CT-guided bone biopsy: Initial experience with a commercially available hand held Black and Decker™ drill

Buckley, Orla; Benfayed, W; Geoghegan, Tony; Al‐Ismail, Khalid; Munk, Peter L.; Torreggiani, William C.

doi:10.1016/j.ejrad.2006.06.015

Cited by 10 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Biopsy procedures facilitated by drill-powered needles have been attempted before, but the devices were prototypes and were never commercially available [5,6]. In recent years, a battery-powered bone marrow biopsy system was developed and cleared by the U.S. Food and Drug Administration to allow health care providers to access the bone marrow space quickly and efficiently.…”

Section: Introductionmentioning

confidence: 99%

Using a Powered Bone Marrow Biopsy System Results in Shorter Procedures, Causes Less Residual Pain to Adult Patients, and Yields Larger Specimens

Berenson

Yellin

Blumenstein³

et al. 2011

Diagn Pathol

View full text Add to dashboard Cite

BackgroundIn recent years, a battery-powered bone marrow biopsy system was developed and cleared by the U.S. Food and Drug Administration to allow health care providers to access the bone marrow space quickly and efficiently. A multicenter randomized clinical trial was designed for adult patients to determine if the powered device had advantages over traditional manually-inserted needles in regard to length of procedure, patient pain, complications, user satisfaction, and pathological analysis of the specimens.MethodsAdult patients requiring marrow sampling procedures were randomized for a Manual or Powered device. Visual Analog Scale (VAS) pain scores were captured immediately following the procedure and 1 and 7 days later. Procedure time was measured and core specimens were submitted to pathology for grading.ResultsTen sites enrolled 102 patients into the study (Powered, n = 52; Manual, n = 50). Mean VAS scores for overall procedural pain were not significantly different between the arms (3.8 ± 2.8 for Powered, 3.5 ± 2.3 for Manual [p = 0.623]). A day later, more patients who underwent the Powered procedure were pain-free (67%) than those patients in the Manual group (33%; p = 0.003). One week later, there was no difference (83% for Powered patients; 76% for Manual patients.) Mean procedure time was 102.1 ± 86.4 seconds for the Powered group and 203.1 ± 149.5 seconds for the Manual group (p < 0.001). Pathology assessment was similar in specimen quality, but there was a significant difference in the specimen volume between the devices (Powered: 36.8 ± 21.2 mm3; Manual: 20.4 ± 9.0 mm3; p = 0.039). Two non-serious complications were experienced during Powered procedures (4%); but none during Manual procedures (p = 0.495).ConclusionsThe results of this first trial provide evidence that the Powered device delivers larger-volume bone marrow specimens for pathology evaluation. In addition, bone marrow specimens were secured more rapidly and subjects experienced less intermediate term pain when the Powered device was employed. Further study is needed to determine if clinicians more experienced with the Powered device will be able to use it in a manner that significantly reduces needle insertion pain; and to compare a larger sample of pathology specimens obtained using the Powered device to those obtained using traditional manual biopsy needles.

show abstract

Section: Introductionmentioning

confidence: 99%

Using a Powered Bone Marrow Biopsy System Results in Shorter Procedures, Causes Less Residual Pain to Adult Patients, and Yields Larger Specimens

Berenson

Yellin

Blumenstein³

et al. 2011

Diagn Pathol

View full text Add to dashboard Cite

show abstract

“…To improve the ability of a physician to precisely penetrate bone, many different strategies have been proposed for automating the drilling operation or providing some means of drill alignment or tracking. Buckley et al coupled the hub of a needle to a drill and found that this provided a cheap, safe, and efficient technique for reducing physician effort for obtaining core biopsy samples [7]. Onogi et al employed a mechanism to rotate a standard percutaneous needle in a reciprocating manner during insertion and found that a force of 25 N was required when the feed rate of the needle was 0.05-0.5 mm/s [8].…”

Section: Introductionmentioning

confidence: 99%

CT-Compatible Medical Drilling Stylet

Walsh

Meskers

Slocum

et al. 2012

Journal of Medical Devices

View full text Add to dashboard Cite

This paper describes the design of a compact, lightweight CT-compatible, drill-press that is designed to be used in either a hand-held or stand-alone mode to assist with percutaneous bone based interventions. Previous medical drilling tools that have been developed have a metal structure and typically have one actuator for advancing the drill (feed) and another for rotating it (speed). After defining the device functional requirements and specifications, a deterministic design process was followed to generate several design concepts that were then evaluated based on their ability to satisfy the functional requirements. A final concept that uses a custom screw-spline to achieve helical motion of a shaft that is attached to a standard orthopedic drill was selected for prototyping. The design uses a single actuator to drive both the screw and spline nuts through two different gear ratios, resulting in a fixed ratio between the feed and speed. Apart from the motor which is placed away from the central drill axis, the device is largely made from plastic materials. A custom experimental setup was developed that enabled drilling into bone inside a CT scanner to be examined. Results showed that the device was successfully able to penetrate thick cortical bone and that its structure did not appreciably distort the medical images.

show abstract

“…Investigators successfully obtained diagnostic material in 80% of the cases with no major complications. 6 …”

Section: Introductionmentioning

confidence: 99%

Powered Bone Marrow Biopsy Procedures Produce Larger Core Specimens, with Less Pain, in Less Time Than with Standard Manual Devices

et al. 2011

View full text Add to dashboard Cite

Bone marrow sampling remains essential in the evaluation of hematopoietic and many non-hematopoietic disorders. One common limitation to these procedures is the discomfort experienced by patients. To address whether a Powered biopsy system could reduce discomfort while providing equivalent or better results, we performed a randomized trial in adult volunteers. Twenty-six subjects underwent bilateral biopsies with each device. Core samples were obtained in 66.7% of Manual insertions; 100% of Powered insertions (P=0.002). Initial mean biopsy core lengths were 11.1±4.5 mm for the Manual device; 17.0±6.8 mm for the Powered device (P<0.005). Pathology assessment for the Manual device showed a mean length of 6.1±5.6 mm, width of 1.0±0.7 mm, and volume of 11.0±10.8 mm3. Powered device measurements were mean length of 15.3±6.1 mm, width of 2.0±0.3 mm, and volume of 49.1±21.5 mm3 (P<0.001). The mean time to core ejection was 86 seconds for Manual device; 47 seconds for the Powered device (P<0.001). The mean second look overall pain score was 33.3 for the Manual device; 20.9 for the Powered (P=0.039). We conclude that the Powered biopsy device produces superior sized specimens, with less overall pain, in less time.

show abstract

CT-guided bone biopsy: Initial experience with a commercially available hand held Black and Decker™ drill

Cited by 10 publications

References 20 publications

Using a Powered Bone Marrow Biopsy System Results in Shorter Procedures, Causes Less Residual Pain to Adult Patients, and Yields Larger Specimens

Using a Powered Bone Marrow Biopsy System Results in Shorter Procedures, Causes Less Residual Pain to Adult Patients, and Yields Larger Specimens

CT-Compatible Medical Drilling Stylet

Powered Bone Marrow Biopsy Procedures Produce Larger Core Specimens, with Less Pain, in Less Time Than with Standard Manual Devices

Contact Info

Product

Resources

About