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Endoscopic biopsy


Medical editor Ane Konglund MD
Physician in Specialization
Oslo University Hospital

General

Endoscopic biopsy is performed for symptom-giving lesions in lateral ventricles or 3rd ventricle when diagnostic clarification is important. This particularly applies to lesions that are not accessible for resection, or when there is suspicion of a tumor type that requires non-surgical treatment.

Indications

  • Brain tumor

Goal

  •  To establish a diagnosis in order to evaluate further treatment.

Equipment

  • Endoscopy tray, adult
  • High speed drill (drill hole)
  • Monitor for image transfer

Preparation

  • General anesthesia is given.
  • Place the patient in the supine position.
  • Fix the head.
  • Prophylaxis for infection (single dose).

 


Implementation

  • Make a small skin incision based on MR images.
  • Make a small drill hole and open the dura.
  • Insert a rigid endoscope until inside the ventricle system.
  • Navigate the scope according to the picture on the monitor until the tumor can be seen.
  • Introduce the biopsy forceps via the biopsy channel of the scope.
  • Take samples for histology and frozen section.
  • Close the skin incision tightly in two layers with sutures.

Follow-up

  • Give thrombosis prophylaxis routinely until full mobilization.
  • CT on first postoperative day.
  • Take blood sample with electrolytes on first postoperative day.
  • Remove bandage after a few days, as normal. Remove sutures after 10-12 days.
  • The patient is usually discharged to the local hospital 1-2 days after the operation (depending on the clinical course).
  • Evaluate oncological treatment according to the histological results.

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