Learning objectives
- To review the value of laparoscopic intraoperative ultrasound (LIOUS) in liver surgery,
especially in cases of minimal parenchymal resection.
- To describe some signs,
findings and tricks of LIOUS to be taken into account before,
during and after laparoscopic liver resections.
Background
Until now,
different studies have highlighted the importance of intraoperative ultrasound in open surgery,
delimitating hepatic resection and its utility in the diagnosis of new liver lesions.
However,
in recent years,
LIOUS has gained greater importance due to the increased widespread of laparoscopy,
especially in the liver surgery field.
Findings and procedure details
Along with inspection and palpation,
intraoperative ultrasound (IOU) has been considered the "gold standard" in the detection of liver tumor lesions.
Although IOU is not globally extended,
it allows real-time guided liver surgery,
especially in difficult cases,
playing an important role when major preservation of parenchyma is necessary,
improving safety of the procedure and postoperative outcome [1,
2].
Nowadays it should be an essential tool in any liver surgical procedure,
especially in those with oncological purpose,
as it provides information on the number,
topography and...
Conclusion
LIOU is an essential tool in any liver surgical procedure,
especially for oncological purposes,
not only providing information about the topography and the relationship of known lesions,
but also improving the detection of new tumors,
allowing better or greater selection of patients for liver surgery.
Apart from this,
it also helps to ensure the section margins and the oncological safety,
guiding the resection and reducing some of the technical limitations of laparoscopy.
References
1- Marcal LP,
Patnana M,
Bhosale P,
Bedi DG.
Intraoperativeabdominalultrasoundinoncologicimaging.
World J Radiol.2013;5:51-60
2- Solomon MJ,
Stephen MS,
Gallinger S,
White GH.
Does intraoperative hepaticultrasonographychangesurgicaldecision making duringliverresection? Am J Surg.
1994;168:307-10
3- Araki K,
Conrad C,
Ogiso S,
Kuwano H,
Gayet B.
Intraoperative ultrasonography of laparoscopic hepatectomy: key technique for safe liver transection.
J Am Coll Surg.
2014;218:e37-41
4- Castaing D,
Emond J,
Kunstlinger F,
Bismuth H.
Utilityofoperativeultrasoundin thesurgicalmanagementofliver tumors.
Ann Surg.
1986;204:600-5
5- Parker GA,
Lawrence W,
Horsley JS,
Neifeld JP,
Cook D,
Walsh...