BACKGROUND: Laparoscopic ultrasonography is increasingly being recognized as an important tool in the evaluation of patients with possible hepatic tumors. The aim of this paper is to describe the technical aspects of imaging and biopsy based on our experience in 310 patients with 1,080 primary and metastatic liver tumors within a 6.5-year period. METHODS: A 10-mm rigid or flexible, 7.5 MHz linear, side-viewing laparoscopic ultrasonography probe was used for imaging, and an 18G spring-loaded core biopsy gun was used for tissue diagnosis. RESULTS: There were no complications. The entire liver was imaged using a right subcostal port. Using a free-hand technique, the needle was best targeted into the lesion when inserted parallel to the plane of the transducer. The rigid transducer was found to be more convenient to guide needle placement. CONCLUSIONS: The use of this minimally invasive technique avoids laparotomy in many patients undergoing staging of malignancy and also offers increased sensitivity for tumor detection compared with conventional imaging modalities.
BACKGROUND: Laparoscopic ultrasonography is increasingly being recognized as an important tool in the evaluation of patients with possible hepatic tumors. The aim of this paper is to describe the technical aspects of imaging and biopsy based on our experience in 310 patients with 1,080 primary and metastatic liver tumors within a 6.5-year period. METHODS: A 10-mm rigid or flexible, 7.5 MHz linear, side-viewing laparoscopic ultrasonography probe was used for imaging, and an 18G spring-loaded core biopsy gun was used for tissue diagnosis. RESULTS: There were no complications. The entire liver was imaged using a right subcostal port. Using a free-hand technique, the needle was best targeted into the lesion when inserted parallel to the plane of the transducer. The rigid transducer was found to be more convenient to guide needle placement. CONCLUSIONS: The use of this minimally invasive technique avoids laparotomy in many patients undergoing staging of malignancy and also offers increased sensitivity for tumor detection compared with conventional imaging modalities.
Authors: Richard S Young; Mohammed Aldiwani; Abdul R Hakeem; Amit Nair; Ashley Guthrie; Judy Wyatt; Darren Treanor; Gareth Morris-Stiff; Rebecca L Jones; K Rajendra Prasad Journal: HPB (Oxford) Date: 2012-12-27 Impact factor: 3.647