The integrated medical apparatus includes an operator handle end and a multi-prong grasping member positioned within and movable relative to a grasper lumen that extends from the handle end, wherein the grasping prongs are moved between an open and closed position by relative axial movement between the prongs of the grasping member and the grasper lumen. The medical apparatus includes a contractible snare and a plurality of axially moveable snare pushing arms. At least two of the snare pushing arms include a snare holding and release mechanism, wherein the snare pushing arms are configured to advance the snare in an open, encircling position to a final deployed position where the snare can be released through the activation of the holding and release mechanism of the pushing arms, and finally tightened in a conventional fashion, such as pulling on an end of the snare at the handle end.