Laparoscopic and intraoperative ultrasound

被引:16
作者
Bezzi, M [1 ]
Silecchia, G [1 ]
De Leo, A [1 ]
Carbone, I [1 ]
Pepino, D [1 ]
Rossi, P [1 ]
机构
[1] Univ Rome La Sapienza, Cattedra 3, Dept Radiol, I-00161 Rome, Italy
关键词
laparoscopy; laparoscopic surgery; intraoperative ultrasound; laparoscopic ultrasound;
D O I
10.1016/S0720-048X(98)00064-3
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective. Intraoperative ultrasound has gradually expanded in the last two decades to a variety of surgical specialties and has gained an established role in many surgical procedures. Laparoscopic and thoracoscopic ultrasound are the latest modes of intraoperative sonography. They have been introduced mainly to overcome the two major drawbacks of laparoscopy, i.e. the capability of showing only the surface of the organs and the lack of manual palpation of the anatomical structures. We review and discuss the established and the most recent applications of intraoperative and laparoscopic ultrasound. Material and methods. The technology, new indications and results of intraoperative and laparoscopic ultrasound are reviewed. This review is based on the experience gained in our Institution during more than 500 surgical procedures and the analysis of the literature on the subject. Results. The yield of intraoperative and laparoscopic ultrasound consists in confirming preoperative studies and acquiring new data which would not be available otherwise. An important role of these techniques is determining the anatomy of the involved organs, thus providing a guidance for surgery. Both techniques have an important role in surgical decision-making, particularly with respect to hepatic, biliary and pancreatic malignancies. In some series the rate of major changes in the surgical strategy can be as high as 38%. A relatively new application of intraoperative ultrasound is the possibility to perform interstitial therapy of tumors at the time of the initial surgery. This can be useful, for example, in patients undergoing liver resection, when other unresectable lesions are found in a different segment or in the contralateral lobe. Finally, laparoscopic sonography has an important role in staging abdominal neoplasm, providing more information than preoperative imaging and laparoscopic exploration.;This feature can be used to effectively stage gastrointestinal malignancies, pancreatic carcinoma, and abdominal lymphomas. Conclusion. The application of intraoperative ultrasound will increase in the era of minimally access surgery and this will be dependent not only on technical improvements in ultrasound technology. Indeed, it may be expected that a variety of open procedures will be performed with videolaparoscopic monitoring and will need the guidance of laparoscopic sonography. In the future, the staging of abdominal neoplasm may be markedly improved by laparoscopy combined with laparoscopic ultrasound; however a cost-benefit analysis of these techniques and a comparison with preoperative tests should be carried out. (C) 1998 Elsevier Science Ireland Ltd. Ah rights reserved.
引用
收藏
页码:S207 / S214
页数:8
相关论文
共 30 条
[1]   Accuracy of laparoscopic ultrasonography in the staging of upper gastrointestinal malignancy [J].
Anderson, DN ;
Campbell, S ;
Park, KGM .
BRITISH JOURNAL OF SURGERY, 1996, 83 (10) :1424-1428
[2]   THE ULTRASONIC-DETECTION OF INSULINOMAS DURING SURGICAL EXPLORATION OF THE PANCREAS [J].
ANGELINI, L ;
BEZZI, M ;
TUCCI, G ;
LIRICI, MM ;
CANDIANI, F ;
RUBALTELLI, L ;
TREMOLADA, C ;
TAMBURRANO, G ;
FEGIZ, G .
WORLD JOURNAL OF SURGERY, 1987, 11 (05) :642-647
[3]  
BARTEAU JA, 1995, SURG ENDOSC-ULTRAS, V9, P490
[4]  
BEMELMAN WA, 1995, J AM COLL SURGEONS, V181, P421
[5]   DIAGNOSTIC LAPAROSCOPY COMBINED WITH LAPAROSCOPIC ULTRASONOGRAPHY IN STAGING OF CANCER OF THE PANCREATIC HEAD REGION [J].
BEMELMAN, WA ;
DEWIT, LT ;
VANDELDEN, OM ;
SMITS, NJ ;
OBERTOP, H ;
RAUWS, EJA ;
GOUMA, DJ .
BRITISH JOURNAL OF SURGERY, 1995, 82 (06) :820-824
[6]  
Bezzi M, 1995, Radiol Med, V89, P82
[7]   LAPAROSCOPIC SONOGRAPHY DURING ABDOMINAL LAPAROSCOPIC SURGERY - TECHNIQUE AND IMAGING FINDINGS [J].
BEZZI, M ;
MERLINO, R ;
ORSI, F ;
DINARDO, R ;
SILECCHIA, G ;
BASSO, N ;
PASSARIELLO, R ;
ROSSI, P .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1995, 165 (05) :1193-1198
[8]  
BEZZI M, 1996, SURG ENDOSC, V10, P195
[9]  
Champault G, 1996, ANN CHIR, V50, P875
[10]  
CHRISTENSEN AH, 1970, ARCH PATHOL, V90, P423