Role of intra-operative contrast-enhanced ultrasound (CEUS) in robotic-assisted nephron-sparing surgery.
This review examines studies of intra-operative contrast-enhanced ultrasound (CEUS) and its emerging role and advantages in robotic-assisted nephron-sparing surgery. Contrast-enhanced ultrasound is a technology that combines the use of second-generation contrast agents consisting of microbubbles with existent ultrasound techniques. Until now, this novel technology has aided surgeons with procedures involving the liver. However, with recent advances in the CEUS technique and the introduction of robotics in nephron-sparing surgery, CEUS has proven to be efficacious in answering several clinical questions with respect to the kidneys. In addition, the introduction of the microbubble-based contrast agents has increased the image quality and signal uptake by the ultrasound probe. This has led to better, enhanced scanning of the macro and microvasculature of the kidneys, making CEUS a powerful diagnostic modality. This imaging method is capable of further lowering the learning curve and warm ischemia time (WIT) during robotic-assisted nephron-sparing surgery, with its increased level of capillary perfusion and imaging. CEUS has the potential to increase the sensitivity and specificity of intra-operative images, and can significantly improve the outcome of robotic-assisted nephron-sparing surgery by increasing the precision and diagnostic insight of the surgeon. The purpose of this article is to review the practical and potential uses of CEUS as an intra-operative imaging technique during robotic-assisted nephron-sparing surgery.
Department of Urology, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Slough, Berkshire, SL2 4HL UK ; Minimal Invasive and Robotic Surgery Fellow, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Wexham, SL2 4HL Berkshire, UK.
Ahmad N
AN
Alenezi
Department of Urology, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Slough, Berkshire, SL2 4HL UK ; Consultant Urological Surgeon, Frimley Health NHS Foundation Trust, Wexham Park Hospital, Wexham, SL2 4HL Berkshire, UK.
Omer
O
Karim
D003287:Contrast Media / Q000627:therapeutic use*; D006801:Humans; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons / Q000000981:diagnostic imaging / Q000601:surgery; D059351:Organ Sparing Treatments / Q000379:methods*; D010743:Phospholipids / Q000627:therapeutic use; D065287:Robotic Surgical Procedures / Q000379:methods*; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
CEUS; Contrast-enhanced ultrasound scan; Nephron sparing; Partial nephrectomy; Robotic assisted; SonoVue; Zero-ischemia