Original Articles| Volume 54, ISSUE 5, P600-604, November 2001

Download started.


Diagnostic quality of biopsy specimens: Comparison between a conventional biopsy forceps and multibite forceps


      Background: The endoscopic biopsy is a prerequisite for histopathologic diagnosis. Various types of forceps are used to obtain tissue specimens. The aim of this study was to assess and compare the diagnostic quality of biopsy specimens obtained with a conventional forceps and a Multibite forceps. Methods: In a prospective, partially blinded, and randomized trial that included 250 patients referred for diagnostic upper and/or lower endoscopy, 510 biopsy specimens obtained with the Multibite forceps were compared with 520 specimens obtained with a conventional forceps. An experienced, blinded pathologist evaluated the specimens for diameter, depth of specimen, artifacts, anatomic orientation, vitality, general histologic quality, and diagnostic quality. Statistical analysis was performed by using the Fisher exact test. A p value of < 0.05 was regarded as significant. Results: There were no statistically significant differences between the specimens obtained with the 2 forceps. The p values for the evaluated parameters were as follows: diameter 0.45, depth of specimen 0.56, artifacts 1.0, pathoanatomic orientation 0.40, vitality 0.45, and histologic diagnostic quality 0.53. Conclusion: The quality of biopsy specimens obtained with the Multibite forceps is comparable with that of specimens taken with a conventional forceps. Use of the Multibite forceps saves time in that 4 specimens can be obtained in 1 pass in situations in which a large number of specimens are needed or when the potential for transmission of infection is of concern. (Gastrointest Endosc 2001;54:600-4.)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Dwyer OM
        • Klein EG
        • Istre GR
        • Robinson MG
        • Neumann DA
        • McCoy GA.
        Salmonella newport infections transmitted by fiberoptic colonoscopy.
        Gastrointest Endosc. 1987; 33: 84-87
        • Spach DH
        • Silverstein FE
        • Stamm WE.
        Transmission of infection by gastrointestinal endoscopy and bronchoscopy.
        Ann Intern Med. 1993; 118: 117-128
        • Yang R
        • Naritoku W
        • Laine L.
        Prospective, randomized comparison of disposable and reusable biopsy forceps in gastrointestinal endoscopy.
        Gastrointest Endosc. 1994; 40: 671-674
        • Bernstein DE
        • Barkin JS
        • Reiner DK
        • Lubin J
        • Phillips RS
        • Grauer L.
        Standard biopsy forceps versus large-capacity forceps with and without needle.
        Gastrointest Endosc. 1995; 41: 573-576
        • Dandalides SM
        • Carey WD
        • Petras R
        • Achkar E.
        Endoscopic small bowel mucosal biopsy: a controlled trial evaluating forceps size and biopsy location in the diagnosis of normal and abnormal mucosal architecture.
        Gastrointest Endosc. 1989; 35: 197-200
        • Danesh BJ
        • Burke M
        • Newman J
        • Aylott A
        • Whitfield P
        • Cotton PB.
        Comparison of weight, depth, and diagnostic adequacy of specimens obtained with 16 different biopsy forceps designed for upper gastrointestinal endoscopy.
        Gut. 1985; 26: 227-231
        • Woods KL
        • Anand BS
        • Cole RA
        • Osato MS
        • Genta RM
        • Malaty H
        • et al.
        Influence of endoscopic biopsy forceps characteristics on tissue specimens: results of a prospective randomized study.
        Gastrointest Endosc. 1999; 49: 177-183
        • Ottenjann R
        • Bartelheimer W
        • Busse R
        • Lux G.
        Endoscopic biopsy using the electrocautery snare (macro particle biopsy).
        Med Klin. 1975; 70 ([in German with English abstract]): 757-759
        • Yang R
        • Vuitch F
        • Wright K
        • McCarthy J.
        Adequacy of disposable biopsy forceps for gastrointestinal endoscopy: a direct comparison with reusable forceps.
        Gastrointest Endosc. 1990; 36: 379-381
        • Ladas SD
        • Tsamouri M
        • Kouvidou C
        • Raptis SA.
        Effect of forceps size and mode of orientation on endoscopic small bowel biopsy evaluation.
        Gastrointest Endosc. 1994; 40: 51-55
        • Levine DS
        • Reid BJ.
        Endoscopic biopsy technique for acquiring larger mucosal samples.
        Gastrointest Endosc. 1991; 37: 332-337
        • Turk DJ
        • Kozarek RA
        • Botoman VA
        • Patterson DJ
        • Ball TJ.
        Disposable endoscopic biopsy forceps: comparison with standard forceps of sample size and adequacy of specimen.
        J Clin Gastroenterol. 1991; 13: 76-78
        • Tytgat GN
        • Ignacio JG.
        Technicalities of endoscopic biopsy.
        Endoscopy. 1995; 27: 683-688
        • Rizzo J
        • Bernstein D
        • Gress F.
        A performance, safety and cost comparison of reusable and disposable endoscopic biopsy forceps: a prospective, randomized trial.
        Gastrointest Endosc. 2000; 51: 257-261
        • Weinstein WM
        • Khatri N
        • Da Z.
        A prospective comparison of a Multibite forceps with a conventional-sized and large cup pinch biopsy forceps.
        Gastrointest Endosc. 1997; 45 ([abstract]): AB42
        • Kozarek RA
        • Raltz SL
        • Merriam LD
        • Sumida SE.
        Disposable versus reusable biopsy forceps: a prospective evaluation of costs.
        Gastrointest Endosc. 1996; 43: 10-13
        • Yang R
        • Ng S
        • Nichol M
        • Laine L.
        A cost and performance evaluation of disposable and reusable biopsy forceps in GI endoscopy.
        Gastrointest Endosc. 2000; 51: 266-270
        • Rey JF.
        Endoscopic disinfection: a worldwide problem.
        J Clin Gastroenterol. 1999; 28: 291-297