[Histonet] Long and short biopsy runs with one processor

Bill Sinai bills <@t> icpmr.wsahs.nsw.gov.au
Thu Apr 14 16:35:31 CDT 2005


We occasionally run cell blocks but most times they are put through the
routine overnight processing.

Bill Sinai
Laboratory Manager
Tissue Pathology, ICPMR
Westmead NSW 2145
Australia
Ph 02 9845 7774


-----Original Message-----
From: dahmed <@t> mdanderson.org [mailto:dahmed <@t> mdanderson.org]
Sent: Thursday, 14 April 2005 11:13 PM
To: Bill Sinai
Subject: RE: [Histonet] Long and short biopsy runs with one processor


What about cell blocks? Do you feel that your currenct processing schedule
for biopsies would be appropriate for cytology cell blocks?  Our current
bx/cell block protocol is 20 minutes in all stations including formalin for
a total run time of 6 hours?  Can I trim this back a little?

David S. Ahmed
Chief Histology Technician
Department of Pathology
M.D. Anderson Cancer Center





                                         "Bill Sinai"
                       <bills <@t> icpmr.wsahs.nsw.gov.au> To:
                                             Sent by:       "'Roxanne Soto'"
<godsgirlnow <@t> MSN.COM>, "histonet (E-mail)"
                       histonet-bounces <@t> lists.utsouth
<histonet <@t> lists.utsouthwestern.edu>
                                          western.edu cc:


                                  04/13/2005 04:55 PM


                                                      Subject:
                                                            RE: [Histonet]
Long and short biopsy runs with one processor








Roxanne,

Most are the small GE biopsies >3mm in diamater or "thin" slices of any
urgents >3mm thick.
Solution                    Time
Formalin                    0min
70%ethanol               5min
95%                         5min
100%                       5min
100%                       10min
100%                       10min
Xylol                        5min
Xylol                        5min
Xylol                        10min
Wax                         5min
Wax                         10min
Wax                         10min

Temperature ambient with Pressur/Vacuum on all stations.

Two Leica ASP300 and two VIP 3000
Bill Sinai
Laboratory Manager
Tissue Pathology, ICPMR
Westmead NSW 2145
Australia
Ph 02 9845 7774

  -----Original Message-----
  From: Roxanne Soto [mailto:godsgirlnow <@t> MSN.COM]
  Sent: Thursday, 14 April 2005 7:37 AM
  To: Bill Sinai
  Subject: Re: [Histonet] Long and short biopsy runs with one processor


  What size is the tissue on the 2 hour run?  How long is each station?
What kind of processor?  Do you use the vacuum?
  Roxanne
    ----- Original Message -----
    From: Bill Sinai
    To: histonet (E-mail)
    Sent: Wednesday, April 13, 2005 5:30 PM
    Subject: RE: [Histonet] Long and short biopsy runs with one processor



    Julia,

    I agree with your philosophy about small runs.  We are a pathology
    department supporting a large teaching hospital and an even larger area
    pathology service.  However, we also do a considerable amount of
private
    work for several endoscopy clinics in our locality.
    The scenario you describe is very similar to ours.
    We have the usual overnight run, usually 450-600 blocks with the large
    material in one processor and the smaller in another.  We receive the
    endoscopy specimens anytime from 7:30am through to 3:00pm each day,
with
any
    pick ups after 6:00pm being processed the next morning in a short run
    2-2.5hrs.  This means we can have at least two runs per day of
endoscopy
    specimens.  The endoscopy specimens from the private clinics are about
30%
    of our work and the TAT for these specimens is >2 days from pick-up to
hard
    copy result to the clinician.

    We also process renal biopsies several times per day as well as the
    occasional urgent specimen.

    Bill Sinai
    Laboratory Manager
    Tissue Pathology, ICPMR
    Westmead NSW 2145
    Australia
    Ph 02 9845 7774


    -----Original Message-----
    From: histonet-bounces <@t> lists.utsouthwestern.edu
    [mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Julia
    Dahl
    Sent: Thursday, 14 April 2005 4:13 AM
    To: Joyce.Rush <@t> sjmcmn.org; Histonet <@t> lists.utsouthwestern.edu
    Subject: RE: [Histonet] Long and short biopsy runs with one processor


    Joyce -

    First let me preface with my bias - I am a GI pathologist (read small
biopsy
    material is what I live and breathe).

    Long processor runs are great for standard surgical material - but
    absolutely overprocess small pieces of tissue, resulting in hard,
    dehydrated, difficult to cut little brittle fragments.

    The best approach that I've seen and used is to examine your
"bottlenecks."
    The main bottlenecks are the points at which you have lots to do in
front of
    you - with limited resource to do it (i.e. you have 150 cassettes to
embed
    coming off of the processor at one time and ONE embedding station.
That's a
    bottleneck.)

    What time do you usually start your processor?  Say your processor
starts at
    10:00 p.m. with a standard 6 hour process run.  Your pathologists or
your
    PAs close the grossing stations at 6:00 p.m. and load the processor -
and
    everything sits there for 4 hours (that's another bottleneck).

    In this scenario - you can add a second processor run at virtually any
time
    that you are staffed that allows you to turn over the processor for the
    standard run by 6:00 p.m. (when the standard next load is).

    Since a small biopsy run usually takes about 2 hours on the Vitek:

    0600 - Standard processor emptied - large surgical cases ONLY (about
2/3
of
    your blocks)
    0600 - 1000: Embed, cut, stain and coverslip surgicals
    0700 - 0800:  Previous day's and early AM courier run of small biopsies
    grossed in
    0800 - 1000:   Small biopsy processor run
    1000 - small biopsy processor emptied
    1000 - 1230: Embed, cut, stain and coverslip biopsies.

    If you wanted to do another biopsy run - to allow same day turnaround
time -
    the 2nd biopsy run could be scheduled at 10:30 each day with slides
coming
    out around 3:30.

    I'm interested to hear other people's ideas.

    Julia



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    >
    >We are a community hospital and last year processed 28,000 blocks.  We
are
    >being challenged by our Laboratory Director to run a long and short,
biopsy
    >run daily, M-F.  Currently we run everything together.  We have one
    >processor, a VIP5.  I'd love to hear of ways people have handled this.
    >Thanks so much!  I always get such good advice from this group!
    >
    >Joyce
    >
    >Joyce A. Rush, BS, MT(ASCP)
    >Laboratory Manager
    >St Joseph's Medical Center
    >523 North Third Street
    >Brainerd, MN  56401
    >Office:218-828-7500   Fax:  218-828-7510
    >
    >
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