Prospective, randomized comparison of disposable and reusable biopsy forceps in gastrointestinal endoscopy

We prospectively compared biopsy specimens obtained with reusable and disposable stainless steel biopsy forceps of varying sizes and configurations. Six types of forceps were used: (1) jumbo reusable forceps, (2) jumbo disposable forceps with a Teflon sheath, (3) regular reusable forceps, (4) regular disposable forceps with a Teflon sheath, (5) regular long-jaw disposable forceps, and 6) regular long-jaw disposable forceps with a Teflon sheath. "Jumbo" forceps were those requiring an endoscopic biopsy channel of at least 3.3 mm. "Regular" forceps were those requiring only a 2.8-mm channel. Two biopsy specimens were obtained with each of the six forceps from normal-appearing stomach, duodenum, and sigmoid colon (25 sets at each location). Mixed and coded specimens were scored by a single pathologist for volume (height, width, and length) and histologic depth. Reusable and disposable jumbo forceps yielded biopsy specimens of similar volumes (30 +/- 1 mm3 and 33 +/- 1 mm3, respectively) and histologic depth (grades of 3.3 +/- 0.1 and 3.5 +/- 0.1, respectively). In comparison, the regular-sized biopsy forceps gave specimens with half the volume of those obtained by the jumbo forceps (reusable, 13 +/- 1 mm3; disposable with Teflon sheath, 15 +/- 1 mm3; long-jaw, 16 +/- 1 mm2; and long-jaw with Teflon sheath, 17 +/- 1 mm3). However, the histologic depths of specimens obtained with the regular disposable forceps were the same as those of specimens obtained with the jumbo forceps. Regular reusable biopsy forceps yielded specimens with the smallest overall volume and histologic depth. We conclude that disposable forceps are equivalent to reusable forceps and that the two types can be used interchangeably in gastrointestinal endoscopy. We recommend the use of jumbo forceps whenever possible because they provide biopsy specimens that are double the size of those obtained with regular forceps.