Endoscopy 2003; 35(4): 338-342
DOI: 10.1055/s-2003-38147
Original Article
© Georg Thieme Verlag Stuttgart · New York

A Prospective Comparison of Performance of Biopsy Forceps Used in Single Passage with Multiple Bites During Upper Endoscopy

K.  M.  Chu 1 , S.  T.  Yuen 2 , W.  M.  Wong 3 , K.  W.  Wong 3 , K.  C.  Lai 3 , W.  H. C.  Hu 3 , S.  Y.  Leung 2 , M.  F.  Yuen 3 , S.  K.  Lam 3 , B.  C. Y.  Wong 3
  • 1 Dept. of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong
  • 2 Dept. of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong
  • 3 Dept. of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
Further Information

Publication History

Submitted 18 April 2002

Accepted after Revision 11 October 2002

Publication Date:
27 March 2003 (online)

Background and Study Aims: A single biopsy is usually obtained for each passage of a biopsy forceps. It was hypothesized that multiple bites per passage might improve the quantity and quality of tissue obtained, without significant artifacts. This hypothesis was tested in a prospective, pathologist-blinded study using different forceps.
Patients and Methods: Forty consecutive patients who underwent elective upper endoscopy were included. Five different forceps were used in six different ways, varying in the number of bites taken per passage. Two pathologists, who were blinded to the type of biopsy forceps used, evaluated the specimens according to the parameters of maximum weight (mg), size of largest fragment (mm), depth, squash artifact, adequacy, and overall rating.

Results: A total of 240 biopsy specimens were obtained. The Microvasive Multibite and Megabite forceps obtained specimens with the maximum weight (P < 0.05) and the largest size (P < 0.05), respectively. Alligator forceps were able to obtain specimens significantly larger in size than the oval-shaped forceps (P < 0.05). The Olympus FB-24K forceps performed best in both the adequacy score and the overall rating score (P < 0.05).

Conclusions: Forceps with a needle, or the Multibite forceps, allow more biopsies to be taken per passage and improve the quality of tissues obtained. “Needleless” forceps can be used to obtain two samples per passage through the endoscope that are as good as when only one sample is collected. This approach can save time, and causes no significant damage to the biopsy specimens.

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B. C. Y. Wong, M.D.

Department of Medicine · The University of Hong Kong

Queen Mary Hospital · 102 Pokfulam Road · Hong Kong · China

Fax: + 852-28725828

Email: bcywong@hku.hk