Patent Publication Number: US-2013253371-A1

Title: Surgical Instrument for Deep Tissue and/or Cell Sampling

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates generally to surgical instruments employed in a biopsy of patient tissue. More specifically, the invention relates to a multipurpose sampling device having a combination aspiration needle and biopsy forceps, or combination aspiration needle and cytology brush. The device is especially well configured for taking deeper tissue and/or cell samples than is currently possible through the provision of a coring needle to form a tunnel into tissue whereafter the forceps or cytology brush may be employed to take tissue and/or cell samples which are protected by the surrounding needle during retrieval. 
     2. Prior Art 
     Screening and early detection, diagnosing, and subsequent treatment of cancer can be a key step in fighting the disease before there are any noticeable symptoms. A commonly known method for screening a patient for cancer involves taking a body image via magnetic resonance imaging (MRI), x-ray, or other imaging method which provides the physician with means to search for visual cues to potential disease. However, there is much speculation on the benefits of performing conventional imaging screening techniques. 
     For example, there is a possibility that radiation exposure during x-ray imaging can pose the risk of initiating a new cancer in a healthy person. Further, typical screening methods are not necessarily useful for many cancers and the possibility of a false positive or false negative diagnosis is widely known where electronic imaging of soft and hard tissue is employed for such a diagnosis. Consequently, such tests are overly dependent on the skill of the medical professional performing the test and visual analysis of the image by a radiologist or imaging specialist. Thus, the diagnosis can be highly subjective which can cause a misdiagnosis absent a subsequent tissue and/or cell sample from the area of suspected anomaly. 
     Subsequent to imaging, once a potential cancer is suspected, or thought to be found, the patient is subjected to invasive diagnostic follow-up procedures to ascertain the validity of the radiological diagnosis. Such procedures conventionally involve a surgical procedure where a tissue and/or cell sample from the suspected disease site is retrieved. Commonly known as a biopsy, subsequent to capture of an appropriate tissue and/or cell sample, the sampled tissue is visually and/or chemically analyzed. 
     An excisional biopsy occurs when a surgeon removes an entire lump or area of tissue. A more common procedure where the potential abnormal tissue is buried in a vital organ such as the lungs, is a surgical procedure known as an incisional biopsy or core biopsy. Another sampling procedure employed by surgeons is an aspiration biopsy where a sample of tissue or fluid is retrieved and removed using a needle adapted for such. 
     As can be imagined, with the subjective nature of electronic imaging, especially in deep body tissues, concise and accurate diagnostic capability provided by the actual retrieval of tissue, yields much more conclusive results. When dealing with a potential life threatening disease, the physical confirmation of tissue suspected of abnormality can be extremely beneficial. 
     However, a challenge to the surgeon when performing a biopsy exists due to the nature of the procedure. This is especially true where samples of tissue buried deep in the body or an organ are required as it can be very difficult to remove the correct type of tissue and/or cell sample from the preferred location. This occurs even if the location has already been electronically imaged. 
     Modernly, there are electronic navigation and real time imaging instruments available to help guide the surgeon to the proper tissue and/or cell sample site within the patient&#39;s body. During this process, surgeons generally employ sampling surgical instruments which are operationally engaged to the distal end of a catheter, which may take time and patience to properly position. Positioning is accomplished using a camera at the end of a scope instrument having internal lumens, and/or using a triangulating radio frequency (RF) system which matches a virtual image of the patient with a current location of the distal end of the scope or catheter to position the sampling component correctly. 
     Once properly positioned, a different problem can occur since the instrument being navigated generally follows a body lumen or hollow cavity of the body to reach the point of sampling. At the sampling point, currently, the tissue and/or cell sample is taken from the tissue in front of the camera or at the surface of the tissue located using RF navigation. This, however, is not the most desirable tissue and/or cell sample in many instances since the suspected cancerous or other diseased tissue lies well beyond the surface layer of the body tissue at the point of sampling. 
     Currently, a coring needle may be employed to sample a small core of tissue at the sampling point which descends into the organ being sampled at partial lengths of the needle. Alternatively, a biopsy forceps or a cytology brush may be employed, again to slice a sample of the tissue at an exterior layer of the organ or body tissue in question. 
     Sampling tissue deeper within the organ or tissue is a problem, however. Forceps and cytology brushes are designed for surface sampling or sampling a small distance below a surface layer of the organ or tissue sampling site. Coring needles are limited by the short length of the core itself to a depth below the organ or tissue sampling site the needle length determines. Sampling deeper is not easily accomplished, if it is accomplished at all. 
     Even if deeper samples are not desired, another problem exists for the surgeon should a different sampling surgical instrument be required than the one mounted on the distal end of the catheter traversing the scope lumen. Changing the sampling surgical instrument requires the removal of the controlling catheter and re-navigation to the sampling site, which not only requires valuable surgeon time, it multiplies the risk to the patient from continued anesthesia and potential injury from the catheter travel. 
     For example, biopsy forceps are a hinged instrument having jaws or a grasping end which are adapted during closure to cut and capture substantial tissue and/or cell samples. However, conventional forceps designs are only intended for tissue capture at the first or surface layer of tissue, and consequently not generally employed for deeper tissue and/or cell samples such as in the lower lobes of the lung. If the surgeon wishes a slightly deeper sample, the control catheter must be removed and a needle aspiration device substituted. 
     Needle aspiration or fine needle aspiration (FNA) employs a coring needle which is adapted for sampling of tissue at deeper organ and body positions. However, the tissue or fluid sample removed, is generally small in quantity and the depth is as noted limited by the coring wall. For example, the surgeon can navigate such a needle deep in the lungs to positions up to 16 mm using such a sampling needle operatively engaged to a catheter. However, once the needle sampling instrument has been threaded to the sampling position, the small samples retrieved may not accurately represent the surrounding diagnosed abnormal tissue area. Further, during retraction, they can become mixed with other tissue and the small samples of larger surrounding identified tissue retrieved, frequently yield a false negative diagnosis which could have been avoided with larger samples. 
     However, to achieve a larger sample with a biopsy forceps, if it is determined the instrument could be navigated to the desired position, again requires removal of the first instrument. Thereafter the forceps are navigated to the proper position at the expense of time and further exposure of the patient to a second threading of a second instrument to the position where it has been determined forceps may be employed instead of a coring needle. 
     As such, there is a continuing unmet need for an improved medical tissue sampling instrument. Such a device should provide the beneficial qualities of both an aspiration needle and a biopsy forceps, and provide a means to retrieve deep tissue and/or cell samples from a sampling site. Such a device should provide a means to protect the integrity of the sample during retrieval in both size and type of tissue. Such a device should also provide the user the concurrent option to employ either or both a biopsy forceps or needle aspiration should surface level or simple tissue sampling be determined acceptable once proper positioning within the body of the patient is determined. 
     Such a device being a combination aspiration needle and biopsy forceps, should provide the surgeon the option of capturing substantial sized deeply located tissue and/or cell samples from the sampling site if possible, and to also capture samples with an aspiration needle should such be better employed at the sampling site. The combination of both instruments in addition to providing options to the surgeon for use of both, also limits the exposure of the patient to the potential for multiple catheter engagements and removals which heretofore are required to change instruments. 
     SUMMARY OF THE INVENTION 
     The surgical instrument device herein disclosed and described provides a solution to the shortcomings noted in prior art. The disclosed device remedies the above noted problems with conventional tissue sampling at a determined sampling location through the provision of a combination aspiration needle and secondary tissue sampling means such as a biopsy forceps or cytology brush, both of which are operationally engaged to the distal end of a single catheter configured for translation through a camera bearing scope or other lumen bearing instrument. The control catheter for the device is configured with appropriate lumens and control wires for operative control and/or translating sheath type operation. 
     In a particularly preferred mode, the device provides a combined aspiration needle and biopsy forceps having tissue sampling jaws as a tissue sampling means at the determined sampling site in a patient. In accordance with the current preferred mode, the device is operationally configured to employ a biopsy forceps handle at a proximal end, which communicates along a guide shaft or control wire to hinged jaws at the distal end of the catheter or other lumen bearing conduit. An aspiration needle is additionally disposed at the distal end of the catheter and so positioned is coaxially and telescopically engaged to surround the hinged forceps, preferably at or near the jaws or grasping end of the forceps. A sleeve of teflon or other suitable polymeric material preferably engages over the forceps and needle as a protective sleeve. 
     In use the biopsy forceps are translatable within the sleeve to extend from the distal end of the surrounding aspiration needle. This translation allows a portion of the distal end of the forceps including the jaws or grasping end, to be moved to a retracted position protected within the core of the aspiration needle, or translated to an extended position where a the jaws of the biopsy forceps are translated to project past the open distal end of the aspiration needle where a deep tissue and/or cell sample may be taken and translated back inside the protected confines of the aspiration needle. 
     During operative employment of the device, camera aided navigation or RF aided navigation or combinations thereof are employed to navigate a camera bearing scope or catheter to a sampling site. Once the device engaged to the distal end of a control catheter is navigated through patient tissues to the sampling site, sampling may take place. 
     For shallow or surface tissue and/or cell samples, either the aspiration needle or the forceps may be employed at the discretion of the surgeon. However, the device provides a means to retrieve and protect deep tissue and/or cell samples from the sampling site also through the provision of the coaxially translatable forceps engaged within the axial passage of the aspiration needle. 
     In a deep tissue sampling process, once the device is properly positioned using RF or camera aided navigation, from the distal end of the control catheter, the aspiration needle is inserted into the organ or tissue sampling site, for a depth, for example of 5-25 mm. Once the aspiration needle is engaged at the desired position and depth, deeper within the organ or tissue sampling site, the jaws of the biopsy forceps may be translated to an extended position, projecting a distance past the distal end of the aspiration needle, and operated by control wire, to thereby provide a means to capture a large desired tissue and/or cell sample, from a deep position at the identified tissue sampling site. Operation of the forceps handle engaged to a control wire communicating with the biopsy forceps, and with translation of the lumen bearing catheter or sheath, allows the physician to translate the forceps to the extended or retracted position, and to manipulate the jaws to slice a large sample of deeply positioned tissue as needed. 
     Once the larger sample is taken using the biopsy forceps, they may be retracted back into the axial passage of the aspiration needle, where both the forceps and the tissue and/or cell sample are surrounded and protected from tissue contamination or loss during removal from the organ or tissue sampling site. Upon removal of the aspiration needle from the tissue sampling site, it may be translated along with the catheter to a position outside the patient, all the while with the forceps and sample being protected from possible loss or contamination during removal translation of the catheter. 
     In accordance with a particularly preferred mode, the present invention provides a medical instrument device with great utility in that it advantageously combines biopsy forceps and an aspiration needle operationally positioned at the distal end of a single lumen of a catheter. The device allows physicians to employ conventional camera aided or RF aided positioning, to translate the lumen bearing the device, to the sampling site in the body. Once so positioned, the surgeon may take very deep tissue and/or cell samples using the aspiration needle to tunnel into the sampling site and forceps to retrieve a larger sample. Should deep tissue sampling not be desired, the surgeon is provided with two different sampling instruments to choose from for a shallow tissue sampling. Such a combination thus is highly utilitarian since it provides the surgeon with a choice of a deep tissue sampling or multiple shallow tissue sampling components, without the need for time consuming removal and repositioning and risk of same to the patient. 
     In another particularly preferred mode of the invention, the tissue sampling means employed in combination with the aspiration needle is a coaxially engaged cytology brush. In use the operationally positioned cytology brush communicates with a control or handle at the proximal end of a catheter and can be telescopically translated from a retracted position surrounded by and within the axial core of the aspiration needle, to an extended position, projecting from the distal end of the aspiration needle as needed. Samples taken by the cytology brush are also protected during retrieval from damage, loss, or contamination, by the surrounding wall of the aspiration needle once the brush is translated back therein. 
     The device may also be provided with a single aspiration needle, and a kit bearing the biopsy forceps and cytology brush which allows the surgeon to choose which translating instrument to engage with the aspiration needle for a procedure. Engagement would be cooperative fasteners such as a threaded receiver and cooperatively threaded member for engagement therein. 
     With respect to the above description, before explaining at least one preferred embodiment of the herein disclosed invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and to the arrangement of the components in the following description or illustrated in the drawings. The invention herein described is capable of other embodiments and of being practiced and carried out in various ways which will be obvious to those skilled in the art. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of description and should not be regarded as limiting. 
     As such, those skilled in the art will appreciate that the conception upon which this disclosure is based may readily be utilized as a basis for designing of other structures, methods and systems for carrying out the several purposes of the present disclosed device. It is important, therefore, that the claims be regarded as including such equivalent construction and methodology insofar as they do not depart from the spirit and scope of the present invention. 
     As used in the claims to describe the various inventive aspects and embodiments, “comprising” means including, but not limited to, whatever follows the word “comprising”. Thus, use of the term “comprising” indicates that the listed elements are required or mandatory, but that other elements are optional and mayor may not be present. By “consisting of” is meant including, and limited to, whatever follows the phrase “consisting of”. Thus, the phrase “consisting of” indicates that the listed elements are required or mandatory, and that no other elements may be present. By “consisting essentially of” is meant including any elements listed after the phrase, and limited to other elements that do not interfere with or contribute to the activity or action specified in the disclosure for the listed elements. Thus, the phrase “consisting essentially of” indicates that the listed elements are required or mandatory, but that other elements are optional and mayor may not be present depending upon whether or not they affect the activity or action of the listed elements. 
     It is an object of the invention to provide a combination biopsy forceps and aspiration needle configured to allow physicians or other medical professionals to employ both instruments in a progression to obtain deep tissue and/or cell samples from identified tissue and/or cell sample sites of potentially abnormal tissue in a patient. 
     It is an object of the disclosed device having a combination biopsy forceps and aspiration needle device to provide more accurate tissue sampling within a desired area of tissue by providing the ability to secure larger tissue and/or cell samples and protect the retrieved sample during translation of the device from the body. 
     It is another object of the invention to provide a combination aspiration needle and cytology brush or biopsy forceps to provide the medical professional options as to which of two components to employ for a shallow tissue and/or cell sample, after a single positioning of a catheter operationally engaged thereto. 
     These together with other objects and advantages which become subsequently apparent, reside in the details of the construction and operation as herein described with reference being had to the accompanying drawings forming a part thereof, wherein like numerals refer to like parts throughout. 
    
    
     
       BRIEF DESCRIPTION OF DRAWING FIGURES 
         FIG. 1  shows a disassembled view of a particularly preferred mode of the device depicting a forceps with control handle, needle component, and protective sleeve. 
         FIG. 2  is a close up view of the distal end of the forceps detailing the forceps jaws used for grasping and removing larger tissue and/or cell samples. 
         FIG. 3  shows a view of yet another particularly preferred mode of the invention wherein a cytology brush is employed as a means for deep tissue sampling. 
         FIG. 4  depicts an assembled view of the preferred mode of the device of  FIG. 1  with the forceps and needle in a stored or retracted position. 
         FIG. 5  depicts an assembled view of one preferred mode of the device of  FIG. 1  with the needle in an extended position and forceps in a stored or retracted position protected during insertion or retraction from the patient. 
         FIG. 6  depicts an assembled view of the preferred mode of the device of  FIG. 1  with the forceps and needle in the as-used tissue sampling position. 
         FIG. 7  shows a close up view of the forceps in the extended or as-used position with the jaws opened as needed for grasping tissue for a deep tissue and/or cell sample or surface sample. 
         FIG. 8  depicts the device in the position of  FIG. 5 . 
         FIG. 8   a  depicts the biopsy forceps in the retracted position coaxial with the aspiration needle. 
         FIGS. 9   a - 9   c  depict the device translating within a lumen on a camera bearing or RF positioning-enabled bronchoscope as employed for a lung tissue biopsy. 
         FIG. 10  depicts components forming an inner tubular structure which translates within a surrounding outer tubular structure. 
         FIG. 11  depicts a translation of the inner tubular structure within the coaxial outer tubular structure to translate the needle between a retracted position and extended position. 
         FIG. 12  depicts the inner tubular structure translated to the extended position and the translation of a control wire to translate the engaged forceps to the extended position. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE INVENTION 
     Now referring to drawings in  FIGS. 1-12 , wherein similar components are identified by like reference numerals, there is seen in  FIG. 1  a view showing components of a particularly preferred mode of the tissue sampling device  10 . As shown, there is a disassembled view of the device  10  which includes at least a combination of an aspiration needle  30  and biopsy forceps  18 . The device  10  includes biopsy forceps  18  having a handle  12  and elongated flexible member such as the depicted control wire  14  extending to a distal end  16 . Located at the distal end  16  is the forceps jaws  19  ( FIG. 2 ) which are employable for tissue and/or cell sampling at a shallow or deep tissue position depending on the use by the surgeon. The handle  12  is engaged to the control wire  14  which provides a means to manipulate the jaws  19  of the forceps  18  by translation of the control wire  14 . 
     The needle assembly  20  is formed and translated using another flexible member the depicted supporting shaft member  22  extending from a handled end  24  to a aspiration needle  30  positioned at the distal end. The shaft member  22  has a hollow axial passageway or axial passage defined by a sidewall of the shaft member  22  and is preferably made from a flexible material with a low coefficient of friction such as Teflon as a means to enhance translation and minimize friction when translatabley engaged within a lumen such as that of a catheter. However, it can be formed from any polymeric or metallic material employable in the art of medical instruments. The aspiration needle  30  is engaged to the shaft  22  via a crimp  28 . However, it can be engaged by any means known in the art such as adhesive, collaring, cooperating fasteners, or other operative means of engagement as would occur to those skilled in the art. 
     The axial passageway or axial passage  32  communicates along the length of the assembly  20  from an open end at the handle  32 , to an open exiting end, lining up the axial passageway with the hollow core of the needle  30  where the passageway or passage  32  extends through the hollow core of the aspiration needle  30  to form a continuous axial passageway. In use, and shown in later figures, the elongated control wire  14  communicating to control the forceps  18  is translatably and coaxially engaged within the passage  32  such as to position the jaws  19  at or near a position within or surrounded by the wall defining the hollow axial core of the aspiration needle  30 . When so surrounded, the forceps  18  bearing a tissue and/or cell sample, are protected during removal, from both the tissue and the lumen, by the wall forming the aspiration needle, which provides a means to protect the sample from loss and contamination. The needle assembly  20  additionally includes a stop member  26 . 
     Additionally shown, is an exterior sleeve component  34  having an elongated shaft member  36  engaged to a circular handled end  38 . The sleeve component  34  has an axial passage  40  communicating therethrough from an open end at the handle  38  to an open distal end  39 . Shown in more detail in subsequent drawings, the sleeve component  34  is translatably and coaxially engaged to encircle the needle assembly  20  and the forceps  18  which are translatable within the axial passage  40  of the sleeve component  34 . 
     In use, shown in ( FIGS. 4-6  and  11 - 12 ) the stop member  26  restricts the translational movement of the sleeve component  34  relative to the needle assembly  20 . The stop member  26  also restricts the distance of translation “D” of  FIG. 11 , of the needle assembly  20  relative to the sleeve component  34 , to the length of the needle assembly  20  between the handle  38  and the stop member  26 . 
     It must be noted that it is within the scope of the invention that the device  10  may be modified in form to be longer, shorter, or to achieve other structural configurations which will allow a physician to obtain deep tissue sampling through translation of the aspiration needle  30  and forceps  18  coaxial to a surrounding sleeve component  34 . As such those skilled in the art will appreciate that the depictions set forth are provided merely for descriptive purposes to portray the overall intent and scope of the invention, and should not be considered limiting. Additionally, the device is capable of achieving the noted goals of obtaining deep tissue and/or cell samples which are protected during retrieval through means other then biopsy forceps  18 , such as the employment of a cytology brush  17  ( FIG. 3 ) which  is translatable to gather cells from deep tissue positions in the same fashion as the forceps  18 . 
       FIG. 2  shows a view of the distal end  16  of the forceps  18  showing the jaws  19  employed for grasping, cutting, and retrieving tissue and/or cell samples from deep tissue positions or at the option of the user, from shallow or surface positions. In use, the aspiration needle  30  penetrates the tissue at the determined sampling site. In doing so, the needle  30  provides a means to tunnel into the tissue and/or cell sampling site and creates an elongated passage or a seam through which the forceps  18  are translated in a second sequential action to retrieve tissue or cells from the deep end of the bored tunnel or tunnel seam into the tissue sampling site. If used separately, the needle  30 , can on its own, remove a portion of tissue. However, such can be small and indeterminate as to actual location. 
     Once the tunnel is formed, the forceps  18  are translated past the distal end of the needle  30  where the jaws  19  can extend and be translated into the seam formed by the needle  30  or a tunnel formed by the needle  30  depending upon the manner in which the needle  30  is employed in the first action of the sequential sampling. Once at the deeper position provided by the seam formed by the wall of the needle  30  or the tunnel formed by the coring of the needle  30 , the jaws  19  may be contracted by the controller to retrieve a large tissue and/or cell sample from a deep tissue location which is at the distal end of the needle  30 . Sample cutting is accomplished through translation of the control wire  14  by translation of the handle  12 . This is of an advantage over prior art in which conventionally forceps  18  are limited to only grasping surface tissue at the sampling site. 
     In the device herein used for deep tissue and/or cell sampling, the forceps  18  are projected past the distal end of the operatively positioned needle  30 , which has formed a tunnel ending at its distal end, to the known deep tissue position. At that point, deep in the tissue sampling site, a piece of tissue is excised, and the forceps  18  are thereafter translated back within the cavity formed by the wall of the needle  30  to a retracted position. In this position, the tissue and/or cell sample is protected from loss and contamination by other tissues during retrieval of the needle and forceps from the patient. Thus, a large sample, from a known position deep in the tissue at the sampling site, is retrieved and protected during the retrieval process. 
     As is shown, the jaws  19  are engaged about a hinge  21  providing a lever to manipulate the jaws  19  during translation of the control wire  14 . It is preferred that the handle  12  of the forceps  18  provide the means to manipulate the jaws  19  however in other modes of the device  10 , the forceps  18  may be manipulated remotely by a robot or by other means as would occur to those skilled in the art. 
       FIG. 3  shows a view of another particularly preferred mode of the device  10  wherein a cytology brush  17  is substituted for the forceps  18  and employed for deep tissue sampling. In this mode, the guide control wire  14  extending from the handle  12  is shown in  FIG. 3  as guidewire  15  in communication with the brush end  17 . The slight modifications necessary to employ the cytology brush  17  or other tissue sampling means that one skilled in the art would immediately recognize are considered within the scope of the invention and are anticipated. Further, the cytology brush  17  and the forceps  18  can have an engagement means on the control wire  14  or guidewire  15  allowing them to be interchanged and they may be provided in a kit to allow the medical professional to engage either to the control wire  14 . Threaded engagement between the two components is one mode using a threaded cavity and threaded guide wire or control wire to engage the cytology brush  17  or forceps  18 . 
     Referring now to  FIG. 4-FIG .  6 , there is shown preferred operative steps of employment of the device  10  employing forceps  18 . Again, it is noted that the device in other modes, employing other means for tissue sampling, would follow the same general operative procedure during use, and is anticipated. 
     In  FIG. 4 , there is shown the assembled device  10  with the needle assembly  20  engaged and translated to surround the forceps guide control wire  14  and the protective sleeve  34  engaged thereover as well with all components coaxial. The concentric coaxial translational engagement of the components allow the aspiration needle  30  and forceps  18  to be translatabley positionable to respective extended or as-used positions and intermediate positions as is shown in  FIGS. 4-6  and  11 - 12  for example. 
     The device  10  in  FIG. 4  is shown in a retracted or stored position with the aspiration needle  30  and forceps  18  both retracted into the distal end  39  of the protective sleeve  34  provided by shaft member  36 . Further, as can be seen, this position is accomplished by translating the protective sleeve  34  away from the handles  12  and  24  until the handle  38  of the sleeve  34  engages the stop element  26  on the needle assembly  20 . 
     The device  10  is positionable to place the aspiration needle  30  in an extended position as shown in  FIG. 5  by actuation of the controller engaged to the needle assembly  20  where it may be employed to form a tunnel, or an elongated incision or seam formed by the wall of the needle  30 , through which the forceps  18  may be subsequently translated by manipulation. The flexible member or control wire  14  may be manipulated by a controller to translate into the tunnel or seam, and then actuated to have the jaws  19  remove a tissue portion in a deep tissue and/or cell sampling. 
     As also depicted, the forceps  18  are maintained in the stored position within the axial passage  32  of the aspiration needle  30 . This is accomplished by translating the protective sleeve element  34  towards the handle  24  of the needle assembly  20  to expose the aspiration needle  30  from the open distal end  39  or by translation of the wire  14  to move the forceps  18  to the retracted position where the tissue or cell sample is protected during retrieval of the needle  30  and the forceps  18 . The manner of control of both of the needle  30  and the forceps  18  of course can be with any mode of a first flexible member for the needle  30  and a second flexible member for the forceps  18  so long as the there is an axial passageway along the first flexible member to allow the second flexible member to operate, translate, and actuate the forceps  18  through it. 
     As can be seen, translating to this position, the handle  24  of the needle assembly  20  acts as a stopper for the handle  38  of the sleeve  34 . This position allows the physician or surgeon to insert the aspiration needle  30  to form the tunnel at the tissue sampling site to the desired depth into tissue to be sampled. Thereafter, from the known position at the distal end of the aspiration needle  30 , tissue may be removed using the forceps  18  or cytology brush. Once a sample is taken, the forceps  18  or brush may be translated back within the safe confines of the cavity surrounded by the wall of the needle  30 . Those skilled in the art will realize that it is within the scope of the invention that the wall of the aspiration needle  30  may be shorter or longer than the depiction as needed to obtain the desired tunnel depth, and such is anticipated within the scope of this invention. 
     As noted, once inserted, the aspiration needle  30  creates the tunnel in the tissue to the deep sampling site where the forceps  18  are extended through translation of the control wire  14 . From the known deep tissue sampling position, the forceps  18  may cut and retrieve a portion of tissue. 
       FIG. 6  depicts a view of the device  10  with the forceps  18  in the extended or as-used tissue excising or sampling position, with the forceps  18  extended past the opening at the distal end of the aspiration needle  30  as shown. This is accomplished by translating the needle assembly  20  and sleeve  34  concurrently toward the forceps handle  12  thereby translating the control wire  14  relative thereto, such that the needle component handle  24  is in an abutment with the distal end of the forceps handle  12  as shown. It must be noted that it is within the scope of the device  10  to employ a longer control wire  14  as to allow the forceps  18  to be translated further into the deep tissue sampling position, and such is anticipated. The forceps  18  are operated in a conventional fashion to take a slice of tissue and once tissue is retrieved and between the jaws  19  of the forceps  18 , the aspiration needle  30  and forceps  18  can be translated back to the stored position. 
       FIGS. 7 and 7   a  shows an enlarged view of forceps  18  in the extended position of  FIG. 6 . Again, the forceps  18  extend from the axial passage  32  of the needle assembly  20  and are surrounded by the wall of the aspiration needle  30 . As is shown, the jaws  19  of the forceps  18  are in an open position as would be accomplished by manipulation by the forceps handle  12 . 
       FIG. 8  depicts the device  10  in which the aspiration needle  30  is in the extended position and  FIG. 8   a  shows an enlarged view of the forceps  18  in the retracted position within the aspiration needle  30 . 
       FIGS. 9   a - 9   c  depict the device  10  translating within a lumen, for example, a lumen  48  formed in a bronchoscope  50  employed for a lung tissue biopsy. Use in any elongated lumen bearing device is anticipated, however. 
       FIG. 10  depicts components forming an inner tubular structure of the needle assembly  20  which translates within a surrounding outer tubular structure of the protective sleeve  34 . The aspiration needle  30  is shown at the distal end. 
       FIG. 11  depicts a translation of the translating needle assembly  20 , within the coaxial surrounding protective sleeve  34  used to translate the aspiration needle  30  between a retracted position of  FIG. 4  and the extended position of  FIG. 5 . 
       FIG. 12  depicts the needle assembly  20  translated to the extended position and the result of translation of a control wire  14  to translate the forceps  18  engaged thereon, to the extended position such as in  FIG. 7   a.    
     While all of the fundamental characteristics and features of the invention have been shown and described herein, with reference to particular embodiments thereof, a latitude of modification, various changes and substitutions are intended in the foregoing disclosure and it will be apparent that in some instances, some features of the invention may be employed without a corresponding use of other features without departing from the scope of the invention as set forth. It should also be understood that various substitutions, modifications, and variations may be made by those skilled in the art without departing from the spirit or scope of the invention. Consequently, all such modifications and variations and substitutions are included within the scope of the invention as defined by the following claims.