EUS gives us phenomenal imaging — but tissue acquisition has historically been the weak link. In this episode of The Interventional Endoscopist, host Mankanwal Sachdev speaks with Dr. Charles Walther, a Swedish interventional cytopathologist and tumor genetics expert who has sampled 15,000+ patients and helped develop a new approach to obtaining high-quality specimens: EndoDrill.

Walther shares the “lightbulb moment” that shaped the device: instead of advancing a needle by punching forward (“stabbing”), use high-RPM rotation to advance with low forward force — aiming for one pass and a more cohesive sample. They discuss how EndoDrill works in practical terms (setup, foot pedal activation, specimen expulsion), contamination concerns, compatibility across major scope platforms, and why tissue quality is becoming even more important in an era of precision medicine, molecular profiling, and organoids.

They also cover early human experience, the learning curve, optimization for different tumor biologies, and the key cost/value debate: when does a premium tool make sense—especially for cases like nodules, GISTs, and lymphoma where yield can be inconsistent?

Plus: Rapid-fire questions, technique pearls, and a reminder to seek help if you’re struggling with mental health.

Links:

https://bibbinstruments.com/en/