Surgical Standardization Guidelines

Clinical Application Progress and Surgical Standardization Guidelines
The application of the Chiba needle in clinical medicine is shifting from a traditional diagnostic sampling tool to a multi-functional interventional treatment platform. The clinical practice in 2025 demonstrated that the innovative application of the Chiba needle technology in various interdisciplinary fields significantly improved the accuracy of disease diagnosis and the safety of treatment, promoting the standardized development of interventional radiology.
In the field of radiofrequency ablation treatment for liver cancer, the Chiba needle guidance technology has achieved a breakthrough. A clinical study involving 48 patients with primary liver cancer showed that using the Chiba needle-guided radiofrequency needle puncture technique under CT guidance for radiofrequency ablation treatment, 236 points (72.6%) were punctured by the Chiba needle in one go, and 318 points (97.8%) were punctured by the radiofrequency needle in one go. Complications related to puncture included 1 case of minor pneumothorax (2.1%) and 2 cases of liver subcapsular hemorrhage (4.2%). There were no serious complications such as intra-abdominal hemorrhage, gallbladder perforation, or colon perforation. The research conclusion indicates that the Chiba needle-guided radiofrequency needle puncture technique can significantly increase the success rate and accuracy of radiofrequency needle puncture at each site, reduce the incidence of complications, and can be widely applied in the radiofrequency treatment of liver cancer.
In the field of percutaneous radio-gastrostomy (PRG), the Chiba needle technique has opened up a new path for special patient groups who are unable to have a nasogastric tube (NG) inserted. A study conducted from 2013 to 2024 involved 37 patients and 39 surgical procedures. After the initial puncture was completed using a 21-22G Chiba needle, a 6F Neff catheter was skillfully replaced for gastric cavity dilation. The data showed that this technique demonstrated remarkable clinical value: a technical success rate of 94.9% (37/39), and in 2 cases of failure, successful remediation was achieved by inserting a vascular angiography catheter through the mouth. What is more noteworthy is that all cases achieved clinical success, and the patients successfully received nutritional support through the feeding tube. In terms of safety, only 1 case of severe complication (abdominal abscess) and 3 cases of minor complications (2 cases of skin infection, 1 case of catheter leakage) were recorded, and none of these were directly related to the ultrasound-guided operation.
In the field of interventional treatment for obstructive jaundice, the Kashima needle plays a crucial role in percutaneous transhepatic biliary drainage (PTCD). Case studies show that a 66-year-old male patient with obstructive jaundice and cholangiocarcinoma, whose preoperative MRCP indicated significant dilation of the left bile duct, successfully had the Kashima needle inserted from the lower part of the sternum into the left bile duct, and the internal and external drainage tubes were successfully implanted. Another 56-year-old male patient with obstructive jaundice and a biliary-enteric anastomosis after surgery, due to surgery and radiotherapy, had fibrotic and hard tissue in the bile duct area. The Kashima needle was successfully inserted into the right bile duct at the 8th and 9th intercostal spaces on the right midaxillary line. The extended puncture sheath could not pass through, so a V-18 elongated guidewire was exchanged, then a 4F single-bend catheter was integrated, and an additional reinforcing guidewire was exchanged. The surgery was successful.
In the field of lung biopsy, the application technique of the Chiba needle has been standardized. According to the information from ScienceDirect, the standard procedure for lung biopsy involves: using a 22-gauge Chiba needle and a 20 mL syringe to percutaneously insert into the lung mass. From the aspirate, two direct smears are prepared for immediate wet fixation in 95% ethanol and staining using the Papanicolaou method. The remaining aspirate is then mixed with 10 mL of balanced salt solution and brought to the laboratory for further processing. The cell suspension is centrifuged, and aliquots are used for membrane filters, direct smears, cell centrifuge specimens, and cell blocks.
In the spinal surgery imaging guidance procedure, the Kiyama needle is used for precise needle placement. The procedure steps include: "pause time" of the procedure, carefully determining the correct level of injection, marking the skin and performing aseptic preparation and draping, applying local anesthetic, and using a fluorescence mirror or CT to evaluate the trajectory to the small joint, then inserting the spine or Kiyama needle into the subcutaneous tissue on the back, and re-evaluating the trajectory to the small joint. Under intermittent fluorescence mirror or CT imaging, the needle is advanced until it feels "pop" and enters the joint or hard bone.
In the ultrasound-guided procedure, the unique design of the Chiba needle offers significant advantages. The Chiba needle from EDM has an internal echo marker, providing doctors with clear echo visibility and making the needle easily visible on the ultrasound display. These fine needle aspiration devices are highly suitable for ultrasound procedures due to their internal echo marking. This feature provides doctors with clear echo visibility and makes the needle easily visible on the ultrasound display.
In thyroid biopsies, the application of the Chiba needle has become mature. These FNA needles are also suitable for thyroid and lung biopsies. Additionally, they can be used in drainage procedures and regional anesthesia (nerve block). Sometimes, FNA needles are also used in liquid collection procedures.
In cytological examinations, the Chiba needle falls under the category of safe needles. According to the information from Daoketabba, 20-23G is referred to as a fine needle, 24-25G is called an ultra-fine needle, and biopsy puncture is considered a cytological examination and is regarded as a safe needle. The commonly used ones have a needle tip slope of 24 degrees, such as the Chiba needle. Among them, 14-19G (Gauge) is called a coarse needle, and biopsy puncture belongs to pathological histology examination.
The common feature of these clinical advancements is that they are patient-centered, aiming to minimize trauma, reduce risks, and enhance efficiency while ensuring the effectiveness of diagnosis and treatment. The Kiyama needle is no longer merely a tool for obtaining tissue samples; instead, it has become an important carrier for achieving precision medicine and personalized treatment. With the continuous changes in clinical needs and the continuous advancement of technological innovation, the Kiyama needle will play a significant role in more interventional radiology and diagnostic imaging fields.