Comparative assessment of biopsy forceps for upper endoscopy: Pathologist blinded randomized study

Background: Several types of biopsy forceps are in use however, there are few comparative data. Objectives: To prospectively evaluate in a double blind fashion, biopsy specimens obtained by disposable vs. reusable forceps of different shape. Methods: Six different forceps were examined: Bard disposable forceps, oval cup with and without needle and alligator cup with and without needle with cup diameter of 2.3 mm. Microvasive disposable alligator shaped forceps without needle (cup size of 2.2 mm) and Olympus reusable oval cup forceps with needle (cup size 2 mm). Two specimens were obtained with each forceps; 12 specimens per patient. All biopsies were obtained by 3 endoscopists. Biopsies were evaluated blindly for weight (mg), dimensions (mm³), depth, crush artifact, shearing effect, and adequacy of histological information (0 = inadequate, 1 = suboptimal, and 2 = adequate). Results: 27 subjects were studied. Disposable forceps were equal to the reusable forceps with respect to the biopsy weight, size, and the amount of tissue shearing. Tissue depth was greater with all disposable alligator forceps and disposable oval forceps without needle, compared to reusable forceps (p<0.001). Disposable oval cups with needle did not perform comparably to the others in all parameters (p<0.01). No difference was observed between the different groups of forceps when assessed according to the adequacy of the biopsy specimens for histological assessment. Conclusions: Our findings indicate that in general, the amount of tissue obtained with most disposable forceps was equal to that with reusable forceps and both types of forceps were similar with respect to the adequacy of the biopsy specimens for histological assessment. This study was funded in part by Bard Interventional Products Division, Billerica, MA.