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.