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Fischer Cone Biopsy Excisor

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Loop excision procedures performed with small diameter wire loop

electrodes produce multiple small pieces of cervical tissue and

provide a less acceptable tissue specimen for histopathologic

analysis. The effectiveness of the procedure and influence of

electrodesign are not completely understood.

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Larger lesions involving multiple quadrants of the cervix are more

difficult to remove with either the small or large diameter loop

electrodes.

SMALL DIAMETER LOOP VS LARGE DIAMETER LOOP

The histological quality of the specimens obtained using the small

diameter loop was inferior to that obtained with the larger diameter loop.

This is because more of the epithelium comes in direct contact with the

small diameter electrode than with the large diameter electrode and that

part of the electrode is not insulated. This results in more thermal damage

to the tissue. In 7% of the samples, the amount of thermal damage

precluded histological evaluation of the excised tissue. In addition, since

multiple, often irregular, strips of epithelium are excised from the cervix, it

is often difficult for the pathologist to orient the specimens for optimal

histopathological examination.

THERMAL INJURY AND DEFECTS OF TISSUE TREATED WITH LOOP

ELECTRODES

Possible injury to cervical tissue may include: (I) thermal coagulation

injury of the cervix, up to one-third the thickness of normal epithelium of

the cervix, (II) fragmentation of squamous epithelium of the cervix

attributable to long exposure periods along the excision site that allows

heat to dissipate laterally, and (III) partial coagulation of the endocervical

epithelium because of lateral radiation of heat.

Loop electrosurgical excision procedures may also produce thermal

defects at the periphery of the excised tissue and may make

histopathological interpretation difficult or impossible and may prevent

accurate diagnosis and the evaluation of the need for further treatment.