Prospective Case Series to Determine the Feasibility, Diagnostic Yield and Safety of Performing EBUS Guided Trans‐Bronchial Mediastinal Cryobiopsy ( EBUS ‐ TBMC ) of Lymph Nodes Using 1.1 mm Cryoprobe Through a Working Channel of Linear EBUS Bronchoscope Versus Conventional En‐Bloc Cryobiopsy

ABSTRACT EBUS‐guided trans‐bronchial mediastinal cryobiopsy (EBUS‐TBMC) improves diagnostic yield over EBUS‐TBNA but conventionally requires en‐bloc removal of bronchoscope and frozen specimen, risking loss of airway control and procedural inefficiency. Retrieval of cryobiopsy specimens through‐working channel (TWC) may address these limitations, but its feasibility and diagnostic adequacy are uncertain. Prospective evaluation was completed of 13 patients undergoing EBUS‐TBMC at a single centre (August 2025 to January 2026). A 1.1 mm Erbe cryoprobe was advanced through an echobronchoscope with a 2.2 mm working channel ( BF‐UC190F , Olympus Medical, Japan) via needle tract formed via EBUS‐TBNA. Fourteen lymph node stations underwent paired en‐bloc and TWC biopsies. Paired biopsies were completed in 92.3% of targets. Median specimen size was equivalent (3 mm each; p = 0.197). Diagnostic yield was 93% (en‐bloc) versus 79% (TWC); p = 0.48; versus 46% (EBUS‐TBNA). There were no post procedural complications. TWC cryobiopsy using a 1.1 mm probe through a standard 2.2 mm working channel is feasible and safe compared to conventional en‐bloc cryobiopsy.