From Roholm & Iversen To Menghini

Liver biopsy remains the gold standard for diagnosing liver disease-a fact unchanged since Roholm and Iversen first reported percutaneous liver puncture in 1939. But the question of "which needle to use" has always masked an internal divide: the Aspiration School​ (represented by Menghini, 1958) versus the Cutting School​ (represented by Tru-Cut, 1960s spring-loaded). To outsiders, it looks like "old design vs. new design"; to insiders, it's a division of labor based on two distinct pathological needs. The reason the Menghini needle-born in 1958-still holds a place in Western OEM catalogs today is not nostalgia; it's that aspiration-style sampling fulfills certain clinical scenarios Tru-Cut simply cannot replace.

1939–1958: The Embryo of Negative-Pressure Aspiration

Roholm & Iversen initially used a "large-bore needle + manual suction"-around 17G, drawing liver tissue into the needle lumen with syringe vacuum before severing it. The sample consisted of fragmented strips mixed with cells. The advantage: speed and the ability to use a relatively thin outer diameter (16–18G sufficed). The drawback: the sample was "fragmented," making it less ideal for lesions requiring visualization of intact hepatic lobule architecture.

In 1958, Italian pathologist Giorgio Menghini systematized the technique: defining the fit between an outer cannula and inner stylet, standardizing the negative pressure value (typically a 20–30 mL syringe pulled to 10–15 mL of vacuum), and establishing a "single insertion, continuous sampling" operational flow. This became the skeleton of the Menghini needle-largely unchanged to this day.

Why Tru-Cut Never Fully Replaced Menghini

Tru-Cut (later evolving into devices like Bard Magnum and Manan spring-loaded systems) operates on a "trocar-within-cannula" principle-upon firing, the inner trocar advances first to anchor the tissue, then the outer cannula slices a circular core, yielding an intact tissue column 1.5–2 cm long. This is excellent for liver fibrosis staging and tumor architecture assessment. Sounds like a clear winner? Yet Menghini prevails in three specific scenarios:

• Patients with borderline coagulation:​ Menghini can be manufactured at 16–18G; Tru-Cut spring-loaded devices generally start at 14–16G. Smaller caliber = lower bleeding risk.
• Fatty liver/cirrhotic tissue texture:​ Aspiration is paradoxically more efficient at retrieving "soft + fragmented" tissue-Tru-Cut frequently returns "empty tubes" in severe fatty liver.
• Combined cytology + histology:​ When lymphoma or leukemic liver infiltration is suspected, aspirated material for smear cytology is more sensitive than core biopsy alone; Menghini naturally delivers both.

The Modern Form of Menghini

The original Menghini was a three-piece design: hub + needle tube + inner stylet + syringe connector. Today's mainstream改良 (modified) versions feature a luer-lock vacuum connector, allowing single-handed operation (the original often required an assistant to pull the syringe). For OEMs like Manners Technology, 90% of Menghini orders are two specifications: 16G/18G × 150–200 mm, with a 20°–25° bevel angle and a "flat-head micro-convex" stylet tip that seals the needle bevel to prevent subcutaneous tissue from entering during insertion. These are refinements layered atop the 1958 original-the skeleton remains.

📌 Procurement Insight:​ Don't dismiss Menghini as "outdated 1958 design." The current Western pathology department paradigm is "Tru-Cut for routine, Menghini reserved for 10–15% specialty cases." Orders for Menghini are actually growing slowly in three niches: fatty liver centers, hematology consultations for liver involvement, and pediatric liver biopsies (Tru-Cut struggles below 16G).