UC Davis Health endoscopy team members performed the world’s first endoscopic, ultrasound-guided core biopsy of a pancreatic tumor. During the endoscopic procedures, the team efficiently collected a larger than normal core of tissue, which allows for improved diagnostic capabilities.

Antonio Mendoza-Ladd, medical director of gastrointestinal endoscopy, performed the procedures using a unique instrument called EndoDrill® GI. Mendoza-Ladd and his team used the instrument to biopsy a gastrointestinal stromal tumor and two pancreatic tumors. Together, these three cases were the first ever performed in the United States and the pancreatic tumor biopsies were the first cases in the world done with the novel instrument.

The new device, developed by BibbInstruments AB, is considered groundbreaking because it has much better access to deep tissues in upper gastrointestinal tract, such as in the pancreas, stomach, esophagus, lymph nodes and liver, where cancer can often go undetected.

“These initial biopsies obtained with this innovative technology provided us with tissue cores that surpassed the typical ones collected with regular needles,” said Mendoza-Ladd.

How novel biopsy procedure works

The new technology allows for the core tissue samples to be taken with the help of electric high-speed drilling. A flexible rotating cylinder operated by an endoscopist removes fine samples while maintaining tissue architecture under high precision.

Additionally, the instrument allows for sampling of deep-lying tumors due to its ultra-flexible design and ability to sample multiple areas at once.

We are excited to continue offering our patients this novel endoscopic biopsy procedure that will allow us to reach more accurate diagnoses and, therefore, offer better treatment that could result in improved outcomes.” —Antonio Mendoza-Ladd

Patient benefits of novel biopsy

Traditionally, tissue samples for diverse types of gastrointestinal tumors are collected using a procedure called endoscopic ultrasound, or EUS. This involves the use of a flexible tube with a small camera attached to an ultrasound probe at the end. The endoscopist inserts the tube down the throat and into the stomach or upper bowel area to collect tissue samples using a repetitive, stabbing motion. Patches of cells and tissue fragments collect in the needle channel.

But the new instrument is more advanced since it removes fragments with a rotating needle.

“Because of the characteristics of certain tumors, sometimes endoscopic ultrasound procedures do not collect a good sample, and we end up needing to repeat the procedure to collect more tissue,” explained Mendoza-Ladd. “With this novel procedure, we were able to easily get a higher-quality core sample on the first pass of the needle, allowing us to provide extra tissue to pathologists that can be used to improve the diagnostic yield of the sample.”

The higher quality samples create a more accurate diagnosis prior to starting treatment for patients with some of the most serious cancers, such as in the pancreas, stomach, esophagus, lymph nodes and liver.

“We are excited to offer our patients this novel endoscopic biopsy procedure that will allow us to reach more accurate diagnoses and, therefore, offer better treatment that could result in improved outcomes,” added Mendoza-Ladd.