Description This “How I Do It” presentation demonstrates my approach to the intraductal treatment of salivary stones using pneumatic lithotripsy. The technique is presented step by step, including endoscopic identification of the stone, positioning and application of the pneumatic probe, fragmentation under direct vision, and removal of the resulting fragments. Procedural videos illustrate the technique and its practical application in routine sialendoscopic stone treatment.

Background Sialendoscopy has enabled the treatment of many salivary stones through a minimally invasive, gland-preserving approach. Stones that cannot be removed intact may require intraductal fragmentation. Pneumatic lithotripsy provides mechanical fragmentation under direct endoscopic control and has been my principal method of intraductal lithotripsy since 2007.

Outcome Objectives Participants will become familiar with the principles and practical steps of intraductal pneumatic lithotripsy, including probe positioning, controlled fragmentation, and endoscopic removal of stone fragments. They will also gain an understanding of how pneumatic lithotripsy can be integrated into routine sialendoscopic management of salivary stones.

Sialendoscopy relies on delicate and costly endoscopes and micro-instruments that require appropriate handling, cleaning, sterilization and maintenance. This seminar will provide a practical overview of how to safely handle sialendoscopes and related instruments before, during and after procedures. Particular attention will be given to prevention of scope and instrument damage, appropriate cleaning and sterilization protocols, maintenance, troubleshooting, and common errors encountered in daily practice. The session will combine clinical and technical perspectives to provide practical recommendations for prolonging instrument life while maintaining patient safety.