Patent Publication Number: US-2022225972-A1

Title: Biopsy device

Description:
This application is a continuation application of U.S. patent application Ser. No. 16/180,391, filed Nov. 5, 2018, the entire contents of which are incorporated by reference herein. 
    
    
     FIELD 
     The present disclosure generally relates to the field of tissue sampling and harvesting. More specifically, the disclosure relates to biopsy needle sets and devices. 
     BACKGROUND 
     In the practice of diagnostic medicine, it is often necessary or desirable to perform a biopsy, or to sample selected tissue from a living patient for medical evaluation. Cytological and histological studies of the biopsy sample can then be performed as an aid to the diagnosis and treatment of disease. Biopsies can be useful in diagnosing and treating various forms of cancer, as well as other diseases in which a localized area of affected tissue can be identified. 
     Biopsies are routinely performed on tissue using a needle set. One known needle set includes an outer cannula having a pointed distal tip and a tissue receiving opening defined near its distal end, and an inner cannula having an open distal end surrounded by an annular cutting blade. The inner cannula is slidably disposed within the outer cannula so that it can close the tissue receiving opening, thereby cutting tissue prolapsing into the lumen of the outer cannula through the tissue receiving opening. Typically, a hub is connected to the proximal end of each needle. Such needle sets are used with or incorporated in various forms of biopsy devices, including single action, double action, and driven (e.g., by motors, etc.) biopsy devices. 
     Currently, there are several soft tissue biopsy devices that are classified as Spring-Loaded Core (SLC) biopsy devices. These all share the characteristics of employing springs to create force and movement in cannulas axially to selectively remove a sample of the tissue. These devices are required to have the springs loaded, or armed, manually to compress and lock the springs in a compressed state to prepare for actuating the device. As the device is actuated the cutter/inner cannula moves rapidly forward to cut through tissue adjacent to the needle/outer cannula and contain it within the inner cannula until it is retrieved by the clinician. Typically, SLC biopsy devices are handheld. 
     Some current biopsy devices utilize a vacuum to remove tissue samples from the inner cannula and are classified as Vacuum Assisted Breast Biopsy (VABB) devices. 
     Some vacuum assisted biopsy devices are table mounted and others are handheld. Mounting the biopsy device to a table can limit the ability of a user to move the device relative to the patient but can offer more precision. Handheld devices can be both technically easier to use and less expensive. Vacuum assisted biopsy devices include tethered and tether-less designs. Tethered vacuum assisted biopsy devices utilize external vacuum sources such as in-wall vacuum sources in clinical rooms. Tether-less vacuum assisted biopsy devices include mechanism for generating a vacuum such as motor driven pistons. Tethered vacuum assisted biopsy devices can restrict a clinician&#39;s movement during a biopsy, reducing effectiveness and increasing patient discomfort. Tether-less vacuum assisted biopsy device can be heavy or bulky (for handheld operation) due to the presence of vacuum generating mechanisms. Those vacuum generating mechanisms can also result in higher cost of the device. 
     Handheld devices, whether SLC devices or VABB devices, are desired to be used during ultrasound guided biopsy procedures, in which a physician operates the handheld biopsy device in one hand and the ultrasound transceiver in the other. 
     Biopsy devices may have single insertion, single core or single insertion, multiple core (SIMC) designs. Single insertion in both these designs refers to a single insertion of the needle/outer cannula during a biopsy procedure. In single sample designs, the cutter/inner cannula moves forward to cut through tissue adjacent to the needle/outer cannula once during a biopsy procedure. In multiple sample designs, the cutter/inner cannula moves forward to cut through tissue adjacent to the needle/outer cannula, then moves backward to rearm and allow the cutter/inner cannula to move forward again to cut through different tissue adjacent to the needle/outer cannula. The needle/outer cannula may be moved or rotated between samples to biopsy a different location in the tissue. 
     SUMMARY 
     For ultrasound procedures many physicians prefer to use SLC devices because they are easier to maneuver and are less costly than the vacuum assisted counterparts. Those physicians would prefer to use SLC devices to acquire multiple samples in a single insertion. However, many current SLC devices are deficient in that they are difficult for users to manually re-arm the inner cannula to acquire a second sample after the outer cannula has been inserted into a patient. Manually overcoming the spring force to re-arm the inner cannula may result in unintended movement of the device with the outer cannula in the patient, thereby causing the patient unnecessary discomfort. While electric motors may be incorporated to drive the inner and outer cannulas, biopsy devices having electric motors are more complicated and costlier than those without electric motors. Further, biopsy devices having electric motors are not amenable to cleaning and sterilization (e.g., with liquids and heat), which may damage various electrical connections and microprocessor controllers. 
     Various embodiments described and claimed herein overcome the above stated problems by providing a single insertion, multiple core device that allows for advantages of both a spring-loaded device and a vacuum assisted device. In one embodiment, a biopsy device includes an elongated housing having a vacuum port. The device also includes a cutter hub slidably mounted in and/or to the housing. The device further includes a cutter having a proximal portion coupled to the cutter hub, where the respective cutter hub and cutter are movable relative to the housing between a proximal, armed position, and a distal, fired position. Moreover, the device includes a sealed cutter spring well fixedly disposed within the housing. In addition, the device includes a cutter firing spring seated in the cutter spring well, where proximal movement of the cutter hub relative to the housing compresses the cutter firing spring. The device also includes a vacuum lumen in communication with each of the vacuum port and the cutter spring well. The device further includes a cutter arming valve assembly having a valve member disposed in or adjacent to the vacuum lumen, where the cutter arming valve assembly is selectively configurable to place the cutter spring well in communication with the vacuum port via the vacuum lumen for arming the cutter, or in communication with atmosphere for firing the cutter. 
     In one or more embodiments, the cutter hub includes or is otherwise attached to a cutter arming latch configured to engage a cutter retention catch that is fixed relative to the housing to thereby retain the cutter hub and the cutter, respectively, in the armed position, where the cutter firing spring is in a compressed configuration when the cutter hub and the cutter are in the armed position. The device may also include a firing mechanism operatively coupled to the cutter arming latch such that actuation of the firing mechanism disengages the cutter arming latch from the cutter retention catch to allow the cutter firing spring to restore from the compressed configuration to an uncompressed configuration when the cutter arming valve assembly is configured to place the cutter spring well in communication with atmosphere. 
     In one or more embodiments, the device also includes a needle hub slidably mounted in and/or to the housing. The device further includes a needle having a lumen and proximal end portion coupled to the needle hub, where the respective needle hub and needle are movable relative to the housing between a proximal, armed position, and a distal, fired position, and where a distal portion of the cutter is slidably disposed in the needle lumen. Moreover, the device includes a needle spring well fixedly disposed within the housing. In addition, the device includes a needle firing spring seated in the needle spring well, where a proximal end portion of the needle hub includes, or is attached to, a movable distal end wall of the needle spring well so that proximal movement of the needle hub relative to the housing compresses the needle firing spring. 
     In one or more embodiments, the needle includes a closed, tissue penetrating distal end, and a side tissue resection window disposed in a distal portion of the needle. The needle hub may include or be otherwise attached to a needle arming member moveably mounted in and/or to the housing, the needle arming member configured for manually-actuated movement from a relaxed, extended position to a loaded, compressed position to define a compressive needle arming stroke. The needle hub and the cutter hub may be configured such that manually actuating the needle arming member moves the cutter hub and the cutter into the armed position and compresses the cutter firing spring. 
     In one or more embodiments, the device also includes a needle retention latch that engages the cutter retention latch. The outer cannula hub may include, or be otherwise attached to, the needle retention latch having a needle catch at a proximal end thereof configured to engage an outer cannula retention catch disposed on, or otherwise attached to, the cutter arming latch to thereby retain the outer cannula hub and outer cannula, respectively, in an armed position, where the outer cannula firing spring is in a compressed configuration when the outer cannula is in the armed configuration. Actuation of the firing mechanism may disengage the outer cannula arming latch from the outer cannula retention catch in order to fire the respective outer cannula hub and outer cannula distally relative to the housing due to the outer cannula firing spring restoring from the compressed configuration to an uncompressed configuration, in which the outer cannula is in a fired position. A proximal end portion of the cutter hub may include, or be otherwise attached to, a movable distal end wall of the cutter spring well. 
     In another embodiment, a method for tissue biopsy includes moving a needle from a distal fired position within an elongate housing to a proximal armed position, thereby compressing a needle firing spring within a needle firing spring chamber. The method also includes moving a cutter slidably and coaxially disposed in the needle from a distal fired position to a proximal armed position, thereby compressing a cutter firing spring within a cutter firing spring chamber. The needle and/or the cutter are moved to their respective proximal armed positions by a vacuum provided through a vacuum port in the elongated housing, where the vacuum generates sufficient force to compress the needle firing spring and/or the cutter firing spring. 
     In one or more embodiments, the method also includes actuating a firing mechanism to release the compressed needle firing spring and the compressed cutter firing spring to allow the compressed needle firing spring and the compressed cutter firing spring to move the needle and the cutter from respective proximal armed positions to respective fired positions. Actuating the firing mechanism may redirect the vacuum from the needle firing spring chamber and the cutter firing spring chamber to a needle firing assist chamber and a cutter firing assist chamber, respectively. 
     In still another embodiment, a biopsy device includes a housing having a vacuum port. The device also includes an outer cannula having a lumen and a tissue penetrating distal end, where a proximal end portion of the outer cannula is movably coupled to the housing, a distal portion of the outer cannula having a having a side tissue resection window. The device further includes a cutter having a distal portion slidably disposed in the outer cannula lumen, where the cutter is movably coupled to the housing, and where a proximal portion of the cutter extends out of a proximal end opening of the outer cannula. Moreover, the device includes an outer cannula firing member movably disposed in said housing, where a proximal end portion of the outer cannula is coupled to the outer cannula firing member. In addition, the device includes a cutter firing member movably disposed in said housing, where a proximal portion of the cutter is coupled to the cutter firing member. The device also includes an outer cannula firing spring seated in an outer cannula firing spring chamber within the housing, where proximal movement of the outer cannula firing member relative to the housing compresses the outer cannula firing spring. The device further includes a first cutter firing spring seated in a first cutter firing spring chamber within the housing, Moreover, the device includes a second cutter firing spring seated in a second cutter firing spring chamber within the housing, where proximal movement of the cutter firing member relative to the housing compresses the first and second cutter firing springs. In addition, the device includes a cutter vacuum lumen that is in fluid communication with each of the vacuum port, the first cutter firing spring chamber and the second cutter firing spring chamber. The method also includes a cutter arming valve member movably disposed in the cutter vacuum lumen and configured to selectively simultaneously place the first and second cutter firing spring chambers in communication with the vacuum port or to simultaneously isolate the first and second cutter firing spring chambers from the vacuum port. 
     In one or more embodiments, the cutter firing member includes or is otherwise attached to a cutter arming latch configured to engage a cutter retention catch that is fixed relative to the housing to thereby retain the cutter firing member and the cutter, respectively, in a proximal armed position, where the cutter firing spring is in a compressed configuration when the cutter hub and the cutter are in the armed position. The device may also include a firing mechanism operatively coupled to the cutter arming latch such that actuation of the firing mechanism disengages the cutter arming latch from the cutter retention catch to allow the cutter firing spring to restore from the compressed configuration to an uncompressed configuration when the cutter arming valve member is configured to place the cutter spring well in communication with atmosphere. 
     In one or more embodiments, the outer cannula firing member includes or is otherwise attached to an outer cannula arming member moveably mounted in and/or to the housing, the outer cannula firing member configured for manually-actuated movement from a relaxed, extended position to a loaded, compressed position to define a compressive arming stroke. The outer cannula firing member and the cutter firing member may be configured such that manually actuating the outer cannula firing member moves the cutter firing member and the cutter into a proximal armed position and compresses the cutter firing spring. The device may also include an outer cannula retention latch that engages the cutter retention latch. The outer cannula firing member may include, or be otherwise attached to, the outer cannula retention latch having an outer cannula catch at a proximal end thereof configured to engage an outer cannula retention catch disposed on, or otherwise attached to, the cutter arming latch to thereby retain the outer cannula firing member and outer cannula, respectively, in an armed position, where the outer cannula firing spring is in a compressed configuration when the outer cannula is in the armed configuration. 
     In one or more embodiments, actuation of the firing mechanism disengages the outer cannula arming latch from the outer cannula retention catch in order to fire the respective outer cannula firing member and outer cannula distally relative to the housing due to the outer cannula firing spring restoring from the compressed configuration to an uncompressed configuration, in which the outer cannula is in a fired position. The outer cannula firing member may form a distal end wall of the outer cannula firing spring chamber. Respective portions of the cutter firing member may form respective distal end walls of the first and second cutter firing spring chambers. 
     In yet another embodiment, a biopsy device includes a housing having a vacuum port. The device also includes an outer cannula having a lumen and a tissue penetrating distal end, where a proximal end portion of the outer cannula is movably coupled to the housing, a distal portion of the outer cannula having a having a side tissue resection window. The device further includes a cutter having a distal portion slidably disposed in the outer cannula lumen, where the cutter is movably coupled to the housing, and where a proximal portion of the cutter extends out of a proximal end opening of the outer cannula. Moreover, the device includes an outer cannula firing member movably disposed in said housing, where a proximal end portion of the outer cannula is coupled to the outer cannula firing member. In addition, the device includes a cutter firing member movably disposed in said housing, where a proximal portion of the cutter is coupled to the cutter firing member. The device also includes an outer cannula firing spring seated in an outer cannula firing spring chamber within the housing, where proximal movement of the outer cannula firing member relative to the housing compresses the outer cannula firing spring. The device further includes a cutter firing spring seated in a cutter firing spring chamber within the housing, where proximal movement of the cutter firing member relative to the housing compresses the cutter firing spring. Moreover, the device includes an outer cannula vacuum lumen in fluid communication with the vacuum port and the outer cannula firing spring chamber. In addition, the device includes a cutter vacuum lumen in fluid communication with the vacuum port and the cutter firing spring chamber. The device also includes an outer cannula arming valve disposed adjacent the outer cannula vacuum lumen and configured to selectively place the outer cannula firing spring chamber in communication with the vacuum port or to isolate the outer cannula firing spring chamber from the vacuum port. The device further includes a cutter arming valve disposed adjacent the cutter vacuum lumen and configured to selectively place the cutter firing spring chamber in communication with the vacuum port or to isolate the cutter firing spring chamber from the vacuum port. 
     In one or more embodiments, the device also includes an outer cannula firing assist chamber within the housing, where the outer cannula firing member forms a proximal end wall of the outer cannula firing assist chamber. The device further includes a cutter firing assist chamber within the housing, where the cutter firing member forms a proximal end wall of the cutter firing assist chamber. Moreover, the device includes a firing assist vacuum lumen that is in fluid communication with each of the vacuum port, the outer cannula firing assist chamber, and the cutter firing assist chamber. In addition, the device includes a firing assist valve disposed adjacent the firing assist vacuum lumen and configured to selectively place the outer cannula firing assist chamber and the cutter firing assist chamber in communication with the vacuum port or to isolate the outer cannula firing assist chamber and the cutter firing assist chamber from the vacuum port. 
     In one or more embodiments, the device also includes an outer cannula vent valve disposed adjacent the outer cannula vacuum lumen and configured to selectively place the outer cannula firing spring chamber in communication with an atmosphere or to isolate the outer cannula firing spring chamber from the atmosphere. The device further includes a cutter vent valve disposed adjacent the cutter vacuum lumen and configured to selectively place the cutter firing spring chamber in communication with the atmosphere or to isolate the cutter firing spring chamber from the atmosphere. Moreover, the device includes a firing assist vent valve disposed adjacent the firing assist vacuum lumen and configured to selectively place the outer cannula firing assist chamber and the cutter firing assist chamber in communication with the atmosphere or to isolate the outer cannula firing assist chamber and the cutter firing assist chamber from the atmosphere. The outer cannula firing member may form a distal end wall of the outer cannula firing spring chamber. The cutter firing member may form a distal end wall of the cutter firing spring chamber. 
     Other and further aspects and features of embodiments of the disclosed inventions will become apparent from the ensuing detailed description in view of the accompanying figures. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The drawings illustrate the design and utility of embodiments of the disclosed inventions, in which similar elements are referred to by common reference numerals. These drawings are not necessarily drawn to scale. In order to better appreciate how the above-recited and other advantages and objects are obtained, a more particular description of the embodiments will be rendered, which are illustrated in the accompanying drawings. These drawings depict only typical embodiments of the disclosed inventions and are not therefore to be considered limiting of its scope. 
         FIG. 1  is a perspective view of a biopsy device, according to some embodiments. 
         FIG. 2A  is a side cross-sectional view of the biopsy device depicted in  FIG. 1  in a fully armed configuration. 
         FIG. 2B  is a detailed side cross-sectional view of the biopsy device depicted in  FIG. 1  in a fully armed configuration. 
         FIG. 3A  is a side cross-sectional view of the biopsy device depicted in  FIG. 1  in a fully fired configuration. 
         FIG. 3B  is a detailed side cross-sectional view of the biopsy device depicted in  FIG. 1  in a fully fired configuration. 
         FIG. 4A  is a side cross-sectional view of the biopsy device depicted in  FIG. 1  in a partially armed configuration. 
         FIG. 4B  is a detailed side cross-sectional view of the biopsy device depicted in  FIG. 1  in a partially armed configuration. 
         FIG. 5  is a perspective view of a biopsy device, according to some embodiments. 
         FIG. 6  is a side cross-sectional view of the biopsy device depicted in  FIG. 5  in a fully armed configuration. 
         FIG. 7  is a side cross-sectional view of the biopsy device depicted in  FIG. 5  in a fully fired configuration. 
         FIG. 8  is a side cross-sectional view of the biopsy device depicted in  FIG. 5  in a partially armed configuration. 
         FIG. 9  is a flow chart illustrating a method for tissue biopsy according to some embodiments. 
     
    
    
     DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS 
     As described above, with a single insertion, single core spring-loaded needle biopsy device, the needle/outer cannula may be manually re-inserted multiple times to take multiple samples. Re-inserting the needle/outer cannula can cause additional pain and scarring for the patient. Such manual manipulation can cause fatigue for the physician operating the device and increase the procedure time if multiple cores are obtained. Similarly, with a manually operated single insertion, multiple core spring-loaded needle biopsy device, the cutter/inner cannula may be manually re-armed before taking each sample. Manually overcoming the spring that fires the cutter/inner cannula can cause fatigue for the physician operating the device and increase the procedure time and discomfort for the patient. Various embodiments described and claimed herein overcome the above stated problems by providing a single insertion, multiple core device that allows for advantages of both a spring-loaded device and a vacuum assisted device. The devices described herein can be attached to a vacuum source, such an in-wall vacuum source or a standing vacuum source which can be found in a procedure room. 
     Vacuum Assisted and Spring-Loaded Core Biopsy Device Embodiment 1 
     Vacuum assisted and spring-loaded core biopsy devices described herein can operate in at least some of three firing modes: sequential, individual and cyclical. In sequential firing mode (Embodiments 1 and 2), the inner and outer cannulas are fired in rapid succession to advance into the target area and acquire the tissue through a single user input. In individual firing mode (Embodiment 2), the inner and outer cannulas are fired individually to allow the user to control the timing of the rapid advancement of the cannulas. In cyclical firing mode (Embodiment 2), the outer cannula is rapidly advanced to the target location, followed by rapid advancement of the inner cannula. After completion of the advancement of the inner cannula, the inner cannula is re-armed, and rapidly advanced another time. This is repeated until the user releases an actuator. This allows multiple cores to be acquired with a single insertion of the device. 
       FIG. 1  depicts a vacuum assisted and spring-loaded core biopsy device  10  according to some embodiments. The springs  32   a,    32   b,    34  in the biopsy device  10  provide the force for rapid advancement of the inner and outer cannulas  18 ,  14 . The vacuum port  22  allows connection to an external vacuum for arming the inner cannula  18  and moving excised samples through the inner cannula  18 . Having vacuum assistance allows the inner cannula  18  to be armed when the outer cannula  14  is in the patient while minimizing force exerted on the device  10  and movement of the device  10  in the patient. 
     The device  10  includes a housing  12 , an outer cannula/needle  14  slidably disposed in the housing  12 , and an inner cannula/cutter  18  coaxially and slidably disposed in the outer cannula  14 . The outer cannula  14  has a sharpened distal end  15  and defines a side window  16  at the distal end thereof. The inner cannula  18  has an open distal end at least partially defined by a sharpened (e.g., annular) cutting surface. The device  10  also includes a pair of sliders/needle hubs  20   a,    20   b  configured to manually arm the outer and inner cannulas  14 ,  18  to perform a biopsy using the device  10 . The device  10  further includes an aspiration/vacuum port  22 , a port for an atmosphere vent  46 , and inner cannula vacuum arming valve  24 , and an actuator/firing mechanism  26 . 
     In operation, the device  10  may be coupled to an aspiration/vacuum source (not shown) via the aspiration/vacuum port  22 . A user may manually move the sliders  20   a,    20   b  in a proximal direction  21   a,    21   b  (e.g., by squeezing with index and middle fingers of a hand) to compress a plurality of springs to arm the outer and inner cannulas  14 ,  18 , thereby placing the device  10  in a fully armed configuration, as described below. Next, the user may place the sharpened distal end  15  of the outer cannula  14  against the skin of a patient and depress the actuator  26  to fire the outer and inner cannulas  14 ,  18  partially into tissue of the patient. Firing the outer and inner cannulas  14 ,  18  places the device  10  in a fully fired configuration, as described below. 
     The user may then depress the inner cannula vacuum arming valve  24  in direction  27  to arm the inner cannula  18 , thereby placing the device  10  in a partially armed configuration, as described below. With the device  10  in the partially armed configuration, the inner cannula  18  is withdrawn proximally relative to the outer cannula  14 , which at least partially opens the side window  16  in the outer cannula  14 . The vacuum exerted through the inner cannula  18  draws tissue through the side window  16  and into an interior of the outer cannula  14 . 
     Next, the user may again depress the actuator  26  to fire the inner cannula  18  across the side window  16  in the outer cannula  14  and the tissue (not shown) extending therethrough. As the inner cannula  18  is fired across the tissue, the sharpened cutting surface at the open distal end of the inner cannula  18  separates the tissue from the patient and deposits the separated tissue sample in an interior of the inner cannula  18 . The vacuum exerted through the inner cannula  18  draws the separated tissue sample proximally down the inner cannula  18  and into a collection area (not shown). In some embodiments, the collection area may be a removable cartridge or a plurality of removable cartridges in the proximal end of the device  10  and removably coupled to the proximal end  30  of the inner cannula  18 . The cartridge(s) may be removed from the device  10  through a door after tissue collection. In other embodiments, the collection area may be one or more tissue traps disposed outside of the device  10  and removably coupled between the aspiration/vacuum port  22  and the vacuum source. The sample(s) may be removed from the tissue trap after tissue collection. Firing the inner cannula  18  places the device  10  in a fully fired configuration, as described below. The user may continue to alternately depress the inner cannula vacuum arming valve  24  and the actuator  26  to re-arm and fire the inner cannula  18  to serially collect a plurality of separated tissue samples with minimal movement of the device  10 , thereby minimizing unnecessary discomfort for the patient. The user may rotate, or otherwise minimally move, the device before each re-arming and firing cycle to collect a plurality of separated tissue samples from the slightly different areas of the patient. 
       FIGS. 2A and 2B  depict in cross-section and detailed cross-section the vacuum assisted and spring-loaded core biopsy device  10  depicted in  FIG. 1 .  FIG. 2A  depicts the device  10  in the fully armed configuration with the outer and inner cannulas  14 ,  18  and the sliders  20   a,    20   b  in proximal positions. The sliders  20   a,    20   b  are coupled to the outer cannula  14  and defined an outer cannula spring chamber/well  52  that contains an outer cannula spring  34 . The outer cannula spring chamber  52  is also defined by a flange  51  at a proximal end thereof. The flange  51  is coupled to the biopsy device housing  12 . The sliders  20   a,    20   b  are movable relative to the flange  51  to reduce the length of the outer cannula spring chamber  52  and compress the outer cannula spring  34  contained therein. With the device  10  in the fully armed configuration depicted in  FIG. 2A , the sliders  20   a,    20   b  are in their proximal positions thereby compressing the outer cannula spring  34  to arm the outer cannula  14  for firing. 
     In the fully armed configuration depicted in  FIG. 2A , the sliders  20   a,    20   b  are disposed adjacent respective spring compression members//cutter hubs  38   a,    38   b  such that moving the sliders  20   a,    20   b  proximally exerts a proximally directed force on the spring compression members  38   a,    38   b  through the respective proximal surfaces  37   a,    37   b  of the sliders  20   a,    20   b.  The proximally directed force has moved the spring compression members  38   a,    38   b  proximally, thereby respectively compressing inner cannulas springs  32   a,    32   b,  which are respectively disposed in inner cannula spring chambers/wells  40   a,    40   b.  The spring compression members  38   a,    38   b  are also coupled to the inner cannula  18  at a yoke  48 , such that moving the spring compression members  38   a,    38   b  proximally also moves the inner cannula  18  proximally. With the spring compression members  38   a,    38   b  and the inner cannula  18  in proximal positions, and with the inner cannulas springs  32   a,    32   b  compressed, the inner cannula  18  is armed for firing. 
     The sliders  20   a,    20   b  are coupled to a needle retention/outer cannula latch  49  having an outer cannula catch  41 . The spring compression members  38   a,    38   b  are coupled to an inner cannula/cutter arming latch  42  having a needle retention/distal catch  53  and a proximal catch  54 . The inner cannula latch  42  is operatively coupled to the actuator  26 . The biopsy device housing  12  is coupled to a housing catch/cutter retention catch  44 . The outer cannula catch  41  is configured to slide proximally past the distal catch  53  to removably couple the sliders  20   a,    20   b  and the spring compression members  38   a,    38   b  together so that they can be fired together from the fully armed configuration depicted in  FIGS. 2A and 2B  to the fully fired configuration depicted in  FIGS. 3  and described below. Similarly, the proximal catch  54  is configured to slide proximally past the housing catch  44  to arm the spring compression members  38   a,    38   b  and the inner cannula  18  coupled thereto in the armed proximal position. When the outer cannula catch  41 /distal catch  53  and the proximal catch  54 /housing catch  44  pairs are both engaged, releasing the proximal catch  54  from the housing catch  44  by depressing the actuator  26  in direction  45  releases both the sliders  20   a,    20   b  and the spring compression members  38   a,    38   b,  allowing the outer and inner cannulas  14 ,  18  to be fired together. When the outer cannula catch  41 /distal catch  53  are disengaged and the proximal catch  54 /housing catch  44  are engaged, releasing the proximal catch  54  from the housing catch  44  by depressing the actuator  26  releases the spring compression members  38   a,    38   b  and the inner cannula  18  to be fired. 
     The device  10  also includes a plurality of O-rings  50   a,    50   b,    50   c,    50   d,    50   e  to form fluid tight seals between various moving components of the device  10 . O-ring  50   a  forms a fluid tight seal between the inner cannula  18  and the portions of the housing  12  defining the inner cannula spring chambers  40   a,    40   b.  O-ring  50   b  forms a fluid tight seal between the inner cannula  18  and the yoke  48  of the spring compression members  38   a,    38   b.  O-rings  50   c  form fluid tight seals between the spring compression members  38   a,    38   b  and the portions of the housing  12  defining the inner cannula spring chambers  40   a,    40   b.  O-ring  50   d  forms a fluid tight seal between the outer cannula  14  and the housing  12 . O-ring  50   e  forms a fluid tight seal between the inner cannula  18  and the flange  51 . These fluid tight seals maintain vacuums that are generated in the inner cannula spring chambers  40   a,    40   b,  and minimize contamination of the interior of the device  10  with liquids that may be withdrawn into the device  10  along with the separated tissue sample. 
     The device  10  further includes a pneumatic system for re-arming the inner cannula  18  as described above. The pneumatic system includes an aspiration/vacuum port  22 , which leads to a lumen  28  extending through the housing  12  of the device adjacent the open proximal end  30  of the inner cannula  18 . The lumen  28  is fluidly coupled to a first vacuum lumen  35 , which ends at a valve body  25  of an inner cannula arming valve  24 . The valve body  25  includes first and second valve openings  29 ,  31  that are fluidly coupled to each other. The valve body  25  of the inner cannula arming valve  24  is also adjacent to second vacuum lumens  36   a  and  36   b,  which are fluidly coupled to inner cannula spring chambers  40   a,    40   b  respectively. The valve body  25  is also adjacent to the atmosphere vent  46  the selectively couples to the second valve lumens  36   a,    36   b.  Under the valve body  25  is disposed a biasing spring  47 , that biases the inner cannula arming valve  24  in a closed position. 
     In  FIGS. 2A and 2B , the inner cannula arming valve  24  is in the closed position due to an unopposed upward force exerted by the biasing spring  47 . Accordingly, the valve body  25  of the inner cannula arming valve  24  is obstructing the first and second vacuum lumens  35 ,  36   a,    36   b.  As a result, any vacuum delivered through the aspiration/vacuum port  22  and the lumen  28  through housing  12  will not reach the inner cannula spring chambers  40   a,    40   b.  In addition, the atmosphere vent  46  is coupled to the second valve lumens  36   a,    36   b,  thereby allowing any vacuum in the inner cannula spring chambers  40   a,    40   b  to vent to atmosphere. With the inner cannula arming valve  24  in the closed position depicted in  FIGS. 2A and 2B , any vacuum in or connected to the device  10  plays no role in the arming or firing of the inner cannula  18 . Instead, the inner cannula  18  has been manually armed by a user depressing the sliders  20   a,    20   b  as described above. 
       FIG. 3A  depicts the biopsy device  10  depicted in  FIG. 1  in a fully fired configuration. A user may trigger the device  10  to fire by depressing the distal end of the actuator  26 , which causes the actuator  26  to pivot about the pin  43  that mounts the actuator  26  to the body  12 . Movement of the actuator  26  in turn, moves the inner cannula latch  42  away from the housing catch  44 , resulting in the proximal catch  54  disengaging from the housing catch  44  and the distal catch  53  disengaging from the outer cannula catch  41 . Disengaging the proximal catch  54  from the housing catch  44  and the distal catch  53  disengaging from the outer cannula catch  41  allows the inner cannula springs  32   a,    32   b,  and the outer cannula spring  34 , which were all compressed in the fully armed configuration depicted in  FIGS. 2A and 2B , to expand and fire the outer and inner cannulas  14 ,  18  distally. This firing transforms the device  10  from the fully armed configuration depicted in  FIGS. 2A and 2B  to the fully fired configuration depicted  3 A and  3 B. 
     In some embodiments, when the device  10  is fired by depressing the actuator  26 , the proximal catch  54  and the housing catch  44  are disengaged from each other, but the distal catch  53  may remain engaged with the outer cannula catch  41 . This ensures that the outer and inner cannulas  14 ,  18  will fire as one unit with the window  16  in the outer cannula  14  closed by the inner cannula  18 . 
     In the fully fired configuration, the inner cannula arming valve  24  remains in the closed position due to an unopposed upward force exerted by the biasing spring  47 . Accordingly, any vacuum in or connected to the device  10  plays no role in the arming or firing of the inner cannula  18  in the fully fired configuration as described above for the fully armed configuration. 
       FIG. 4A  depicts the biopsy device  10  depicted in  FIG. 1  in a partially armed configuration. A user may trigger the device  10  to armed the inner cannula  18  using a vacuum by depressing the inner cannula arming valve  24  while depressing (to a greater extent compared to actuating the device to fire as described above) and holding the distal end of the actuator  26 . Depressing the distal end of the actuator  26  a greater extent causes the actuator  26  to pivot a greater extent about the pin  43  that mounts the actuator  26  to the body  12 . This greater movement of the actuator  26  in turn, moves the inner cannula latch  42  further away from the housing catch  44 , resulting in the distal catch  53  disengaging from the outer cannula catch  41 . Disengaging the distal catch  53  from the outer cannula catch  41  allows the spring compression members  37   a,    37   b  to be separated from the sliders  20   a,    20   b.    
     While continuing to hold the depressed actuator  26 , which continues to disengage the distal catch  53  from the outer cannula catch  41 , the user depresses the inner cannula arming valve  24 . Depressing the inner cannula arming valve  24  overcomes the upward force exerted by the biasing spring  47 , thereby opening the inner cannula arming valve  24 . With the inner cannula arming valve  24  in the open position shown in  FIG. 4B , the first valve opening  29  is fluidly coupled to the first vacuum lumen  35  and the second valve opening  31  is fluidly coupled to the second vacuum lumens  36   a,    36   b.  Further, with the inner cannula arming valve  24  in the open position shown in  FIG. 4B , the valve body  25  includes the atmosphere vent  46 . Coupling the first and second vacuum lumens  35 ,  36   a,    36   b  via the valve body  25  and occluding the atmosphere vent  46  fluidly couples any vacuum applied at the aspiration/vacuum port  22  to the inner cannula spring chambers  40   a,    40   b.  The vacuum force applied at the aspiration/vacuum port  22  and the inner cannula springs  32   a,    32   b  are configured such that the vacuum pulls the spring compression members  38   a,    38   b  proximally to compress the inner cannula springs  32   a,    32   b  and move the inner cannula  18  proximally. As described above, moving the inner cannula  18  proximally opens the window  16  in the outer cannula  14  to allow the vacuum to draw tissue into the interior of the outer cannula through the open window  16  to be separated and sampled. 
     After the vacuum has drawn the spring compression members  38   a,    38   b  proximally to compress the inner cannula springs  32   a,    32   b  and move the inner cannula  18  proximally, the user may release the actuator  26 , which is biased to return to the position depicted in  FIG. 4B . In the firing actuator  26  position depicted in  FIG. 4B , the proximal catch  54  and the housing catch  44  are engaged with each other, while the distal catch  53  remains disengaged from the outer cannula catch  41 . This moves the device  10  from the fully fired configuration depicted in  FIGS. 3A and 3B  to the partially armed configuration depicted in  FIGS. 4A and 4B , in which the inner cannula  18  is armed and ready to be fired. 
     In order to fire the inner cannula  18  with the device  10  in the partially armed configuration depicted in  FIGS. 4A and 4B , the user may depress the distal end of the actuator  26  as described above for the transition from the fully armed configuration depicted in  FIGS. 2A and 2B  to the fully fired configuration depicted in  FIGS. 3A and 3B . Firing the inner cannula  18  with the device  10  in the partially armed configuration results in the fully fired configuration depicted in  FIGS. 3A and 3B . 
     As described above, before moving the device  10  from the fully fired configuration to the partially armed configuration, the user can manipulate the device  10  to move the window  16  in the patient&#39;s tissue. The device  10  can be cycled between the fully fired configuration and a partially armed configuration to acquire multiple tissue samples. 
     Vacuum Assisted and Spring-Loaded Core Biopsy Device Embodiment 2 
       FIG. 5  depicts another embodiment of a vacuum assisted and spring-loaded core biopsy device  60 , which utilizes vacuum assistance to arm both the inner and outer cannulas and re-arm the inner cannula after firing. On the other hand, the device  10  depicted in  FIG. 1  utilizes manual force to arm both the inner and outer cannulas and utilizes vacuum to re-arm the inner cannula after firing. As such, the device  60  depicted in  FIG. 5  minimizes physician fatigue. The device  60  depicted in  FIG. 5  also utilizes vacuum to assist the springs in firing the inner and outer cannulas. Consequently, the device  60  can generate greater firing force, and has greater control over the sequence of arming and firing of the inner and outer cannulas. 
     The device  60  includes a housing  62 , an outer cannula  64  slidably disposed in the housing  62 , and an inner cannula/cutter  68  coaxially and slidably disposed in the outer cannula  64 . The outer cannula  64  has a sharpened distal end  65  and defines a side window  66  at the distal end thereof. The inner cannula  68  has an open distal end at least partially defined by a sharpened (e.g., annular) cutting surface. The device  60  also includes a pair of grips  70   a,    70   b  configured to allow users to ergonomically manipulate the device  60 . The device  60  further includes a first aspiration/vacuum port  72 , a second aspiration/vacuum port  73 , and an atmosphere a vent port  97 . 
       FIG. 6  depicts the vacuum assisted and spring-loaded core biopsy device  60  in a fully armed configuration. The inner cannula  68  is coupled to and passes through a proximal piston/seal  71 . The proximal piston  71  and the housing  62  respectively define the distal and proximal ends of an inner cannula spring chamber  82  in which is disposed an inner cannula spring  83 . While the inner cannula spring  83  is compressed in the fully armed configuration depicted in  FIG. 6 , the inner cannula spring  83  is biased to expand. The proximal piston  71  and wall  90  respectively define the proximal and distal ends of an inner cannula firing chamber  86 . 
     The outer cannula  64  is coupled to a distal piston/seal  95 . The distal piston  95  and wall  90  respectively define the distal and proximal ends of an outer cannula spring chamber  92  in which is disposed an outer cannula spring  93 . While the outer cannula spring  93  is compressed in the fully armed configuration depicted in  FIG. 6 , the outer cannula spring  93  is biased to expand. The distal piston  95  and the housing  62  respectively define the proximal and distal ends of an outer cannula firing chamber  98 . 
     The pneumatic system in the device  60  includes a valve assembly that allows the device  60  to utilize vacuum assistance to arm both the inner and outer cannulas, re-arm the inner cannula after firing, and to assist the springs in firing the inner and outer cannulas. The pneumatic system also includes a first aspiration/vacuum port  72 , a second aspiration/vacuum port  73 , an atmosphere vent  97 , and various lumens  76 ,  78 ,  80  all operatively coupled to the valve assembly  75 . The first aspiration/vacuum port  72  is disposed adjacent an open proximal and  87  of the inner cannula  68  and functions to provide vacuum to draw tissue into the window  66  in the outer cannula  64  for biopsy sample collection. The second aspiration/vacuum port  73  and the atmosphere vent  97  are selectively coupled to the inner cannula spring chamber  82 , the outer cannula spring chamber  92 , the inner cannula firing chamber  86 , and the inner cannula spring chamber  98  via various valves in the valve assembly  75  and various lumens  76 ,  78 ,  80 . The first lumen  76  is fluidly coupled to the inner cannula firing chamber  86  and the inner cannula spring chamber  98 . The second woman  78  is fluidly coupled to the inner cannula spring chamber  83 . The third lumen  80  is fluidly coupled to the outer cannula spring chamber  93 . 
     The valve assembly  75  includes first, second, and third vacuum valves  87 ,  89 ,  94 . The first vacuum valve  87  selectively fluidly couples the second aspiration/vacuum port  73  to the inner cannula firing chamber  86  and the outer cannula firing chamber  98  (via the first lumen  76 ) and a first atmosphere vent valve  88 . The second vacuum valve  89  selectively fluidly couples the second aspiration/vacuum port  73  to the inner cannula spring chamber  82  (via the second lumen  78 ) and a second atmosphere vent valve  91 . The third vacuum valve  94  selectively fluidly couples the second aspiration/vacuum port  73  to the outer cannula spring chamber  92  (via the third lumen  80 ) and a third atmosphere vent valve  96 . The first second and third atmosphere vent valves  88 ,  91 ,  96  selectively fluidly couple the valve assembly  75  to the atmosphere vent port  97 . 
     Movement of the proximal and distal seals  71 ,  95  and the inner and outer cannula  68 ,  64  coupled thereto is controlled by pressure differentials in the inner cannula spring chamber  82 /inner cannula firing chamber  86  and the outer cannula spring chamber  92 /outer cannula firing chamber  98  respectively. The pressure differentials are in turn controlled by the many valves of the valve assembly  75 . 
     In the fully armed configuration depicted in  FIG. 6 , the first vacuum valve  87  is closed and the first atmosphere vent valve  88  is open. This configuration of valves  87 ,  88  allows any vacuum in the inner cannula firing chamber  86  and the outer cannula firing chamber  98  to vent to atmosphere. At the same time, the second vacuum valve  89  is open and the second atmosphere vent valve  91  is closed. This configuration of valves  89 ,  91  allows vacuum from the second vacuum port  73  to be communicated to the inner cannula spring chamber  82 . At the same time, the third vacuum valve  94  is open and the third atmosphere vent valve  96  is closed. This configuration of valves  94 ,  96  allows vacuum from the second vacuum port  73  to be communicated to the outer cannula spring chamber  92 . The vacuum in the inner and outer cannula spring chambers  82 ,  92  and the venting in the inner cannula firing chamber  86  and the outer cannula firing chamber  98  moves the proximal and distal seals  71 ,  95  proximally, thereby compressing the inner and outer cannula springs  83 ,  93  and placing the device  60  in the fully armed configuration. 
     In the fully fired configuration depicted in  FIG. 7 , the first vacuum valve  87  is open and the first atmosphere vent valve  88  is closed. This configuration of valves  87 ,  88  allows vacuum from the second vacuum port  73  to be communicated to the inner cannula firing chamber  86  and the outer cannula firing chamber  98 . At the same time, the second vacuum valve  89  is closed and the second atmosphere vent valve  91  is open. This configuration of valves  89 ,  91  allows any vacuum in the inner cannula spring chamber  82  to vent to atmosphere. At the same time, the third vacuum valve  94  is closed and the third atmosphere vent valve  96  is open. This configuration of valves  94 ,  96  allows any vacuum in the outer cannula spring chamber  92  to vent to atmosphere. The venting in the inner and outer cannula spring chambers  82 ,  92  allows the compressed inner and outer cannula springs  83 ,  93  to expand, moving the proximal and distal seals  71 ,  95  distally. The vacuum in the inner cannula firing chamber  86  and the outer cannula firing chamber  98  and the venting in the inner and outer cannula spring chambers  82 ,  92  also assists in moving the proximal and distal seals  71 ,  95  distally. This pneumatic arrangement and the expanding inner and outer cannula springs  83 ,  93  place the device  60  in the fully fired configuration. 
     In the partially armed configuration depicted in  FIG. 8 , the first vacuum valve  87  is closed and the first atmosphere vent valve  88  is open. This configuration of valves  87 ,  88  allows any vacuum in the inner cannula firing chamber  86  and the outer cannula firing chamber  98  to vent to atmosphere. At the same time, the second vacuum valve  89  is open and the second atmosphere vent valve  91  is closed. This configuration of valves  89 ,  91  allows vacuum from the second vacuum port  73  to be communicated to the inner cannula spring chamber  82 . At the same time, the third vacuum valve  94  is closed and the third atmosphere vent valve  96  is open. This configuration of valves  94 ,  96  allows any vacuum in the outer cannula spring chamber  92  to vent to atmosphere. The vacuum in the inner cannula spring chamber  82  and the venting in the inner cannula firing chamber  86  moves the proximal seal  71  proximally, thereby compressing the inner cannula spring  83  and placing the device  60  in the partially armed configuration. 
     With the device  60  in the partially armed configuration, the inner cannula  68  is withdrawn proximally relative to the outer cannula  64 , which at least partially opens the side window  66  in the outer cannula  64 . The vacuum exerted through the inner cannula  68  draws tissue through the side window  66  and into an interior of the outer cannula  64  for tissue sample collection. From the partially armed configuration, the valves  87 ,  88 ,  89 ,  91 ,  94 ,  96  in the valve assembly  75  can change to place the device  60  in the fully fired configuration to move the inner cannula  68  distally relative to the outer cannula  64  to separate the tissue drawn through the side window  66 . Excising tissue pulled into the interior of the outer cannula  64  by the vacuum allows for clean tissue collection and minimizes damage to the surrounding tissue during sample collection. 
     As described above, before moving the device  60  from the fully fired configuration to the partially armed configuration, the user can manipulate the device  60  to move the window  66  in the patient&#39;s tissue. The device  60  can be cycled between the fully fired configuration and a partially armed configuration to acquire multiple tissue samples. Acquiring multiple tissue samples from an area in a patient can increase the diagnostic value of the biopsy samples. With the device  60  operating in a single insertion, multiple core mode, multiple tissue samples can be acquired while minimizing procedure time and patient discomfort. 
     The various valve changes can be triggered by a controller (not shown), such as an electronic or pneumatic controller. The controller may be operatively coupled to one or more actuators (e.g., the grips  70   a,    70   b ). 
       FIG. 9  depicts a method  100  for single insertion, multiple core tissue biopsy according to some embodiments. At step  110 , the user arms a needle and a cutter of a biopsy device (e.g., devices  10  and  60  depicted in  FIGS. 1-4B and 5-8 , respectively). In device  10 , the user can arm the needle and the cutter by moving sliders  20   a,    20   b  proximally. In device  60 , the user can arm the needle and the cutter by opening the second and third vacuum valves  89 ,  94  and the first atmosphere vent valve  88 , and closing the second and third atmosphere vent valve  91 ,  96  and the first vacuum valve  87 . 
     At step  112 , the user fires the needle and the cutter into patient tissue. In device  10 , the user can fire the needle and the cutter by depressing the actuator  26  to release the inner cannula proximal catch  54  from the housing catch  44 . In device  60 , the user can fire the needle and the cutter by opening the second and third atmosphere vent valves  91 ,  96  and the first vacuum valve  87 , and closing the second and third vacuum valves  89 ,  94  and the first atmosphere vent valve  88 . 
     At step  114 , the user re-arms the cutter. In device  10 , the user can re-arm the cutter by depressing the inner cannula arming valve  24 . In device  60 , the user can re-arm the cutter by opening the second vacuum valve  94  and the first atmosphere vent valve  88 , and closing the second atmosphere vent valve  91  and the first vacuum valve  87 . 
     At step  116 , the user optionally moves the needle within the patient tissue. The user may rotate the needle and/or slide the needle along the needle track formed during insertion into the patient tissue. 
     At step  118 , the user fires the re-armed cutter. In device  10 , the user can fire the cutter by depressing the actuator  26  to release the inner cannula proximal catch  54  from the housing catch  44 . In device  60 , the user can fire the cutter by opening the second atmosphere vent valve  91  and the first vacuum valve  87 , and closing the second vacuum valve  89  and the first atmosphere vent valve  88 . 
     At step  120 , the user decides whether additional samples are needed. If additional samples are needed  122 , the method goes back to step  114 . If no additional samples are needed  124 , the method ends. 
     The method  100  described above allow users to perform single insertion, multiple core tissue biopsy using a vacuum to re-arm a previously fired cutter. Using a vacuum to compress the cutter firing spring minimizes procedure time, user fatigue, and unintended movement of the needle in the patient, which in turn minimizes user discomfort. 
     Other aspects of exemplary biopsy devices are described in U.S. patent application Ser. No. 14/555,531 [Attorney Docket No. 14.178 US1], filed Nov. 26, 2014; U.S. patent application Ser. No. 14/864,432 [Attorney Docket No. 14.184011 US], filed Sep. 24, 2014; U.S. patent application Ser. No. 14/497,046 [Attorney Docket No. 14.185011 US1], filed Sep. 25, 2014; and U.S. patent application Ser. No. 15/024,631 [Attorney Docket No. 14.186 US1], filed Mar. 24, 2016. The above-referenced patent applications are assigned to the same assignee as the instant application, and the full contents thereof are hereby incorporated by reference as though fully set forth herein. 
     For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification. 
     All numeric values are herein assumed to be modified by the term “about,” whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure. 
     The recitation of numerical ranges by endpoints includes all numbers within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5). 
     As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise. 
     Various embodiments of the disclosed inventions are described hereinafter with reference to the figures. It should be noted that the figures are not drawn to scale. It should also be noted that the figures are only intended to facilitate the description of the embodiments. They are not intended as an exhaustive description of the invention or as a limitation on the scope of the invention, which is defined only by the appended claims and their equivalents. In addition, an illustrated embodiment of the disclosed inventions needs not have all the aspects or advantages shown. An aspect or an advantage described in conjunction with a particular embodiment of the disclosed inventions is not necessarily limited to that embodiment and can be practiced in any other embodiments even if not so illustrated. In order to better appreciate how the above-recited and other advantages and objects are obtained, a more particular description of the embodiments will be rendered, which are illustrated in the accompanying drawings. These drawings depict only typical embodiments of the disclosed inventions and are not therefore to be considered limiting of its scope. 
     Although particular embodiments of the disclosed inventions have been shown and described herein, it will be understood by those skilled in the art that they are not intended to limit the present inventions, and it will be obvious to those skilled in the art that various changes and modifications may be made (e.g., the dimensions of various parts) without departing from the scope of the disclosed inventions, which is to be defined only by the following claims and their equivalents. The specification and drawings are, accordingly, to be regarded in an illustrative rather than restrictive sense. The various embodiments of the disclosed inventions shown and described herein are intended to cover alternatives, modifications, and equivalents of the disclosed inventions, which may be included within the scope of the appended claims.