Intraoperative Ultrasound-Guided Procedures

While the continuous development and improvements in tumor ablation techniques and equipment have made the percutaneous non-surgical approach ever more successful, even for larger lesions, there is still a need for ablative treatments in the operating room. In some practices, based on local referral patterns, the surgical approach to tumor ablation may be predominant, either via laparoscopy or open laparotomy. In other settings, additional tumor sites may be encountered during a planned surgical excision that can be efficiently treated intraoperatively with a variety of ablative approaches. Finally, some techniques, such as cryoablation, may be best performed intraoperatively, particularly when treating large tumors with 5- to 10-mm diameter cryoprobes. Therefore, a review of intraoperative ultrasound (IOUS) scanning and guidance techniques for ablation is appropriate. This chapter discusses the optimal approach to intraoperative and laparoscopic ultrasound (LUS) scanning techniques, equipment, technical preparations, and methods for guidance of interventional techniques.