[Minimally invasive autopsies-Methods and limitations]

Despite major advances in ante-mortem diagnostics, clinicopathological autopsy remains a central instrument for determination of the cause of death, clinical quality assurance, and medical research. At the same time, autopsy rates in Germany have been declining for decades. Minimally invasive autopsy techniques may increase acceptance of postmortem examinations.

To outline the role of minimally invasive autopsy techniques, to distinguish them from non-invasive imaging-based approaches, and to comparatively evaluate established methods of postmortem tissue sampling.

Selective, non-systematic narrative review of the literature focusing on image-guided core needle biopsies, including sonography-based approaches, as well as laparoscopic and thoracoscopic minimally invasive autopsy techniques.

Sonography-guided core needle biopsies enable rapid and cost-effective tissue sampling but are limited with regard to tissue representativeness and determination of the cause of death. Combination with cross-sectional imaging improves diagnostic reliability at the expense of higher costs and limited availability. Laparoscopic and thoracoscopic approaches allow visual organ assessment and retrieval of larger excisional tissue samples with high diagnostic yield but require specialized equipment and expertise.

Minimally invasive autopsies represent a meaningful adjunct to conventional autopsy; however, conventional autopsy remains the diagnostic gold standard.