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The lower esophageal ring (Schatzki ring) is a diaphragm-like narrowing not infrequently found in the lower esophagus, usually associated with a sliding hiatal hernia. These rings consist of submucosal fibrosis with normal overlying musoca and occur at the junction of the squamous epithelium of the esophagus and the columnar epithelium of the stomach. Although most patients are asymptomatic, the ring may be responsible for dysphagia and, in particular, cause intermittent food impaction. A variety of therapeutic options are available, but none are consistently effective in relieving symptoms.• Transendoscopic electrosurgical incision, a new approach to the treatment of lower esophageal rings in which conventional bougienage could not be accomplished or failed, is described in this report.

Endoscopic biopsy under direct vision is widely used to establish the diagnosis of gastric lesions. Numerous reports indicate that the diagnostic accuracy of endoscopic biopsy for gastric cancer varies from 70% to >90%.1-7 Secure histodiagnosis is the major goal of both gastroenterologist and pathologist; yet, biopsy specimens obtained by forceps are frequently too small to allow definitive diagnosis. The amount and depth of tissue sampled at biopsy would appear to be important determinants of overall accuracy of the diagnostic biopsy. The present study was undertaken to assess the role of biopsy forceps size as a variable in the accuracy of the diagnosis of gastric lesions.