Drill biopsy

Table 37.4. Commercially available needles for CT-guided drill biopsy (exemplary selection of different manufacturers and...

To prepare liver slices with the Krumdieck sheer, cylindrical cores of tissue are first isolated from the liver specimens (Figure 12.1). These tissue cores are prepared preferably by advancing a sharp rotating metal tube into the liver tissue using a drilling press, thus assuring the preparation of accurately cylindrical cores. If a biopsy punch is used to prepare the cores, it is difficult to obtain a uniform cylindrical shape. 

A variety of bone biopsy needles are available, ranging from sharp-threaded, drilling-type 17-G needles to large-bore 8-G needles (Table 37.4). For sclerotic or osteoplastic bone lesions of the spine, it is advantageous to collect as much material as possible, because these lesions are often difficult to adequately decalcify for diagnostic workup. Therefore, for sclerotic bone lesions, bone biopsy needles of 11 G or larger are usually best. 

Bonopty coaxial biopsy system eccentric drill penetration set (Radi Medical Systems, Uppsala, Sweden) 14 ... 

Shown in Figure 5.19, our MR-compatible bone biopsy robot has two modes of operation tele-operative and autonomous. The system has 5 DOFs (linear, turret, elbow roU, wrist pitch, and penetration) in addition to the drilling joint. The tool is equipped with force sensors to send drilling forces as haptic feedback to the operator. The system allows the surgeon to tele-operatively control the drilling process during the bone biopsy procedure by means of force and vision feedbacks. 

In contrast, the nidus can easily be identified by CT, which can guide a minimally invasive device into the nidus. In some cases the nidus is encapsulated by the surrounding reactive sclerosis. Then, it can be impossible to penetrate the bone with the ablation device directly. In such cases the access route to the nidus must be prepared by drilling a hole. For this purpose generally a bone biopsy cannula with a crown cut is suitable. Nevertheless, the sclerosis surrounding the nidus can be so hard that a mechanical drilling device is necessary to create the access route (Fig. 9.1). When the access is established the tip of the probe can be placed directly into the nidus. 

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