ABSTRACT
Introduction .......................................................................................................................... 179 Indications fo r Laparoscopic Ultrasound....................................................................... 180 Technique................................................................................................................................. 182 P ancreas ................................................................................................................................. 182 Role ofLU S in Intra-abdom inal Malignancy: Results............................................... 184 Pancreatic-Biliary-(M alignant G rou p)........................................................................... 186 Pancreas-Benign G roup ..................................................................................................... 187 Liver M alignant G roup ...................................................................................................... 187 Liver-Benign G rou p ............................................................................................................ 187 Colon Cancer Staging ......................................................................................................... 188 Unknown P rim ary .............................................................................................................. 188 Stomach, Spleen and A drenals......................................................................................... 192 M iscellaneous........................................................................................................................ 192 Su m m ary ................................................................................................................................. 192
INTRODUCTION
Currently laparoscopic surgeons are involved in the diagnosis, staging, treat ment, and palliation o f intra-abdominal malignancies. One major drawback o f oncologic laparoscopic surgery is the loss of tactile feedback to the surgeon’s hand. This hampers the diagnostic and therapeutic capabilities o f laparoscopic surgery. Laparoscopic ultrasound (LUS) may compensate for this tactile deficit and in some scenarios may exceed the sensitivities of manual palpation. While laparoscopy alone is a useful tool for staging intra-abdominal malignancies, the addition o f LUS enhances the surgeon’s capabilities. LUS is thus the “stethoscope” o f the laparo scopic surgeon. The currently available LUS probes can be inserted through a 10 mm cannula and range in frequencies from 6-7.5 MHZ. These probes can be used for laparoscopic sonography of the liver, bile ducts, pancreas, retroperitoneum, and hollow viscera such as the colon.
