A performance, safety and cost comparison of reusable and disposable endoscopic biopsy forceps: a prospective, randomized trial

Background: Many gastroenterologists believe that disposable forceps are more expensive than reusable forceps. It has been shown, however, that cross contamination and spread of infection are possible with reusable forceps. We conducted a prospective, randomized study to evaluate the performance, safety and cost of reusable versus disposable biopsy forceps. Methods: Endoscopists were randomly assigned reusable or disposable biopsy forceps during upper and lower endoscopy Forceps were evaluated for ease of passage through the endoscope, ease of opening and closing, adequacy of sample, and overall evaluation following the endoscopy using an ordinal scale. The cost per biopsy session was calculated using the following formula: (Acquisition cost + Reprocessing costs)/Number of biopsy sessions. Results: Disposable forceps received a predominantly excellent rating versus a predominantly good rating for reusable forceps. Disposable forceps were also found to be more cast-effective than reusable forceps with an average savings of $5.94 per biopsy session. Examination of reusable forceps revealed residual patient debris despite "adequate" cleansing. Conclusions: Disposable forceps outperformed reusable forceps and were found to be more cost-effective. Residual patient debris on reusable forceps may pose a risk of cross contamination and the spread of infection.