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. 2024 Apr 30;14(9):942.
doi: 10.3390/diagnostics14090942.

Intraoperative Ultrasound: Bridging the Gap between Laparoscopy and Surgical Precision during 3D Laparoscopic Partial Nephrectomies

Ionela Mihai  1 , Horatiu Dura  1 , Cosmin Adrian Teodoru  1 , Samuel Bogdan Todor  1 , Cristian Ichim  1 , Nicolae Grigore  1 , Cosmin Ioan Mohor  1 , Alin Mihetiu  1 , George Oprinca  1 , Nicolae Bacalbasa  2 , Denisa Tanasescu  1 , Dan Georgian Bratu  1 , Adrian Boicean  1 , Bogdan Oros  3 , Adrian Hasegan  1
Affiliations

Intraoperative Ultrasound: Bridging the Gap between Laparoscopy and Surgical Precision during 3D Laparoscopic Partial Nephrectomies

Ionela Mihai et al. Diagnostics (Basel). .

Abstract

The use of 3D laparoscopic partial nephrectomy has emerged as a cornerstone in the surgical arsenal for addressing renal tumors, particularly in managing challenging cases characterized by deeply seated tumors embedded within the renal parenchyma. In these intricate scenarios, the utilization of intraoperative ultrasound (IOUS) acquires paramount importance, serving as an indispensable tool for guiding and meticulously monitoring the surgical process in real time. To further explore the efficacy of IOUS-guided techniques, we conducted a retrospective study comparing outcomes in patients who underwent partial nephrectomy with IOUS guidance (n = 60) between 2020 and 2022 with a cohort from 2018 to 2019 without IOUS guidance (n = 25). Our comprehensive analysis encompassed various post-operative parameters, including the duration until food resumption, analgesia requirements, and length of the hospital stay. While these parameters exhibited comparable outcomes between the two groups, notable distinctions emerged in the intraoperative metrics. The IOUS-guided cohort demonstrated significantly reduced blood loss, a shorter median operative duration, and diminished ischemia time (p = 0.001). These compelling findings underscore the undeniable benefits of IOUS-guided techniques in not only facilitating the attainment of negative surgical margins but also in enhancing procedural safety and precision, thereby contributing to improved patient outcomes in the management of renal tumors.

Keywords: intraoperative ultrasound; laparoscopy; partial nephrectomy; renal tumor.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
IOUS (intraoperative ultrasound) probe through the retroperitoneal space at the level of the kidney surface (personal collection).
Figure 2
Figure 2
Tumor position and size (personal collection).
Figure 3
Figure 3
EcoDoppler image of the tumor and vascularization (personal collection).
Figure 4
Figure 4
The position of the trocars and ultrasound probe inserted through the 12 mm trocar (personal collection).
Figure 5
Figure 5
Laparoscopic instrumentation and LUS-type IPX7 range probe (personal collection).
See this image and copyright information in PMC

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