HPB ultrasound guidance techniques - Targeting

Area of Science:

• Hepatobiliary surgery
• Minimally invasive surgical techniques
• Medical imaging and interventional procedures

Background:

• Ultrasound is essential for intraoperative assessment and treatment of hepatopancreatobiliary (HPB) pathology.
• Minimally invasive surgery and parenchymal-sparing liver resections are increasingly important in HPB surgical practice.
• Effective targeting is critical for successful surgical interventions in the HPB region.

Purpose of the Study:

• To review techniques for intraoperative targeting of liver lesions for biopsy and ablation.
• To focus on targeting methods applicable in the laparoscopic setting for HPB surgery.
• To highlight the role of ultrasound in guiding these procedures.

Main Methods:

• Discussion of patient positioning and port placement optimization for targeting.
• Review of current evidence supporting ablation for liver lesions (e.g., hepatocellular carcinoma, colorectal cancer metastases).
• Emphasis on techniques for precise lesion localization during minimally invasive procedures.

Main Results:

• Ablation is supported by evidence for various liver lesions, especially smaller ones.
• Optimal patient positioning and port placement are key to successful targeting.
• Strategic sequencing of treatment for multiple lesions is vital for maintaining visualization and outcomes.

Conclusions:

• Skillful intraoperative targeting using ultrasound is increasingly vital in HPB surgery, particularly with the rise of minimally invasive and parenchymal-sparing approaches.
• Laparoscopic techniques for targeting liver lesions for biopsy and ablation are a key focus.
• Optimizing patient setup and treatment strategy are critical for successful outcomes in HPB interventions.