西村 庸夫¹, 中西 正¹, 波多野 誠¹, 浦岡 佳子¹, 棟田　 三保¹, 有馬 祥子¹, 吉野　 守彦¹, 柚木　 茂², 平田　 真美³, 平田　 康隆⁴

Nobuo NISHIMURA¹, Tadashi NAKANISHI¹, Makoto HATANO¹, Yoshiko URAOKA¹, Miho MUNETA¹, Shouko ARIMA¹, Morihiko YOSHINO¹, Shigeru YUNOKI², Mami HIRATA³, Yasutaka HIRATA⁴

¹松山市民病院内科, ²松山市民病院外科, ³松山城東病院内科, ⁴松山城東病院外科

¹Department of Internal Medicine, Matsuyama Shimin Hospital, ²Department of Surgery, Matsuyama Shimin Hospital, ³Department of Internal Medicine, Matsuyama Joutou Hospital, ⁴Department of Surgery, Matsuyama Joutou Hospital

キーワード : New Needle, Aspiration Biopsy, Ultrasonography

We devised a lowcost needle and a method for an aspirating biopsy to sample hepatic tissue in sufficient length and width for safety and security.
The needle for our own device is 15 cm long and devised to reduce the puncture resistance at the tip of the needle, as well as to take up the tissue easily, and the surface of the needles tip is roughened.
In the use of a 14 G Silverman needle, two cases showed a 38°C fever, and one case showed severe pain requiring an analgesic. For the use of a 15 G true cut needle, sometimes the amount of the tissue was insufficient, therefor a double puncture had to be made in 11 cases, and a triple-puncture was made in 3 cases. In the use of 16 G sure cut needle, as well, sometimes no tissue was taken at all, which required a double-puncture in 3 cases. With the use of our own type of needle, practically none of the 67 cases complained of pain, thus a sufficient amount of tissue was obtained from 1 puncture in 66 cases, and only 1 case required a double-puncture. The conventional needles for aspirating biopsy present problems such as tissue damage due to a high aspirating pressure, an insufficient air flow due to the presence of the inner needle resistance, etc. We found that a high negative pressure is required for taking up the tissue into the biopsy needle and cutting it, and that the needle resistance is not necessary when the tip of the needle is inside the liver. Therefore, it is not necessary to use the resistant needle if the negative pressure is released just before pulling the needle out of the liver, which can give only a pulse of a high negative pressure before the time required for the biopsy is up and the image of the needle under the echo was very clear.