Direct electrohydraulic lithotripsy with a novel peroral cholangioscope through the overtube for surgically-altered anatomy

Endoscopic management of choledocholithiasis in patients with surgically altered anatomy is challenging and likely to be difficult [1] [2]. Although the mother–baby type of peroral cholangioscopy is a useful modality, there are some limitations when using the mother scope, related to the working channel diameter and extended scope length [3] [4]. In this video, we present a direct electrohydraulic lithotripsy (EHL) using a novel type of cholangioscope without a mother scope in a patient with Roux-en-Y reconstruction.