, Volume 197, Issue 1, pp 61–66 | Cite as

The Effect of Using Different Types of Forceps in the Efficacy of Transbronchial Lung Biopsy

  • Abdulrahman AlmadaniEmail author
  • Melissa N. Y. Ping
  • Anu Deenadayalu
  • Jean Saunders
  • Aidan O’Brien



Transbronchial lung biopsy (TBBX) is a common respiratory diagnostic procedure performed to investigate several lung diseases. There are different types of forceps used to perform this procedure. The alligator and cupped (oval) forceps are most commonly used ones. To date, there are few studies that have compared the efficacy of these two types of forceps. This study compares the two types of forceps relating to the rate of complications and diagnostic value.


In this retrospective observational study, 40 patients who underwent TBBX using the alligator forceps were compared to a previous group of 40 patients who underwent the same procedure using the cupped forceps. The two groups were compared with respect to the rate of complications (bleeding and pneumothorax), diagnostic value and size of biopsies.


The rate of complications was higher in patients who underwent TBBX using alligator forceps, in which seven patients (17.5%) had significant bleeding in the group that used alligator forceps versus three patients (7.5%) in cupped forceps group. Pneumothorax developed in three patients, all of whom were in the alligator forceps group. While there was no significant difference in the adequacy and size of the samples, the diagnostic yield was higher in the cupped forceps group.


The results of the study showed that using cupped forceps in performing TBBX had fewer complications (pneumothorax and bleeding) and a higher diagnostic yield in comparison with alligator forceps, but the difference did not reach a statistical significant value.


Bronchoscopy Transbronchial biopsy Forceps Interventional pulmonology 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest. The authors whose names are listed have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.


  1. 1.
    Jain P, Hadique S, Mehta AC (2013) Transbronchial lung biopsy. In: Mehta AC, Jain P (eds) Interventional bronchoscopy: a clinical guide, respiratory medicine 10. Springer Science+Business Media, New York. Google Scholar
  2. 2.
    De Fenoyl O, Capron F, Lebeau B, Rochemaure J (1989) Transbronchial biopsy without fluoroscopy: a five year experience in outpatients. Thorax 44(11):956–959CrossRefGoogle Scholar
  3. 3.
    Tukey MH, Wiener RS (2012) Population-based estimates of transbronchial lung biopsy utilization and complications. Respir Med 106(11):1559–1565CrossRefGoogle Scholar
  4. 4.
    Pue CA, Pacht ER (1995) Complications of fiberoptic bronchoscopy at a university hospital. Chest 107:430CrossRefGoogle Scholar
  5. 5.
    Jabbardarjani H, Eslaminejad A, Mohammadtaheri Z, Kiani A, Arab A, Masjedi MR (2010) The effect of cup versus alligator forceps on the results of transbronchial lung biopsy. J Bronchol Interv Pulmonol 17(2):117–121CrossRefGoogle Scholar
  6. 6.
    Sehgal IS, Bal A, Dhooria S, Agrawal P, Gupta N, Ram B, Aggarwal AN, Behera D, Agarwal R (2016) A prospective randomized controlled trial comparing the efficacy and safety of cup vs alligator forceps for performing transbronchial lung biopsy in patients with sarcoidosis. Chest 149(6):1584–1586CrossRefGoogle Scholar
  7. 7.
    Hautmann H, Henke MO, Bitterling H (2010) High diagnostic yield from transbronchial biopsy of solitary pulmonary nodules using low dose CT guidance. Respirology 15:677CrossRefGoogle Scholar
  8. 8.
    Rittirak W, Sompradeekul S (2007) Diagnostic yield of fluoroscopy-guided transbronchial lung biopsy in non-endobronchial lung lesion. J Med Assoc Thai 90(Suppl 2):68–73Google Scholar
  9. 9.
    Curley FJ, Johal JS, Burke ME et al (1998) Transbronchial lung biopsy: can specimen quality be predicted at the time of biopsy. Chest 113:1037–1041CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University Hospital LimerickLimerickIreland
  2. 2.CSTAR@UL, University of LimerickLimerickIreland
  3. 3.Bahrain Defence Force Hospital—Royal Medical Services (BDF-RMS)RiffaBahrain

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