[Laparoscopic ultrasonography in laparoscopic surgery and diagnosis]

The authors report their experience with 101 patients examined with laparoscopic ultrasound (LU) using a dedicated 7.5-MHz linear probe which can be introduced through the 10-mm surgical trocars. In the patients undergoing laparoscopic cholecystectomy (77 cases), LU adequately demonstrated gallbladder wall and contents in all cases and visualized the main bile duct in 93.5% of cases; stones of the CBD or cystic duct were demonstrated in two cases. The liver was studied in 18 patients undergoing diagnostic laparoscopy or laparoscopic colonic resection: secondary lesions were identified in two cases, while benign lesions (cysts or angiomas) were seen in 6 cases. In the patients operated on for colonic resection (8 cases), LU was successfully used to localize the enteric tract affected by the tumor and to mark safety margins for excision. The technical features of the exam are reported and the main imaging findings discussed. The authors conclude that LU is a safe method which is easy to perform and does not significantly increase the operating time; the indications of this laparoscopic application of ultrasound are not yet defined but the application area will certainly widen in the future, as operative and diagnostic laparoscopy are more and more frequently used by surgeons.