Mayo stand and back table instruments for Breast Biopsy surgery setup

Clamping & Occluding

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  Penetrating Towel Clamp

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  Curved Hemostat

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  Kocher Forceps

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  Mosquito Clamp – Curved

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  Straight Hemostat

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  Tonsil Clamp

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  Allis Forceps

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Adson Forceps

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  Non toothed Pickup

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  Debakey Forceps

Retracting & Exposing

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  Freer Skin Hook

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  Freeman Rake

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  Weitlaner Retractor

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  Army-Navy Retractor

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  Senn Retractor

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  Richardson Retractor

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  Deaver Retractor

Suctioning

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  Yankauer Suction

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  Ferg-Frazier Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Breast Biopsy

A breast biopsy is a medical procedure used to obtain a small sample of breast tissue for examination under a microscope. It is typically done to investigate a suspicious lump or abnormality found during a breast exam or imaging test, such as a mammogram or ultrasound. The biopsy helps determine if the tissue is cancerous or not, and provides important information for the diagnosis and treatment of breast cancer.

Extra Equipment
ESU, suction

Drapes
Four folded towels, laparotomy drape

Step 1: Incision
The doctor will make an incision near the location of the biopsy, using a 10 or 15 blade depending on the size of the incision needed.

Step 2: Retraction
For small incisions, use senns, rakes, or skin hooks for retraction. For larger incisions, use army-navys or Richardsons.

Step 3: Dissection
The doctor will dissect down to reach the lesion, using cautery, DeBakey forcep, and Metzenbaum scissors.

Step 4: Retraction
Once dissected down, use a Weitlaner to retract the lesion into view.

Step 5: Clamping
An Allis clamp may be used to grasp the lesion and remove it.

Step 6: Stitching
After removing the lesion, a making/orientation stitch is usually placed using a needle driver, adsons, and straight mayo scissors.

Step 7: Pathology
The specimen is then sent to pathology for analysis.

Step 8: Drain
If the incision was bigger, a drain may also be used at the end.

Tips and tricks
Always make a note of the side and location of the specimen, as well as where the orientation stitch is placed, and double check specimen sheets.
Formalin is usually not used on breast biopsies.

The Surgery Sparknotes

1. Make incision with 15 or 10 blade
2. Retract with senns, rakes, skin hooks or army-navys, Richardsons for larger incisions
3. Dissect with cautery, DeBakey forcep, and Metzenbaum scissors
4. Use Weitlaner to retract when lesion is in view
5. Grasp lesion with Allis clamp and remove it
6. Place making/orientation stitch with needle driver, adsons, and straight mayo scissors
7. Send specimen to pathology and consider using a drain for larger incisions