Herbert Skip Brown, M. Div. HT(ASCP)
Lab Storage Systems, Inc.
While CT scan, X-ray, MRI, and other forms of graphic imagery provide a visual picture of internal anatomy, gross pathology is a pathologist or assistants intimate assessment of morphology that cannot be seen in the aforementioned procedures. Unlike scans or graphic pictures, gross pathology provides information that gives critical detail such as color, texture, tactile sensation (as with fibrosity or calcifications); all of which help identify abnormal pathology. It is a vital initial piece of the puzzle of investigative anatomic pathology that leads the pathologist down the correct pathway towards supportive tests and accurate diagnoses.
Even though this is a general mandatory element of all surgical procedures, health care costs have caused administrators at hospitals and doctors offices to streamline gross pathology services. Except in the case of larger institutions and reference labs that have extremely high surgical volumes all day, seldom do we find the trained professionals that perform this service working all day at that one institution. Hospitals and labs have sought to contract these services out; thus leading to the frequent need and use of traveling pathologists or P.A,s. Particularly with doctors offices or small hospitals, oftentimes there may be no pathologist or P.A. on staff. These services are outsourced. Also, with small rural facilities, there sometimes may be no space or equipment (such as grossing stations) dedicated to gross pathology. In these extreme cases, mobile gross pathology stations are set up to accommodate the basic need to perform this service.
As with any gross pathology operation, safety and hygiene are a primary concern, and a mobile service requires special considerations. Regulatory standards as well as common sense require that grossing personnel are equipped with personal protective equipment (PPE). Image 1 (above) shows properly protected personnel wearing Tyvek sleeves, surgical apron, and protective gloves; all easily disposable in a bio-hazard bag. These can be used as a standard in any grossing service and work particularly well in a mobile situation where they can be carried
in by the traveling grosser and discarded after use. Safety glasses with side shields are also necessary and light-weight and can be carried in from site to site. Image 2 demonstrates disposable grossing boards complete with inch, metric and circular measurement scales. The copolymer boards can be used with dissecting pins and will not dull your knife or scalpel blade with use. Disposable scalpels can be brought in, used and discarded in a disposal container approved for sharp hazardous items such as knives, blades, and needles.
In situations where small biopsy excisions are done, such as in dermatology or other outpatient clinics, pre-filled biopsy containers in various sizes filled with 10% neutral buffered formalin can be shipped in, or carried in; and the specimen can be separated, preserved, and transported to the lab where histopathology services will be performed (Image 3). The grosser does not have to be burdened with measuring and pouring fixative with each specimen.
Having mentioned most of the core items needed to set up and operate a mobile gross pathology station for routine grossing, there are numerous additional items that could be used based on the need and preference of the Pathologist or P.A. Items such as surgical marking dyes, specimen bio-hazard and transport bags that are leak-proof and tamper resistant, prostate biopsy kits, etc. The industry provides all that is needed to provide a professional service and complete quality care for patient specimens. The only thing needed from the grossing personnel is the professional skill and technique that they demonstrate day to day, and safety in their travels from site to site.
Lab Storage Systems, Inc. has a complete line of products to assist you in your mobile as well as permanent grossing station set ups. For more information contact your Customer Relations representative today.
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