A tissue removal device (1000; 1100), comprising: a housing (1002; 1102); an outer tubular member (1008; 1108) coupled to the housing (1002; 1102) and having a distal portion including a tissue resection window; an inner tubular member (1016; 1116) slidably disposed within the outer tubular member (1008; 1108) and defining an inner lumen extending from an open distal end to an open proximal end, the open distal end comprising a cutting edge to sever tissue extending through the tissue resection window; a vacuum generation chamber (1030; 1120) disposed in the housing (1002; 1102) including a movable piston disposed in the vacuum generation chamber (1030; 1120); a tissue trap (1032; 1122) disposed in or coupled to the housing (1002; 1102), the tissue trap (1032; 1122) defining a sealed interior in fluid communication with the vacuum generation chamber (1030; 1120), wherein the open proximal end of the inner tubular member is disposed within the tissue trap interior; and a manual actuator (1020; 1128) moveably coupled to the housing (1002; 1102) and operatively connected to the piston, such that movement of the actuator (1020; 1128) relative to the housing (1002; 1102) causes movement of the piston within the vacuum generation chamber (1030; 1120); characterized in that the tissue trap interior is in fluid communication with the vacuum generation chamber (1030; 1120) via a one-way valve, so that air may be withdrawn from the tissue trap interior into the vacuum generation chamber (1030; 1120) by movement of the piston in a first direction, while air is prevented from entering the tissue trap interior from the vacuum generation chamber (1030; 1120) due to movement of the piston in a second direction opposite the first direction; and the actuator (1020; 1128) can be selectively operatively coupled to the inner tubular member (1016; 1116) such that movement of the actuator (1020; 1128) relative to the housing (1002; 1102) causes movement of the inner tubular member (1016; 1116) relative to the outer tubular member (1008; 1108). a housing (1002; 1102); an outer tubular member (1008; 1108) coupled to the housing (1002; 1102) and having a distal portion including a tissue resection window; an inner tubular member (1016; 1116) slidably disposed within the outer tubular member (1008; 1108) and defining an inner lumen extending from an open distal end to an open proximal end, the open distal end comprising a cutting edge to sever tissue extending through the tissue resection window; a vacuum generation chamber (1030; 1120) disposed in the housing (1002; 1102) including a movable piston disposed in the vacuum generation chamber (1030; 1120); a tissue trap (1032; 1122) disposed in or coupled to the housing (1002; 1102), the tissue trap (1032; 1122) defining a sealed interior in fluid communication with the vacuum generation chamber (1030; 1120), wherein the open proximal end of the inner tubular member is disposed within the tissue trap interior; and a manual actuator (1020; 1128) moveably coupled to the housing (1002; 1102) and operatively connected to the piston, such that movement of the actuator (1020; 1128) relative to the housing (1002; 1102) causes movement of the piston within the vacuum generation chamber (1030; 1120); the tissue trap interior is in fluid communication with the vacuum generation chamber (1030; 1120) via a one-way valve, so that air may be withdrawn from the tissue trap interior into the vacuum generation chamber (1030; 1120) by movement of the piston in a first direction, while air is prevented from entering the tissue trap interior from the vacuum generation chamber (1030; 1120) due to movement of the piston in a second direction opposite the first direction; and the actuator (1020; 1128) can be selectively operatively coupled to the inner tubular member (1016; 1116) such that movement of the actuator (1020; 1128) relative to the housing (1002; 1102) causes movement of the inner tubular member (1016; 1116) relative to the outer tubular member (1008; 1108).