Published Feb 13, 2017
BklynHeightsRN
45 Posts
Hello all,
I have worked in two difference endoscopy environments where materials were used to aid in getting pesky pieces of tissue off forceps. These have ranged from tiny cut pieces of Gelfoam (in the hospital), to non-woven gauze, to even pieces of paper towel.
I am now at a facility with its own pathology department, and I am waiting to hear back on what, if anything, might be acceptable to use. Of course the last thing I would want is to send them a specimen with something floating in the formalin that compromises the morphology of the tissue!
I'm curious - do any of you use things like this? My endoscopy technician frequently uses a needle which proves to be time consuming. I have ordered larger forceps which I think will also help, but we mostly do IBD cases and studies and typically have large numbers of specimens.
Thanks in advance!
brownbook
3,413 Posts
We've always used needles. I don't know that they are especially time consuming? Sure once in a while but still rare? One of our doctors said we should use toothpicks. We got some, but I was away for a few weeks and when I returned it was back to needles.
it is waaaaay above my pay grade but I think it would be rare or impossible for "something" to compromise the morphology of the tissue?
Thank you for your input! The specimens we submit are smaller ones, I think. 9 times out of 10 they are for IBD patients just checking for dysplasia every 10cm. We don't take out as many polyps at this facility. Maybe it is my tech who has trouble with needles? Do you use Olympus forceps? I noticed the Boston Scientific Radial Jaw 4's are a little larger with a tighter "grip." I think they help but want to just use the Gelfoam. I hope they get back to me soon.
Thanks again!
::Goodie::, RN
25 Posts
We use draw needles in most cases, and we have one particular forceps - the Moray - each which comes packaged with what is *probably* a dental pick. We usually run them through the DSD re-processor and they wind up.... somewhere.... and then we use a needle because they're RIGHT THERE, clean, cheap, and handy. The specimens from that particular tool are TINY, while larger than what we get from an FNA. HTH
LollygaggerRN
24 Posts
If tissue is routinely getting stuck on the forceps it could be the doc is taking too many bites. I work with one doc who tries to get 6 bites each pass with standard forceps. We use tweezers to pry off the "hangers-on". Doc just has to be patient while we work at it.
This is EXACTLY what I think too! I've never seen a doc take so many bites at one site! He will take 3 or 4 bites with each of maybe 3 passes of the same site before he is ready to close the jar and move on to the next 10cm! I actually just got BostonScientific Radial Jaw 4 forceps which feel like they have stronger jaws than the Olympus forceps. These seem to be helping a lot, but if it continues to be a problem he is frustrated with I will suggest he take fewer bites with each pass. Thanks!
ILoveGI
7 Posts
We use good old fashioned toothpicks! Yes, toothpicks. Dirt cheap, disposable and not a "stick" risk. Our techs swear by the colored/dyed toothpicks. í ½í¸€