The advent of endoscopic ultrasound (EUS) and guided fine needle aspiration (FNA) has significantly altered the management of benign and malignant gastrointestinal, biliary-pancreatic and mediastinal disorders. Over the past two decades, EUS has evolved from being a diagnostic imaging modality to an interventional modality. Several evolving therapeutic applications are paving the way to previously unimaginable procedures such as transluminal endosurgery (Giovannini 2004). The technique of EUS-guided fine needle aspiration (EUS-FNA) forms the basis for all of the more invasive applications such as EUS-guided celiac ganglion neurolysis, pseudocyst drainage, pancreatic necrosectomy, periluminal abscess drainages, transgastric or transduodenal biliary-pancreatic drainage procedures etc (Giovannini 2004; Fritscher-ravns 2006).