title: Laparoscopic ultrasonography and biopsy of hepatic tumors in 310 patients.
abstract: BACKGROUND
  Laparoscopic ultrasonography is increasingly being recognized as an important tool in the evaluation of patients with possible hepatic tumors. The aim of this paper is to describe the technical aspects of imaging and biopsy based on our experience in 310 patients with 1,080 primary and metastatic liver tumors within a 6.5-year period.
  
  
  METHODS
  A 10-mm rigid or flexible, 7.5 MHz linear, side-viewing laparoscopic ultrasonography probe was used for imaging, and an 18G spring-loaded core biopsy gun was used for tissue diagnosis.
  
  
  RESULTS
  There were no complications. The entire liver was imaged using a right subcostal port. Using a free-hand technique, the needle was best targeted into the lesion when inserted parallel to the plane of the transducer. The rigid transducer was found to be more convenient to guide needle placement.
  
  
  CONCLUSIONS
  The use of this minimally invasive technique avoids laparotomy in many patients undergoing staging of malignancy and also offers increased sensitivity for tumor detection compared with conventional imaging modalities.
authors.affiliation: The Cleveland Clinic Foundation, Department of General Surgery, A80, 9500 Euclid Ave., Cleveland, OH 44195, USA.
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
authors.forename: Adella M
authors.initials: AM
authors.lastname: Garland
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Engle
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Rogers
authors.forename: Allan E
authors.initials: AE
authors.lastname: Siperstein
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D014463:Ultrasonography / Q000379:methods*