Advice after your nerve block for surgery
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Introduction
We have been advised by your hospital consultant that you need to have a biopsy performed in the Radiology (X-ray) Department under ultrasound, CT or fluoroscopic control. This information tells you about having a biopsy, what is involved, and what the possible risks are.
This leaflet may not answer all your questions, so if you have any queries or concerns,
please contact us using the telephone number on your appointment letter, or ask the ward staff.
What is a biopsy?
A biopsy is a way of taking a small piece of tissue out of your body using only a tiny cut in the skin and a thin needle. The biopsy will then be examined under a microscope by a pathologist (an expert in making a diagnosis from tissue samples). We will use one or more types of radiology method to guide the needle into the correct place in the body. The biopsy may therefore take place in the CT, Ultrasound or Fluoroscopy Departments within Radiology.
The biopsy will be performed by a radiologist (doctor specialising in medical imaging) who will be assisted by a radiographer and / or a radiology nurse.
What is a CT scan?
A CT scan is an examination using X-rays by lying on a flat table inside a scanner that
produces detailed cross sectional images of your body. These images are cross-sectional (like slices) and are used to produce 2D and 3D images of the body’s organs
What is Fluoroscopy?
Fluoroscopy is a process that uses X-rays to produce a real time moving image on a
television monitor.
What is Ultrasound?
An ultrasound scan is an examination that uses sound waves to take pictures of the part of the body being examined. It does not involve X-rays.
Which imaging modality used will depend upon the location, type and accessibility of the tissue to be biopsied, and will be decided by the radiologist before your appointment is made.
Before your appointment
Please let us know if:
- you are taking any medication which impair the bloods ability to clot (anticoagulation or blood thinning drugs) e.g. Warfarin or clopidigrel, or, if you are aware that you may have bleeding problems. The radiologist who will be performing your examination can be notified and may need to discuss this with you and your hospital consultant before your appointment can be confirmed as the medication may need to be stopped or changed before the procedure. The Interventional nursing team can be informed on 0300 613 2161 (Frimley) or 0300 615 3544 (Wexham).
Please also let us know if:
- you have limited mobility and will require assistance to get on and off the scanner.
- you will need an interpreter. We are not able to use family members or friends to interpret.
- there is any possibility that you may be pregnant. All patients from 12-55 years of age (regardless of gender) who will undergo a Radiology procedure will be asked about the possibility of them being pregnant.
- you are diabetic - please note that you are required to starve before the examination. You may be given an early morning appointment or alternative medication will be given on the ward.
In order to make your appointment run more smoothly, please let us know if any of these apply, in advance, by calling our bookings team (contact details are displayed on the main Radiology page).
What to bring with you
You will usually be admitted for the procedure as a day case. The location where you should attend for the procedure will be on the first page of this appointment or you will be given the location by telephone. Occasionally it is necessary for patients to stay overnight in hospital after the biopsy. For this reason we advise that you prepare an overnight bag and bring this with you. You may wish to bring your own dressing gown, slippers and reading material.
Please bring with you to your appointment any sprays or inhalers that you are taking. Please bring a list of any regular medications you are taking
Eating and Drinking
You should have nothing to eat 6 hours prior to the time of your procedure. You can continue to drink clear fluids (water) up to 2 hours prior to the procedure but then nothing should be consumed.
During the procedure
Referral and consent
You will be asked to sign a consent form confirming that you understand the procedure and are aware of the risks and benefits involved. Where practical this is usually done on the ward, before you come to the Radiology Department or in an outpatient clinic environment before your admission to hospital for the procedure.
The biopsy is normally done as a planned procedure and you should have plenty of time to discuss the situation with your doctor or the nurse specialist looking after you before you sign the consent form. When you arrive for the procedure you will also discuss the procedure with the radiologist who will be performing the procedure who will again sign the consent form with you.
If after discussion with your hospital doctor or radiologist, you do not want the procedure carried out, then you can decide against it. If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary then they will explain this to you and they will communicate with the referring doctor who will review your situation as soon as possible. At all times the radiologist and referring doctor will be acting in your best interests.
Procedure
You may need a cannula (small tube) inserted into a vein in your arm to allow access for fluids and for administering medication.
You will need to wear a hospital gown. The Porters will collect you from the ward and bring you to the X-ray Department, on your bed, for the procedure.
The procedure will be explained to you by the radiologist. You will be able to ask any further questions that you may have.
You will be asked to lie on the examination table. It is important that you stay very still until the procedure is over. If you are uncomfortable please let the doctor know.
The ultrasound, fluoroscopy unit or the CT scanner will be used to decide on the most suitable place for inserting the biopsy needle.
Everything will be kept sterile and the radiologist will wear sterile gloves. Your skin will be cleaned with antiseptic solution and sterile drapes will be placed over this area. Then your skin will be numbed with local anaesthetic. When the local anaesthetic is injected, it will sting to start with, but this soon wears off, and the skin and deeper tissues should then feel numb.
The radiologist will insert the thin biopsy needle whilst looking at the images to ensure accuracy of positioning. You may be aware of a pushing sensation as the needle is positioned, but this is generally done so quickly that it does not cause much discomfort.
If the procedure does become painful you should tell the radiologist performing the biopsy and they may give you more local anaesthetic.
Once in place the biopsy needle often makes a small clicking noise when the biopsy is taken; this should not alarm you. The radiologist may need to take one or many samples.
When the procedure is finished, a small dressing "will be placed to cover the incision and you will be returned to the ward.
After the procedure
Once you have returned to your ward, nurses will carry out close and regular observations.
Once you have returned to your ward, nurses will carry out close and regular observations, such as taking your pulse, blood pressure and temperature, to make sure that there are no problems. You may be required to stay in bed for at least four hours. You should tell the nurses if you feel worsening pain or a rise in your body temperature.
You should drink plenty of fluids and eat normally.
If you have any problems after the procedure please speak to the staff on the ward or contact your GP or emergency doctor if problems occur when you have returned home.
As an approximate guide, expect to be in the Radiology Department for about 45 minutes to one hour. However much of this time is taken up by preparation rather than the procedure itself. You will normally be expected to rest on the ward for at least four hours after the procedure. If you have been admitted specifically for this procedure as a day case patient, you should then be able to go home. In some cases you may be asked to stay overnight.
The Results
The results of your test will be made available to the requesting doctor and will usually take about 10 working days. You will receive an outpatient appointment to obtain the results.
Risks
As with any procedure or operation, complications are possible. We have included the most common risks and complications in this leaflet. The possibility of these occurring will vary for each patient and the possibility of these happening to you will be discussed with you, before you sign the consent form.
Bleeding: Any biopsy carries a small risk of bleeding. On rare occasions, this may become severe. There may be soreness around the biopsy site and some bruising.
Infection: Occasionally there may be infection in the area surrounding the biopsy site. This can usually be treated with antibiotics.
Damage to underlying tissues: Rarely, as the biopsy needle passes through the body to the target area, surrounding tissues may be damaged.
Unfortunately, not all biopsies are successful. This may be because, in spite of taking every possible care, the piece of tissue which has been taken may not contain enough abnormal cells for the pathologist to make a definite diagnosis. If you need any further investigations, they will be discussed with you in clinic
X-rays are a type of radiation. We are all exposed to natural background radiation every day from the sun, food we eat, and the ground. Exposure to medical X-rays carries a small additional risk, but your doctor feels that this risk is outweighed by the benefits of having the test and the amount of radiation you will receive is kept to as low as reasonably possible
Contact us
If you have any queries relating to this information, please contact the Radiology service.
About this information
Service:
Radiology
Reference:
PILS-IR.16
Approval date:
2 October 2024
Review date:
2 October 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.