title: Can general surgeons evaluate visceral slide with transabdominal ultrasound to predict safe sites for primary laparoscopic port placement? A prospective study of sonographically naïve operators at a tertiary center.
abstract: BACKGROUND
  Port placement injuries are a potentially devastating complication of laparoscopic surgery. Ultrasound assessment for visceral slide has the ability to preoperatively determine adhesion-free areas. The utility of this technique has not been studied when performed by surgeons.
  
  
  METHODS
  Surgeons without expertise in ultrasound were taught the visceral slide technique. Patients with a history of abdominal surgery were then assessed for adhesion-free areas on the abdominal wall. Ultrasound assessments were validated against intraoperative visualization.
  
  
  RESULTS
  Nine surgeons using the visceral slide technique assessed 145 patients for the presence of adhesions immediately before surgery. Surgeon who performed ultrasound demonstrated a sensitivity of 69.6%, specificity of 98.7%, and positive predictive value of 99.5% for detection of areas free from critical adhesions. The median time to perform the examination was 2 minutes.
  
  
  CONCLUSIONS
  The visceral slide technique was easily learned, was rapid to perform, and reliably identified adhesion-free areas of the abdominal wall.
authors.affiliation: Department of Surgery, Island Health, Victoria, BC, Canada; Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Minaker
authors.affiliation: Department of Surgery, Island Health, Victoria, BC, Canada; Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Cailan
authors.initials: C
authors.lastname: MacPherson
authors.affiliation: Department of Surgery, Island Health, Victoria, BC, Canada; Department of Surgery, University of British Columbia, Vancouver, BC, Canada. Electronic address: ahayashi@surg.bc.ca.
authors.forename: Allen
authors.initials: A
authors.lastname: Hayashi
mesh_terms: D034861:Abdominal Wall / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D066231:Surgeons / Q000193:education*; D062606:Tertiary Care Centers; D000267:Tissue Adhesions / Q000000981:diagnostic imaging / Q000517:prevention & control; D014463:Ultrasonography; D014781:Viscera / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Bowel injury; Intra-abdominal adhesions; Laparoscopic surgery; Patient safety; Surgical complications; Trocar injuries