The present disclosure is directed to a tissue removal device. The tissue removal device may include a distal portion. The distal portion may include an outer distal portion including a tissue removal tool, and an inner distal portion positioned within the outer distal portion and having a closed distal end, a lumen, and at least one side port, wherein the lumen is configured to receive a medical device, and the inner distal portion is movable relative to the outer distal portion and the medical device.