Introduction: The Importance of Ultrasound in a Surgical Practice

Parks, Kevin Ryan; Hagopian, Ellen J.

doi:10.1007/978-1-4614-9599-4_1

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Harlow et al suggest from their experience in treating breast carcinoma "that an individual facile with the technique and interpretation of ultrasound be present in the operating room" and that "surgeons who are in the early stages of their experience with ultrasound will be best served by having radiology assistance until they can reliably identify all lesions themselves in patients on whom this procedure is done" [10]. It is considered that after completion of general ultrasound training, the learning curve for screening liver metastases is a minimum of 25 intraoperative examinations, while the learning curve for interventional techniques such as radiofrequency ablation of liver lesions is at least 50 maneuvers [11].…”

Section: Discussionmentioning

confidence: 99%

Surgical Planning of Hepatic Metastasectomy Using Radiologist-Performed Intraoperative Ultrasound

Menard¹,

Jalink²,

O’Malley³

et al. 2020

JSO

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Background: Intraoperative ultrasound (IOUS) of the liver is a useful adjunct for surgical planning during hepatic metastasectomy. This study aims to (1) report the frequency of change in operative plan as a result of IOUS findings and (2) determine whether IOUS is still beneficial after implementing a standardized, comprehensive process of preoperative hepatic imaging. Methods: First, a retrospective review of all patients undergoing hepatic metastasectomy at a single institution was conducted to identify how frequently IOUS findings altered the surgical plan. Second, a prospective study was conducted where patients underwent both preoperative CT and MRI within 30 days before surgery to determine if IOUS may still have benefit despite the implementation of a standardized preoperative imaging protocol. Results: In the retrospective review, 39 liver resections were completed; 100% and 36% of patients underwent preoperative CT and MRI, respectively. The mean time between preoperative imaging and surgery was 46 days (7-126). Operative plans were changed in 10/39 (26%) cases based on IOUS. After the standardization of preoperative imaging, 27 liver resections were performed. All patients underwent preoperative CT and MRI; the mean time between preoperative imaging and surgery was 20 days (1-98) (p=0.001). The operative plan was amended in 5/27 (19%) cases based on IOUS (χ 2=1.405, p=0.24). Conclusion: Even after standardizing the quality and timing of preoperative imaging, the operative plan was changed in nearly 1/5 patients due to IOUS. These findings demonstrate the utility of IOUS in surgical planning for hepatic metastasectomy and provide the basis for a quality improvement strategy regarding standardized preoperative imaging.

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Section: Discussionmentioning

confidence: 99%

Surgical Planning of Hepatic Metastasectomy Using Radiologist-Performed Intraoperative Ultrasound

Menard¹,

Jalink²,

O’Malley³

et al. 2020

JSO

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“…Even today, in the era of high-resolution MR and CT, IOUS, or more precisely, contrast-enhanced intraoperative ultrasound (CEIOUS), have superior qualities [16,18], and their accuracy has a fundamental effect on surgical strategies in liver surgery [19,20]. Nevertheless, the intra-operative use of US requires expertise, with a notable learning curve of 40 pancreatic and 50 liver cases [21]. Other potential problems include a lack of precise visibility in subcapsular areas and lesions less than 5 mm [22,23].…”

Section: Where Do We Stand?mentioning

confidence: 99%

Intraoperative Imaging in Hepatopancreatobiliary Surgery

Husarova,

MacCuaig,

Dennahy

et al. 2023

Cancers

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Hepatopancreatobiliary surgery belongs to one of the most complex fields of general surgery. An intricate and vital anatomy is accompanied by difficult distinctions of tumors from fibrosis and inflammation; the identification of precise tumor margins; or small, even disappearing, lesions on currently available imaging. The routine implementation of ultrasound use shifted the possibilities in the operating room, yet more precision is necessary to achieve negative resection margins. Modalities utilizing fluorescent-compatible dyes have proven their role in hepatopancreatobiliary surgery, although this is not yet a routine practice, as there are many limitations. Modalities, such as photoacoustic imaging or 3D holograms, are emerging but are mostly limited to preclinical settings. There is a need to identify and develop an ideal contrast agent capable of differentiating between malignant and benign tissue and to report on the prognostic benefits of implemented intraoperative imaging in order to navigate clinical translation. This review focuses on existing and developing imaging modalities for intraoperative use, tailored to the needs of hepatopancreatobiliary cancers. We will also cover the application of these imaging techniques to theranostics to achieve combined diagnostic and therapeutic potential.

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“…The examination can be performed by physicians specialized in imaging diagnosis, but the most benefits could be obtained from surgeons by transforming ultrasound into an "extension" of the hands, under the conditions of the routine use in the operating room. For therapeutical purposes the learning curve is considered to be completed after 40 examinations of the pancreas and 50 of the liver [26]. For surgeons, this can be obtained only after obtaining the competence in general ultrasound, basic levels of knowledge being mandatory for obtaining optimum results.…”

Section: Equipment and Techniquesmentioning

confidence: 99%

Intraoperative ultrasound in liver and pancreatic surgery

et al. 2020

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This paper summarizes the current knowledge of intraoperative ultrasonography (IOUS) in open and laparoscopic ab-dominal surgery. The abdominal IOUS contributes to the diagnosis and staging (for parenchymal organ tumors), to establish surgical procedure and to guide surgical maneuvers. The main applications are represented by liver, biliary tract and pancreatic pathology. Diagnostic approaches are frequently combined with therapeutic purposes. The technique, equipment, training, benefits and limits of IOUS in abdominal surgery are discussed and cases from our experience are used as examples.

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Introduction: The Importance of Ultrasound in a Surgical Practice

Cited by 4 publications

References 16 publications

Surgical Planning of Hepatic Metastasectomy Using Radiologist-Performed Intraoperative Ultrasound

Surgical Planning of Hepatic Metastasectomy Using Radiologist-Performed Intraoperative Ultrasound

Intraoperative Imaging in Hepatopancreatobiliary Surgery

Intraoperative ultrasound in liver and pancreatic surgery

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