Which needle for which job: FNB, FNA, access and drainage items. The needle selector matches the type a guideline recommends for a target with the needles we supply.
This page is intended for healthcare professionals.
EUS-guided tissue sampling of a solid mass in the pancreatic body: six steps from finding the target to assessing the sample, and the separate path taken when access is needed instead of sampling.
The linear echoendoscope images the pancreatic body from the stomach, the mass looks hypoechoic, and the needle path is checked for vessels with colour Doppler.
The linear echoendoscope is advanced into the stomach; when needed its tip balloon is filled with water and the transducer is placed against the posterior gastric wall. The image shows the pancreatic body, the splenic vein and portal confluence behind it and the main pancreatic duct within it; the mass appears as a hypoechoic area. The needle path is checked for vessels with colour Doppler. For the pancreatic head and uncinate process the scope works from the duodenum; the same principle applies to lymph nodes and subepithelial lesions.
The 2025 ESGE update recommends end-cutting FNB needles for solid pancreatic lesions; where rapid on-site evaluation (ROSE) is available, FNA needles still have a role.
For solid pancreatic lesions the 2025 ESGE update recommends end-cutting FNB needles; where rapid on-site evaluation (ROSE) is available, FNA needles still have a role. Routine sampling uses 22G or 25G; when a core is the aim, a 19G or a 22G FNB needle is used. The needle is attached to the working channel with the stylet in and the needle locked; the sheath is advanced until its tip shows just beyond the elevator on the endoscopic image, then locked.
The needle type guidelines recommend for each target, and our needles of that type: needle selector
The needle is followed as a bright line into the mass, where the stylet is withdrawn; ESGE suggests using the stylet with FNB needles.
The needle is advanced through the gastric wall into the mass, followed in real time as a bright line on the image. The stylet keeps the needle lumen closed while it crosses the wall and is withdrawn once the needle is in the mass. ESGE makes no recommendation for or against the stylet with FNA needles and suggests using it with FNB needles.
APuncture with the FNB needle
SonoTip TopGain EUS FNB Needle SystemSheath locked, stylet in
SonoTip TopGain Flex EUS FNB Needle System (Nitinol)Coming Soon · nitinol 22GAlso at this step
The needle moves to and fro in the mass, shifting angle each stroke (fanning); suction is the physician's choice, closed before the needle leaves.
The needle is moved to and fro within the mass; with each stroke the angle is changed slightly with the up-down knob or the elevator, so that different areas of the mass are sampled (fanning). The suction method is the physician's choice: dry suction with a syringe, slow withdrawal of the stylet (slow-pull), or wet suction with the needle primed with saline. Suction is closed before the needle leaves the mass; a VacLok aspiration syringe comes in the pack.
BProControl FNA
The sample goes onto slides and into a tube; ESGE 2025 recommends on-site cytology (ROSE) with FNA and visual core inspection (MOSE) with FNB.
The needle is drawn back into the sheath, locked and removed from the scope; the sample is expressed with the stylet or air onto slides and into a tube. Rapid on-site evaluation (ROSE) tells adequacy during the procedure; without ROSE, looking at the white core by eye (MOSE) helps the decision on another pass; ESGE 2025 recommends ROSE with FNA and MOSE with FNB. ESGE suggests that assessment should not be limited to smear cytology but include histological preparations such as a cell block or formalin-fixed tissue fragments.
Without ROSE, ESGE 2025 suggests 2 passes with an end-cutting FNB needle, 3 with a reverse-bevel FNB needle and at least 4 with FNA.
If the sample is not adequate, a new pass is made with the same needle into another area of the mass. Without ROSE, ESGE 2025 suggests 2 passes with an end-cutting FNB needle, 3 with a reverse-bevel FNB needle and at least 4 with an FNA needle. The target, the needle and on-site assessment set the number of passes; the decision is the physician's.
Source: Facciorusso A et al. ESGE, Endoscopy 2025;57:390-418 (PMID 40015316)
AAnother pass with the same needle
Entering a pseudocyst, bile duct or pancreatic duct is a separate path: 19G access needle, 0.035 inch guidewire, a dilated tract and a stent.
Entering a pseudocyst, the bile duct or the pancreatic duct is a separate path. The target is punctured with a 19G access needle, the stylet is removed and a 0.035 inch guidewire is coiled into the space through the needle; the tract is dilated and kept open with a stent. This section covers sampling; access and drainage steps are described separately.
AAccessPro access needle
This section is intended for healthcare professionals. The steps are summarised from the ESGE tissue sampling guideline (2021) and the ESGE technical review (2025); indication, technique and product choice are the physician's decision, and each product's instructions for use apply.
Needle selector
First the difference between the two needle types, then the type the guidelines recommend for each target, and last our needles of that type. The guideline rows name the needle type; our needles are matched only by purpose and tip.
The tip geometry decides what comes back. The drawings are schematic.
Brings back cells and cell clusters; diagnosis is mostly cytological, and a cell block can also be prepared.
Aims for a tissue core with preserved architecture, for histology and immunohistochemistry.
The guideline in brief. For solid pancreatic masses, ESGE 2025 prefers end-cutting FNB needles over reverse-bevel FNB and FNA (strong recommendation, high quality evidence); where on-site cytology (ROSE) is available, FNA keeps a role [1].
ASGE 2024 also prefers FNB over FNA and 22G over 25G [2]. For lymph nodes and autoimmune pancreatitis, end-cutting FNB is suggested (conditional, very low quality); for subepithelial lesions of 20 mm or more, FNB and mucosal incision-assisted biopsy are recommended equally [1] [3].
Each row shows the needle type the guideline recommends for that target and the level of evidence. When you choose a row, our needles of that type are brought forward below.
Guidelines grade a recommendation on two axes: the strength of the recommendation and the quality of the evidence behind it. A strong recommendation can rest on low quality evidence, and a conditional one on high quality evidence. [10]
Matching uses only the purpose and tip recorded for each product; it is not a recommendation.
| G | Catalogue no. | Sheath | SUT | Product page |
|---|---|---|---|---|
| 19G | GUB-33-21-019 | 2.1 mm | GS1810 | View |
| 22G | GUB-33-18-022 | 1.8 mm | GS1810 | View |
| 25G | GUB-33-18-025 | 1.8 mm | GS1820 | View |
| G | Catalogue no. | Sheath | SUT | Product page |
|---|---|---|---|---|
| 19G | GUS-33-21-019 | 2.1 mm | GS1810 | View |
| 22G | GUS-33-18-022 | 1.8 mm | GS1810 | View |
| 25G | GUS-33-18-025 | 1.8 mm | GS1820 | View |
| G | Catalogue no. | Sheath | SUT | Product page |
|---|---|---|---|---|
| 19G | GUA-34-21-019 | 2.1 mm | GS1810 | View |
| Model | Product | Purpose | Tip | Needle | Sheath (mm) | Shaft | Needle extension | Guidewire | Stylet | Ultrasound visibility | SUT |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GUB-33-21-019 | TopGain EUS FNB | FNB | Crown cut, 3 point | 19G · 1.1 mm | 2.1 | Stainless steel | 0 to 8.5 cm | 0.030 in | Round tip | Specially treated surface (manufacturer statement) | GS1810 |
| GUB-33-18-022 | TopGain EUS FNB | FNB | Crown cut, 3 point | 22G · 0.7 mm | 1.8 | Stainless steel | 0 to 8.5 cm | 0.018 in | Round tip | Specially treated surface (manufacturer statement) | GS1810 |
| GUB-33-18-025 | TopGain EUS FNB | FNB | Crown cut, 3 point | 25G · 0.5 mm | 1.8 | Stainless steel | 0 to 8.5 cm | Not stated | Round tip | Specially treated surface (manufacturer statement) | GS1820 |
| GUS-33-21-019 | ProControl EUS FNA | FNA | Not stated | 19G · 1.1 mm | 2.1 | Stainless steel | 0 to 8.5 cm | 0.030 in | Round tip | Specially treated needle, coloured sheath (manufacturer statement) | GS1810 |
| GUS-33-18-022 | ProControl EUS FNA | FNA | Not stated | 22G · 0.7 mm | 1.8 | Stainless steel | 0 to 8.5 cm | 0.018 in | Round tip | Specially treated needle, coloured sheath (manufacturer statement) | GS1810 |
| GUS-33-18-025 | ProControl EUS FNA | FNA | Not stated | 25G · 0.5 mm | 1.8 | Stainless steel | 0 to 8.5 cm | No value | Round tip | Specially treated needle, coloured sheath (manufacturer statement) | GS1820 |
| GUA-34-21-019 | AccessPro EUS access | Access | Blunt cannula, trocar cut stylet | 19G · 1.1 mm | 2.1 | Stainless steel | 0 to 8.5 cm | 0.035 in | Nitinol, trocar cut | Not stated | GS1810 |
| (coming soon) | TopGain Flex EUS FNB | FNB | Crown cut, 3 point | 22G / 0.7 mm | 1.8 and 2.7 | Nitinol | 0-8.5 cm | Not stated | Not stated | Not stated | Not stated |
| (coming soon) | ProFlex EUS FNA | FNA | Not stated | 22G / 0.7 mm | 1.8 and 2.7 | Nitinol | 0-8.5 cm | 0.018 in | Not stated | Zig-zag laser engraving | Not stated |
Dimensions from the manufacturer's catalogues and instructions for use registered in Türkiye; SUT (Turkish reimbursement) codes from the national device registry export (03.10.2026). "Not stated" means our documents do not give the value. The guideline rows are at needle-type level and are not a recommendation for any product listed. The instructions for use decide selection and compatibility; needle choice is the physician's decision. This section is intended for healthcare professionals.
An endoscopic ultrasound fine needle biopsy (FNB) system with a crown-cut needle tip for core-tissue sampling.
A 100% Nitinol fine needle biopsy system that carries the TopGain three-point crown cut on a nitinol shaft, for work at difficult access angles.
Coming Soon
An EUS fine needle aspiration (FNA) system with Twist-Lock technology for single-handed needle and tube length adjustment.
A 100% Nitinol EUS-FNA needle for aspiration cytology at extreme scope positioning angles.
Coming Soon
