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Dale H. Rice, M.D. Tiber/Alpert Professor and Chair Keck School of Medicine, University of Southern California Los Angeles, CA This new tissue collecting device is designed to address several problems. All of the tissue removed with a microdebrider is lost in the suction system and never seen by the pathologist. Legal and medical issues arise. A recent study has shown in a cost-benefit analysis, that the cost of examining all tissue removed during nasal sinus surgery is much less than the cost incurred from a missed or delayed diagnosis(1). In addition, most states require that all tissue removed from a patient be sent to pathology. There also exists the potential for missing an important diagnosis with a subsequent delay in diagnosis and its ramifications. As has been observed, "litigation may also be possible when particular test have not been performed."(2) This collector saves all tissue removed in an easy to use container that facilitates examination by the pathologist. Zweig et al (3) have shown that the microdebrider does not alter the histopathology of the tissue removed. Furthermore, Christmas et al have recently reported on the problem of tissue loss with powered instruments.(4) The collector is merely placed in the suction line coming from the microdebrider. It is bi-directional, so orientation is irrelevant. At the conclusion of the procedure, the cap is removed and the tissue in the collecting basket is sent to pathology. Thus patient safety is assured in that all removed tissue can be examined while complying with all legal and medicolegal requirements. 1. Diamantopoulos II, Jones NS, Lowe J: All nasal polyps need histological examination: an audit based appraisal of clinical practice. J. Laryngol Otol 2000; 114: 755-759. 2. Cherry J. Weir R: Medicolegal and ethical aspects of ORL-HNS in the new millennium. J Laryngol Otol 2000; 114: 737-740. 3. Zweig JL, Schaitkin BM, Fan CY, Barnes EL: Histopathology of tissue samples removed using the microdebrider technique: implications for endoscopic sinus surgery. Am J Rhinol 2000; 14: 27-32. 4. Christmas DA, Marotta JC, Yanagisawa E: Nasal malignancy masquerading as polyposis: Importance of biopsy in powered endoscopic sinus surgery. Ear Nose &Throat Journal 2001; 80;856-7 |