0:00

So let's talk about biopsy needles.

0:03

Fine gauge is typically greater than

0:06

or equal to 20 gauge.

0:09

When we think about the gauge of the needle itself, the smaller

0:12

finer gauges the tips vary in

0:15

their shape. Their configuration one is

0:18

a cutting tip. The other is a sharp or bevel tipped

0:21

when we think about the larger gauge. This is typically less than

0:24

20 gauge.

0:27

And these include side cutting needles or end cutting

0:30

needles. So let's talk about the fine gauge needles.

0:33

So the fine gauge needles are needles that

0:36

are typically thin walled and Hollow use exclusively

0:39

for the fine needle aspiration and they

0:42

require gentle motion to obtain cells we talk about that

0:45

sort of to and fro agitation in order

0:48

to obtain the tissue into the bore of the needle for cytology or

0:51

with gentle aspiration. When we

0:54

think about the sharp of bevel tip needles. They're usually

0:57

sort of asymmetrically tipped needles.

1:00

Okay, usually slanted Edge or

1:03

bevel that allows for good maneuverability and sterility.

1:06

We're thinking about the Chiba and spinal needles

1:09

in this particular setting when we think about the cutting tip needles.

1:13

Usually we're thinking about those that have greater than or

1:16

equal to two opposing cutting edges and that facilitates their

1:19

sort of advancement of the biopsy needle through

1:22

the tissue in the case of the Westcott. It has a little bit of a notch

1:25

just proximal to the tip and that

1:28

allows tissue to be invaginated in and then

1:31

cut with every two and flow motion. When

1:34

you think about the green it's almost as if the lips

1:37

of a leech or the

1:40

tip or configuration of a fountain pen cylindrical

1:43

with a little bit of a bevel allowing us

1:46

to sort of be Advanced and cut into the tissues as we

1:49

perform our to and for emotion and there are other examples

1:52

that include the last caught the green and the Maytag

1:55

Then we think about the large gauge needles the

1:58

end cutting the side cutting.

2:00

So these large gauge needles are ones that are typically a

2:03

double styled design. We have the inner style it which is partially

2:06

Hollow almost like a little tray and then

2:09

the outer style it has a spring loaded core that

2:12

then advances over it and that's used

2:15

to cut the sample. These are using

2:18

exclusively for the core needle biopsy.

2:21

Usually in the setting of the spring device that spring

2:24

devices necessary because it Springs the

2:27

outer style it that

2:30

outer layer of the device over

2:33

the tree trapping the

2:36

tissue in the tree in the center inner

2:39

style it what are some advantages some

2:42

advantages include the reduced procedure time

2:45

needed in order to get tissue.

2:48

If you want a certain volume of tissue, of course,

2:51

you can get small samples with

2:54

larger g h i e smaller biopsy

2:57

bites or you can use the

3:00

larger gauge needles which are

3:03

going to acquire more tissue for every past

3:06

taken. This will yield uniform samples given

3:09

the nature of the large gauge again mentioning that

3:12

they preserve the tissue architecture and

3:15

they're very suitable for histology when

3:18

compared to the small gauge needles.

3:21

Which as I mentioned before are used for finding the aspiration

3:24

typically don't allow us to maintain the architecture

3:27

of the tissue. So when we're thinking

3:30

about large gauge needles the end cutting versus

3:33

the side cutting these large gaze needles can be either end cutting or side

3:36

cutting and when we think about the end cutting needle the end

3:39

cutting needle is almost a bit of a jagged

3:42

edge that's circumferential and fashion at the

3:45

very tip of the needle and it's almost like a claw that goes

3:48

in and just gonna grabs the tissue and it sort of Cuts Like

3:51

It says from the end particularly good for solid masses

3:54

that are hard to penetrate now, when we think

3:57

of the side cutting the side cutting allows us

4:00

to extend that inner style

4:03

at into that mass often a softer mass

4:06

that allows penetration of that inner Thailand

4:09

at the point proximal to the very tip and then we able

4:12

to cut from the top with that outer style

4:15

it.