NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
Status In progress
Process IP
ID number 1789
Description Laser lithotripsy aims to fragment bile duct stones that cannot be treated using conventional endoscopic stone removal techniques. This procedure is usually performed with the patient under sedation. In this procedure, an endoscope is inserted into the biliary track and the stone can be observed under direct visualisation. The laser fibre is introduced gently through the working channel of the visualisation system. Once the tip of the fibre is in direct contact with the stone, a laser is then focussed on the surface of the stone to create a plasma bubble, which oscillates and induces cavitation with compressive waves to fragment the stone under direct visualisation. When the fragmentation is complete, small pieces are removed by conventional methods (e.g. a basket or balloon catheter), while small sand-like pieces may be retained and will be gradually passed through the body. The endoscope is then removed. This procedure usually takes 30 to 60 minutes to complete.

Provisional Schedule

Expected publication 26 May 2021


Key events during the development of the guidance:

Date Update
15 January 2021 - 12 February 2021 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance