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Breast Biopsy mayo stand and back table surgery setup

Diana Lei-aloha Avatar

setup author

Surgery setup images for Breast Biopsy

Breast Biopsy surgery instruments

Clamping & Occluding instruments

Penetrating Towel Clamp
Penetrating Towel Clamp
Curved Hemostat
Curved Hemostat
Kocher Forceps
Kocher Forceps
Mosquito Clamp - Curved
Mosquito Clamp – Curved
Straight Hemostat
Straight Hemostat
Tonsil Clamp
Tonsil Clamp
Allis Forceps
Allis Forceps

Cutting & Dissecting instruments

#3 Knife Handle
#3 Knife Handle
Metzenbaum Scissor
Metzenbaum Scissor
Straight Mayo Scissor
Straight Mayo Scissor

Grasping & Holding instruments

Toothed Forcep
Toothed Forcep
Adson Forceps
Adson Forceps
Non toothed Pickup
Non toothed Pickup
Debakey Forceps
Debakey Forceps

Retracting & Exposing instruments

Freer Skin Hook
Freer Skin Hook
Freeman Rake
Freeman Rake
Weitlaner Retractor
Weitlaner Retractor
Army-Navy Retractor
Army-Navy Retractor
Senn Retractor
Senn Retractor
Richardson Retractor
Richardson Retractor
Deaver Retractor
Deaver Retractor

Suctioning instruments

Yankauer Suction
Yankauer Suction
Ferg-Frazier Suction
Ferg-Frazier Suction

Suturing & Stapling instruments

Mayo-Hegar Needle Holder
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

2 responses to “Breast Biopsy”

  1. James roberts Avatar
    James roberts

    Awesome deep dive into the breast biopsy process! It’s always great to have guides like this. A little curious about the ‘double-checking specimen sheets’ tip. I’m assuming this is crucial to ensure no mistakes in pathology? Would be cool to hear more about best practices there. The ‘Surgery Sparknotes’ is such a neat addition for a quick overview!

    1. Diana Lei-aloha Avatar
      Diana Lei-aloha

      Thank you! Yes, it’s always a good idea to double check with the surgeon that you have written down the specimen names correctly, as well as make sure the circulator has written them correctly on the pathology sheet.
      Sometimes there can be multiple specimens with similar names, and clarification is very important to avoid any confusion in pathology.

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