Use of the Ambu^® aScope 2^TM in laparoscopic common bile duct exploration

We have recently begun to use a sterile disposable endoscope to perform laparoscopic common bile duct exploration. We evaluated our practice in a large district general hospital and reported the early feasibility of this equipment in performing bile duct exploration.

We began to use the Ambu^® aScope 2^TM from June 2015 in our institution. Any case eligible for a laparoscopic common bile duct exploration was included. Our study period is from June 2015 to November 2015. Data were collected and analysed retrospectively.

Thirteen patients were included. Nine were female and five were male. The mean age was 59 years old (range 28 to 82 years). Seven were performed as an emergency and six were performed for elective cases. All patients had common bile duct stones with no history of previous cholecystectomy. The Ambu^® aScope 2^TM was used in 11 cases, and a standard choledocoscope was used in two cases due to lack of availability of the Ambu^® aScope 2^TM. There was one conversion due to an impacted bile duct stone and technical difficulty intra-operatively. Five cases were performed as a transcystic exploration with 1 case being converted to a choledocotomy due to inability to pass the cystic duct using the Ambu^® aScope 2^TM. The mean operating time was 158 min (range 85-255 min). The mean operative time using the reusable endoscope was 130 min. The mean postoperative stay was 3 days (range 0-8 days).

The use of the Ambu^® aScope 2^TM is safe and feasible in laparoscopic common bile duct exploration. It confers significant financial benefits and offers an economical alternative to expensive reusable endoscopes.