A novel cryoprobe for minimal invase liver biopsies. First experimental results of a new device

Background: Minimally invasive laparoscopy allows for diagnosis and staging of cancer and liver cirrhosis with targeted biopsies. This study evaluates a novel cryoprobe for liver biopsy in comparison with true-cut biopsy.

Methods: This prospective blinded animal study was designed to compare a novel flexible cryoprobe (18G, Erbe, Tübingen, Germany) for liver biopsies with a standard, rigid true-cut biopsy (18G) probe in live anaesthetized pigs. All biopsies were performed under laparotomy to assess bleeding times of each technique. For each group 12 biopsies were obtained. All specimens were assessed by a pathologist, who was blinded towards the biopsy method, for artefacts and histopathological assessibility using a seven point likert scale. In a cadaver model laparoscopic and transgastric endoscopic punctures were tested for technical feasibility.

Results: Bleeding time was not significantly different between both groups (p<0.54, Figure 1). There was a trend towards more artefacts in the true-cut biopsy group compared to Cryoprobe biopsies (p<0.098, Figure 1). Histopathological assessibility of the liver parenchyma was the same for both groups (Figure 1). Cadaver model experiments demonstrated technical feasibility using the probe in conjunction with laparoscopic and transgastric endoscopic organ punctures.

Figure 1

Conclusions: Cryobiopsy is a novel technique that allows obtaining large biopsy samples of liver parenchyma with a quality comparable to the gold standard true-cut biopsy. This novel technique might become a useful biopsy tool during minimal invasive laparoscopy or translumenal endoscopic interventions.