Intraoperative abdominal ultrasonography

Background: Ultrasonography during abdominal surgery has been reported sinc e the 1960s, but its use did not become widespread until the recent availab ility of high-frequency, high-resolution transducers. This review discusses the application of intraoperative ultrasonography to open and laparoscopic abdominal surgery. Methods: A literature search (Medline) was undertaken. All papers pertainin g to the subject matter that were located were included in the review. Results: Intraoperative ultrasonography influences surgical strategy in up to 50 per cent of liver resections for malignancy. It is the single most se nsitive technique for the detection of occult hepatic metastases at the tim e of primary colorectal resection. In pancreatic surgery, intraoperative ul trasonography is of value in the localization of islet cell tumours and in the assessment of resectability of adenocarcinoma. The technique may also h ave a role in staging laparoscopy, and in the operative management of kidne y and gastrointestinal diseases. Conclusion: Ultrasonography is an ideal operative tool as it is safe, repro ducible and requires no special patient preparation or positioning. It shou ld be regarded as an essential component of major hepatobiliary and pancrea tic procedures. The recent availability of flexible laparoscopic probes is likely to lead to a similar impact on minimal access surgery.