Randomized, controlled trial of standard, large-capacity versus jumbo biopsy forceps for polypectomy of small, sessile, colorectal polyps

Background: Polypectomy with cold biopsy forceps is a frequently used technique for removal of small, sessile, colorectal polyps. Jumbo forceps may lead to more effective polypectomy because of the larger size of the forceps cup. Objective: To evaluate the efficiency of cold jumbo biopsy forceps compared with standard forceps for polypectomy of small, sessile, colorectal polyps. Design: Randomized, controlled trial. Setting: Outpatient endoscopy center. Patients: This study involved 140 patients found to have at least one eligible polyp defined as a sessile polyp measuring <= 6 mm. Intervention: Polypectomy with cold biopsy forceps. Main Outcome Measurements: Complete visual polyp eradication with one forceps bite. Results: In 140 patients, a total of 305 eligible polyps were detected (151 removed with jumbo forceps and 154 with standard forceps). Complete visual eradication of the polyp with one forceps bite was achieved in 78.8% of the jumbo forceps group and 50.7% of the standard forceps group (P < .0001). Biopsies from the polypectomy sites of adenomatous polyps thought to be visually completely eradicated with one bite showed a trend toward a higher complete histologic eradication rate with the jumbo forceps (82.4%) compared with the standard forceps (77.4%), but the difference did not reach statistical significance (P = .62). The withdrawal time for visual inspection of the colon and time to perform polypectomies were significantly shorter in the jumbo forceps group (mean 21.43 vs 18.23 minutes; P = .02). Limitations: Lack of blinding to the type of forceps used. Conclusion: The jumbo biopsy forceps is superior to the standard forceps in removing small, sessile polyps. (Clinical trial registration number: NCT00855790.) (Gastrointest Endosc 2012;75:118-26.)