Advances in endoscopic ultrasound–guided tissue acquisition (EUS-TA) have increasingly shifted diagnostic strategies toward histology-based assessment, expanding the need for needles capable of providing consistent core tissue while maintaining optimal flexibility and procedural control. To assess, in pancreatic solid lesions, the technical performance, histological yield, and diagnostic accuracy of a novel 22-gauge (22G) FNB needle featuring a Franseen tip made of cobalt-chromium alloy, designed to optimize puncture control and flexibility through a spring-coiled, dual-coated sheath.

Consecutive patients undergoing EUS-FNB for solid pancreatic lesions at a single referral center were prospectively included. Each lesion was sampled with three standardized passes using the study needle. All specimens were fixed in formalin and assessed for microcore quantity and quality. The primary endpoint was microcore procurement (number and size >550 μm). Secondary endpoints included diagnostic accuracy and adverse events.

From May to October 2025, 51 patients (51% male; mean age 62 years, range 38–86) were enrolled. Technical success was achieved in all cases. High-quality histological cores were obtained in 75% of procedures. Overall diagnostic accuracy was 90.2%. No major adverse events occurred. Endoscopists reported excellent needle sharpness, low puncture resistance, and improved maneuverability, particularly within anatomically challenging regions of the pancreas.

This novel cobalt-chromium 22G Franseen-tip FNB needle demonstrated excellent technical performance, reliable core tissue procurement, and high diagnostic accuracy in EUS-guided sampling of solid pancreatic lesions. The combination of controlled tip penetration and enhanced shaft flexibility appears to facilitate safe, effective access to difficult pancreatic locations and may represent an advancement in EUS-TA technology.