EUS/Fine Needle Biopsy

Endoscopic Ultrasound (EUS) is a procedure which requires a specially designed endoscope with a miniaturised electronic ultrasound transducer embedded at its distal end. The combination enables both endoscopic and ultrasonic examinations of deeper tissue structures not usually visible to an ordinary endoscope. This special capability allows accurate diagnosis of small masses in the liver, pancreas and small stones in the bile duct missed out in CT scans and MRI at times. In essence, we are now able to perform an ultrasound scan of your body from the inside, instead of outside, the body. The advantage of such an approach is bringing the organ of interest much closer to our ultrasound scanner for better imaging, which is not possible with the routine external approach that has to pass through many layers of signal-degrading skin tissues. Best of all, through a special fine needle, we are able to obtain tissue samples of the organ in a scar-less and pain free manner. These special characteristics make EUS the investigation of choice in many situations, including assessment of secondary tumours involving the liver before surgery.

Just like routine OGD, this procedure is usually done in the left lateral position. A mouth spray and an intravenous sedation will be given before the procedure. Endoscopic Ultrasound study takes about 30-60 minutes to complete. Fine needle aspiration (FNA) can be performed to obtain tissues from deeper structure through tiny punctures made using a special FNA needle. In some cases which requires endoscopic therapy, plastic or metal stents can also be deployed to drain fluids within a compartment using EUS guided technique.