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• EHL and Holmium Laser. While the SpyBite is best suited to
diagnose indeterminate strictures, electrohydraulic lithotripsy (EHL)
and Holmium Laser lithotripsy are ideal for managing large (>1cm)
stones, impacted stones that are stuck on bile walls or intrahepatic
stones caught in difficult areas. Both of these technologies provide
the same efficiency in breaking up and gathering stones. The only
difference is that the Holmium Laser features a pointing device to
aim before it executes the procedure. Here's how it works: a tiny
probe, plugged into a generator, is passed down through the
SpyGlass to align itself with the stone. Using the generator and
pump, the provider activates the device to fragment the stones into
more manageable bits to gather. At this point, traditional devices
like extraction balloons and retrieval baskets are then passed down
to gather the remaining pieces. With the initial help of EHL or the
Holmium Laser, Boston Scientific boasts a 75% success rate in
removing all stones from bile ducts.
