Standardized Operating Procedures And Complication Prevention Systems

The No. 1 core biopsy needle procedure is a technically demanding interventional operation. Success depends not only on the equipment itself but also critically on the operator's adherence to standardized technique and comprehensive risk management awareness. A rigorous operational protocol and safety strategy serve as the lifeline for ensuring diagnostic accuracy and patient safety.

Standardized Operating Procedure (SOP):

1. Pre-operative Preparation:​ Strictly verify patient identity, imaging data, and coagulation profiles (INR < 1.5, Platelets > 50 × 10⁹/L). Thoroughly explain the purpose, process, and potential risks to the patient, and obtain signed informed consent. Select the optimal entry point and trajectory, carefully avoiding major vessels, nerves, and hollow viscera.
2. Aseptic Technique and Anesthesia:​ Strictly adhere to aseptic principles. Administer local infiltration anesthesia layer-by-layer using 1%-2% Lidocaine, extending from the skin and subcutaneous tissue down to the lesion capsule. Adequate anesthesia is key to minimizing patient discomfort and preventing involuntary movement during the procedure.
3. Puncture and Firing:​ Under real-time imaging guidance (Ultrasound/CT), precisely advance the coaxial introducer needle to the edge of the target lesion. Once the needle tip position is confirmed, load and fire the No. 1 core biopsy needle. The "Two-Step" firing technique​ is the standard: first fire the inner stylet (ejecting the sample notch), then fire the outer cannula (closing the cutting sheath). The entire process should be swift and decisive.
4. Specimen Handling and Transport:​ Withdraw the biopsy needle. Using a sterile needle or forceps, gently expel the tissue core from the sample notch onto filter paper or place it directly into a designated specimen container. Document the number of passes, as well as the macroscopic appearance of the sample (color, texture, size). Based on clinical requirements, allocate samples for routine pathology, immunohistochemistry, microbiological culture, or molecular testing.
5. Post-operative Observation and Compression:​ Immediately after needle withdrawal, apply firm pressure to the puncture site with sterile gauze for at least 5–10 minutes (extending to 15 minutes for highly vascular organs like the breast or liver). Instruct the patient to rest in bed for 2 hours, monitoring for active bleeding, pneumothorax (for chest biopsies), or severe abdominal pain.

Complication Prevention and Management Strategies:

Although the No. 1 core needle is relatively safe, the following risks must be anticipated:

• Hemorrhage and Hematoma:​ The most common complication. Prevention hinges on avoiding vessels and ensuring adequate post-procedure compression. For high-risk locations (e.g., liver, kidney), consider tract embolization using gelatin sponge particles or coils. In the event of a progressively enlarging hematoma, emergency angiography and transcatheter arterial embolization are required.
• Pneumothorax (Thoracic Biopsy):​ Incidence ranges from 1%–5%. Preventive measures include selecting entry points with thicker lung parenchyma, avoiding interlobar fissures, and instructing the patient to hold their breath during needle passage. Small pneumothoraces may resolve spontaneously, while large ones require closed thoracic drainage.
• Needle Tract Seeding:​ Incidence is extremely low (<0.01%). The use of the coaxial cannula technique, which restricts the biopsy needle to moving within the sheath, is the most effective preventive measure.
• Infection:​ Strict adherence to aseptic technique is fundamental. For immunocompromised patients or those with known bacteremia, prophylactic antibiotics may be considered.

Mastering these standardized protocols and contingency plans transforms the No. 1 core biopsy needle into a truly reliable asset for the clinician.