Application of laparoscopic intraoperative ultrasound in laparoscopic hepatic resection for liver tumor

Laparoscopic or robotic surgery accounts for an increasing proportion of liver surgery. However, the lack of haptic feedback results in a certain amount of risk. The use of laparoscopic ultrasound (LUS) enables the operator to observe internal structures of the liver in real time to easily avoid the main blood vessels. It also allows for the detection of tumor boundaries and the extent of tumor thrombi, considerably improving the success rate of the operation. Besides its advantages in detecting small lesions that are not detectable through preoperative imaging, thus assisting diagnosis and staging, the LUS can also be used to monitor ablation therapy, portal vein puncture staining, and lesion blood perfusion. Recent advances in technology like contrast-enhanced intraoperative ultrasound and real-time virtual sonography can help surgeons better perform laparoscopic surgery. For liver surgeons, LUS is an essential technique for safely performing laparoscopic surgery, making their proficiency in the use of LUS vital. This article reviews the application of LUS in laparoscopic hepatic resection of liver tumors and the new technology of LUS to help liver surgeons understand the current application status of LUS and the future research directions.