Principles of Tumour Biopsy

Open

Longitudinal incision
Sharp dissection should proceed directly to tumour, through muscle not between muscle planes
Uninvolved anatomic compartments should not be exposed
Avoid all major neurovascular structures to prevent contamination
Excise block of reactive tissue, pseudo capsule, capsule, & block of tumour ® formalin ± frozen section
Windows in bone should be as small as possible & oval to avoid stress risers & pathological fracture
Release tourniquet prior to closure ® haemostasis
Close with sub cuticular stich
Drains should come out through wound
If proceed following biopsy ® new instruments & drapes to stop seeding

Needle

As for open biopsy
Place biopsy tract where it can be excised