For trepanobiopsy, special instruments are used with a wide handle, a needle with a stylet, and a cannula. The needle is different, depending on the area of its application and on the thickness of the patient's subcutaneous fat layer.
The standard duration of such manipulations as bone marrow trepanobiopsy is about 20-25 minutes. If necessary, the hair is shaved off in the area of the procedure. Local anesthesia is used, sometimes in conjunction with general sedation. Less commonly, general anesthesia is used.
The skin in the puncture zone is disinfected, anesthetic is injected. Next, the needle is inserted into the required area with a translational-rotational movement, a column of biomaterial is removed, which is then transferred to formalin. The affected area is disinfected again, a sterile bandage is applied. The results of trepanobiopsy can be ready within a few hours or several weeks, depending on the situation.
Trepanobiopsy of tumors refers to puncture methods for diagnosing a patient: a biopsy specimen is removed in the form of tissue or cells for subsequent laboratory research. Such a diagnosis is mandatory for making a diagnosis if there is a suspicion of oncological pathology. Trepanobiopsy helps to assess and analyze the structural composition of biological material. The procedure is necessary not only for the diagnosis, but also for the further determination of the treatment tactics. Since the treatment regimen for oncopathology everywhere includes complex chemotherapy, radiation therapy, surgical intervention, it is imperative that diagnostic studies are performed in the form of cytological or histological analysis that can identify the type of neoplasm. 
Trepanobiopsy of the breast may involve partial or complete resection of the pathological focus, therefore this procedure is often included in the category of surgical operations. To remove biological material, a specific needle is used, which consists of a rod and a cutter, has a flexible cannula and a mandrel. First, a small scalpel incision is made into which a cannula is inserted. After reaching the required depth, the mandrel is removed. Further, the surgeon excises the pathological neoplasm with the help of a rod and an incisor. 
Trepanobiopsy of the bone marrow with lymphoma involves the removal of biomaterial from one or two points in the ilium. Manipulation is performed under general anesthesia and is mandatory for all patients except stage I or IIa Hodgkin's lymphoma. 
Bone trepanobiopsy is included in the mandatory list of diagnostics for patients with non-Hodgkin's lymphomas, regardless of the immunomorphology of the disease. This is due to the fact that non-Hodgkin's lymphomas can affect the bone marrow without corresponding leukemic signs in the blood and aspirate. Trepanobiopsy is prescribed to correctly determine the stage of the disease, for a competent choice of treatment tactics. The procedure is performed in the area of the ilium with further immunohistochemical analysis of the biomaterial. 
Trepanobiopsy of the ilium takes longer than, for example, the same procedure in the breast area. The manipulations can last up to one hour. The patient is laid down on the couch. The surgeon treats the proposed puncture site with an antiseptic solution, inserts the needle, and removes the rod. Performing screw movements, he inserts the cannula to the required depth for material removal. Next, it extracts the sample. Trepanobiopsy of the femur can be accompanied by the introduction of an electrocoagulator, which allows you to treat the walls of the wound channel. The current is applied simultaneously with the withdrawal of the needle. Thanks to this method, it is possible to prevent bleeding and the possible spread of malignant structures through the circulatory system. There is no need for suturing: the puncture area is covered with a sterile bandage. 
Trepanobiopsy of the lymph node is prescribed by an oncologist, hematologist if malignant processes, mononucleosis, inflammatory diseases or tuberculosis are suspected. The resulting material is sent to the laboratory. The result can be obtained within a few days to two weeks. Usually, the study is subjected to enlarged and indurated lymph nodes in the groin, neck, armpits or above the collarbone.
Percutaneous trepanobiopsy of the liver is prescribed for diffuse and focal hepatic pathologies. Diffuse pathologies are chronic hepatitis of viral and non-viral origin. Focal pathologies are benign or malignant (primary or secondary) tumors in the liver. Before manipulation, the doctor performs an ultrasound examination to accurately determine the puncture site. After processing the skin, the doctor performs anesthesia, makes a puncture and the required amount of biopsy is removed. At this time, the patient lies on his back with his right hand behind his head. At the time of taking the material, the patient is asked not to breathe or move for a few seconds. After the procedure, the patient remains in the clinic for another 1-2 hours: an ice pack is applied to the puncture area, then a control ultrasound examination is performed to assess the state of the organ after diagnosis. If everything is in order, the patient is allowed to go home.
Biopsy and trepanobiopsy of the prostate gland is prescribed for all patients if there is a suspicion of prostate cancer. The results of such a study determine not only the treatment tactics, but also the prognosis for the patient. Before starting the procedure, an anesthetic (often a special lidocaine gel) is injected into the rectal cavity through the anus. After 6-8 minutes, an ultrasound probe is inserted into the rectum, equipped with a nozzle for introducing a needle: with its help, the points of manipulation are determined. This trepanobiopsy is usually well tolerated, with only occasional slight discomfort. Important: before the study, it is imperative to cleanse the intestines with an enema. The procedure is carried out on an empty stomach, and after it antibiotic therapy is prescribed to prevent inflammatory processes in the prostate (prostatitis, orchiepididymitis).