Percutaneous pediatric renal biopsy: use of the biopsy gun.

Abstract

A recently developed biopsy gun was used in the ultrasound (US)-guided biopsy of native kidneys in seven children. The biopsy gun employs a needle (18 gauge) smaller than that usually used for renal biopsies. In all seven cases it provided a core biopsy specimen that contained enough glomeruli to make a definitive histologic diagnosis of renal parenchymal disease. Use of the biopsy gun eliminated the more complicated movements needed to obtain samples with the conventional manual biopsy techniques. No major complications occurred, and in only one case a minor complication, trace hematuria determined by means of dipstick analysis, was found. The time required to obtain the tissue samples was decreased with use of this technique. Because of the advantages of the biopsy gun, the authors now use it exclusively in percutaneous US-guided biopsy of native pediatric kidneys and recommended that this method be considered by other institutions performing similar biopsies.

Percutaneous Renal Biopsy in Children: A 27-Year Experience

“…Our experience needs to be compared with other studies applying the different needles for renal biopsy. Successful application of the Biopty device has been demonstrated in adults [19, 20] and children [14, 15, 21], but those studies comparing the efficacy of the Biopty gun with that of other needles yielded conflicting results, ranging from no change in efficacy observed in adults [20] and children [22] to an improved rate of retrieval of glomeruli [19]. …”

“…This change reflects growth and spatial distribution of glomeruli in the first years of life and is in keeping with previous comparisons of biopsies in adults and children. In children <10 years of age the number of glomerular sections per square millimeter of renal cortex is more than 100% higher than in adults [15, 31]. …”

“…In the 70s it was replaced by the disposable TruCut needle [11, 12]. In order to simplify and standardize the puncture, automated biopsy devices [13] like Biopty have been developed in the 80s and are in widespread use nowadays in adults and children [5, 14, 15]. …”

Postmortem evaluation of four randomly selected automated biopsy devices for transthoracic lung biopsy

“…Several studies have confirmed the effectiveness of these biopsy "guns" for obtaining high quality histopathologic specimens from the liver, kidney, and pancreas [2][3][4][5]. A controlled trial proved the superiority of automated devices over conventional biopsy needles for abdominal puncture [6].…”

Ultrasound-Guided Core Biopsy of the Kidneys in Infants and Children: Kuwait Experience

“…Other authors [9] also reported a low incidence of this minor complication, though other minor complications like local pain or discomfort are not uncommon [6]. In patients with coagulation defects the risk of postbiopsy bleeding can be reduced by fresh frozen plasma infusion and vitamin K. Various sizes and types of needles have been used by different authors [4,10,11] with the aim to minimize bleeding complications. We used 14 G and 18 G Tru-cut needles with exact positioning of the needles under ultrasound guidance and found both equally safe and effective with no major complication.…”