Laparoscopic ultrasonography for abdominal tumor staging: technical aspects and imaging findings

Delden, Otto M. van; Wit, L. T. de; Bemelman, Willem A.; Reeders, Jacques W. A. J.; Gouma, Dirk J.

doi:10.1007/s002619900156

Cited by 14 publications

(5 citation statements)

References 13 publications

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“…5,6 And even though laparoscopic ultrasound (LUS) was described over 35 years ago, 7 it was not until the early 1990s that the application of intracorporeal ultrasound as an adjunct to standard laparoscopy allowed the use of minimally invasive staging of malignancies as a new diagnostic modality. [8][9][10] The minimally invasive surgeon is hampered by the loss of traditional tactile sensation. However, the magnified view provided by laparoscopes, combined with the ability to "see" beyond the surface of intraabdominal structures provided by LUS, yields an increasingly sensitive diagnostic modality.…”

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

“…One recent report of LUS imaging in over 300 patients with upper-gut malignancies purports excellent assessment of the entire pancreas and adjacent structures via transduodenal and transgastric probe positioning, thus eliminating the need for Kocherization of the duodenum or dissection in the lesser sac as previously described. 10 Finally, as a result of the increased sensitivity of SL with LUS, unusual and very small lesions are being identified with increasing frequency. Biopsy of these lesions has traditionally relied on percutaneous techniques, which are frequently non-diagnostic, especially for smaller lesions.…”

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

“…The value of laparoscopy alone for diagnosis of pancreatic disease was described in the early 1970s 56. And even though laparoscopic ultrasound (LUS) was described over 35 years ago,7 it was not until the early 1990s that the application of intracorporeal ultrasound as an adjunct to standard laparoscopy allowed the use of minimally invasive staging of malignancies as a new diagnostic modality …”

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

“…Adequate gastric decompression facilitates lesser sac access. One recent report of LUS imaging in over 300 patients with upper‐gut malignancies purports excellent assessment of the entire pancreas and adjacent structures via transduodenal and transgastric probe positioning, thus eliminating the need for Kocherization of the duodenum or dissection in the lesser sac as previously described 10…”

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

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Current status of laparoscopic surgery of the pancreas

Underwood

Soper

1999

Journal of Hepato-Biliary-Pancreatic Surgery

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Laparoscopic surgery of the pancreas remains, other than for certain clear indications, primarily investigational. However, in the past few years, laparoscopic therapy for pancreatic diseases has made significant strides and will undoubtedly contribute increasingly to the care of the surgical patient with pancreatic disease. This review discusses the current status of minimally invasive surgical therapy of pancreatic diseases and reviews the current literature. There are four major areas of clinical and laboratory investigation, including diagnostic laparoscopy for staging of pancreatic cancer, laparoscopic palliation of unresectable pancreatic cancer, laparoscopic management of pancreatic pseudocyst, and laparoscopic partial pancreatectomy (pancreaticoduodenectomy, distal pancreatectomy, and enucleation for islet cell tumors). The increased sensitivity of staging laparoscopy with laparoscopic ultrasound as a staging modality in the diagnosis of previously unrecognized metastatic disease from pancreatic cancer is clearly the most utilitarian application of laparoscopic technology in this patient population. Additionally, a natural extension of staging laparoscopy with laparoscopic ultrasound is the ability to improve the quality of life for the patient with unresectable pancreatic cancer by palliating the biliary and gastrointestinal obstruction and the debilitating pain, without the need for and morbidity of open laparotomy. Laparoscopic internal drainage of pancreatic pseudocysts remains early in its development but appears to have potential benefit from application of minimal access techniques. And laparoscopic partial pancreatectomy, both pancreaticoduodenectomy, and, to a lesser degree, distal pancreatectomy, remain primarily investigational without clearly established benefits from the use of minimal access techniques.

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Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

See 2 more Smart Citations

Current status of laparoscopic surgery of the pancreas

Underwood

Soper

1999

Journal of Hepato-Biliary-Pancreatic Surgery

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“…The intra-abdominal examination follows the same principles as transcutaneous ultrasonography. Nonetheless special aspects of the LUS technique have been described [7]. …”

Section: Methodsmentioning

confidence: 99%

Is There Additional Information from Laparoscopic Ultrasound in Tumor Staging?

2002

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Accurate preoperative staging of gastrointestinal malignancies is of major importance in the decision for adequate stage-related therapy. There is evidence that laparoscopy in combination with laparoscopic ultrasound is more accurate in the detection of intra-abdominal metastases than conventional preoperative imaging. Staging laparoscopy in combination with laparoscopic ultrasound is a minimally invasive technique that reveals intra-abdominal disseminated tumor spread and local tumor extent. Therefore laparoscopic ultrasound is an ideal adjunct to laparoscopy because this technique may compensate for the lack of tactile feedback with laparoscopic instruments. Color-coded Doppler imaging can be very valuable for the assessment of resectability in patients with pancreatic cancer. Current data confirm that laparoscopic ultrasound is capable of enhancing the accuracy of staging laparoscopy. Compared to standard laparoscopy, a combination of both techniques markedly increases the sensitivity of staging laparoscopy in the determination of unresectable disease. This is of major importance in the assessment of occult liver metastases and lymph node involvement. Laparoscopic ultrasonography improves the diagnostic accuracy compared to conventional imaging techniques and should be considered as integral part of staging laparoscopy.

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