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Endoscopic techniques for full thickness intestinal biopsy

Hajiyeva, Gularaa,b; Ngamruengphong, Saowaneea

Current Opinion in Gastroenterology: September 2018 - Volume 34 - Issue 5 - p 295–300
doi: 10.1097/MOG.0000000000000464
ENDOSCOPY: Edited by Anthony N. Kalloo

Purpose of review Accurate diagnosis of gastrointestinal neuromuscular diseases requires full thickness biopsy for adequate histologic evaluation of the enteric neuromuscular and ancillary cells. Historically, this has been achieved by surgical approaches. An overview of procedure evolution and current techniques of endoscopic full thickness biopsy (EFTB) for diagnosis of gastrointestinal neuromuscular disorders will be presented.

Recent findings Emergence and advancement of endoscopic full thickness resection techniques has offered a less invasive, nevertheless an effective modality of tissue acquirement. Recently, clip-assisted close-then-cut EFTB has been utilized in clinical practice under research protocol. Early experience has shown that this technique provides an adequate full-thickness specimen including the myenteric plexus and ganglia cells, with acceptable safety profiles.

Summary EFTB is a promising means in diagnosing the nature of the disease and guiding therapy. Available animal and human studies have shown the noninferiority of endoscopic methods to surgical ones in term of adequacy of tissue samples, while potentially decreasing the risk and occurrence of complications. Further large prospective studies are needed to assess its efficacy, safety and impacts on patient's outcomes.

aDivision of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland

bBenefis Health System, Great Falls, Montana, USA

Correspondence to Saowanee Ngamruengphong, MD, Assistant Professor of Medicine, Division of Gastroenterology & Hepatology, Johns Hopkins Medicine, 4940 Eastern Avenue, A Building, 5th Floor. A-501, Baltimore, MD 21224, USA. Tel: +1 410 550 8124; fax: +1 410 550 7861; e-mail:

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