Liver ultrasound: A key procedure in the surgeon's toolbox

Abstract

Intraoperative liver ultrasound (US) is an imperative adjunctive procedure during any liver surgical procedure. Intraoperative US can be used to confirm preoperative findings, to identify new findings, and to guide the conduct of the procedure. A major barrier to incorporation of US into the surgeon's toolbox is training and education.A standardized training program for surgical fellows has been developed based on the mastery learning framework. K E Y W O R D S intraoperative ultrasound, liver ultrasound, surgical ultrasound education, surgical ultrasound training

Brazilian Society of Surgical Oncology surgical standards for resectable colorectal cancer liver metastases

“…Intraoperative ultrasound (IOUS) of the liver potentially offers an ideal tool to locate liver lesions as well as to guide resection and, at the same time, evaluate surrounding vascular and biliary structures. Thus, IOUS aids in delineating the transection planes in accordance with oncological principles, as well as in preserving the tumor‐free liver parenchyma 32–36 …”

“…Thus, IOUS aids in delineating the transection planes in accordance with oncological principles, as well as in preserving the tumor-free liver parenchyma. [32][33][34][35][36] In the past, there was strong evidence to support the routine use of this technique, particularly to ensure that no additional lesions were missed. Recently, the high efficacy of new imaging modalities and liver-specific contrast agents has led to the revision of this statement.…”

Laparoscopic Microwave Ablation: Which Technologies Improve the Results

“…The identification of the exact location of a nodule within the hepatic parenchyma is established by the relationships with the vascular-biliary structures that define the segmental anatomy of the liver and which is very often different in many patients [ 9 , 10 ]. Based on the two-dimensional information obtained from preoperative imaging (CT and MRI), expert surgeons can have a mental picture of a 3D representation scan to perform the operation successfully, but it can be a serious challenge for surgeons to identify the presence of anatomical variants using only the LUS evaluation [ 11 , 12 ]. In this setting, 3D reconstruction from 2D images and virtual reality technologies can clearly show the exact spatial anatomy of a nodule and can help LUS in planning the thermoablation procedures [ 13 , 14 , 15 ].…”

Getting going: Incorporating ultrasound into an HPB practice

“…The AHPBA HPB Ultrasound Fellows' Course is the annual US training pathway for AHPBA-Fellowship Council HPB fellowships, which includes didactic and hands-on skills training at the start of the fellowship year followed by supervised volume and content requirements over the fellowship year(s) (ie, evaluated by HPB training faculty and program directors). This year-long "coursework" culminates with a hands-on skills practicum prior to graduation [ 3 , 4 ]. Other fellowship training programs offered by the American Society of Transplant Surgeons and Complex General Surgical Oncology Accreditation Council for Graduate Medical Education are well-recognized routes to HPB surgical practices [ [10] , [11] , [12] ].…”

“…It is clear that intraoperative ultrasound is a central requirement of modern HPB surgery [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] ]. In fact, numerous global HPB societies, consensus guidelines, and large volume centers believe the contemporary practice of HPB surgery is simply not possible without up-to-date intraoperative ultrasound skills.…”