Patent Publication Number: US-2015088193-A1

Title: Membrane removing forceps

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of U.S. Provisional Application No. 61/881,620, filed Sep. 24, 2013. 
    
    
     FIELD OF THE INVENTION 
     The present disclosure relates to a surgical instrument, and, more particularly, to a microsurgical forceps. 
     BACKGROUND OF THE INVENTION 
     A microsurgical forceps may be used to perform a microsurgical procedure, e.g., an ophthalmic surgical procedure. For example, a surgeon may use a forceps to grasp and manipulate tissues or other surgical instruments to perform portions of a surgical procedure. A particular microsurgical procedure may require a surgeon to separate a first tissue from a second tissue without causing trauma to at least one of the tissues. Such a separation procedure may be particularly difficult for a surgeon to perform if the tissue surface geometry is not flat, e.g., if the tissue surface geometry is convex. For example, an ophthalmic surgeon may be required to remove an internal limiting membrane from a patient&#39;s retina without causing trauma to the patient&#39;s retina. Accordingly, there is a need for a microsurgical forceps that enables a surgeon to separate a first tissue from a second tissue without causing significant trauma to at least one of the tissues. 
     BRIEF SUMMARY OF THE INVENTION 
     Illustratively, a membrane removing forceps may comprise a plurality of forceps jaws and a plurality of membrane hooks. In one or more embodiments, each membrane hook may comprise a membrane hook outer height. Illustratively, each membrane hook outer height may be less than an average thickness of a membrane, e.g., each membrane hook outer height may be less than the average thickness of an internal limiting membrane. In one or more embodiments, a surgeon may pierce a membrane wherein only the membrane hooks penetrate the membrane, e.g., a surgeon may pierce an internal limiting membrane wherein only the membrane hooks penetrate the internal limiting membrane. 
     Illustratively, the surgeon may then grasp and remove the membrane without damaging an underlying tissue, e.g., the surgeon may then grasp and remove the internal limiting membrane without damaging an underlying retina. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and further advantages of the present invention may be better understood by referring to the following description in conjunction with the accompanying drawings in which like reference numerals indicate identical or functionally similar elements: 
         FIG. 1  is a schematic diagram illustrating an exploded view of a surgical instrument assembly; 
         FIGS. 2A and 2B  are schematic diagrams illustrating an assembled surgical instrument; 
         FIG. 3  is a schematic diagram illustrating a membrane removing forceps; 
         FIGS. 4A ,  4 B, and  4 C are schematic diagrams illustrating a gradual closing of a membrane removing forceps; 
         FIGS. 5A ,  5 B, and  5 C are schematic diagrams illustrating a gradual opening of a membrane removing forceps; 
         FIGS. 6A ,  6 B,  6 C,  6 D,  6 E and  6 F are schematic diagrams illustrating a membrane removal; 
         FIG. 7  is a schematic diagram illustrating a membrane removing forceps; 
         FIGS. 8A ,  8 B, and  8 C are schematic diagrams illustrating a gradual closing of a membrane removing forceps; 
         FIGS. 9A ,  9 B, and  9 C are schematic diagrams illustrating a gradual opening of a membrane removing forceps; 
         FIGS. 10A ,  10 B,  10 C,  10 D,  10 E and  10 F are schematic diagrams illustrating a membrane removal. 
     
    
    
     DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT 
       FIG. 1  is a schematic diagram illustrating an exploded view of a surgical instrument assembly  100 . In one or more embodiments, surgical instrument assembly  100  may comprise a nosecone  105  having a nosecone distal end  106  and a nosecone proximal end  107 ; one or more links  108 ; one or more link pins  109 ; one or more spacers  104 ; a handle  110  having a handle distal end  111  and a handle proximal end  112 ; a front plug  115 ; a distal O-ring  116 ; a proximal O-ring  117 ; a housing sleeve  120  having a housing sleeve distal end  121  and a housing sleeve proximal end  122 ; an actuation facilitating sleeve  130  having an actuation facilitating sleeve distal end  131  and an actuation facilitating sleeve proximal end  132 ; an inner hypodermic tube  140  having an inner hypodermic tube distal end  141  and an inner hypodermic tube proximal end  142 ; a piston tube  150  having a piston tube distal end  151  and a piston tube proximal end  152 ; an end plug  160  having an end plug distal end  161  and an end plug proximal end  162 ; a fixation mechanism  165 ; an outer hypodermic tube  170  having an outer hypodermic tube distal end  171  and an outer hypodermic tube proximal end  172 ; and a surgical blank  180  having a surgical blank distal end  181  and a surgical blank proximal end  182 . 
     Illustratively, outer hypodermic tube  170  may be fixed to nosecone  105 , e.g., outer hypodermic tube proximal end  172  may be fixed to nosecone distal end  106 . In one or more embodiments, one or more links  108  and one or more link pins  109  may be configured to connect nosecone  105  and handle  110 , e.g., a portion of nosecone  105  may be disposed within handle  110 . Illustratively, nosecone  105  may be connected to one or more links  108 , e.g., one or more link pins  109  may be disposed within both nosecone  105  and one or more links  108 . In one or more embodiments, handle  110  may be connected to one or more links  108 , e.g., one or more link pins  109  may be disposed within both handle  110  and one or more links  108 . Illustratively, at least one link  108  may be connected to both nosecone  105  and handle  110 , e.g., by one or more link pins  109 . 
     In one or more embodiments, inner hypodermic tube  140  may be at least partially disposed within piston tube  150 , e.g., inner hypodermic tube proximal end  142  may be disposed within piston tube  150 . Illustratively, inner hypodermic tube  140  and piston tube  150  may be at least partially disposed within actuation facilitating sleeve  130 . In one or more embodiments, actuation facilitating sleeve  130  and piston tube  150  may be disposed within housing sleeve  120 . Illustratively, inner hypodermic tube  140  may be at least partially disposed within housing sleeve  120 , e.g., inner hypodermic tube distal end  141  may extend a distance from housing sleeve distal end  121 . 
     In one or more embodiments, distal O-ring  116  may be disposed over a portion of front plug  115 . Illustratively, distal O-ring  116  may be disposed within housing sleeve  120  and actuation facilitating sleeve  130 . In one or more embodiments, at least a portion of front plug  115  may be disposed within housing sleeve  120  and actuation facilitating sleeve  130 , e.g., housing sleeve distal end  121  and actuation facilitating sleeve distal end  131  may be disposed over a portion of front plug  115 . Illustratively, proximal O-ring  117  may be disposed over a portion of end plug  160 . In one or more embodiments, proximal O-ring  117  may be disposed within housing sleeve  120  and actuation facilitating sleeve  130 . Illustratively, at least a portion of end plug  160  may be disposed within housing sleeve  120  and actuation facilitating sleeve  130 , e.g., housing sleeve proximal end  122  and actuation facilitating sleeve proximal end  132  may be disposed over a portion of end plug  160 . 
     In one or more embodiments, front plug  115 , distal O-ring  116 , housing sleeve  120 , actuation facilitating sleeve  130 , piston tube  150 , inner hypodermic tube  140 , proximal O-ring  117 , and end plug  160  may be disposed within handle  110 . For example, end plug  160  may be disposed within handle  110  wherein end plug proximal end  162  may be adjacent to handle proximal end  112 . Illustratively, inner hypodermic tube  140  may be fixed to nosecone  105 , e.g., inner hypodermic tube distal end  141  may be fixed to nosecone proximal end  107 . 
     In one or more embodiments, surgical blank  180  may be disposed within outer hypodermic tube  170 , nosecone  105 , inner hypodermic tube  140 , piston tube  150 , and end plug  160 . Illustratively, fixation mechanism  165  may be configured to fix surgical blank  180  in a position relative to handle  110 . For example, fixation mechanism  165  may comprise a setscrew configured to fix surgical blank  180  in a position relative to handle  110 . In one or more embodiments, fixation mechanism  165  may comprise an adhesive material configured to fix surgical blank  180  in a position relative to handle  110 . Illustratively, fixation mechanism  165  may comprise any suitable means of fixing surgical blank  180  in a position relative to handle  110 . 
       FIGS. 2A and 2B  are schematic diagrams illustrating an assembled surgical instrument  200 .  FIG. 2A  illustrates a side view of an assembled surgical instrument  200 . In one or more embodiments, housing sleeve  120  may be disposed within handle  110 . Illustratively, actuation facilitating sleeve  130  may be disposed within housing sleeve  120 . In one or more embodiments, piston tube  150  may be disposed within actuation facilitating sleeve  130 . Illustratively, a portion of inner hypodermic tube  140  may be disposed within piston tube  150 , e.g., inner hypodermic tube proximal end  142  may be disposed within piston tube  150 . In one or more embodiments, a portion of inner hypodermic tube  140  may be fixed to an inner portion of piston tube  150 , e.g., by a biocompatible adhesive. For example, an actuation of inner hypodermic tube  140  relative to handle  110  may be configured to actuate piston tube  150  relative to handle  110  and an actuation of piston tube  150  relative to handle  110  may be configured to actuate inner hypodermic tube  140  relative to handle  110 . 
     Illustratively, handle  110  may comprise a spring return aperture  210 . In one or more embodiments, spring return aperture  210  may comprise one or more hinges  215 . Illustratively, spring return aperture  210  may be configured to separate a first portion of handle  110  and a second portion of handle  110 . In one or more embodiments, spring return aperture  210  may be configured to separate a particular point on the first portion of handle  110  from a particular point on the second portion of handle  110  at a first distance. Illustratively, an application of a compressive force to a portion of handle  110  may be configured to separate the particular point on the first portion of handle  110  from the particular point on the second portion of handle  110  at a second distance. In one or more embodiments, the first distance may be greater than the second distance. 
     Illustratively, handle  110  may comprise one or more surgical grip points  220 . In one or more embodiments, one or more surgical grip points  220  may be configured to prevent undesirable movements of handle  110 , e.g., during a surgical procedure. Illustratively, one or more surgical grip points  220  may be configured to interface with a surgeon&#39;s fingertips. In one or more embodiments, one or more surgical grip points  220  may be configured to increase a total contact area between a surgeon&#39;s fingertips and handle  110 . Illustratively, one or more surgical grip points  220  may be configured to facilitate an application of a compressive force to handle  110 , e.g., by increasing a coefficient of friction between a surgeon&#39;s fingertips and handle  110  as the surgeon applies a compressive force to handle  110 . Handle  110  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     In one or more embodiments, handle  110  may comprise one or more handle link pin housings  230 . Illustratively, handle link pin housing  230  may be configured to house link pin  109 . In one or more embodiments, nosecone  105  may comprise one or more nosecone link pin housings  235 . Illustratively, nosecone link pin housing  235  may be configured to house link pin  109 . In one or more embodiments, at least one link pin  109  may be configured to connect nosecone  105  to link  108 , e.g., link pin  109  may be disposed within both nosecone link pin housing  235  and link  108 . Illustratively, at least one link pin  109  may be configured to connect handle  110  and link  108 , e.g., link pin  109  may be disposed within both handle link pin housing  230  and link  108 . In one or more embodiments, at least one link  108  may be connected to both nosecone  105  and handle  110 , e.g., at least one link pin  109  may be disposed within both nosecone link pin housing  235  and link  108  and at least one link pin  109  may be disposed within both handle link pin housing  230  and link  108 . 
       FIG. 2B  illustrates a cross-sectional view of an assembled surgical instrument  200 . In one or more embodiments, nosecone  105  may comprise a nosecone inner bore  205 . Illustratively, inner hypodermic tube distal end  141  may be fixed within nosecone inner bore  205 , e.g., by a machine press fit, a biocompatible adhesive, etc. In one or more embodiments, outer nosecone proximal end  172  may be fixed within nosecone inner bore  205 , e.g., by a machine press fit, a biocompatible adhesive, etc. 
     Illustratively, end plug  160  may comprise a surgical blank housing  240 , an end plug inner bore  250 , an interface taper  260 , and a fixation mechanism housing  270 . In one or more embodiments, end plug inner bore  250  may comprise an end plug inner bore distal cone  251  and an end plug inner bore proximal chamber  252 . Illustratively, interface taper  260  may be configured to interface with one or more components, e.g., to provide one or more surgical utilities. In one or more embodiments, interface taper  260  may comprise a Luer taper. End plug  160  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     Illustratively, surgical blank  180  may be disposed within outer hypodermic tube  170 , nosecone inner bore  205 , inner hypodermic tube  140 , piston tube  150 , actuation facilitating sleeve  130 , surgical blank housing  240 , and fixation mechanism housing  270 . In one or more embodiments, fixation mechanism  165  may be configured to fix surgical blank  180  in a position relative to handle  110 , e.g., at fixation mechanism housing  270 . For example, fixation mechanism  165  may be disposed within fixation mechanism houses ing  270 , e.g., to fix surgical blank  180  in a position relative to handle  110 . 
     Illustratively, surgical blank  180  may modified to provide a one or more surgical utilities, e.g., surgical blank distal end  181  may be modified to provide one or more particular surgical utilities of a plurality of surgical utilities. In one or more embodiments, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical forceps, e.g., with a grasping utility. Illustratively, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical scissors, e.g., with a cutting utility. In one or more embodiments, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical manipulator, e.g., with a manipulation utility. Illustratively, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical hook, e.g., with a hook utility. In one or more embodiments, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical chopper, e.g. with a chopping utility. Illustratively, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical pre-chopper, e.g., with a pre-chopping utility. In one or more embodiments, surgical blank  180  may be modified wherein surgical blank  180  may comprise a surgical pick, e.g., with a pick utility. Illustratively, surgical blank  180  may be modified to comprise any surgical instrument with any surgical utility as will be appreciated by one having ordinary skill in the relevant technological art. Surgical blank  180  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     In one or more embodiments, handle  110  may be compressed, e.g., by an application of a compressive force to handle  110 . For example, a surgeon may compress handle  110  by gently squeezing handle  110 , e.g., at one or more surgical grip points  220 . Illustratively, a compression of handle  110  may be configured to actuate nosecone  105  relative to handle proximal end  112 . Illustratively, a compression of handle  110  may be configured to extend nosecone  105  relative to handle proximal end  112 . 
     In one or more embodiments, a compression of handle  110  may be configured to extend one or more links  108  connected to nosecone  105 , e.g., by one or more link pins  109 , away from handle proximal end  112 . Illustratively, a compression of handle  110  may be configured to gradually project nosecone  105  relative to handle proximal end  112 . In one or more embodiments, a compression of handle  110  may be configured to gradually actuate outer hypodermic tube  170  relative to handle proximal end  112 . For example, a compression of handle  110  may be configured to gradually extend outer hypodermic tube  170  relative to handle proximal end  112 . Illustratively, a compression of handle  110  may be configured to gradually actuate outer hypodermic tube  170  relative to surgical blank  180 . For example, a compression of handle  110  may be configured to gradually extend outer hypodermic tube  170  relative to surgical blank  180 . 
     In one or more embodiments, a compression of handle  110  may be configured to actuate inner hypodermic tube  140  relative to handle  110 . Illustratively, a compression of handle  110  may be configured to extend inner hypodermic tube  140  relative to handle proximal end  112 . In one or more embodiments, a compression of handle  110  may be configured to actuate piston tube  150  relative to handle  110 . Illustratively, a compression of handle  110  may be configured to extend piston tube  150  relative to handle proximal end  112 . 
     In one or more embodiments, handle  110  may be decompressed, e.g., by reducing a magnitude of a compressive force applied to handle  110 . For example, a surgeon may decompress handle  110  by decreasing an amount of compressive force applied to handle  110 , e.g., at one or more surgical grip points  220 . Illustratively, a decompression of handle  110  may be configured to actuate nosecone  105  relative to handle proximal end  112 . Illustratively, a decompression of handle  110  may be configured to retract nosecone  105  relative to handle proximal end  112 . 
     In one or more embodiments, a decompression of handle  110  may be configured to retract one or more links  108  connected to nosecone  105 , e.g., by one or more link pins  109 , towards handle proximal end  112 . Illustratively, a decompression of handle  110  may be configured to gradually retract nosecone  105  relative to handle proximal end  112 . In one or more embodiments, a decompression of handle  110  may be configured to gradually actuate outer hypodermic tube  170  relative to handle proximal end  112 . For example, a decompression of handle  110  may be configured to gradually retract outer hypodermic tube  170  relative to handle proximal end  112 . Illustratively, a decompression of handle  110  may be configured to gradually actuate outer hypodermic tube  170  relative to surgical blank  180 . For example, a decompression of handle  110  may be configured to gradually retract outer hypodermic tube  170  relative to surgical blank  180 . 
     In one or more embodiments, a decompression of handle  110  may be configured to actuate inner hypodermic tube  140  relative to handle  110 . Illustratively, a decompression of handle  110  may be configured to retract inner hypodermic tube  140  relative to handle proximal end  112 . In one or more embodiments, a decompression of handle  110  may be configured to actuate piston tube  150  relative to handle  110 . Illustratively, a decompression of handle  110  may be configured to retract piston tube  150  relative to handle proximal end  112 . 
     In one or more embodiments, actuation facilitating sleeve  130  and piston tube  150  may be configured to minimize a coefficient of friction between actuation facilitating sleeve  130  and piston tube  150 . Illustratively, actuation facilitating sleeve  130  and piston tube  150  may be manufactured from one or more materials configured to minimize a friction force, e.g., when piston tube  150  is actuated relative to handle  110 . For example, actuation facilitation sleeve  130  and piston tube  150  may be manufactured from one or more materials configured to minimize a friction force, e.g., when piston tube  150  is actuated relative to actuation facilitating sleeve  130 . In one or more embodiments, at least an inner portion of actuation facilitating sleeve  130  may comprise a non-crystalline material, e.g., glass. Illustratively, at least an outer portion of piston tube  150  may comprise carbon or a carbon allotrope, e.g., graphite. In one or more embodiments, at least an inner portion of actuation facilitating sleeve  130  may comprise a carbon or a carbon allotrope, e.g., graphite. Illustratively, at least an outer portion of piston tube  150  may comprise a non-crystalline material, e.g., glass. 
     Actuation facilitating sleeve  130  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. Piston tube  150  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. In one or more embodiments, an inner portion of actuation facilitating sleeve  130  may be coated with a material configured to minimize a coefficient of friction between actuation facilitating sleeve  130  and piston tube  150 , e.g., Teflon. Illustratively, an outer portion of piston tube  150  may be coated with a material configured to minimize a coefficient of friction between piston tube  150  and actuation facilitation sleeve  130 , e.g., Teflon. 
       FIG. 3  is a schematic diagram illustrating a membrane removing forceps  300 .  FIG. 3  illustrates a top view and a front view of a membrane removing forceps  300 . Illustratively, membrane removing forceps  300  may be manufactured with dimensions configured for performing microsurgical procedures, e.g., ophthalmic surgical procedures. In one or more embodiments, membrane removing forceps  300  may be manufactured from surgical blank  180 . In one or more embodiments, membrane removing forceps  300  may be manufactured by modifying surgical blank  180 , e.g., with an electric discharge machine, a laser, a file, deep reactive ion etching, or any suitable modification means. Illustratively, membrane removing forceps  300  may comprise a plurality of forceps jaws  310  wherein each forceps jaw  310  has a forceps jaw distal end  311  and a forceps jaw proximal end  312 . In one or more embodiments, each forceps jaw distal end  311  may have a surface area in a range of 0.03 to 0.15 square millimeters, e.g., each forceps jaw distal end  311  may have a surface area of 0.065 square millimeters. Illustratively, each forceps jaw distal end  311  may have a surface area less than 0.03 square millimeters or greater than 0.15 square millimeters. In one or more embodiments, forceps jaws distal ends  311  may be separated by a forceps jaw maximum separation distance  315 . Illustratively, forceps jaw maximum separation distance  315  may comprise a distance in a range of 50.0 to 800.0 micrometers, e.g., forceps jaw maximum separation distance  315  may comprise a distance of 600 micrometers. In one or more embodiments, a geometry of membrane removing forceps  300  may comprise a first contour angle  320  and a second contour angle  330 . Illustratively, first contour angle  320  may comprise any angle less than or equal to 90.0 degrees, e.g., first contour angle  320  may comprise an 80.0 degree angle. In one or more embodiments, first contour angle  320  may comprise an angle in a range of 60.0 to 80.0 degrees, e.g., first contour angle  320  may comprise a 72.3 degree angle. Illustratively, first contour angle  320  may comprise an angle less than 60.0 degrees or greater than 80.0 degrees. In one or more embodiments, second contour angle  330  may comprise any angle greater than or equal to 90.0 degrees, e.g., second contour angle  330  may comprise a 100.0 degree angle. Illustratively, second contour angle  330  may comprise an angle in a range of 95.0 to 120.0 degrees, e.g., second contour angle  330  may comprise a 107.0 degree angle. In one or more embodiments, second contour angle  330  may comprise an angle less than 95.0 degrees or greater than 120.0 degrees. 
     Illustratively, membrane removing forceps  300  may comprise a plurality of membrane hooks  340  wherein each membrane hook  340  has a membrane hook distal end  341  and a membrane hook proximal end  342 . In one or more embodiments, each membrane hook  340  extends from a forceps jaw distal end  311 , e.g., forceps jaw distal end  311  may be adjacent to membrane hook proximal end  342 . For example, a first membrane hook  340  may extend from a first forceps jaw distal end  311  and a second membrane hook  340  may extend from a second forceps jaw distal end  311 . Illustratively, membrane hook  340  may be configured to grasp a portion of a membrane, e.g., membrane hook  340  may be configured to grasp a portion of an internal limiting membrane  670 . In one or more embodiments, membrane hook  340  may be configured to grasp a portion of a first tissue disposed over a second tissue without damaging the second tissue. Illustratively, membrane hook  340  may be configured to grasp a first tissue having a convex surface geometry disposed over a second tissue having a convex surface geometry without damaging the second tissue. In one or more embodiments, each membrane hook  340  may have a surface area in a range of 25.0 to 75.0 square micrometers, e.g., each membrane hook  340  may have a surface area of 48.7 square micrometers. Illustratively, each membrane hook  340  may have a surface area less than 25.0 square micrometers or greater than 75.0 square micrometers. 
     Illustratively, each membrane hook  340  may comprise a membrane hook outer height  350 , a membrane hook inner height  355 , and a membrane hook angle  360 . In one or more embodiments, membrane hook angle  360  may comprise any angle less than 90.0 degrees, e.g., membrane hook angle  360  may comprise a 45.0 degree angle. Illustratively, membrane hook angle  360  may comprise an angle in a range of 5.0 to 20.0 degrees, e.g., membrane hook angle  360  may comprise a 10.0 degree angle. In one or more embodiments, membrane hook angle  360  may comprise an angle less than 5.0 degrees or greater than 20.0 degrees, e.g., membrane hook angle  360  may comprise a 3.8 degree angle. Illustratively, membrane hook outer height  350  may be configured to prevent damage to a tissue underlying a membrane, e.g., membrane hook outer height  350  may be configured to prevent damage to a retina  660  underlying an internal limiting membrane  670 . In one or more embodiments, membrane hook outer height  350  may comprise a distance that is a fraction of an average membrane thickness, e.g., membrane hook outer height  350  may comprise a distance that is a fraction of an average internal limiting membrane thickness. Illustratively, membrane hook outer height  350  may comprise a distance in a range of 0.25 to 3.0 micrometers, e.g., membrane hook outer height  350  may comprise a distance of 1.25 micrometers. In one or more embodiments, membrane hook outer height  350  may comprise a distance less than 0.25 micrometers or greater than 3.0 micrometers, e.g., membrane hook outer height  350  may comprise a distance of 0.15 micrometers. Illustratively, a particular membrane hook outer height  350  may be selected, e.g., by a surgeon, on a case-by-case basis. For example, a surgeon may select a first membrane removing forceps  300  having a first membrane hook outer height  350  to remove a first membrane and the surgeon may select a second membrane removing forceps  300  having a second membrane hook outer height  350  to remove a second membrane wherein the first membrane is thicker than the second membrane and the first membrane hook outer height  350  is greater than the second membrane hook outer height  350 . Illustratively, membrane hook inner height  355  may be configured to grasp a portion of a membrane, e.g., membrane hook inner height  355  may be configured to grasp a portion of an internal limiting membrane  670 . In one or more embodiments, membrane hook inner height  355  may comprise any distance less than membrane hook outer height  350 , e.g., membrane hook inner height  355  may comprise a distance equal to 80.0 percent of membrane hook outer height  350 . Illustratively, membrane hook inner height  355  may comprise a distance in a range of 0.1 to 2.9 micrometers, e.g., membrane hook inner height  355  may comprise a distance of 1.0 micrometers. In one or more embodiments, membrane hook inner height  355  may comprise a distance less than 0.1 micrometers or greater than 2.9 micrometers, e.g., membrane hook inner height  355  may comprise a distance of 0.05 micrometers. 
     Illustratively, membrane hook  340  may be manufactured by modifying surgical blank  180 , e.g., by laser ablation. In one or more embodiments, membrane hook  340  may be manufactured by modifying surgical blank  180 , e.g., by femtosecond laser ablation. Illustratively, membrane hook  340  may be manufactured by laser ablation of surgical blank  180  in multiple orientations. In one or more embodiments, membrane hook  340  may be manufactured by performing laser ablation of surgical blank  180  in a first orientation, e.g., and then performing laser ablation of surgical blank  180  in a second orientation. Illustratively, membrane hook  340  may be manufactured by performing a first laser ablation of surgical blank  180  and then rotating surgical blank  180  to perform a second laser ablation of surgical blank  180 . In one or more embodiments, membrane hook  340  may be manufactured by performing a first laser ablation of surgical blank  180  and then rotating surgical blank  180  by 90.0 degrees to perform a second laser ablation of surgical blank  180 . Illustratively, membrane hook  340  may be formed by high precision micromachining using a 355 nm Nd: vanadate laser operating at 10 kHz and with an average power of 7.0 Watts and pulse duration of 35.0 nanoseconds. In one or more embodiments, membrane hook  340  may be manufactured by using an electric discharge machine to shape membrane removing forceps  300  from blank  180  and then using laser micromachining to shape membrane hook  340 . Illustratively, membrane hook  340  may be manufactured by modifying surgical blank  180 , e.g., by deep reactive-ion etching. In one or more embodiments, membrane hook  340  may be manufactured by modifying surgical blank  180 , e.g., by the Bosch process of time-multiplexed etching. Illustratively, membrave hook  340  may be manufactured by exposing a portion of surgical blank  180  to repeated cycles of isotropic plasma etching followed by deposition of a chemically inert passivation layer. In one or more embodiments, membrane hook  340  may be manufactured by fabricating a membrane hook  340  on a substrate and then fixing the substrate to a portion of surgical blank  180 . Illustratively, surgical blank  180  may be modified, e.g., by deep reactive-ion etching, to manufacture membrane hook  340 . In one or more embodiments, surgical blank  180  may be modified wherein one or more portions of surgical blank  180  comprise membrane hook  340  and then surgical blank  180  may be modified to manufacture membrane removing forceps  300 . Illustratively, membrane hook  340  may be manufactured by deep reactive-ion etching of surgical blank  180  in multiple orientations. In one or more embodiments, membrane hook  340  may be manufactured by performing deep reactive-ion etching of surgical blank  180  in a first orientation, e.g., and then performing deep reactive-ion etching of surgical blank  180  in a second orientation. Illustratively, membrane hook  340  may be manufactured by performing a first deep reactive-ion etching of surgical blank  180  and then rotating surgical blank  180  to perform a second deep reactive-ion etching of surgical blank  180 . In one or more embodiments, membrane hook  340  may be manufactured by performing a first deep reactive-ion etching of surgical blank  180  and then rotating surgical blank  180  by 90.0 degrees to perform a second deep reactive-ion etching of surgical blank  180 . Illustratively, surgical blank  180  may be modified, e.g., by an electric discharge machine, to manufacture membrane removing forceps  300  and then membrane removing forceps  300  may be modified, e.g., by deep reactive-ion etching, to fabricate membrane hook  340 . 
       FIGS. 4A ,  4 B, and  4 C are schematic diagrams illustrating a gradual closing of a membrane removing forceps  300 .  FIG. 4A  illustrates a top view and a front view of an open membrane removing forceps  400 . In one or more embodiments, membrane removing forceps  300  may comprise an open membrane removing forceps  400 , e.g., when a first forceps jaw distal end  311  is separated from a second forceps jaw distal end  311  by forceps jaw maximum separation distance  315 . Illustratively, membrane removing forceps  300  may comprise an open membrane removing forceps  400 , e.g., when outer hypodermic tube  170  is fully retracted relative to forceps jaws proximal ends  312 . Illustratively, membrane removing forceps  300  may comprise an open membrane removing forceps  400 , e.g., when handle  110  is fully decompressed. 
       FIG. 4B  illustrates a top view and a front view of a partially closed membrane removing forceps  410 . In one or more embodiments, a compression of handle  110  may be configured to gradually close a membrane removing forceps  300 , e.g., from an open membrane removing forceps  400  to a partially closed membrane removing forceps  410 . Illustratively, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . In one or more embodiments, a compression of handle  110  may be configured to decrease a distance between a first forceps jaw distal end  311  and a second forceps jaw distal end  311 , e.g., a first forceps jaw distal end  311  and a second forceps jaw distal end  311  may be separated by a distance less than forceps jaw maximum separation distance  315  when membrane removing forceps  300  comprises a partially closed membrane removing forceps  410 . 
       FIG. 4C  illustrates a top view and a front view of a fully closed membrane removing forceps  420 . Illustratively, a compression of handle  110  may be configured to gradually close a membrane removing forceps  300 , e.g., from a partially closed membrane removing forceps  410  to a fully closed membrane removing forceps  420 . In one or more embodiments, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . Illustratively, an extension of outer hypodermic tube  170  over forceps jaws proximal ends  312  may be configured to close forceps jaws  310  wherein forceps jaws  310  initially contact at forceps jaws distal ends  311 . In one or more embodiments, an extension of outer hypodermic tube  170  over forceps jaws proximal end  312  may be configured to close forceps jaws  310  wherein membrane hooks  340  initially contact at membrane hooks distal ends  341 . Illustratively, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein forceps jaws  310  initially contact at forceps jaws distal ends  311 . In one or more embodiments, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein membrane hooks  340  initially contact at membrane hooks distal ends  341 . Illustratively, after forceps jaws distal ends  311  initially contact, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein a contact area between forceps jaws  310  gradually increases. In one or more embodiments, forceps jaws  310  may be configured to close wherein an amount of a first forceps jaw  310  in contact with a second forceps jaw  310  increases gradually from forceps jaws distal ends  311 , e.g., forceps jaws  310  may be configured to close wherein an amount of a first forceps jaw  310  in contact with a second forceps jaw  310  increases gradually towards forceps jaws proximal ends  312 . Illustratively, a compression of handle  110  may be configured to close forceps jaws  310  starting at forceps jaws distal ends  311  and gradually progressing towards forceps jaws proximal ends  312 . In one or more embodiments, a compression of handle  110  may be configured to close a first forceps jaw  310  and a second forceps jaw  310  wherein the first and second forceps jaws  310  initially contact each other at first and second forceps jaws distal ends  311 . Illustratively, a compression of handle  110  may be configured to close a first membrane hook  340  and a second membrane hook  340  wherein the first and second membrane hooks  340  initially contact each other at first and second membrane hook distal ends  341 . In one or more embodiments, after the first and second forceps jaws  310  initially contact at first and second forceps jaws distal ends  311 , a compression of handle  110  may be configured to cause medial portions of the first and second forceps jaws  310  to gradually contact each other starting at medial portions of the first and second forceps jaws  310  adjacent to first and second forceps jaws distal ends  311 . 
       FIGS. 5A ,  5 B, and  5 C are schematic diagrams illustrating a gradual opening of a membrane removing forceps  300 .  FIG. 5A  illustrates a top view and a front view of a closed membrane removing forceps  500 . In one or more embodiments, membrane removing forceps  300  may comprise a closed membrane removing forceps  500 , e.g., when a first forceps jaw distal end  311  is adjacent to a second forceps jaw distal end  311 . Illustratively, membrane removing forceps  300  may comprise a closed membrane removing forceps  500 , e.g., when outer hypodermic tube  170  is fully extended over forceps jaws proximal ends  312 . In one or more embodiments, membrane removing forceps  300  may comprise a closed membrane removing forceps  500 , e.g., when handle  110  is fully compressed. 
       FIG. 5B  illustrates a top view and a front view of a partially open membrane removing forceps  510 . In one or more embodiments, a decompression of handle  110  may be configured to gradually open a membrane removing forceps  300 , e.g., from a closed membrane removing forceps  500  to a partially open membrane removing forceps  510 . Illustratively, a decompression of handle  110  may be configured to retract outer hypodermic tube  170  relative to surgical blank  180 , e.g., a decompression of handle  110  may be configured to retract outer hypodermic tube distal end  171  relative to forceps jaws proximal ends  312 . In one or more embodiments, a decompression of handle  110  may be configured to gradually separate forceps jaws  310 . Illustratively, a decompression of handle  110  may be configured to gradually separate forceps jaws  310  wherein a first forceps jaw distal end  311  contacts a second forceps jaw distal end  311  until all other portions of forceps jaws  310  are separated. In one or more embodiments, a decompression of handle  110  may be configured to separate forceps jaws  310  wherein forceps jaws distal ends  311  are the last portions of forceps jaws  310  to separate. 
       FIG. 5C  illustrates a top view and a front view of a fully open membrane removing forceps  520 . Illustratively, a decompression of handle  110  may be configured to gradually open a membrane removing forceps  300 , e.g., from a partially open membrane removing forceps  510  to a fully open membrane removing forceps  520 . In one or more embodiments, a decompression of handle  110  may be configured to retract outer hypodermic tube  170  relative to surgical blank  180 , e.g., a decompression of handle  110  may be configured to retract outer hypodermic tube distal end  171  relative to forceps jaws proximal ends  312 . Illustratively, a decompression of handle  110  may be configured to gradually separate forceps jaws  310 . In one or more embodiments, a first forceps jaw distal end  311  and a second forceps jaw distal end  311  may be separated by forceps jaw maximum separation distance  315 , e.g., when membrane removing forceps  300  comprises a fully open membrane removing forceps  520 . 
       FIGS. 6A ,  6 B,  6 C,  6 D,  6 E and  6 F are schematic diagrams illustrating a membrane removal.  FIG. 6A  illustrates an attached membrane  600 . Illustratively, an attached membrane  600  may comprise an internal limiting membrane  670  attached to a retina  660 . In one or more embodiments, a surgeon may remove an attached membrane  600  by grasping a portion of a membrane between forceps jaws  310  and peeling the membrane off of an underlying tissue. Illustratively, a surgeon may remove an internal limiting membrane  670  attached to a retina  660  by grasping a portion of internal limiting membrane  670  between forceps jaws  310  and peeling internal limiting membrane  670  off of retina  660 . In one or more embodiments, a surgeon may remove an attached membrane  600  by grasping a portion of a membrane between membrane hooks  340  and peeling the membrane off of an underlying tissue. Illustratively, a surgeon may remove an internal limiting membrane  670  attached to a retina  660  by grasping a portion of internal limiting membrane  670  between membrane hooks  340  and peeling internal limiting membrane  670  off of retina  660 . 
       FIG. 6B  illustrates an initial membrane contact  610 . Illustratively, a surgeon may manipulate membrane removing forceps  300  within an eye to cause a contact between a portion of membrane removing forceps  300  and a portion of an attached membrane  600 , e.g., a surgeon may manipulate membrane removing forceps  300  within an eye to cause an initial membrane contract  610 . In one or more embodiments, an initial membrane contact  610  may comprise a contact between a portion of membrane hook  340  and a portion of a membrane, e.g., an initial membrane contact  610  may comprise a contact between membrane hook distal end  341  and internal limiting membrane  670 . 
       FIG. 6C  illustrates a membrane piercing  620 . Illustratively, a surgeon may manipulate membrane removing forceps  300  within an eye to cause a portion of membrane removing forceps  300  to penetrate into a membrane, e.g., a surgeon may manipulate membrane removing forceps  300  within an eye to penetrate membrane hooks  340  into internal limiting membrane  670 . In one or more embodiments, a surgeon may manipulate membrane removing forceps  300  within an eye to cause a portion of membrane removing forceps  300  to penetrate into a membrane without damaging a tissue underlying the membrane, e.g., a surgeon may manipulate membrane removing forceps  300  within an eye to cause membrane hooks  340  to penetrate into internal limiting membrane  670  without damaging retina  660 . Illustratively, a surgeon may manipulate membrane removing forceps  300  within an eye to cause a membrane piercing  620 . In one or more embodiments, a membrane piercing  620  may comprise penetrating a portion of membrane removing forceps  300  into a membrane, e.g., a membrane piercing  620  may comprise penetrating membrane hooks  340  in to internal limiting membrane  670 . Illustratively, a membrane piercing  620  may be configured to prevent damage to a tissue underlying a pierced membrane, e.g., one or more properties of membrane removing forceps  300  may be configured to prevent damage to a tissue underlying a pierced membrane. In one or more embodiments, membrane hook outer height  350  may be configured to prevent damage to a tissue underlying a membrane, e.g., membrane hook outer height  350  may be a distance that is less than the average thickness of the membrane. Illustratively, a surface area of forceps jaw distal end  311  may be configured to prevent damage to a tissue underlying a membrane. In one or more embodiments, membrane removing forceps  300  may be configured to perform a membrane piercing  620  wherein only membrane hooks  340  penetrate a membrane, e.g., membrane removing forceps  300  may be configured to perform a membrane piercing  620  wherein only membrane hooks  340  penetrate internal limiting membrane  670 . Illustratively, a surface area of forceps jaws distal ends  311  may be configured to prevent any portion of membrane removing forceps  300  other than membrane hooks  340  from penetrating a membrane. In one or more embodiments, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  340  may be in a range of 750.0 to 1500.0, e.g., a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  340  may be 1334.7. Illustratively, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  340  may be less than 750.0 or greater than 1500.0. In one or more embodiments, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  340  may large enough to allow membrane hook  340  to penetrate a membrane and prevent forceps jaw distal end  311  from penetrating the membrane. Illustratively, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  340  may large enough to allow membrane hook  340  to penetrate internal limiting membrane  670  and prevent forceps jaw distal end  311  from penetrating internal limiting membrane  670 . 
       FIG. 6D  illustrates a membrane grasping  630 . Illustratively, a membrane grasping  630  may comprise disposing a portion of a membrane between forceps jaws  310 , e.g., a membrane grasping  630  may comprise disposing a portion of a membrane between forceps jaws distal ends  311 . In one or more embodiments, a membrane gasping  630  may comprise disposing a portion of internal limiting membrane  670  between forceps jaws distal ends  311 . Illustratively, a membrane grasping  630  may comprise disposing a portion of a membrane between membrane hooks  340 , e.g., a membrane grasping  630  may comprise disposing a portion of a membrane between membrane hooks distal ends  341 . In one or more embodiments, a membrane grasping  630  may comprise disposing a portion of internal limiting membrane  670  between membrane hooks distal ends  341 . Illustratively, a surgeon may perform a membrane grasping  630  by compressing handle  110 , e.g., a surgeon may perform a membrane grasping  630  by compressing handle  110  after a membrane piercing  620 . In one or more embodiments, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . Illustratively, a compression of handle  110  may be configured to decrease a distance between a first membrane hook distal end  341  and a second membrane hook distal end  341 . In one or more embodiments, decreasing a distance between a first membrane hook distal end  341  and a second membrane hook distal end  341  may be configured to perform a membrane grasping  630 . 
       FIG. 6E  illustrates a partially removed membrane  640 . Illustratively, a partially removed membrane  640  may comprise a membrane partially separated from an underlying tissue, e.g., a partially removed membrane  640  may comprise an internal limiting membrane  670  partially separated from a retina  660 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane removing forceps  300  and pulling the membrane apart from the underlying tissue, e.g., a surgeon may peel a membrane apart from an underlying tissue by performing a membrane grasping  630  and pulling the membrane apart from the underlying tissue. Illustratively, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane removing forceps  300  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrave  640 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  340  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrane  640 . Illustratively, a surgeon may peel internal limiting membrane  670  apart from an underlying retina  660  by grasping internal limiting membrane  670  with membrane removing forceps  300  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  640 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from an underlying retina  660  by grasping internal limiting membrane  670  with membrane hooks  340  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  640 . 
       FIG. 6F  illustrates a fully removed membrane  650 . Illustratively, a fully removed membrane  650  may comprise a membrane completely separated from an underlying tissue, e.g., a fully removed membrane  650  may comprise an internal limiting membrane  670  completely separated from retina  660 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrave removing forceps  300  and pulling the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  650 . Illustratively, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  340  and pulling the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  650 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  340  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrane  640 , e.g., a surgeon may then the grasp the membrane with forceps jaws  310  and peel the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  650 . Illustratively, a surgeon may continue to peel a partially removed membrane  640  apart from an underlying tissue until the membrane comprises a fully removed membrane  650 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane removing forceps  300  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  650 . Illustratively, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane hooks  340  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  650 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane hooks  340  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  640 , e.g., a surgeon may then the grasp internal limiting membrane  670  with forceps jaws  310  and peel internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  650 . Illustratively, a surgeon may continue to peel a partially removed membrane  640  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  650 . 
       FIG. 7  is a schematic diagram illustrating a membrane removing forceps  700 .  FIG. 7  illustrates a top view and a front view of a membrane removing forceps  700 . Illustratively, membrane removing forceps  700  may be manufactured with dimensions configured for performing microsurgical procedures, e.g., ophthalmic surgical procedures. In one or more embodiments, membrane removing forceps  700  may be manufactured from surgical blank  180 . In one or more embodiments, membrane removing forceps  700  may be manufactured by modifying surgical blank  180 , e.g., with an electric discharge machine, a laser, a file, deep reactive ion etching, or any suitable modification means. Illustratively, membrane removing forceps  700  may comprise a plurality of forceps jaws  310  wherein each forceps jaw  310  has a forceps jaw distal end  311  and a forceps jaw proximal end  312 . In one or more embodiments, each forceps jaw distal end  311  may have a surface area in a range of 0.03 to 0.15 square millimeters, e.g., each forceps jaw distal end  311  may have a surface area of 0.065 square millimeters. Illustratively, each forceps jaw distal end  311  may have a surface area less than 0.03 square millimeters or greater than 0.15 square millimeters. In one or more embodiments, forceps jaws distal ends  311  may be separated by a forceps jaw maximum separation distance  315 . Illustratively, forceps jaw maximum separation distance  315  may comprise a distance in a range of 50.0 to 800.0 micrometers, e.g., forceps jaw maximum separation distance  315  may comprise a distance of 600 micrometers. In one or more embodiments, a geometry of membrane removing forceps  700  may comprise a first contour angle  320  and a second contour angle  330 . Illustratively, first contour angle  320  may comprise any angle less than or equal to 90.0 degrees, e.g., first contour angle  320  may comprise an 80.0 degree angle. In one or more embodiments, first contour angle  320  may comprise an angle in a range of 60.0 to 80.0 degrees, e.g., first contour angle  320  may comprise a 72.3 degree angle. Illustratively, first contour angle  320  may comprise an angle less than 60.0 degrees or greater than 80.0 degrees. In one or more embodiments, second contour angle  330  may comprise any angle greater than or equal to 90.0 degrees, e.g., second contour angle  330  may comprise a 100.0 degree angle. Illustratively, second contour angle  330  may comprise an angle in a range of 95.0 to 120.0 degrees, e.g., second contour angle  330  may comprise a 107.0 degree angle. In one or more embodiments, second contour angle  330  may comprise an angle less than 95.0 degrees or greater than 120.0 degrees. 
     Illustratively, membrane removing forceps  700  may comprise a plurality of membrane hooks  740  wherein each membrane hook  740  has a membrane hook distal end  741  and a membrane hook proximal end  742 . In one or more embodiments, each forceps jaw  310  may comprise a plurality of membrane hooks  740 . Illustratively, each membrane hook  740  extends from a forceps jaw distal end  311 , e.g., forceps jaw distal end  311  may be adjacent to membrane hook proximal end  742 . In one or more embodiments, a first membrane hook  740  may extend from a first forceps jaw distal end  311  and a second membrane hook  740  may extend from a second forceps jaw distal end  311 . Illustratively, a first membrane hook  740  and a second membrane hook  740  may extend from a first forceps jaw distal end  311  and a third membrane hook  740  may extend from a second forceps jaw distal end  311 . In one or more embodiments, a first membrane hook  740  and a second membrane hook  740  may extend from a first forceps jaw distal end  311  and a third membrane hook  740  and a fourth membrane hook  740  may extend from a second forceps jaw distal end  311 . Illustratively, a first membrane hook  740 , a second membrane hook  740 , and a third membrane hook  740  may extend from a first forceps jaw distal end  311  and a fourth membrane hook  740  may extend from a second forceps jaw distal end  311 . In one or more embodiments, a first membrane hook  740 , a second membrane hook  740 , and a third membrane hook  740  may extend from a first forceps jaw distal end  311  and a fourth membrane hook  740  and a fifth membrane hook  740  may extend from a second forceps jaw distal end  311 . Illustratively, a first membrane hook  740 , a second membrane hook  740 , and a third membrane hook  740  may extend from a first forceps jaw distal end  311  and a fourth membrane hook  740 , a fifth membrane hook  740 , and a sixth membrane hook  740  may extend from a second forceps jaw distal end  311 . Illustratively, membrane hook  740  may be configured to grasp a portion of a membrane, e.g., membrane hook  740  may be configured to grasp a portion of an internal limiting membrane  670 . In one or more embodiments, membrane hook  740  may be configured to grasp a portion of a first tissue disposed over a second tissue without damaging the second tissue. Illustratively, membrane hook  740  may be configured to grasp a first tissue having a convex surface geometry disposed over a second tissue having a convex surface geometry without damaging the second tissue. In one or more embodiments, each membrane hook  740  may have a surface area in a range of 25.0 to 75.0 square micrometers, e.g., each membrane hook  740  may have a surface area of 48.7 square micrometers. Illustratively, each membrane hook  740  may have a surface area less than 25.0 square micrometers or greater than 75.0 square micrometers. 
     Illustratively, each membrane hook  740  may comprise a membrane hook outer height  750 , a membrane hook inner height  755 , and a membrane hook angle  760 . In one or more embodiments, membrane hook angle  760  may comprise any angle less than 90.0 degrees, e.g., membrane hook angle  760  may comprise a 45.0 degree angle. Illustratively, membrane hook angle  760  may comprise an angle in a range of 5.0 to 20.0 degrees, e.g., membrane hook angle  760  may comprise a 10.0 degree angle. In one or more embodiments, membrane hook angle  760  may comprise an angle less than 5.0 degrees or greater than 20.0 degrees, e.g., membrane hook angle  760  may comprise a 3.8 degree angle. Illustratively, membrane hook outer height  750  may be configured to prevent damage to a tissue underlying a membrane, e.g., membrane hook outer height  750  may be configured to prevent damage to a retina  660  underlying an internal limiting membrane  670 . In one or more embodiments, membrane hook outer height  750  may comprise a distance that is a fraction of an average membrane thickness, e.g., membrane hook outer height  750  may comprise a distance that is a fraction of an average internal limiting membrane thickness. Illustratively, membrane hook outer height  750  may comprise a distance in a range of 0.25 to 3.0 micrometers, e.g., membrane hook outer height  750  may comprise a distance of 1.25 micrometers. In one or more embodiments, membrane hook outer height  750  may comprise a distance less than 0.25 micrometers or greater than 3.0 micrometers, e.g., membrane hook outer height  750  may comprise a distance of 0.15 micrometers. Illustratively, a particular membrane hook outer height  750  may be selected, e.g., by a surgeon, on a case-by-case basis. For example, a surgeon may select a first membrane removing forceps  700  having a first membrane hook outer height  750  to remove a first membrane and the surgeon may select a second membrane removing forceps  700  having a second membrane hook outer height  750  to remove a second membrane wherein the first membrane is thicker than the second membrane and the first membrane hook outer height  750  is greater than the second membrane hook outer height  750 . Illustratively, membrane hook inner height  755  may be configured to grasp a portion of a membrane, e.g., membrane hook inner height  755  may be configured to grasp a portion of an internal limiting membrane  670 . In one or more embodiments, membrane hook inner height  755  may comprise any distance less than membrane hook outer height  750 , e.g., membrane hook inner height  755  may comprise a distance equal to 80.0 percent of membrane hook outer height  750 . Illustratively, membrane hook inner height  755  may comprise a distance in a range of 0.1 to 2.9 micrometers, e.g., membrane hook inner height  755  may comprise a distance of 1.0 micrometers. In one or more embodiments, membrane hook inner height  755  may comprise a distance less than 0.1 micrometers or greater than 2.9 micrometers, e.g., membrane hook inner height  755  may comprise a distance of 0.05 micrometers. 
     Illustratively, membrane hook  740  may be manufactured by modifying surgical blank  180 , e.g., by laser ablation. In one or more embodiments, membrane hook  740  may be manufactured by modifying surgical blank  180 , e.g., by femtosecond laser ablation. Illustratively, membrane hook  740  may be manufactured by laser ablation of surgical blank  180  in multiple orientations. In one or more embodiments, membrane hook  740  may be manufactured by performing laser ablation of surgical blank  180  in a first orientation, e.g., and then performing laser ablation of surgical blank  180  in a second orientation. Illustratively, membrane hook  740  may be manufactured by performing a first laser ablation of surgical blank  180  and then rotating surgical blank  180  to perform a second laser ablation of surgical blank  180 . In one or more embodiments, membrane hook  740  may be manufactured by performing a first laser ablation of surgical blank  180  and then rotating surgical blank  180  by 90.0 degrees to perform a second laser ablation of surgical blank  180 . Illustratively, membrane hook  740  may be formed by high precision micromachining using a 355 nm Nd: vanadate laser operating at 10 kHz and with an average power of 7.0 Watts and pulse duration of 35.0 nanoseconds. In one or more embodiments, membrane hook  740  may be manufactured by using an electric discharge machine to shape membrane removing forceps  700  from blank  180  and then using laser micromachining to shape membrane hook  740 . Illustratively, membrane hook  740  may be manufactured by modifying surgical blank  180 , e.g., by deep reactive-ion etching. In one or more embodiments, membrane hook  740  may be manufactured by modifying surgical blank  180 , e.g., by the Bosch process of time-multiplexed etching. Illustratively, membrane hook  740  may be manufactured by exposing a portion of surgical blank  180  to repeated cycles of isotropic plasma etching followed by deposition of a chemically inert passivation layer. In one or more embodiments, membrane hook  740  may be manufactured by fabricating a membrane hook  740  on a substrate and then fixing the substrate to a portion of surgical blank  180 . Illustratively, surgical blank  180  may be modified, e.g., by deep reactive-ion etching, to manufacture membrane hook  740 . In one or more embodiments, surgical blank  180  may be modified wherein one or more portions of surgical blank  180  comprise membrane hook  740  and then surgical blank  180  may be modified to manufacture membrane removing forceps  700 . Illustratively, membrane hook  740  may be manufactured by deep reactive-ion etching of surgical blank  180  in multiple orientations. In one or more embodiments, membrane hook  740  may be manufactured by performing deep reactive-ion etching of surgical blank  180  in a first orientation, e.g., and then performing deep reactive-ion etching of surgical blank  180  in a second orientation. Illustratively, membrane hook  740  may be manufactured by performing a first deep reactive-ion etching of surgical blank  180  and then rotating surgical blank  180  to perform a second deep reactive-ion etching of surgical blank  180 . In one or more embodiments, membrane hook  740  may be manufactured by performing a first deep reactive-ion etching of surgical blank  180  and then rotating surgical blank  180  by 90.0 degrees to perform a second deep reactive-ion etching of surgical blank  180 . Illustratively, surgical blank  180  may be modified, e.g., by an electric discharge machine, to manufacture membrane removing forceps  700  and then membrane removing forceps  700  may be modified, e.g., by deep reactive-ion etching, to fabricate membrane hook  740 . 
       FIGS. 8A ,  8 B, and  8 C are schematic diagrams illustrating a gradual closing of a membrane removing forceps  700 .  FIG. 8A  illustrates a top view and a front view of an open membrane removing forceps  800 . In one or more embodiments, membrane removing forceps  700  may comprise an open membrane removing forceps  800 , e.g., when a first forceps jaw distal end  311  is separated from a second forceps jaw distal end  311  by forceps jaw maximum separation distance  315 . Illustratively, membrane removing forceps  700  may comprise an open membrane removing forceps  800 , e.g., when outer hypodermic tube  170  is fully retracted relative to forceps jaws proximal ends  312 . Illustratively, membrane removing forceps  700  may comprise an open membrane removing forceps  800 , e.g., when handle  110  is fully decompressed. 
       FIG. 8B  illustrates a top view and a front view of a partially closed membrane removing forceps  810 . In one or more embodiments, a compression of handle  110  may be configured to gradually close a membrane removing forceps  700 , e.g., from an open membrane removing forceps  800  to a partially closed membrane removing forceps  810 . Illustratively, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . In one or more embodiments, a compression of handle  110  may be configured to decrease a distance between a first forceps jaw distal end  311  and a second forceps jaw distal end  311 , e.g., a first forceps jaw distal end  311  and a second forceps jaw distal end  311  may be separated by a distance less than forceps jaw maximum separation distance  315  when membrane removing forceps  700  comprises a partially closed membrane removing forceps  810 . 
       FIG. 8C  illustrates a top view and a front view of a fully closed membrane removing forceps  820 . Illustratively, a compression of handle  110  may be configured to gradually close a membrane removing forceps  700 , e.g., from a partially closed membrane removing forceps  810  to a fully closed membrane removing forceps  820 . In one or more embodiments, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . Illustratively, an extension of outer hypodermic tube  170  over forceps jaws proximal ends  312  may be configured to close forceps jaws  310  wherein forceps jaws  310  initially contact at forceps jaws distal ends  311 . In one or more embodiments, an extension of outer hypodermic tube  170  over forceps jaws proximal end  312  may be configured to close forceps jaws  310  wherein membrane hooks  740  initially contact at membrane hooks distal ends  741 . Illustratively, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein forceps jaws  310  initially contact at forceps jaws distal ends  311 . In one or more embodiments, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein membrane hooks  740  initially contact at membrane hooks distal ends  741 . Illustratively, after forceps jaws distal ends  311  initially contact, a compression of handle  110  may be configured to gradually close forceps jaws  310  wherein a contact area between forceps jaws  310  gradually increases. In one or more embodiments, forceps jaws  310  may be configured to close wherein an amount of a first forceps jaw  310  in contact with a second forceps jaw  310  increases gradually from forceps jaws distal ends  311 , e.g., forceps jaws  310  may be configured to close wherein an amount of a first forceps jaw  310  in contact with a second forceps jaw  310  increases gradually towards forceps jaws proximal ends  312 . Illustratively, a compression of handle  110  may be configured to close forceps jaws  310  starting at forceps jaws distal ends  311  and gradually progressing towards forceps jaws proximal ends  312 . In one or more embodiments, a compression of handle  110  may be configured to close a first forceps jaw  310  and a second forceps jaw  310  wherein the first and second forceps jaws  310  initially contact each other at first and second forceps jaws distal ends  311 . Illustratively, a compression of handle  110  may be configured to close a first membrane hook  740  and a second membrane hook  740  wherein the first and second membrane hooks  740  initially contact each other at first and second membrane hook distal ends  741 . In one or more embodiments, after the first and second forceps jaws  310  initially contact at first and second forceps jaws distal ends  311 , a compression of handle  110  may be configured to cause medial portions of the first and second forceps jaws  310  to gradually contact each other starting at medial portions of the first and second forceps jaws  310  adjacent to first and second forceps jaws distal ends  311 . 
       FIGS. 9A ,  9 B, and  9 C are schematic diagrams illustrating a gradual opening of a membrane removing forceps  700 .  FIG. 9A  illustrates a top view and a front view of a closed membrane removing forceps  900 . In one or more embodiments, membrane removing forceps  700  may comprise a closed membrane removing forceps  900 , e.g., when a first forceps jaw distal end  311  is adjacent to a second forceps jaw distal end  311 . Illustratively, membrane removing forceps  700  may comprise a closed membrane removing forceps  900 , e.g., when outer hypodermic tube  170  is fully extended over forceps jaws proximal ends  312 . In one or more embodiments, membrane removing forceps  700  may comprise a closed membrane removing forceps  900 , e.g., when handle  110  is fully compressed. 
       FIG. 9B  illustrates a top view and a front view of a partially open membrane removing forceps  910 . In one or more embodiments, a decompression of handle  110  may be configured to gradually open a membrane removing forceps  700 , e.g., from a closed membrane removing forceps  900  to a partially open membrane removing forceps  910 . Illustratively, a decompression of handle  110  may be configured to retract outer hypodermic tube  170  relative to surgical blank  180 , e.g., a decompression of handle  110  may be configured to retract outer hypodermic tube distal end  171  relative to forceps jaws proximal ends  312 . In one or more embodiments, a decompression of handle  110  may be configured to gradually separate forceps jaws  310 . Illustratively, a decompression of handle  110  may be configured to gradually separate forceps jaws  310  wherein a first forceps jaw distal end  311  contacts a second forceps jaw distal end  311  until all other portions of forceps jaws  310  are separated. In one or more embodiments, a decompression of handle  110  may be configured to separate forceps jaws  310  wherein forceps jaws distal ends  311  are the last portions of forceps jaws  310  to separate. 
       FIG. 9C  illustrates a top view and a front view of a fully open membrane removing forceps  920 . Illustratively, a decompression of handle  110  may be configured to gradually open a membrane removing forceps  700 , e.g., from a partially open membrane removing forceps  910  to a fully open membrane removing forceps  920 . In one or more embodiments, a decompression of handle  110  may be configured to retract outer hypodermic tube  170  relative to surgical blank  180 , e.g., a decompression of handle  110  may be configured to retract outer hypodermic tube distal end  171  relative to forceps jaws proximal ends  312 . Illustratively, a decompression of handle  110  may be configured to gradually separate forceps jaws  310 . In one or more embodiments, a first forceps jaw distal end  311  and a second forceps jaw distal end  311  may be separated by forceps jaw maximum separation distance  315 , e.g., when membrane removing forceps  700  comprises a fully open membrane removing forceps  920 . 
       FIGS. 10A ,  10 B,  10 C,  10 D,  10 E and  10 F are schematic diagrams illustrating a membrane removal.  FIG. 1  OA illustrates an attached membrane  1000 . Illustratively, an attached membrane  1000  may comprise an internal limiting membrane  670  attached to a retina  660 . In one or more embodiments, a surgeon may remove an attached membrane  1000  by grasping a portion of a membrane between forceps jaws  310  and peeling the membrane off of an underlying tissue. Illustratively, a surgeon may remove an internal limiting membrane  670  attached to a retina  660  by grasping a portion of internal limiting membrane  670  between forceps jaws  310  and peeling internal limiting membrane  670  off of retina  660 . In one or more embodiments, a surgeon may remove an attached membrane  1000  by grasping a portion of a membrane between membrane hooks  740  and peeling the membrane off of an underlying tissue. Illustratively, a surgeon may remove an internal limiting membrane  670  attached to a retina  660  by grasping a portion of internal limiting membrane  670  between membrane hooks  740  and peeling internal limiting membrane  670  off of retina  660 . 
       FIG. 10B  illustrates an initial membrane contact  1010 . Illustratively, a surgeon may manipulate membrane removing forceps  700  within an eye to cause a contact between a portion of membrane removing forceps  700  and a portion of an attached membrane  1000 , e.g., a surgeon may manipulate membrane removing forceps  700  within an eye to cause an initial membrane contract  1010 . In one or more embodiments, an initial membrane contact  1010  may comprise a contact between a portion of membrane hook  740  and a portion of a membrane, e.g., an initial membrane contact  1010  may comprise a contact between membrane hook distal end  741  and internal limiting membrane  670 . 
       FIG. 10C  illustrates a membrane piercing  1020 . Illustratively, a surgeon may manipulate membrane removing forceps  700  within an eye to cause a portion of membrane removing forceps  700  to penetrate into a membrane, e.g., a surgeon may manipulate membrane removing forceps  700  within an eye to penetrate membrane hooks  740  into internal limiting membrane  670 . In one or more embodiments, a surgeon may manipulate membrane removing forceps  700  within an eye to cause a portion of membrane removing forceps  700  to penetrate into a membrane without damaging a tissue underlying the membrane, e.g., a surgeon may manipulate membrane removing forceps  700  within an eye to cause membrane hooks  740  to penetrate into internal limiting membrane  670  without damaging retina  660 . Illustratively, a surgeon may manipulate membrane removing forceps  700  within an eye to cause a membrane piercing  1020 . In one or more embodiments, a membrane piercing  1020  may comprise penetrating a portion of membrane removing forceps  700  into a membrane, e.g., a membrane piercing  1020  may cornprise penetrating membrane hooks  740  in to internal limiting membrane  670 . Illustratively, a membrane piercing  1020  may be configured to prevent damage to a tissue underlying a pierced membrane, e.g., one or more properties of membrane removing forceps  700  may be configured to prevent damage to a tissue underlying a pierced membrane. In one or more embodiments, membrane hook outer height  750  may be configured to prevent damage to a tissue underlying a membrane, e.g., membrane hook outer height  750  may be a distance that is less than the average thickness of the membrane. Illustratively, a surface area of forceps jaw distal end  311  may be configured to prevent damage to a tissue underlying a membrane. In one or more embodiments, membrane removing forceps  700  may be configured to perform a membrane piercing  1020  wherein only membrane hooks  740  penetrate a membrane, e.g., membrane removing forceps  700  may be configured to perform a membrane piercing  1020  wherein only membrane hooks  740  penetrate internal limiting membrane  670 . Illustratively, a surface area of forceps jaws distal ends  311  may be configured to prevent any portion of membrane removing forceps  700  other than membrane hooks  740  from penetrating a membrane. In one or more embodiments, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  740  may be in a range of 750.0 to 1500.0, e.g., a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  740  may be 1334.7. Illustratively, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  740  may be less than 750.0 or greater than 1500.0. In one or more embodiments, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  740  may large enough to allow membrane hook  740  to penetrate a membrane and prevent forceps jaw distal end  311  from penetrating the membrane. Illustratively, a ratio of a surface area of each forceps jaw distal end  311  to a surface area of each membrane hook  740  may large enough to allow membrane hook  740  to penetrate internal limiting membrane  670  and prevent forceps jaw distal end  311  from penetrating internal limiting membrane  670 . 
       FIG. 10D  illustrates a membrane grasping  1030 . Illustratively, a membrane grasping  1030  may comprise disposing a portion of a membrane between forceps jaws  310 , e.g., a membrane grasping  1030  may comprise disposing a portion of a membrane between forceps jaws distal ends  311 . In one or more embodiments, a membrane gasping  1030  may comprise disposing a portion of internal limiting membrane  670  between forceps jaws distal ends  311 . Illustratively, a membrane grasping  1030  may comprise disposing a portion of a membrane between membrane hooks  340 , e.g., a membrane grasping  1030  may comprise disposing a portion of a membrane between membrane hooks distal ends  741 . In one or more embodiments, a membrane grasping  1030  may comprise disposing a portion of internal limiting membrane  670  between membrane hooks distal ends  741 . Illustratively, a surgeon may perform a membrane grasping  1030  by compressing handle  110 , e.g., a surgeon may perform a membrane grasping  1030  by compressing handle  110  after a membrane piercing  1020 . In one or more embodiments, a compression of handle  110  may be configured to extend outer hypodermic tube  170  relative to surgical blank  180 , e.g., a compression of handle  110  may be configured to extend outer hypodermic tube distal end  171  over forceps jaws proximal ends  312 . Illustratively, a compression of handle  110  may be configured to decrease a distance between a first membrane hook distal end  741  and a second membrane hook distal end  741 . In one or more embodiments, decreasing a distance between a first membrane hook distal end  741  and a second membrane hook distal end  741  may be configured to perform a membrane grasping  1030 . 
       FIG. 10E  illustrates a partially removed membrane  1040 . Illustratively, a partially removed membrane  1040  may comprise a membrane partially separated from an underlying tissue, e.g., a partially removed membrane  1040  may comprise an internal limiting membrane  670  partially separated from a retina  660 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane removing forceps  700  and pulling the membrane apart from the underlying tissue, e.g., a surgeon may peel a membrane apart from an underlying tissue by performing a membrane grasping  1030  and pulling the membrane apart from the underlying tissue. Illustratively, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane removing forceps  700  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrane  1040 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  740  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrane  1040 . Illustratively, a surgeon may peel internal limiting membrane  670  apart from an underlying retina  660  by grasping internal limiting membrane  670  with membrane removing forceps  700  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  1040 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from an underlying retina  660  by grasping internal limiting membrane  670  with membrane hooks  740  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  1040 . 
       FIG. 10F  illustrates a fully removed membrane  1050 . Illustratively, a fully removed membrane  1050  may comprise a membrane completely separated from an underlying tissue, e.g., a fully removed membrane  1050  may comprise an internal limiting membrane  670  completely separated from retina  660 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane removing forceps  700  and pulling the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  1050 . Illustratively, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  740  and pulling the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  1050 . In one or more embodiments, a surgeon may peel a membrane apart from an underlying tissue by grasping the membrane with membrane hooks  740  and pulling the membrane apart from the underlying tissue until the membrane comprises a partially removed membrane  1040 , e.g., a surgeon may then the grasp the membrane with forceps jaws  310  and peel the membrane apart from the underlying tissue until the membrane comprises a fully removed membrane  1050 . Illustratively, a surgeon may continue to peel a partially removed membrane  1040  apart from an underlying tissue until the membrane comprises a fully removed membrane  1050 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane removing forceps  700  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  1050 . Illustratively, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane hooks  740  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  1050 . In one or more embodiments, a surgeon may peel internal limiting membrane  670  apart from retina  660  by grasping internal limiting membrane  670  with membrane hooks  740  and pulling internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a partially removed membrane  1040 , e.g., a surgeon may then the grasp internal limiting membrane  670  with forceps jaws  310  and peel internal limiting membrane  670  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  1050 . Illustratively, a surgeon may continue to peel a partially removed membrane  1040  apart from retina  660  until internal limiting membrane  670  comprises a fully removed membrane  1050 . 
     The foregoing description has been directed to particular embodiments of this invention. It will be apparent; however, that other variations and modifications may be made to the described embodiments, with the attainment of some or all of their advantages. Specifically, it should be noted that the principles of the present invention may be implemented in any system. Furthermore, while this description has been written in terms of a surgical instrument, the teachings of the present invention are equally suitable to any systems where the functionality may be employed. Therefore, it is the object of the appended claims to cover all such variations and modifications as come within the true spirit and scope of the invention.