Excisional Biopsy or Exeresis: What is it? How it is performed? Interpretation of Results and Preparation

It is a procedure by which the surgeon performs a biopsy in an operating room.

The surgeon will use local anesthesia to numb the area that will be analyzed and give a general sedative intravenously.

This procedure removes an entire lesion, both in superficial extension and in-depth. Pain is avoided in most cases by local anesthesia, but in large lesions, general anesthesia may be necessary. Then it is closed by direct suture.

To further clarify this, there are several options to obtain a tissue sample:

Fine needle aspiration is the simplest and least invasive test and uses the smallest needle to remove the cells from the abnormality. This is not always adequate to obtain a diagnosis, depending on the area to be examined.

A central needle biopsy removes the cells and a tiny amount of the surrounding tissue. This provides additional information to assist in the identification of the injury. A biopsy of this type extracts even more surrounding tissue.

It eliminates part of the abnormality, but not all. The doctor will cut into the injury and remove only part of it.


More surgery may be needed to eliminate the abnormality if the lesion is cancerous. Generally, the entire area in question is destroyed.

How is this test performed?

They are carried out as an outpatient procedure, using local anesthesia.

Occasionally, depending on the location of the affected area, a painkiller may also be administered to calm the patient.

A small cut will be made on the skin to access the area. If the site can not be felt, X-rays or ultrasound can be used to locate it. Usually, the procedure takes about an hour.

If a sedative is administered, it should be recovered for one or two hours. You will also need company or transportation to your home because you will not be allowed to drive or leave without supervision.

What happens next?

The sample is sent for review to the pathologist, a physician who observes the tissues under a microscope. After the pathologist has established a diagnosis, a report will be generated for your doctor.

As with any biopsy, bleeding is the most common risk associated with the procedure. A hematoma or blood bag may form at the biopsy site.

This can be uncomfortable but should be resolved during the following week. You should contact your doctor immediately if there is severe pain after the procedure.

Results analysis

A preliminary report can be delivered to the doctor; however, the final report usually takes several days.

The report usually indicates the patient’s name, date of birth, biopsy site, and indication (the reason for the test) at the top of the information.

The pathology reports follow a standard scheme, regardless of where they are obtained. The findings are discussed in a very systematic approach. For this reason, discussing the results with your doctor is essential.

The first paragraph usually informs the final diagnosis. This summary of the findings is often generated to answer the question posed by the doctor placing the order.

If the biopsy is obtained for oncological purposes, it will usually indicate whether the findings are benign (non-cancerous), malignant ( cancer ), or can not be determined.

Because reports are generated for other medical professionals, the terminology is often medicine-oriented and challenging to interpret.

You may want to request a copy of the report for your records, but you should ask your health care provider to review the results with you.

How do I prepare for an exeresis?

If full sedation is going to be given, you will need to fast 6 to 8 hours before the procedure. If only local anesthesia is used, fasting is not necessary.

If you take anticoagulants, your doctor may ask you to stop them several days in advance. This should be discussed when the biopsy is scheduled.