Complications of the hot biopsy forceps technique

The Safety of Hot Biopsy Forceps in the Removal of Small Colonic Polyps

“…Complications such as perforations and bleeding have been reported [9, 10, 11, 12]after the use of HBF. At least 1 death has been reported [10].…”

“…At least 1 death has been reported [10]. The majority of the perforations and episodes of bleeding occurred when polyps in the cecum and ascending colon were treated compared to those in the sigmoid-rectum region.…”

“…The technique of electrocoagulation (‘hot’) biopsy for the removal of small polyps and the management of vascular ectasias of the gastrointestinal tract has become popular [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. In this technique the insulated monopolar electrocoagulation forceps, i.e.…”

“…Recently bipolar HBF has been used for the same purpose. Some authors [1, 2, 3, 4, 5, 6]have found this technique to be safe while others [9, 10, 11, 12]have reported complications such as massive bleeding and colonic perforation.…”

Colonoscopic polypectomy

“…When this injury zone is 1-2 mm wide, current should be discontinued and the specimen retrieved as with any biopsy technique. Because of reported complications with the hot biopsy forceps [23], many endoscopists only use them to eradicate polyps in the range 1-5 mm. Small polyps in the range 1-4 mm have small nutrient blood vessels and can safely be removed by "cheese-wiring" with a mini-snare without electric current. This technique results in minimal bleeding [24,25].…”