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The value of laparoscopic intraoperative ultrasound of the liver by the surgeon

Ultrasonography is an extremely cheap, safe and minimally invasive diagnostic tool in the hands of a skillful user. It has been an important instrument in abdominal surgery for more than 30 years (1). Intraoperative ultrasound (IOUS) is an important tool to surgeons in liver resections for several reasons. It assists the operator in identifying the surgical anatomy with real time imaging and it gives him information about the size and quantity of the tumors with also a good accuracy for detecting small lesions (2,3). Different studies have shown the added value of ultrasound during laparotomic liver surgery. Zacherl et al. found that IOUS changed surgical strategy in 22.8% of cases. The sensitivity of IOUS in a segment-by-segment analysis for colorectal liver metastasis was 95.2%, which was the highest amongst the diagnostic techniques including CT and MRI. Based on these findings, they concluded that IOUS even should be considered the gold standard for hepatic neoplasms (4). Original Article