[Laparoscopic ultrasonography. A review and authors' own experiences]

Laparoscopic ultrasound scanning has long been available, but interest in and reports of the technique have until the last few years been sporadic. The rapid development and growing interest in laparoscopic surgery as well as the advent of commercially available systems designed for laparoscopic ultrasound have resulted in renewed interest in the technique. The available published reports lack prospective, controlled clinical studies with respect to where and when laparoscopic ultrasound would be indicated. A favourable picture is given as concerns the use of laparoscopic ultrasound in the diagnosis and evaluation of primary liver and pancreas tumours as well as liver metastases. Laparoscopic ultrasound is also mentioned as a reliable alternative to cholangiography in laparoscopic cholecystectomy. Our own preliminary experiences with two laparoscopic ultrasound systems and a simple system using an ultrasound finger-probe are described. A laparoscopic ultrasound scanning system consisting of a stiff instrument with a convex (linear) transducer mounted on a flexible support and with the possibility of ultrasound-guided biopsy and colour-Doppler seems optimal. Prospective studies are being carried out to identify areas of utilization and limitations of laparoscopic ultrasound.