The document discusses cervical biopsy procedures, which involve the removal of tissue from the cervix for examination to diagnose and treat cervical cancer and precancerous conditions. It details various types of biopsies including punch, wedge, ring, and cone biopsies, along with the procedures, indications, and potential complications associated with them. It emphasizes the importance of these biopsies in accurately assessing cervical health and guiding treatment decisions.

1. Cervical Biopsy
Dr.Yashika

2. Cervix Anatomy
• Lowermost part of uterus
• Cylindrical shape
• Diameter and length are 2.5 cm.
• Parts Supravaginal
Infravaginal
• Extends from histological
internal os to anatomical
external os.
• Nulliparous - Pin hole cervix
• Parous - Bilateral slit

3. Cervical Biopsy
Removal of a small sample of tissue from the cervix for
examination under microscope; used for the diagnosis and
treatment of cervical cancer and precancerous conditions.
Types:
1. Punch Biopsy
2. Wedge Biopsy
3. Ring Biopsy
4. Cone Biopsy
5. Surface Biopsy

4. Punch Biopsy
• An out patient procedure without
anesthesia.
• Using Cusco’s Bivalve Speculum
biopsy is taken from the
suspected area or a 4-quadrant
using Punch Biopsy forceps.
• It can be also Colposcopic directed or stained with Schiller’s
iodine or Acetic acid.

5. Iodine staining revealing saffron-
colored abnormal area.
Acetowhite lesion after
washing with acetic acid.

7. Wedge Biopsy
• It is done when definite growth is visible.
• An area near the edge is the ideal site.
Steps:
a) Posterior vaginal speculum is introduced.
b) Anterior and the posterior lip of the
cervix is held by Alley’s forceps.
a) With a scalpel, a wedge of tissues is cut from the edge of the
lesion including the healthy tissue for comparative histological
study.

8. Ring Biopsy
• Whole of squamo-columnar junction area of the cervix
is excised with a special knife.
• The tissue is subjected to serial section to detect cervical
intraepithelial neoplasia (CIN) or early invasive
carcinoma.

9. Cone Biopsy - Conization
• Both diagnostic and therapeutic
purpose
• Removal of cone of the cervix which
includes entire squamocolumnar
junction, stroma with glands and
endocervical mucous membrane.
• Methods: Cold knife, CO₂ laser, Laser
diathermy loop

10. Indication:
– Unsatisfactory Colposcopic findings.
– Inconsistent findings : Colposcopic, Cytology and directed
biopsy.
– Positive endocervical curettage for CIN II and III.
– When biopsy cannot rule out invasive cancer from
carcinoma in-situ.
– Biopsy shows microinvasion – to exclude gross invasive
carcinoma.

11. Complications
• Secondary hemorrhage.
• Cervical stenosis leading to haematometra.
• Infertility.
• Diminished cervical mucus.
• Cervical incompetence leading to recurrent miscarriage.

12. Thank
you