comprises fixed handle means 300 and movable handle means 400 turning first to cutting assembly 10 outer tube 100 generally comprises a distal end 105 a proximal end 110 and an interior passageway 115 a rectangular distal opening 120 is formed in the distal end of outer tube 100 a sharp cutting edge 125 is provided at the distal end of opening 120 an annular groove 130 is formed in the distal end of outer tube 100 annular groove 130 starts approximately flush with sharp cutting edge 125 and extends distally thereof annular groove 130 defines a cylindrical plug 140 a front knob 145 is disposed on the outer tube 39 s distal end surface 146 a plurality of barb receiving bores 147 extend through the wall of outer tube 100 stationary tissue barbs 150 are disposed in bores 147 barbs 150 are arranged so that they extend inwardly and proximally from the wall of outer tube 100 so as to project significantly into the interior of outer tube 100 barbs 150 are formed out of a relatively strong and resilient material e g stainless steel outer tube 100 also comprises an annular proximal end surface 155 and two diametrically.