ABSTRACT
Seven cases of renal tumor treated at our hospital from May 2009 to November 2011 were assigned to undergo laparoscopic ultrasonography assisted laparoscopic partial nephreetomy.The mean operative duration was 109 minutes (range:102-121).And the mean volume of blood loss was 82 ml (range:60-120).All patients had confirmed negative margins.Renal clear cell carcinoma was definitely diagnosed in all cases.Laparoscopic ultrasonography could provide more precise information of renal tumor within renal capsule.Thus it may be used to guide the operation so that tumors are excised more completely,residual tumor tissues avoided and normal renal tissues protected.
ABSTRACT
Objective To evaluate the clinical value of laparoscopic uItrasonography ( LUS) in u-rinary laparoscopic surgery .Methods In 6 cases of urological laparoscopic surgery , laparoscopic ultra-sound examination were taken , including 3 cases of simple renal cysts , 1 case of adrenal pheochromocyto-ma, 2 cases of hamartoma , were excised under the LUS guidance and the results were compared with the traditional simple laparoscopic surgery .Results With laparoscopic uItrasonography guidance , the bounda-ry and blood supply of cyst or tumor could be shown more clearly compared with trans -abdominal ultrasound . We could differ the tumors from dilated pelvis and renal calices , So the damage to the collecting system and renal blood vessels were avoided .With LUS guidance , tumors were excised more completely , so that re-mained tumor tissues would be avoided and normal renal tissues would be protected .Conclusion LUS may provide more precise surgical information and may play an important role guiding laparoscopic operation in urinary surgery .
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We report the case of a postoperative foreign body granuloma, which was misdiagnosed as a metastatic lymph node, but confirmed by laparoscopic removal. A-68-year old man was admitted for the management of a suspected metastatic lymph node. He had undergone a laparoscopy-assisted distal gastrectomy, with simultaneous D2 lymph node dissection and a left adrenalectomy for T1N0M0 early gastric cancer and an adrenal adenoma 8 months previously. Preoperative computed tomography and whole body PET showed a 1.6 cm sized suspected metastatic lymph node between the efferent jejunal loop and pancreas tail. A diagnostic laparoscopy was performed for pathological confirmation. After laparoscopic adhesiolysis, the lesion was localized using laparoscopic ultrasonography, with the mass also removed laparoscopically. Permanent pathology revealed the mass to be a foreign body granuloma, but without malignancy. In cases of suspected local recurrence or lymph node metastasis following radical surgery, a diagnostic laparoscopic procedure could play a role in confirming the recurrence.
Subject(s)
Adenoma , Adrenalectomy , Foreign Bodies , Gastrectomy , Granuloma, Foreign-Body , Laparoscopy , Lymph Node Excision , Lymph Nodes , Neoplasm Metastasis , Pancreas , Pathology , Recurrence , Stomach Neoplasms , UltrasonographyABSTRACT
Objective To appraise the diagnostic capability of laparoscopic ultrasonography (LUS) for urinary system injury induced by laparoscopic surgery in goats. Methods Animal models of different types of urinary system injury at different sites were established in five goats. One goat without injury was set as a negative control. LUS was used to examine the animals following randomization and single-blind principles. Results The sensitivity of LUS was 76.9% (10/13),specificity was 100%,and the false-negative rate was 23.1% (3/13). No false-positive results were detected in this study. The sham injury was accurately detected through LUS. The scan time of LUS ranged from 19 to 25 min with a mean of 21 min. Conclusions LUS is of value in the diagnosis of urinary system injury.
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Objective To analyze the clinical value of laparoscopic ultrasonography (LUS) in laparoscopic hepatobiliary surgeries. Methods A total of 156 cases of laparoscopic hepatectomy, hepatic abscess fenestration, and complicated cholecystectomy were analyzed. LUS was used during all the 156 operations; the anatomy and stage of the tumors were investigated. Results In 19 cases of hepatectomy and 39 cases of hepatic abscess fenestration, the direction of critical intrahepatic and extrahepatic ducts were indicated by using LUS, and the operations were performed under the guidance of LUS. Moreover, in 15 cases of complicated cholecystectomy, the tumor was precisely located and further distinguished by LUS. Conclusions Laparoscopic ultrasonography can precisely locate the tumor, guide the treatment, and resolve the problem of reduced feedback in touching for surgeons during laparoscopic hepatobiliary surgeries. It is of value to improve the operative outcomes.
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Objective To evaluate the significance of intraoperative laparoscopic ultrasonography (IOUS) during hepatobiliary surgery. Methods Sixty-eight cases of hepatobiliary lithiasis (liver disease 23 and cholecystopathy with difficulty in management by preoperative estimation, 45 ) were examined by intraoperative laparoscopic ultrasonography. Results Two CBD stones and one Mirrizi syndrome were found in IOUS. The laparoscopic procedures were successful fulfilled in 68 cases under the guidance of sonography including fenestration on liver cyst, incision and drainage on liver abscess, resection and biopsy on space occupied liver lesion with unknown cause, resection of solitary space occupied mass in liver, destruction of unre-sectable liver cancer by microwave and injection of absolute alcohol and chemotherapy through portal vein catheterization, cholecystectomy in acute cholecystitis, chronic cholecystitis with chiledolithiasis, and broad pedicle polyps in gallbladder etc. Conclusion IOUS has the advantages of non-invasive, fast, repeatable, high accuracy and has important clinical significance in laparoscopic diagnosis and treatment.
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Objective To introduce the techniques of scanning the common bile duct(CBD) in full length with laparoscopic ultrasonography through the sonic window dorsal to the first portion of the duodenum(FPD). Methods The lower segment of the CBD in 300 cases was scanned in full length through the sonic window dorsal to the FPD. Results In our series, 97.67% of the lower segment of the CBD can be visualized with simple techniques through sonic window dorsal to the FPD. Visualization in 25 cases were improved with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum. Conclusion Through the sonic window dorsal to the FPD and with simple techniques, the lower segment of the CBD in majority of our cases can be satisfactorily imaged in full length. Visualization can be improved in some individuals with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum.
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Objective To evaluate the effect of laparoscopic ultrasonography in laparoscopic cholecystectomy. Methods Laparoscopic ultrasonography system of Sharplan Company was used for the examination of the liver, gallbladder, bile duct and pancreas in 410 patients performed by laparoscopic cholecystectomy. Results The rates of biliary duct abnormality, preoperative diagnosis change, preoperative inexpectant disease finding, bile injury and residual stone were 3.5%, 4.4%, 2.4% and 0%, respectively. Conclusion During laparoscopic cholecystectomy, laparoscopic ultrasonography is helpful for the improvement of correct diagnosis and the decrease of complications.