Extraction of Stuck Bone Biopsy Fragment within the Cannula Using Heat from Cautery Device

Educational Poster Background: Image-guided bone biopsy is a commonly performed intervention. Most bone biopsy instruments contain a guiding trocar and an inner biopsy cannula. Sample core getting stuck within the biopsy cannula is a known complication, and it may be impossible to extrude the fragment, rendering the procedure futile. Furthermore, in children, target may be small and repeat biopsy may be difficult. Therefore, extruding the stuck fragment becomes essential. The risk of tight lodging of the core increases when the core length is longer than 1 cm and when target bone is sclerotic. Some authors have described a “biopsy-the-biopsy” technique, but this technique fragments the sample and works only for large biopsy cannula. We describe a technique to extrude the stuck fragment utilizing a battery-operated disposable cautery device wherein the heated tip is brought in contact with the distal end of the biopsy cannula. The heat causes expansion of the metallic biopsy cannula and thus facilitates easy extrusion of the bony fragment. We have used this technique in five cases and have successfully recovered the biopsied fragment in all. In two cases, we noted slight charring of the margins, but this did not impede the diagnosis by pathology. We have not determined whether this technique affects culture yield. In conclusion, a stuck core can be easily recovered using a cautery device to cause metallic cannula expansion. This easy remedy can obviate the need for additional sampling or salvage a futile procedure; this technique may not impede the pathological diagnosis. Stuck bone biopsy core within the cannula can be removed by applying heat to the cannula, which causes metal expansion and thus facilitates extrusion of the fragment. This technique is simple and can prevent additional sampling or additional new device usage.

Publication History

Article published online:
26 April 2021