Utilizing a novel highly rotatable and dual‐action sphincterotome for precise cannulation and endoscopic sphincterotomy in surgically altered anatomy.

The article discusses the challenges of performing precise cannulation and endoscopic sphincterotomy in patients with surgically altered anatomy during balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP). A novel highly rotatable and dual-action sphincterotome (ENGETSU) is introduced as a potential solution to orient the blade in any direction, enabling efficient cannulation and incision. The device was successfully used in a case of choledocholithiasis in a patient with Roux-en-Y reconstruction, demonstrating its utility in both normal and surgically altered anatomy. The authors declare no conflict of interest in the study. [Extracted from the article]