This technique improves insertability and safety in endoscopic laser lithotripsy for stone fragmentation, suggesting a valuable tool in complex cases.
Endoscopic laser lithotripsy (ELL) can be indicated for stone fragmentation or tumor ablation [1] [2] [3]. A 9-Fr pancreatocholangioscope (eyeMAX, Micro-Tech, Nanjing, China) has recently become available. Although operability and insertion into the target site are easy owing to the slimness of this new scope, the working channel is also small, meaning insertion of accessory devices into the scope may be challenging. In particular, owing to the high rigidity of the ELL probe, this may become lodged within the channel if the scope is significantly angulated, making it impossible to advance the probe through the thin endoscope. To overcome this limitation, we recently performed ELL assisted by a micro-ERCP catheter (3 Fr; Damon ERCP catheter, HANACO Medical Co., Ltd., Saitama, Japan) ([Fig. 1]). Herein we describe some technical tips for ERCP catheter-assisted ELL.
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Ogura et al. (2025) studied this question.
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