
ADVANTAGES:
Expedites LCBDE
Provides systematic procedural methods for destruction & extraction of physiologic calculi from biliary tree
Minimizes potential injury hazards due to inadvertent migration of stone or fragments into intrahepatic ducts or liver
Applicable to vast majority of choledocholithiasis patients, including most difficult cases
Choledochoscope and multiple tools are deployed via MIG through a single laparoscopic port site
Compatible w/ available instrumentation
Fast, precise introduction of choledochoscope via choledochotomy
Prevention of damage to choledochoscope during insertion and manipulation by use of grasping forceps
Facilitates use of several tools simultaneously (E.G. balloon catheter and basket or lithotripter), with real-time video viewing through choledochoscope
Irrigation is possible while tool in use to improve visualization
Tool easily repositioned 180 degrees to facilitate visualization of intrahepatic biliary ducts
Less wasted motion inserting and removing scope and tools
Greater control of insertion of
choledochoscope
Controls pneumoperitoneum (prevents excessive Loss of CO2 and loss
of operative space)
Precludes need for ERCP (minimizes associated risk of pancreatitis)
Does not require injection of x-ray contrast medium (an implicated causitive agent in pancreatitis associated with ERCP procedures)