Initial experience with new dedicated needles for laparoscopic ultrasound-guided fine-needle aspiration and histological biopsies

Background and Study Aims: Laparoscopic ultrasonography (LUS) is an importa nt imaging modality during laparoscopic staging of intra-abdominal malignan cies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine-needle as piration (FNA) and Tru-cut biopsies. Patients and Methods: LUS-guided biopsy was performed in 20 patients with u pper gastrointestinal tract tumors. The biopsied lesions had either not bee n previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate. Primary diagnosis, duration of b iopsy procedure, needle monitoring (visibility, penetration, and deviation) , complications, technical failures, and pathological findings were prospec tively recorded. Results: 44 biopsies were performed with 25 needles (19, 20, and 22-G), Nee dle monitoring and penetration were good or acceptable in 18 patients (90%) , Slight needle deviation (<10 mm) was seen in eight patients (40%), The LU S-guided biopsy specimen was sufficient for analysis in 13 patients (65%), In two additional patients, adequate material was obtained, but pathologica l examination was impossible owing to incorrect handling of the specimen. T he biopsy procedures lasted 16.3 minutes (range 10-20 minutes) and no compl ications were seen. Conclusions: LUS-guided fine-needle aspiration or Tru-cut biopsy is possibl e using this newly developed biopsy system. These preliminary data suggest that LUS-guided biopsy may further improve the diagnostic possibilities of LUS.