The knife is not used frequently in endoscopic surgery due to the problems associated with the safety of a blade, which cannot be closed or deactivated. However it does have some important uses.
In our practice a disposable blade (Beaver) is mounted on a metal rod, which has a socket at the distal end into which it can be screwed.
The most common use of the knife is for opening the hepatic duct or common bile duct during exploration for stones. A small, clean cut, linear stab wound is created in the anterior wall. Great care is required during incision and removal of the knife. However a sharp curved scissors is better and safer than the endoknife for the choledochotomy.