Shores-Little Cerebral Biopsy Device
• D esigned to obtain quality biopsies from deep or superficial cerebral structures. • Includes biopsy sleeve, stylet, extension set and 5cc syringe. • P lacement is guided by intraoperative ultrasound imaging or direct visualization of the target tissue. • S terile, single use.
16Fr x 10.5cm (4.1in)
About 4 years ago, we began working on a design for a simple biopsy device that would be economical, effective, and could work with our approach of using intraoperative ultrasound (IOUS) in our intracranial surgeries. The genesis of this was the
difficulty of getting sufficient quantity of tissue samples for our pathologists to perform necessary tests to deliver an accurate diagnosis. Not every facility has the stereotactic equipment to localize tumors for biopsy and with the issue of brain shift that occurs with decompression of the brain, something that complimented our use of IOUS was one of our goals. Initially a sleeve was designed in an attempt to core biopsy the masses with ultrasound guidance; however the difference in tissue densities made this impractical. After reading several papers on the most effective use of biopsy needles, it appeared that applying suction would effectively deliver a variety of tissue types into the sleeve. The amount of effective suction was contained in one excellent article and was listed as 6 mPa (millipascals). Our engineering department was consulted and determined that with this device 6 mPa was achieved with a 2 to 3 ml suction using the syringe on our device. Our testing model was a tomato - this showed us that the combination of the device and suction delivered ample samples into the biopsy sleeve. Next, we tested this on cadaver brains and submitted samples for histopathology. The sample size and tissue architecture were said to be excellent. Our clinical experience with the device has spanned a period of a little over 3 years. We have not had complications using this with the IOUS and biopsy samples have been consistently excellent. Visualizing the device with IOUS as it enters the mass assures us of a good sample. We hope this device will be useful for a number of neurosurgery groups.
Andy Shores, DVM, MS, PhD; DACVIM(Neurology) Clinical Professor and Chief, Neurosurgery/Neurology Mississippi State University College of Veterinary Medicine and Veterinary Specialty Center
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