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Intraoperative Abdominal Ultrasound: Animals Need Ultrasound Too - Research Paper Example

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Intraoperative Abdominal Ultrasound: Animals Need Ultrasound Too

According to Machi et al (2004), "being safe, quick, accurate, and versatile intraoperatively, IOUS is a valuable technique that surgeons are recommended to master to improve intraoperative decision making and surgical procedures." In this research essay, intraoperative abdominal ultrasound and its clinical implications will be discussed. Intraoperative ultrasound is mainly useful to image liver, pancreas and bile ducts (Charnley, and Hardcastle, 1990). It is the only method by which it is possible for a surgeon to ascertain the conformation of anatomy of the hepatic veins. Through the knowledge of such anatomy, it is possible to allow localization of the lesion to the particular segment involved, thus providing information for segmental resection and thereby avoiding the need for hemihepatectomy. It is also possible to image the portal vein branch that feeds the particular segment under study and can be cannulated using a fine needle (Charnley, and Hardcastle, 1990). The concept of performing intraoperative ultrasound was introduced first in 1960s and it was introduced mainly to evaluate stones in the bile duct. Limitations in the technology of ultrasound prevented further use of the application until 1980s when more advanced forms of ultrasound applications were introduced (Patel and Roh, 2004). The main limiting factors were poor image quality and bulky transducers (Patel and Roh, 2004). Resolution and the amount of information provided by ultrasound depends on the attenuation of the tissue and the transducer frequency (Charnley, and Hardcastle, 1990). The first modern concept of intraoperative ultrasound came into vogue for adjunct application during pancreatic and hepatobiliary surgery, especially hepatectomy. Since then, the application of intraoperative ultrasound has grown exponentially. As of now, intraoperative abdominal ultrasound in the mainstay in all hepatobiliary procedures related to tumors and cancers (Patel and Roh, 2004). In surgeries related to hepatobiliary system, intraoperative ultrasound is useful to ascertain the resectability and the characteristics of the tumor and these are based on the appearance of the tumor on sonography and also the relationship of the tumor with intrahepatic vasculature. There are several approaches for imaging hepatic tumors in the preoperative period. Transabdominal ultrasound is not only a fast method of imaging, but also noninvasive, cheap and the imaging modality of choice for distinguishing non-obstructive from obstructive causes of jaundice. Transabdominal ultrasound also helps in providing general information with regard to the overall condition of the hepatic parenchyma. In current day practice, CT can of the pelvis and the abdomen is used rampantly because of the valuable information it provides anatomically and also helps in evaluation of the presence of extrahepatic disease. However, the sensitivity of detection of lesions is modest, i.e., only 34- 76 percent (Patel and Roh, 2004). With regard to sensitivity, spiral CT scan is better. The sensitivity is about 86 percent. The sensitivity can be improved by using adjunct arterial portography, but it is an invasive procedure and even that cannot detect lesions less than 20mm diameter. The portography also has high false positive values. When compared to these imaging modalities, MRI is more specific ...Show more
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Summary

Abdominal Ultrasound Intra-abdominal ultrasound has become an indispensable evaluating tool for surgeons especially in the field of surgery related to the hepatobiliary system. In this research essay, intraoperative abdominal ultrasound and its clinical implications will be discussed…
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