How exactly is a combined laparoscopic and choledochoscopic choledochal stone removal procedure done?

The stones you are referring to are supposed to be removed from the bile ducts inside and outside the liver. Laparoscopy is a procedure in which holes are made in the abdomen and instruments are operated in the peritoneal cavity to deal with the lesion. Choledochoscopy, on the other hand, involves incision of the common bile duct during laparoscopy or dissection, and when stone removal is incomplete with traditional stone extraction tools, choledochoscopy is utilized to enter and explore the bile duct through the opening of the aforementioned incision, and residual stones are found and removed using a special mesh basket. The two intraoperative operations can be used in conjunction to remove stones that cannot be easily removed by simple laparoscopic choledochotomy or cesarean exploratory lithotripsy.

The more common use of the choledochoscope is to place a "T" tube about four weeks into both of these procedures, and then enter the bile ducts through the sinus tracts that encircle the "T" tube to remove the stones, which can be done multiple times for a better and more complete removal of the stones.