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Practical and Cost-Effective Use of Open-Surgery-Type Ultrasound Probes in Laparoscopic Hepatectomy: A Single-Center
Yoichi Kawano1, Yukio Ohshiro2, Tetsuya Shimizu1
1Department of Gastrointestinal Surgery, Nippon Medical School.
Background:
Laparoscopic hepatectomy (Lap-H) is increasingly being performed in Japan, but the high cost and handling complexity of laparoscopic ultrasonographic (US) probes remain a barrier to its wider adoption. Intraoperative ultrasonography is essential for safe liver resection; however, specialized laparoscopic probes are expensive, have a limited field of view, and are difficult to manipulate.
Methods:
To overcome these limitations, we developed a practical technique using an open-surgery-type microconvex US probe in Lap-H. The probe is inserted via an umbilical incision using a Lap Protector mini™ and EZ Access™, and probe manipulation is achieved through a cord-based control system. We applied this method in over 150 Lap-H cases before the introduction of a dedicated laparoscopic US system.
Results:
This technique enabled the acquisition of axial and sagittal images with a wide and deep field of view, enhancing anatomical orientation and lesion visualization. There were no complications such as air leaks or equipment failure. The method allowed for the use of contrast-enhanced ultrasound and minimized interference with the operative field.
Conclusions:
The use of open-surgery-type US probes in Lap-H offers a cost-effective, safe, and practical alternative to expensive laparoscopic US systems. This innovation may lower the barrier for institutions initiating Lap-H programs and promote the broader adoption of high-quality intraoperative ultrasonography in minimally invasive liver surgery.
