Peter van Mourik

80 Chapter 4 Step by Step Method Details: Obtaining human (colon) rectal biopsies Timing ~2 h NOTE : both the forceps biopsy (A) and the rectal suction biopsy (B) are medical procedures which should only be performed by trained medical staff in a medical clinic. Make sure all necessary precautions are in place for a safe procedure. CRITICAL : Clinical procedures to isolate rectal or colon biopsies from patients should ALWAYS be performed by trained medical staff in a medical clinic. Make sure all necessary precautions are in place for a safe procedure. 1. Fill a 50 mL conical tube with +/- 20 mL of PBS0 at 4 °C 2. If biopsies are transported over long distance or long duration (>8 h) before crypt isolation procedure can take place, biopsies should be stored at 4 °C in Ad-DF +++ with additional gentamicin (50 µg/mL) and vancomycin (50 µg/mL). CAUTION: Authorized personnel should wear gloves and a physician’s coat. This is the minimum protection that should be worn when working in the OR (operating room). Make sure all the apparatus are calibrated and sterilized. CRITICAL: Procedures should not take place: If the patient suffers from thrombocytopenia (less than 50 x 10 9 thrombocytes /L). If the patient suffers from coagulation disorder. If the patient is currently suffering from severe inflammation of the intestine. In case of visibility problems during the endoscopy. Possible complications during and after the procedure Perforation of the intestinal wall. Severe or persistent bleeding. Attention points The nurse notifies the physician if the biopsies are of excellent, decent or inferior quality (see figure 3). Be considerate with regards to the position and signs of any pain or discomfort of the patient.