title: Jumbo forceps are superior to standard large-capacity forceps in obtaining diagnostically adequate inflammatory bowel disease surveillance biopsy specimens.
abstract: BACKGROUND
  In inflammatory bowel disease (IBD) surveillance colonoscopy, an increased number of biopsy specimens correlates with a higher dysplasia detection rate. Larger biopsy specimens may also increase the diagnostic yield.
  
  
  OBJECTIVE
  To compare a new jumbo forceps with a standard large-capacity forceps in obtaining diagnostically adequate IBD surveillance biopsy specimens.
  
  
  METHODS
  Prospective single-center study.
  
  
  METHODS
  Twenty-four patients who were undergoing an IBD surveillance colonoscopy were enrolled. As part of standard IBD surveillance, 8 paired biopsy specimens were obtained from the rectosigmoid by using the jumbo forceps and a standard large-capacity forceps.
  
  
  METHODS
  Biopsy specimens were deemed adequate if they met all 3 of the following criteria: (1) length > or =3 mm, (2) penetration into the muscularis mucosa, and (3) < 20% crush artifact.
  
  
  RESULTS
  The proportion of adequate biopsy specimens obtained with the jumbo forceps was significantly higher than that obtained with the large-capacity control forceps (67% vs 48%, P < .0001). The average length of the biopsy specimen obtained with the jumbo forceps was 4.00 mm (95% CI, 3.81-4.20 mm) compared with 3.19 mm (95% CI, 2.99-3.38 mm) with the large-capacity (control) forceps.
  
  
  CONCLUSIONS
  (1) No validated outcome measurement for the quality of GI biopsy specimens exists and (2) in this study, interobserver variability between pathologists was high.
  
  
  CONCLUSIONS
  The jumbo forceps was superior to a standard large-capacity forceps in obtaining diagnostically adequate IBD surveillance biopsy specimens. Because biopsy specimens obtained with the jumbo forceps were larger, the use of this forceps for IBD surveillance will allow the endoscopist to sample a larger colonic mucosal surface area, potentially resulting in an increased dysplasia detection rate.
authors.affiliation: Division of Gastroenterology Pathology, University of Michigan School of Medicine, Ann Arbor, Michigan 48109, USA.
authors.forename: B Joseph
authors.initials: BJ
authors.lastname: Elmunzer
authors.forename: Peter D R
authors.initials: PD
authors.lastname: Higgins
authors.forename: Yong M
authors.initials: YM
authors.lastname: Kwon
authors.forename: Christopher
authors.initials: C
authors.lastname: Golembeski
authors.forename: Joel K
authors.initials: JK
authors.lastname: Greenson
authors.forename: Sheryl J
authors.initials: SJ
authors.lastname: Korsnes
authors.forename: Grace H
authors.initials: GH
authors.lastname: Elta
mesh_terms: D001707:Biopsy, Needle / Q000295:instrumentation*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000517:prevention & control; D016001:Confidence Intervals; D004502:Education, Medical, Continuing; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D008297:Male; D008403:Mass Screening; D015588:Observer Variation; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D013525:Surgical Instruments