Together we shape the future of HPB

Advancing  therapeutic​ options in HPB*​ stone management​

*Hepato-pancreato-biliary

Electrohydraulic Lithotripsy (EHL) with direct visualization​

Leverage a powerful solution to fragment and clear difficult stones.​

Cholangioscopy-assisted lithotripsy is an effective treatment for difficult bile duct stones​

Autolith controler

Managing difficult bile duct stones with balloon or basket catheters can be challenging. This may be due to their location (e.g., stones that are intra-hepatic or in the cystic duct), specific stone features, the anatomical characteristics of the biliary tract, or the patient’s clinical needs.1 Cholangioscopy-assisted lithotripsy with electrohydraulic lithotripsy (EHL) or laser system are effective ESGE-recommended therapeutic options for the management of difficult bile duct stones.*1​

​Results from a recent 2021 meta-analysis evaluating the efficacy and safety of cholangioscopy-assisted lithotripsy contribute to the body of evidence supporting this approach, which showed an overall stone fragmentation success of 95 %, a single session fragmentation and duct clearance of 82% and a rate of 4.6% for the adverse events.2​

*Fragmentation of pancreatic stones is an unapproved indication for use of EHL, including the AutolithTM Touch system.​

The Autolith™ Touch Biliary EHL System is designed for ease of use and efficiency

When conventional stone removal methods are not sufficient to tackle difficult bile duct stones, fragmentation with EHL may be considered as an alternative approach.3 The Autolith™ Touch Biliary EHL System is designed to provide improved patient safety, treatment efficacy, and ease of operation while achieving stone clearance.4 The system is made up of two separate components:

Autolith™ Touch Probe​

  • A 375cm-long single use device optimized for use with the SpyGlass™ DS System​

  • The direct visualization of difficult stones with the SpyGlass™ DS System may also reduce the need for  repeat procedures by enabling more efficient clinical evaluations5​

EHL probe

Autolith™ Touch EHL Generator

  • The generator provides a precise balance of energy to avoid probe power overload, and monitors the probe to alert the user when it needs to be replaced.​

Autolith controler

SpyGlass™ Retrieval Basket​

  • In addition, the SpyGlass™ Retrieval Basket enables the straight forward capture and removal of residual biliary and pancreatic stones and stone fragments. It has also proven efficient to retrieve stones in the intra-hepatic and the cystic duct.6-8​
Spyscope basket

Download the brochure to learn more about​ the Autolith™ Touch Biliary EHL System: 

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Operate with clarity outside of ERCP​

The SpyGlass™ Discover is the only four-way steering single-use digital catheter indicated for use in the pancreaticobiliary system including the hepatic ducts. It represents a comprehensive solution to facilitating stone clearance under direct visualization with alternative approaches, including: ​

  • ​Laparoscopic cholecystectomy with common bile duct exploration (LCBDE; a BSG-recommended solution for common bile duct stone removal in patients undergoing laparoscopic cholecystectomy9)​
  • Percutaneous transhepatic cholangioscopy in cases of failed ERCP, altered anatomy, or in patients with peripheral stones10​

In both cases, SpyGlass™ Discover can be used with the Autolith™ Touch Biliary EHL System to fragment stones and the SpyGlass™ Retrieval Basket to remove stones or stone fragments.​

Explore our solutions for electrohydraulic lithotripsy with direct visualization:​

SpyGlassTM DS Direct Visualization System​

The SpyGlassTM DS system enables direct visualization of the pancreatic and bile ducts. It is used to evaluate suspected benign and malignant conditions and to treat difficult stones and strictures.​

EXALT Model D3

SpyGlass™ Discover Digital Catheter​

The SpyGlass™ Discover System was adapted from the latest SpyGlass™ DS II technology, to enable surgeons to perform intra-operative:  ​

  • ​Common bile duct (CBD) stone clearance, including trans-cystic lithotripsy, during LCBDE​
  • Visual and biopsy-guided mapping of cancer margins during resection of cholangiocarcinoma or main duct intraductal papillary mucinous neoplasms​
  • Visualization and therapeutic treatment via percutaneous access​
SpyGlass DS II clinical SpyBite

Autolith™ Touch Biliary EHL System​

The Autolith Touch 1.9Fr., 375cm EHL Probe is a single-use device and is to be used with the Autolith Touch EHL Generator. The EHL probe was optimized for use with the SpyGlass™ DS Direct Visualization System to help manage large biliary stones.​

Autolith controler

Enabling effcient and effective treatment procedures​

At Boston Scientific, we work tirelessly to deliver innovative solutions that help you offer the best possible patient experience. ​

Extractor pro balloons silho

Stone retrieval with extraction balloons 

Extract with precision using our balloon catheters to achieve stone clearance.​

Stone retrieval with extraction balloons
cre-pro

Dilatation-assisted stone extraction

Dilatate with control to remove difficult common bile duct stones.

Dilatation-assisted stone extraction
trapezoid rx biliary

Mechanical lithotripsy​

Use a combined retrieval and mechanical lithotripsy basket to crush large stones with confidence.

Mechanical lithotripsy​
Advanix family

Stenting​

Reliable drainage options to provide bile duct patency past a stone.

Stenting​
Single hot axios

Gallbladder drainage with Lumen Apposing Metal Stent

A non-surgical treatment option for patients at high risk or unsuitable for surgery.

Gallbladder drainage with Lumen Apposing Metal Stent

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References

1. Stefanidis G, Christodoulou C, Manolakopoulos S, et al. Endoscopic extraction of large common bile duct stones: A review article. World J Gastrointest Endosc. 2012;4(5):167–179.​

​2. Tringali A, Costa D, Fugazza A, et al. Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review. World J Gastroenterol. 2021;27(44):7597–7611.​

​3. Manes G, Paspatis G, Aabakken L et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2019;51(5):472–491.​

​4. McCarty T, Gulati R, Rustagi T. Efficacy and safety of peroral cholangioscopy with intraductal lithotripsy for difficult biliary stones: a systematic review and meta-analysis. Endoscopy. 2021;53(02):110–122.​

​5. Deprez PH, Duran RG, Moreels T, et al. The economic impact of using single-operator cholangioscopy for the treatment of difficult bile duct stones and diagnosis of indeterminate bile duct strictures. Endoscopy. 2018;50(02):109–118.​

​6. Pawa R, Dorrell R, Pawa S. Endoscopic management of cystic duct stones and Mirizzi's syndrome: experience at an academic medical center. Endosc Int Open. 2022 Jan 14;10(1):E135-E144. doi: 10.1055/a-1594-1515.​

​7. Elmunzer BJ. Advanced techniques for pancreaticobiliary stone extraction. VideoGIE. 2020;5(7):324–325.​

​8. Sejpal D, Trindade A, Lee C et al. Digital cholangioscopy can detect residual biliary stones missed by occlusion cholangiogram in ERCP: a prospective tandem study. Endosc Int Open 2019; 07: E608–E614.​

​9. Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut. 2008;57(7):1004–1021.​

​10. Gerges C, Vázquez AG, Tringali A, et al. Percutaneous transhepatic cholangioscopy using a single-operator cholangioscope (pSOC), a retrospective, observational, multicenter study. Surg Endosc. 2021;35(12):6724–6730.

CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France.​​All images owned by Boston Scientific.​