| Abstract: | Minute lesions of the esophagus were biopsied using a transparent hood designed by the authors to fit on the tip of a forward viewing endoscope. The quality of the bite biopsies performed using the hood and their accuracy, as well as technical difficulty, were investigated. Minute lesions of less than 5 mm in diameter located at 1, 2 or 3 o'clock were chosen for investigation since these are usually difficult areas from which to obtain a biopsy. Twenty subjects were biopsied using the hood and 20 were biopsied without it, in the conventional way, over the 15 month period from November 1993 to January 1995. A comparison of first biopsy success rates, with and without the hood, was made. The rate of success was very high (19/20; 95%) when the hood was used, but low (11/20; 55%) when the hood was not used (p<0.01). A comparison of the time taken for the first biopsy showed that when the hood was used, the time taken was shorter, averaging 21.9 seconds, in contrast to the rather slow average of 118.2 seconds taken when the hood was not used (p<0.01). The transparent hood is used by positioning it gently on the oral side of a tangential lesion, and then angulating the tip of the endoscope with this point as a fulcrum to position the tip so as to be virtually perpendicular to the esophageal wall, facilitating attainment of a frontal view of the lesion. The lesion thus brought forward can then be fixed, enabling the operator to obtain a biopsy with great ease and accuracy. |
