Intraoperative ultrasonography in open and laparoscopic abdominal surgery: an overview

Jakimowicz, Jack J.

doi:10.1007/s00464-006-0035-2

Cited by 41 publications

(26 citation statements)

References 101 publications

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“…In the late 1980s and early 1990s, several studies proved IOUS to be more accurate in detecting liver metastases than the existing scanning methods, including extracorporeal US, CT, MRI, and surgical exploration [14,15,16,17]. In our study, ILUS was used to look for satellite lesions in all malignant cases; however, there were no positive findings.…”

Section: Discussionmentioning

confidence: 69%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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Objective: To evaluate the value of intraoperative laparoscopic ultrasonography (ILUS) in retrolaparoscopic nephron-sparing surgery. Methods: A total of 81 cases were studied during a 5-year period: 38 patients with a benign renal tumor who underwent enucleation of the tumor and 43 patients with a suspected malignant renal tumor who underwent wedge resection of the tumor. ILUS was used to evaluate renal perfusion, locate the tumor, precisely delineate the tumor border, characterize the tumor, and look for any suspected satellite renal masses. Results: All procedures were successful without conversion to open surgery. The mean operating time was 106 min for enucleation (range 70– 150 min) and 114 min for wedge resection (range 80– 235 min). The mean size of benign tumors was 4.02 cm and that of malignant tumors was 3.13 cm, and all margins were negative. An additional renal artery branch was detected in 11 patients. In 2 cases the operative procedure was changed based on the ILUS findings. No satellite lesion was found in any of the patients with malignant tumors. Conclusions: ILUS provides significant benefit in retrolaparoscopic nephron-sparing surgery. In a number of situations, especially endogenic lesions, it is an essential surgical tool.

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Section: Discussionmentioning

confidence: 69%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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“…Recent publications also confirm the ability of LUS to detect neuroendocrine tumors of the pancreas as small as 3-5 mm in diameter [23,26,27]. The ability of intraoperative ultrasound to detect extrahepatic gastrinoma is lower (about 58%) (Level III) [28,29].…”

Section: Risks and Benefitsmentioning

confidence: 88%

SAGES guidelines for the use of laparoscopic ultrasound

et al. 2009

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PreambleThe use of ultrasound in the operating room by surgeons is increasing, and the indications and use of ultrasound by laparoscopists and endoscopists are evolving. These guidelines are intended to provide current recommendations for the use and benefits of laparoscopic ultrasound (LUS) for the surgeon. They are not intended to show the only uses and applications but rather ones for which data are available to make a recommendation. Recommendations are based on the current medical evidence and are graded according to that evidence. DisclaimerClinical practice guidelines are intended to indicate the best available approach to medical conditions as established by systematic review of available data and expert opinion. The approach suggested may not be the only acceptable one given the complexity of the health care environment. These guidelines are intended to be flexible, as the surgeon must always choose the approach best suited to the patient and to the variables in existence at the time of the decision. These guidelines are applicable to all physicians who are appropriately credentialed and address clinical situations regardless of specialty.Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and its guidelines committee and approved by the Board of Governors. The recommendations for each guideline undergo multidisciplinary review and are considered valid at the time of production based on the data available. Recent developments in medical research and practice pertinent to each guideline will be reviewed, and guidelines will be updated on a periodic basis. Literature review methodsA moderate body of literature applies to LUS. Our systematic literature search of MEDLINE for the period 1966 through May 15, 2007, limited to English-language articles, identified 146 relevant reports. The search strategy used the terms The articles were divided into the following categories:(a) Randomized studies, meta-analyses, and systematic reviews (b) Prospective studies (c) Retrospective studies (d) Case reports (e) Review articles All case reports, old reviews, and smaller studies were excluded.

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“…16,17 Color Doppler flow imaging facilitates to delineate the anatomy and to identify the vascular structures invading malignant tumors. [18][19][20][21][22] Recently, advanced navigation techniques have been introduced, such as 3D-CT angiography and intraoperative ultrasonography.…”

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confidence: 99%

Clinical Impact of Intraoperative Navigation Using a Doppler Ultrasonographic Guided Vessel Tracking Technique for Pancreaticoduodenectomy

Maemura

Mataki

Kurahara

et al. 2014

International Surgery

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During pancreaticoduodenectomy (PD), early ligation of critical vessels such as the inferior pancreaticoduodenal artery (IPDA) has been reported to reduce blood loss. Color Doppler flow imaging has become the useful diagnostic methods for the delineation of the anatomy. In this study, we assessed the utility of the intraoperative Doppler ultrasonography (Dop-US) guided vessel detection and tracking technique (Dop-Navi) for identifying critical arteries in order to reduce operative bleeding. Ninety patients who received PD for periampullary or pancreatic disease were enrolled. After 14 patients were excluded because of combined resection of portal vein or other organs, the remaining were assigned to 1 of 2 groups: patients for whom Dop-Navi was used (n ¼ 37) and those for whom Dop-Navi was not used (n ¼ 39; controls). We compared the ability of Dop-Navi to identify critical vessels to that of preoperative multi-detector computed tomography (MD-CT), using MD-CT data, as well as compared the perioperative status and postoperative outcome between the 2 patient groups. Intraoperative Dop-US was significantly superior to MD-CT in terms of identifying number of vessels and the ability to discriminate the IPDA from the superior mesenteric artery (SMA) based on blood flow velocity. The Dop-Navi patients had shorter operation times (531 min versus 577 min; no significance) and smaller bleeding volumes (1120 mL versus 1590 mL; P , 0.01) than the control patients without increasing postoperative complications. Intraoperative DopNavi method allows surgeons to clearly identify the IPDA during PD and to avoid injuries to major arteries.Key words: Pancreaticoduodenectomy -Doppler ultrasonography -Blood flowmeter P ancreaticoduodenectomy (PD) is a standard treatment for malignant tumor of periampullary and pancreas head. As lymphatics (lymph node and lymph vessels) accompany the arteries and are distributed in the surrounding neural plexuses, complete clearance of peripancreatic tissue, including lymphatics and nerve plexus, is necessary for curative resection of the tumor. [1][2][3][4] As this operation is considered a complex procedure, a surgeon is required to be well trained in this specific surgical technique and to possess sufficient anatomic knowledge.Despite a low mortality rate and improvements in perioperative care and operative management, there is still a relatively high complication rate following PD. 5,6 Several studies showed that intraoperative bleeding and red blood cell (RBC) transfusion are serious risk factors of postoperative complications in PD. 6,7 Recently, several procedures for artery-first approaches such as posterior, uncinated, and mesenteric approach have been introduced for improving perioperative outcomes such as curability and decreasing blood loss and morbidity. [8][9][10][11] Incidentally, it has been well known that early ligation of the inferior pancreaticoduodenal artery (IPDA)-one of the efferent arteries of the pancreas head-considerably reduces intraoperative bleeding and postoperative co...

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Intraoperative ultrasonography in open and laparoscopic abdominal surgery: an overview

Cited by 41 publications

References 101 publications

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

SAGES guidelines for the use of laparoscopic ultrasound

Clinical Impact of Intraoperative Navigation Using a Doppler Ultrasonographic Guided Vessel Tracking Technique for Pancreaticoduodenectomy

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