoscopic grasping device  10 . 
     The inside of the sheath  12  may include or be formed from a lubricious material, such as a High-density polyethylene (HDPE) or other thermoplastic polymers, or in some embodiments, the sheath  12  may include a tubing of some lubricious material, such as HDPE, running through the length of the endoscopic grasping device  10 . It should be appreciated that the tubing may reduce metal-on-metal contact between the sheath  12  and the drive wire, which may further reduce wear and provide for a smoother operation of the endoscopic grasping device  10 . It should further be appreciated that other friction-reducing structure(s) may be used. 
     In some embodiments, the needle  14  may be a 22 gauge hollow needle. It should be appreciated that embodiments of the microforceps assembly  100  disclosed herein may be sized or otherwise shaped for being disposed (e.g., at least partially disposed) within the 22 gauge needle. It should further be appreciated that due to the size of the needle  14 , one or more parts of the microforceps assembly  100  (or the device itself) may be fabricated via a micromachining process, metal injection molding process, a ceramic injection molding process, a stamping process, or other process configurable to fabricate microforceps of a same or similar size for use with, e.g., the 22 gauge needle. 
     With reference now to  FIG. 2 , the endoscopic grasping device  10  may be operably connected to a handle assembly  20  for operably controlling the grasping function (e.g., an opening and closing) of the microforceps assembly  100  in operation. The handle assembly  20  may be at the proximal end of the endoscopic grasping device  10 . In some embodiments, the handle assembly  20  may include at least a base  22  and a slider  24 . The handle assembly  20  may be used to transfer a linear motion of the slider  24  to open and close jaws of the microforceps assembly  100  at the distal end of the endoscopic grasping device  10 . In some embodiments, the handle assembly  20  may include a ring  26  and link  28  for operably opening and closing the jaws. 
     In operation, a user may insert a thumb from one hand into the ring  26  and rest several fingers (e.g., from the same hand) on, or around the slider  24 . The link  28  may be attached directly or indirectly to the drive wire within the sheath  12 . Moving the slider  24  relative to the base  22  may cause the link  28  to move. Consequently, the user may open the jaws by actuating the slider  24  and moving it, for example, in the distal direction, and may close the jaws by moving the slider, for example, in the proximal direction. It should be apparent to one skilled in the art that the design and operation of the handle assembly  20  and the link  28  to the control and/or drive wire may vary in the practice of this invention. 
     With reference now to  FIG. 3  and  FIG. 4 , the microforceps assembly  100  may include at least a fork  110 , and in some embodiments, a pusher  120  operably connected to one or more arms  130  (two shown in  FIG. 3 ) and a first jaw  140  and second jaw  142 . 
     As illustrated in  FIG. 4 , and to improve the closing force of the jaws in operation, length A of the first jaw  140  and/or second jaw  142  may be greater than length B of one or more of the arms  130 . 
     In some embodiments, length A may be the distance between a first point of a first opening in the jaw and a second point of a second opening in the same jaw. For example,  FIG. 4  (and also  FIG. 12A ) shows length A measured from a distal point of a first opening  150  to a point of a second opening  152 , which may be at or near a center of the second opening  152 . Additionally, or alternatively, length A may be measured between a center point of the first opening  150  and a point of the second opening  152 . 
     In some embodiments, length B may be the distance between a first point at one end of the arm  130  (e.g., where the arm  130  may be pivotally connected to the jaw) and a second point at an opposite end of the arm  130 . In the embodiment of  FIG. 4  (and also  FIG. 10B ), length B is shown measured between a center point of an arm pin  132  at a distal end of the arm  130  and a center point of an opening (e.g., a first opening  134 ) at a proximal end of the arm  130 , for example, where the arm  130  may be connectable to the fork  110  and/or a pusher  120 . 
     It should be appreciated that length A and/or length B may be measured from one or more points or areas proximate to and/or surrounding a center point of the openings described above. 
     With reference now to  FIG. 5  and  FIG. 6A - FIG. 6D , the fork  110  may include one or more guide channels  112 . In some embodiments, portions of the guide channel  112  (e.g., at a proximal end of the guide channel  112 ) may be sized or otherwise shaped for receiving at least a portion of the pusher  120  therebetween. Additionally, or alternatively, portions of the guide channel  112  may be sized or otherwise shaped for receiving portions of one or more of the remaining parts of the microforceps assembly  100  therebetween (e.g., one or more arms  130  and/or first jaw  140  and second jaw  142 ). 
     The fork  110  may include one or more fork pins  114  for connecting parts of the microforceps assembly  100 . In the embodiment of  FIG. 5 , a pair of fork pins  114  may be provided at a distal end of the fork  110 . In some embodiments, for example, as shown in  FIG. 6C , the pair of fork pins  114  may be offset from one another. It should be appreciated that offset fork pins  114  provides a mechanical advantage and improves the closing force of the microforceps assembly  100  in operation. For example, the offset fork pins  114  may raise the point of leverage during operation, so when the pusher  120  pulls in the proximal directions, the arm  130  pushes down resulting in an increased closing force. 
     Additionally, or alternatively, each fork pin  114  may be sized or otherwise shaped for being at least partially received between openings within the jaws and/or arms of the microforceps assembly  100  so that the jaws and/or arms may pivot therefrom when operably connected to the fork  110 . In some embodiments, the fork pin  114  may be secure to or formed on an inside wall of the fork  110  within the guide channel  112 . 
     With continue reference to the figures, the fork  110  may include a collar  116  at the proximal end of the fork  110 . The distal end of the sheath  12  may be attached to the fork  110  at the collar  116 . The collar  116  may include an opening  118  for receiving the drive wire therebetween and into the guide channel  112  for connecting the drive wire (e.g., via weld) to portions of the pusher  120 . The opening  118  may extend from the proximal end of the fork  110  through the collar  116  and into the guide channel  112  to allow for the drive wire to connect to the pusher  120  via the collar  116 . 
     Additionally, or alternatively, the fork  110  may include one or more openings or slots  119  ( FIG. 20 ) in opposed sides of the fork  110 . Each slot  119  may be sized or otherwise shaped to allow for a movement (e.g., a slidable movement) of one or more arms  130  (or arm extensions  138 ) operably connected to the fork  110  via the slot  119  when opening and closing the jaws of the microforceps assembly  100  in operation. In some embodiments, the slot  119  may be elongated. 
     It should be appreciated that the slot  119  (e.g., the elongated slot) provides a mechanical advantage by allowing for an improved opening width of the jaws based on the slidable movement within the slot  119 , and also improves/increases the closing force of the jaws. It should further be appreciated that the slot  119  may assist with aligning one or more parts of the microforceps assembly  100  (e.g., the arm  130  and/or pusher  120 ) in operation. 
     In some embodiments, the slot  119  allows for a shorter arm  130  to be provided without sacrificing the opening width of the jaws. A shorter arm  130  may increase the downward force on the arm pin  132 , which increases the closing force on the jaws. 
     With reference now to  FIG. 7A - FIG. 7B  and  FIG. 8A - FIG. 8C , the pusher  120  may be sized or otherwise shaped to be at least partially disposed within the guide channel  112 . It should be appreciated that the portions of the fork  110  (e.g., the guide channel  112 ) may be arranged (or designed) to keep the pusher  120  in a substantially straight line for the entire stroke of the endoscopic grasping device  10  in operation. 
     In some embodiments, the pusher  120  may include one or more pusher pins  122  at a distal end of the pusher  120 . The pusher pin  122  may be sized or otherwise shaped to be at least partially disposed between an opening in the arm  130  for pivotably connecting the arm  130  thereto. 
     Additionally, or alternatively, the pusher  120  may include one or more openings or recessed areas. In one embodiment, an opening  124  may be formed at a proximal end of the pusher for receiving, for example, the drive wire therethrough. The drive wire may be disposed between the opening  124  at a proximal end of the pusher  120  and may be welded or otherwise affixed to the pusher  120 . 
     Additionally, or alternatively, a gap may be formed in the pusher  120 . The pusher  120  may be placed or otherwise positioned within the guide channel  112  such that the pusher  120  may then move (e.g., slide) within the guide channel  112  from a proximal end of the guide channel to a distal end of the guide channel  112 . 
     In operation, for example, a movement of the pusher  120  within the guide channel  112  in a distal direction may result in the jaws being opened, while a movement of the pusher  120  in a proximal direction may result in the jaws being closed. Additionally, the jaws may be opened via two separate pins that push outward to open the jaws and pulled inward to close the jaws. 
     With continued reference to the figures, and now with reference to  FIG. 9 - FIG. 11 , the arm  130  may include an arm pin  132  disposed at or near a distal end of the arm  130 . Additionally, or alternatively, the arm  130  may include one or more openings, including at least a first opening  134  at a proximal end of the arm  130 . 
     The arm pin  132  may be sized or otherwise shaped for connecting (e.g., pivotably connecting) the arm  130  to at least one of the first jaw  140  and/or second jaw  142 . The first opening  134  may be sized or otherwise shaped for receiving at least a portion of the pusher  120  (e.g., the pusher pin  122 ) therebetween. 
     In some embodiments, the arm  130  may include a shoulder  136 . The shoulder  136  may protrude or otherwise be formed from a side of the arm  130  and may be arranged such that the arm pin may be disposed between the shoulder and a side of the arm  130  at the distal end. As shown in  FIG. 10A , the shoulder  136  may protrude at or near a center of the arm  130  and may extend in a distal direction towards the distal end of the arm  130 . In some embodiments, a distal end of the shoulder  136  may extend beyond the distal end of the arm  130 . 
     With continued reference to the figures, and now with reference to  FIG. 12 - FIG. 15 , exemplary embodiments of the first jaw  140  and second jaw  142  are illustrated. As illustrated in the figures, each jaw includes at least a jaw body  144  having a connection portion  146  and a grasping portion  148 . In some embodiments, the connection portion  146  may have a thickness T ( FIG. 13B ) less than a width of the grasping portion  148 . In some embodiment, the combined thickness of the connection portions  146  for the first jaw  140  and second jaw  142  may be equal to or less than a width of any one jaw grasping portion  148 . 
     The connection portion  146  may include one or more openings at or near a distal end and/or proximal end of the connection portion  146 . In some embodiments, a first opening  150  may be provided at or near a distal end of the connection portion  146 . The first opening  150  may be sized for receiving at least a portion of the fork pin  114  therebetween and for connecting the fork  110  to the first jaw  140  and/or second jaw  142 . The first opening  150  may be shaped to allow for a movement (pivoting and/or sliding movement) of the fork pin  114  within the first opening  150  in operation. In some embodiments, the first opening  150  may be elongated to provide for slidable movement. 
     With continued reference to the figures, a second opening  152  may be provided at or near a proximal end of the connection portion  146 . In some embodiments, the second opening  152  may be sized or otherwise shaped for receiving at least a portion of the arm pin  132  therebetween. In some embodiments, the second opening  152  may be elongated (e.g., as shown in  FIG. 19 ) to allow for movement (pivoting and/or sliding) of the arm pin  132  within the second opening  152  in operation. It should be appreciated that the described geometries for the openings (e.g., the first opening  150  and/or the second opening  152 ) allow for a greater opening width of the jaws while improving the closing force by allowing for the arm  130  to be fabricated as short as possible. In yet a further exemplary embodiment, the arm pin  132  may be elongated. 
     In some embodiments, a thickness T of the connection portion  146  may be equal to or less than an arm pin gap (AG of  FIG. 11A ) between the shoulder  136  and the arm  130  body from where the shoulder  136  protrudes. 
     With continue reference to the figures, the grasping portion  148  may include at least a topside  154 , an underside  156 , a distal end, and a proximal end. The proximal end of the grasping portion  148  may begin at or near the distal end of the jaw body  144 . As illustrated in the figures, the grasping portion  148  of each jaw may include a plurality of teeth formed thereon or otherwise extending from an underside  156  of each jaw. As described herein, one or more teeth at a distal end of the grasping portion  148  may be referred to as a forward tooth and/or teeth  162  while one or more teeth at a proximal end of the grasping portion  148  of each jaw may be referred to a rear tooth and/or teeth  164 . 
     In some embodiments, the first jaw  140  may include a pair of forward teeth  162  formed at or near the distal end of the grasping portion  148 , and on opposed sides of the underside  156 . It should be appreciated that each opposed side where any teeth may be formed may be referred to as a row of teeth, even if only one tooth may be provided in a particular row. 
     As illustrate in  FIG. 13A , the forward teeth  162  may be aligned with each other on opposed sides of the grasping portion  148  at the distal end. In some embodiments, a jaw gap JG ( FIG. 13B ) may be defined or otherwise formed between the forward teeth  162 . The jaw gap JG may extend from the distal end of the grasping portion  148  towards the proximal end of the grasping portion  148  where a rear tooth  164  may be formed, or in some embodiments, towards the distal end of the connection portion  146 . In some embodiments, the rear tooth  164  may have a width corresponding to a width of the jaw gap JG. 
     With continued reference to the figures, the first jaw may include one or more intermediate teeth  166 . The intermediate teeth  166  may be disposed in a row along opposed sides of the underside  156  of the grasping portion  148 . 
     In some embodiments, the intermediate teeth  166  may be backward curved teeth (i.e., teeth curved or otherwise angled in the proximal direction). At least one intermediate tooth  166  may be adjacent to a forward tooth  162  on one side of the grasping portion  148  such that a tooth gap TG ( FIG. 13A ) is defined or otherwise formed between the forward tooth  162  and the adjacent intermediate teeth  166 . In some embodiments, the tooth gap TG between a forward tooth  162  and a next intermediate tooth  166  may be less than the tooth gap between intermediate teeth  166  in the same row of teeth along the underside  156 . 
     Additionally, or alternatively, a tooth gap TG between a forward tooth  162  and intermediate tooth  166  in one row may be different (e.g., equal to or less and/or equal to or greater) than a tooth gap TG between a forward tooth  162  and intermediate tooth  166  in a second opposite row. In some embodiments, the tooth gap TG between intermediate teeth  166  may be the same for each row of teeth. Additionally, or alternatively, the tooth gap TG between the rear tooth  164  and any intermediate teeth  166  on either row may be the same or vary. 
     With continue reference to the figures, the grasping portion  148  of one or more jaws may include one or more openings  168  (or similar fenestrations) extending through a thickness of the grasping portion  148  (i.e., through the topside  154  and underside  156 ). 
     In some embodiments, a diameter of each fenestration may be between 0.003 and 0.150 inches. Additionally, or alternatively, the diameter may be between 0.003 and 0.012 inches when used, for example, with a 22 gauge needle. In the embodiment of  FIG. 13B , at least 4 fenestrations  168  are shown extending through the thickness of the grasping portion  148 . In some embodiments, where multiple fenestrations are provided, a diameter for each fenestration  168 , or one or more of the fenestrations  168  may be at or about 0.008 inches. 
     In the embodiment of  FIG. 13B , the first jaw  140  is shown with four (4) openings  168  between the distal end and proximal end of the grasping portion  148 . It should be appreciated that the series of openings  168  on the jaws may assist with capturing samples from the grasp of the microforceps assembly  100  after the MFA is removed from the patient. It should be appreciated that the fenestrations (i.e., openings  168 ) are provided to assist with removing samples after the microforceps assembly  100  has been removed from the patient by allowing for any samples to be pushed out via the fenestrations. 
     In some embodiments, the openings  168  may be spaced an equidistance apart from one another. Additionally, or alternatively, the openings  168  in the first jaw  140  may be aligned (fully or partially) with openings  168  in the second jaw  142 . 
     With continued reference to the figures, a height H of the forward teeth  162  ( FIG. 12B ) may extend vertically pass a centerline of both the first jaw  140  and second jaw  142  when the first jaw and second jaw are operably connected. Additionally, or alternatively, the height of the intermediate teeth  166  may be less than a height of the forward teeth  162 , and in some embodiments, greater than a height of the rear tooth  164  and/or teeth. 
     In some embodiments, one or more of the forward teeth  162  may extend in a vertical direction such that a tip of the forward teeth  162  points toward the underside of the opposed jaw. Additionally, or alternatively, one or more tips for the intermediate teeth  166  may be pointed in the proximal direction (i.e., towards the proximal end of the microforceps assembly  100 ). 
     With reference to  FIG. 14A  and  FIG. 14B , the second jaw  142  may include a topside  170  and underside  172 . The underside  172  may include only one forward tooth  174  disposed at or near the distal end of the grasping portion  148 . In some embodiments, the forward tooth  174  may be positioned at the distal end such that the forward tooth  174  may be seated between the forward teeth  162  when the first jaw  140  and second jaw  142  are operably connected ( FIG. 16B ) and in a closed position. In this embodiment, for example, the forward tooth  174  may be disposed at or near a center of the jaw gap JG ( FIG. 15B ) formed on the underside  172 . 
     In some embodiments, the forward tooth  174  may extend from the underside  172  of the second jaw  142 . Additionally, or alternatively, the forward tooth  174  may extend outwardly from the distal end of the second jaw  142  and not the underside  172 . It should be appreciated that in an embodiment where the forward tooth  174  extends from the distal end of the second jaw  142 , the distal most point of the forward tooth  174  may be aligned (fully or partially aligned) with the distal most point of the forward teeth  162  when the microforceps assembly  100  is in the closed position. 
     Additionally, or alternatively, one or more rear teeth  176  of the second jaw  142  may be greater in height than the rear tooth  164  of the first jaw  140 . In the embodiment of  FIG. 15A , the second jaw  142  is shown with two rear teeth  176  disposed at opposite sides of the grasping portion  148  and spaced apart by the jaw gap JG, which may extend to the distal end of the connection portion  146 . In some embodiments of the second jaw  142 , the rear teeth  176  may be the only pair of teeth that may be aligned with one another on opposite sides of the grasping portion  148 . Additionally, or alternatively, at least one intermediate tooth  166  on one side of the grasping portion  148  may be arranged closer to the rear tooth  176  than another intermediate tooth  166  on the opposite side of the grasping portion  148  is closer to the rear tooth  176  on the opposite side. 
     With continued reference to the figures, and now with reference to  FIG. 16A , one or more teeth of the first jaw  140  may overlap with one or more teeth of the second jaw  142 . Additionally, or alternatively, one or more teeth of the first jaw  140  and the second jaw  142  may alternate as the outermost tooth of the microforceps assembly  100 .  FIG. 16A  illustrates an exemplary embodiment where teeth from both jaws alternate as the outermost teeth of the microforceps assembly  100  such that each outermost tooth belongs to a different jaw. 
     With reference now to  FIG. 17A  and  FIG. 17B , one or more teeth of the first jaw  140  and second jaw  142  may be primarily backwards angled (i.e., with minimal or no curvatures). This embodiments may be similar to the other embodiments of the jaws described herein in that a gap may be formed between the forward teeth of the first jaw  140  (and intermediate teeth  166  of both jaws) that may extend the length (or a portion of the length) of the grasping portion  148  (e.g., from the distal end of the grasping portion to a rear tooth at or near a proximal end of the grasping portion  148 ). 
     With reference now to  FIG. 18 , one or more teeth in the first jaw  140  may be grooved or recessed (e.g., via machining) to allow for one or more tips of teeth in the second jaw  142  to be seated therein when the microforceps assembly  100  is in the closed position. It should be appreciated that only the intermediate teeth  166  of the first jaw  140  may be configured for corresponding teeth tips of the second jaw  142  to be seated therein. In some embodiments, one or more rear teeth  164  of the first jaw  140  may be recessed for seating any tips of corresponding rear teeth of the second jaw  142 . Additionally, or alternatively, and as illustrated in  FIG. 18 , the tip portions within the seated (recessed) area near the distal end of the grasping portions  148  may be greater than the tip portions within the seated area near the proximal end of the grasping portions  148 . It should be appreciated that providing an embodiment of the microforceps assembly  100  where one set of teeth sits inside another set of teeth may result in an improved closing and gripping force of the microforceps assembly  100 . 
     It is to be understood that the detailed description is intended to be illustrative, and not limiting to the embodiments described. Other embodiments will be apparent to those of skill in the art upon reading and understanding the above description. Moreover, in some instances, elements described with one embodiment may be readily adapted for use with other embodiments. Therefore, the methods and systems described herein are not limited to the specific details, the representative embodiments, or the illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the general aspects of the present disclosure. 
     Additionally, the components and materials described hereinafter as making up the various embodiments are intended to be illustrative and not restrictive. It should be appreciated that many suitable components and materials that would perform the same or a similar function as the materials described herein are intended to be embraced within the scope of embodiments of the present disclosure.