title: Prospective, randomized, pathologist-blinded study of disposable alligator-jaw biopsy forceps for gastric mucosal biopsy.
abstract: BACKGROUND
  Endoscopic biopsy forceps differ in the size and shape of the biopsy cup and the presence or absence of a needle.
  
  
  METHODS
  We compared four different "large cup" forceps (three with needles) designed for 2.8mm biopsy channels. A gastric antral and corpus biopsy were obtained with each. Parameters examined included: weight (mg), length (mm), orientation (poor, good), intactness (1, 2, or 3 pieces), depth (superficial, above muscularis mucosae, included muscularis mucosae), crush artefact (yes, no), and overall adequacy (inadequate, suboptimal, adequate).
  
  
  RESULTS
  Twenty-four patients were enrolled (191 biopsies). The median length was approximately 5mm (range 1.1-8.2mm). Histologically inadequate specimens were present in 4% with the forceps without needle compared to 16% of those with needles (P=0.061) and there were significantly fewer specimens in three or more pieces than did the forceps with needles 2.1% vs. 12.6% (P<0.05).
  
  
  CONCLUSIONS
  Current alligator style forceps provide a high proportion of acceptable specimens with only minor differences between brands. Forceps from one source were least preferred by endoscopy assistants and had the highest rates of inadequate biopsies and biopsies with crush artefact. Forceps without needles provide histologically acceptable samples slightly more frequently than those with needles.
authors.affiliation: Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
authors.forename: S
authors.initials: S
authors.lastname: Abudayyeh
authors.forename: J
authors.initials: J
authors.lastname: Hoffman
authors.forename: H T
authors.initials: HT
authors.lastname: El-Zimaity
authors.forename: D Y
authors.initials: DY
authors.lastname: Graham
mesh_terms: D016477:Artifacts; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods; D004209:Disposable Equipment; D016145:Endoscopy, Digestive System / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D011446:Prospective Studies; D016037:Single-Blind Method; D013525:Surgical Instruments
references.citation: Gastrointest Endosc. 1996 Oct;44(4):510
references.pmid: 8905385
references.citation: Gastrointest Endosc. 2000 Mar;51(3):257-61
references.pmid: 10699767
references.citation: Gastrointest Endosc. 1996 Jan;43(1):10-3
references.pmid: 8903810
references.citation: Gastrointest Endosc. 2000 Mar;51(3):262-5
references.pmid: 10699768
references.citation: Gastrointest Endosc. 1995 Jun;41(6):573-6
references.pmid: 7672551
references.citation: Gastrointest Endosc. 1999 Feb;49(2):177-83
references.pmid: 9925695
references.citation: Gastrointest Endosc. 1990 Jul-Aug;36(4):379-81
references.pmid: 2210280
references.citation: Gastrointest Endosc. 2001 Nov;54(5):600-4
references.pmid: 11677476
references.citation: Gastrointest Endosc. 1983 Feb;29(1):35-6
references.pmid: 6826006
references.citation: Gut. 2007 May;56(5):631-6
references.pmid: 17142647
references.citation: Endoscopy. 1995 Nov;27(9):683-8
references.pmid: 8903983
references.citation: J Clin Gastroenterol. 1991 Feb;13(1):76-8
references.pmid: 2007750
references.citation: Endoscopy. 2003 Apr;35(4):338-42
references.pmid: 12664392
references.citation: Gut. 1985 Mar;26(3):227-31
references.pmid: 3972269
references.citation: Am J Surg Pathol. 1996 Oct;20(10):1161-81
references.pmid: 8827022