Instruments and Procedures– Liver biopsy needles

Liver biopsy needles and procedures —

liver biopsy needle

Liver biopsy needles

  1. Menghini’s aspiration biopsy needle

  2. Vim-Silverman cutting needle.

Precautions in Liver biopsy

  • Bleeding time should be within normal limits.
  • Vein should be patent and blood should be arranged Hydatid cyst, subphrenic abscess, bleeding tenden­cies should be ruled out.
  • Patient should be sedated.

Vim-Silverman liver biopsy needle

Vim-Silverman liver biopsy needle

liver biopsy needle

  • (It has 3 parts) It consists of a long sharp needle, a stilette, prong, or fork which is longer than the needle so that it pro­trudes out of the needle when inside the needle. Both the fork and the stilette fit inside the needle nicely.
  • The fork or prong has very sharp cutting edge. There is no guard on this needle.

Site of puncture —

  • Anterior or midaxillary line 2 spaces below the upper edge of liver dullness during full expiration i.e. 9th or 10th right intercostal space.

Procedure of liver biopsy —

liver biopsy

Procedure of liver biopsy

 

  • Patient should hold the breath in full expiration.
  • The site of puncture is infused with local anaesthetic into the skin.
  • The needle is thrust into the liver 2-3 cm deep at the puncture site. The stillete is removed and the prongs are inserted. The prong which projects out of the needle is rotated through 3600 so as to remove a portion of liver tissue between the prongs.
  • The tissue is sent for histopathological examination.
Complications of liver biopsy
  • · Pleurisy
  • · Perihepatitis
  • · Intraperitoneal or intrathoracic haemorrhage
  • · Intrahepatic hematoma
  • · Biliary peritonitis
  • · Pulmonary bile embolism
  • · Bacteremia.

RENAL BIOPSY Indications

  • · Nephrotic syndrome
  • · Acute renal failure
  • · Undiagnosed proteinuria
  • · Hematuria
  • · Nephritic syndrome
  • · Systemic diseases with renal failure.

biopsy Instrument —

  • · Vim – Silverman’s biopsy needle
  • · Menghini’s biopsy needle.

Method —

  • · Bleeding and clotting time should be normal.
  • · Blood pressure should be controlled.
  • · Plain X-ray abdomen is taken.
  • · Sedate the patient.
  • · The patient lies on his belly with a pillow under his abdomen.
  • · A puncture is made with the Vim – Silverman’s needle on a line between the anterior end of 11 th rib and 2nd lumbar vertebra at the back on the right side.
  • · The right side is preferred because of lower po­sition of kidney and because the great vessels are on the left side.
  • · The part is cleaned and draped. Local anaesthetic is infiltrated. A small nick is made and puncture needle is introduced into the kidney. When the needle enters the kidney it starts moving in a wide arc with respiration.
  • · The stilette is removed and prong is introduced into the renal parenchyma. The prong is ad­vanced till it enters the kidney tissue, it is then rotated in a circle and taken out along with the needle.
  • · The patient is asked to remain on his back for 12 hours and drink a lot of water to prevent clot formation.

Complications

  • · Retroperitoneal haemorrhage
  • · Hematuria
  • · Pain in loins.
This is small description about liver, renal, abdo men biopsy, etc.
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