Influence of endoscopic biopsy forceps characteristics on tissue specimens: results of a prospective randomized study

Background: A large variety of endoscopic biopsy forceps are commercially a vailable. However, little is known regarding the influence of forceps chara cteristics such as disposability, size, shape, and presence of a needle on the adequacy of the specimens for histologic diagnosis. Our aim was to anal yze in a prospective, randomized, pathologist-blinded study the performance of different biopsy forceps. Methods: Twelve biopsy forceps were tested, 6 each at upper endoscopy and c olonoscopy. Two biopsy specimens were obtained with each forceps, for a tot al of 12 specimens per patient. The tissue samples were examined for the fo llowing parameters: weight (mg), size (mms), depth, crush artifact, sheerin g effect, and adequacy of the specimens for histologic information (0 = ina dequate, 1 = suboptimal, and 2 = adequate). Results: Fifty-five patients undergoing routine upper or lower gastrointest inal endoscopy were included in the study, and a total of 624 tissue sample s were available for analysis. Overall, disposable forceps provided specime ns of greater size and depth. At upper endoscopy, alligator-shaped forceps improved the depth of the sample as did the absence of a needle within the cup. These factors, however, had no impact on the specimens obtained at col onoscopy. When the adequacy of the specimens was assessed for histologic di agnosis, no significant difference was noted between any of the individual forceps, although collectively oval-shaped forceps were superior to alligat or-shaped forceps at colonoscopy. Conclusions: The biopsy forceps currently available in the market are equal ly efficient in providing histologic diagnosis. The primary consideration w hen selecting an endoscopic biopsy forceps, therefore, should be the cost a nd ease of use and not any perceived advantage in performance.