Development and Evaluation of Novel Lateral Forceps for Bronchoscopic Guide Sheaths: A Cadaveric Study

Background Bronchoscopic biopsies are commonly performed to diagnose peripheral pulmonary nodules. Unfortunately, biopsies from lesion edges often result in significantly lower diagnostic rates. To address this issue, we developed and evaluated novel lateral biopsy forceps designed to improve the diagnostic accuracy by obtaining adequate tissue samples from lesion margins. Methods Two types of forceps and one guide sheath were prototyped and evaluated for safety and functionality in cadaveric models. Simulated lesion margins were created to target specific bronchi. This study assessed the feasibility of reaching the lesions, as well as the tissue-sampling capabilities of the devices and the frequency of experiencing difficulties with removing forceps from the guide sheath. Results Four simulated lesions were created at the margins of target bronchi in two cadaveric bodies. Both types of forceps 100% successfully accessed the lesions. Biopsies were performed from the edge toward the center of the simulated lesions, and, in three of the four simulated lesions, all collected samples consisted exclusively of simulated lesion components. Although difficulty with removing the forceps from the guide sheaths was encountered in 7.7% of cases, the entire bronchoscope and forceps were successfully withdrawn in all procedures. Conclusion Our newly developed lateral biopsy forceps demonstrated the ability to successfully access target lesions and perform biopsies effectively, even from lesion margins. These results indicate the potential of these prototypes to improve the diagnostic accuracy for peripheral pulmonary nodules.