CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(12): E1658-E1662
DOI: 10.1055/a-0998-3997
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

The “Twist-Needle” – a new concept for endoscopic ultrasound-guided fine needle-biopsy

Alexander Hann
1  Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany
2  Department of Internal Medicine I, Ulm University, Ulm, Germany
,
Benjamin M. Walter
2  Department of Internal Medicine I, Ulm University, Ulm, Germany
,
Sonja Epp
1  Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany
2  Department of Internal Medicine I, Ulm University, Ulm, Germany
,
Younan Kabara Ayoub
3  Faculty of Medicine, Kasr-Al Ainy Hospital, Cairo University, Cairo, Egypt
,
Alexander Meining
1  Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany
2  Department of Internal Medicine I, Ulm University, Ulm, Germany
› Author Affiliations
Further Information

Publication History

submitted 18 March 2019

accepted after revision 11 June 2019

Publication Date:
25 November 2019 (online)

  

Abstract

Background and study aims Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) represents a standard method for tissue acquisition of lesions adjacent to the gastrointestinal wall. Needles of 19 gauge acquire more tissue than needles with a smaller diameter, but are often unable to penetrate solid, rigid masses. In this study we evaluated a novel prototype that links forward movement of the needle to rotation of the needle tip.

Materials and methods Two needle-models that generate either a regular axial movement or a combination of axial movement with rotation of the needle tip were compared ex vivo for measurement of pressure needed to penetrate artificial tissue. Furthermore, a standard 19-gauge EUS-FNB needle was compared to a modified model (“Twist Needle”) in an ex vivo model to measure the amount of tissue obtained.

Results Pressure measurements using the rotating needle revealed that significantly less pressure is needed for penetration compared to the regular axial movement (mean ± SEM; 3.7 ± 0.3 N vs. 5.5 ± 0.3 N). Using the modified 19-gauge “Twist Needle” did not diminish tissue acquisition measured by surface amount compared to a standard needle (37 ± 5 mm² vs. 35 ± 6 mm²).

Conclusion The method of rotation of an EUS-FNB needle tip upon forward movement requires less pressure for penetration but does not diminish tissue acquisition. Hence, the concept of our “Twist Needle” may potentially reduce some of the current limitations of standard EUS-FNB.