Endometrial biopsies using small-diameter hysteroscopes and 5F instruments: How can we obtain enough material for a correct histologic diagnosis?

Study Objective. To evaluate the quantity of biopsy tissue obtained by hysteroscopic grasp technique compared with classic punch technique. Design. Observational study (Canadian Task Force classification II-2). Setting. University hospital. Patients. One thousand two hundred seventy-six women. Intervention. Targeted biopsies performed in an office setting using two biopsy forceps, classic spoon and crocodile, and two methods, classic punch and grasp technique. Measurements and Main Results. With either biopsy forceps, the mean increase in amount of tissue obtained by grasp technique compared with punch technique was statistically significant (p<0.005). With grasp technique, the mean amount of tissue obtained was even larger with crocodile than with spoon forceps. Conclusion. Targeted biopsy, when performed with the appropriate instrument and applying correct technique, can provide the pathologist with a large amount of tissue (mean 5.7 mm(2)) that is invariably adequate for histologic examination.