Use of a novel through-the-needle biopsy forceps in endoscopic ultrasound

Abstract

Background and aims: Pancreatic cysts are becoming more common. Their differential diagnosis includes benign, premalignant, and malignant lesions. Distinguishing the type of cyst helps in the management decision making. We report on a novel tissue acquisition device for pancreatic cysts. Methods: Data on two patients who underwent endoscopic ultrasound (EUS) – guided fine-needle aspiration with a new micro forceps device are presented. Results: Two patients had large pancreatic cystic lesions in the pancreatic head. Linear EUS was performed, and tissue samples were obtained with the Moray micro forceps through a 19-gauge needle. In both patients, mucinous columnar epithelium lined the cystic walls. One patient underwent surgical resection, and the other elected surveillance. Examination of the surgical specimen from the first patient confirmed the cyst was a side-branch intraductal papillary mucinous neoplasm (IPMN), gastric type. Conclusions: The Moray micro forceps is a new tool that can be used to help determine the nature of pancreatic cysts and aid in their risk stratification and management.

Endoscopic ultrasound‐through‐the‐needle biopsy in pancreatic cystic lesions: A multicenter study

“…Since 2010, several case reports using different micro‐forceps working through a 19‐gauge EUS needle, and a recently published, small, single‐center, retrospective study, have shown encouraging results on the possibility of sampling of PCL cystic walls.…”

Endoscopic diagnosis of cystic lesions of the pancreas

“…Recently, several studies reported the utility of EUS‐through‐the‐needle biopsy (EUS‐TTNB) for the diagnosis and risk stratification of the malignancy of pancreatic cystic lesions . This novel technique enables direct sampling from the walls of pancreatic cystic lesions using biopsy microforceps through an EUS‐FNA needle.…”

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

“…Other applications for 19‐G needles are represented by the insertion of miniaturized devices, such as confocal microscopy fiberoptic probe or biopsy forceps for the diagnosis of cystic pancreatic lesions …”