Prince Philip Hospital has become the first and currently only centre in Wales to offer CryoEBUS — a procedure that combines ultrasound guidance with a freezing technique to collect lymph node tissue samples that are larger and better preserved than those obtained through conventional methods.
The technique, known in full as Cryobiopsy Endobronchial Ultrasound, uses special biopsy needles alongside a freezing process to collect tissue from lymph nodes and, in some cases, lung masses. The improved sample quality makes diagnosis more accurate and is increasingly important for the molecular testing now used to guide newer treatments in lung cancer.
The procedure was introduced at Prince Philip Hospital in November 2025 and is performed under conscious sedation. It integrates into existing bronchoscopy and endobronchial ultrasound pathways, combining two sampling techniques into one streamlined procedure — reducing the need for repeat procedures and supporting earlier treatment planning for more complex cases.
The first procedures were carried out by Dr Robin Ghosal, Clinical Director at Prince Philip Hospital and Consultant Respiratory Physician, working alongside Dr Jonathan Fisher-Black, Consultant Respiratory Physician, and the hospital’s Endoscopy team. Dr Ghosal has completed specialist CryoEBUS training to bring the service to west Wales.
“It’s a very new technology which is gaining momentum and Prince Philip Hospital is the first in Wales to use it and one of only a handful in the whole of the UK,” said Dr Ghosal.
He said the improved diagnostic capability represented a real step forward for patients. “This allows us to obtain significantly improved tissue samples while remaining minimally invasive. This has important implications for diagnostic confidence, particularly in complex lymph node pathology, and supports more efficient progression to treatment decisions.”
CryoEBUS is particularly valuable for diagnosing complex respiratory conditions including lymphoproliferative and granulomatous diseases, where sample size and preservation are critical for accurate analysis.
The procedure uses endobronchial ultrasound guidance alongside specialised biopsy needles and a freezing technique, allowing doctors to get larger and better-preserved samples in a single visit rather than requiring multiple procedures. For patients, that means shorter diagnostic pathways and more timely access to treatment.
The technology is becoming increasingly significant as molecular testing takes on a greater role in guiding newer cancer treatments. Better tissue samples mean better molecular analysis — and better molecular analysis means more targeted and effective care.
Dr Ghosal said the procedure also enhances clinicians’ ability to diagnose conditions beyond cancer, including complex lymph node diseases where sample quality has historically been a limiting factor in reaching a confident diagnosis.
“The procedure integrates an innovative technique into established bronchoscopic and endobronchial ultrasound workflows, offering an advanced less invasive option that can reduce the need for repeat procedures and support earlier treatment planning for more complex cases,” he said.
Hywel Dda University Health Board’s Medical Director, Mr Mark Henwood, said the health board was always looking at innovative ways to improve patient care. “I’m very proud that Prince Philip Hospital is leading the way in which we diagnose respiratory diseases,” he said.
“This just goes to show that you don’t have to live in a big city to have access to the most pioneering and effective health care. Congratulations to Robin and his team for all the hard work and training they have put in to bring the CryoEBUS testing to west Wales.”
The adoption of CryoEBUS at Prince Philip Hospital reflects the continued evolution of respiratory diagnostics across NHS services and reinforces the hospital’s commitment to innovation for patients in Carmarthenshire, Ceredigion and Pembrokeshire.
The service is now available as part of the hospital’s standard diagnostic pathway, meaning eligible patients in west Wales can now access a technique previously only available at a handful of centres across the entire UK.
