The endoscope for biliary sphincterotomy is the same as that used for endoscopic retrograde cholangiopancreatography - a side-viewing duodenoscope.
The cutting instrument is a sphincterotome, of which there are a number of types of varying length and shape. All have an exposed wire through which an alternating electric current is passed.
The current generator permits a variety of waveforms and alternation frequencies, e.g. between 0.4 and 1.0MHz. 'Blended current' is most frequently used, a combination of continuous sinusoidal waves and short, interrupted bursts that allows both cutting and coagulation.
Patients should be properly earthed and screened for pacemakers.
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