[Intraoperative ultrasonography during laparoscopic surgery].

Area of Science:

• Minimally Invasive Surgery
• Diagnostic Imaging
• Surgical Oncology

Background:

• Laparoscopic surgery offers numerous benefits but requires effective intraoperative visualization.
• Assessing biliary tree pathology and detecting malignancy during laparoscopy presents challenges.
• Traditional methods like cholangiography have limitations.

Purpose of the Study:

• To introduce and evaluate the efficacy of laparoscopic ultrasonography (LUS) in a prospective surgical setting.
• To assess LUS as an alternative to cholangiography for common bile duct (CBD) pathology.
• To explore the utility of LUS in evaluating abdominal malignancies.

Main Methods:

• A prospective study involving 37 patients undergoing laparoscopic surgery.
• Utilized an Aloka SSD 2000 mobile scanner with a flexible linear-array transducer and Doppler capabilities.
• LUS was frequently employed during laparoscopic cholecystectomy and in cases of suspected malignancy.

Main Results:

• LUS was successfully performed in all cases, visualizing the distal CBD (89.2%) and common hepatic duct (97.3%).
• Identified biliary disorders in 6/27 cholecystectomy cases, including CBD stones.
• Demonstrated high visualization quality (83.8% very good) and effective use of Doppler for structure differentiation.
• Accurately excluded liver metastasis in a colon cancer case.

Conclusions:

• LUS integrates diagnostic laparoscopy with intraoperative ultrasonography advantages.
• It is a simple, efficient, and recommended technique for intraoperative CBD exploration.
• LUS enhances abdominal malignancy assessment, potentially altering therapeutic strategies.
• Color Doppler mode aids surgeons in complex surgical directions.