Although laparoscopic surgery is a less invasive technique for
abdominal surgery, a drawback is the fact that it visualizes only
the surface of the abdominal cavity and may miss abnormalities
within solid abdominal organs, such as the liver. The use of laparoscopic
ultrasound during laparoscopic surgery offers improved resolution,
as the probe is placed directly on the liver surface, rather than
on the skin surface, as in a routine ultrasound examination. In
addition to providing increased proximity of the ultrasound probe
to the organ being examined, laparoscopic liver sonography increases
sensitivity for the detection of small lesions and provides blood
flow information when used with color Doppler and duplex Doppler.
In a study conducted by Rick I. Feld, md, and coworkers at the
Thomas Jefferson University Hospital, the new ultrasound probe
was studied in 13 patients who underwent laparoscopic surgery.
Each of the patients underwent CT arterial portography (CTAP)
prior to surgery.
"In our preliminary series, laparoscopic ultrasound assisted
surgeons in critical decision-making by providing important new
information, clarifying questionable areas, complementing the
results of CTAP, or providing ultrasound guidance for biopsy,"
said Dr. Feld.
The study found that in 31% (4/13) of the patients, laparoscopic
ultrasound directly influenced surgical management. In 23% of
the patients studied, laparoscopic ultrasound provided guidance
for biopsy or added important anatomic information. In another
23%, laparoscopic ultrasound was found to be complementary to
CTAP but added no additional information. In the remaining 23%
of cases, laparoscopic ultrasound either added no information
(two cases; 15%) or was falsely negative (one case; 8%).
Dr. Feld presented his findings at the American Institute of Ultrasound
in Medicine's 40th Annual Convention held March 20 in New York.