1
|
Shimooki O, Ito N, Hakozaki M, Minakawa Y, Tono C, Abe T. A sewing needle in the liver: a case report and literature review. J Surg Case Rep 2023; 2023:rjad678. [PMID: 38164206 PMCID: PMC10758222 DOI: 10.1093/jscr/rjad678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Intrahepatic foreign bodies are rarely reported. Although rare, a few reports of swallowed foreign bodies straying into the liver from the gastrointestinal tract have been published. Herein, we report a case in which an asymptomatic intrahepatic needle was removed laparoscopically. An 81-year-old woman presented to our hospital with an abnormal shadow on her abdominal X-ray image. Abdominal computed tomography displayed a needle-like shadow obliquely lying in the lateral segment of the left lobe of the liver. No subjective symptoms were reported; however, the patient underwent laparoscopic extraction. The postoperative course was good, and the patient was discharged without any complications. We also present a literature review of 27 patients with intrahepatic foreign bodies, a sewing needle.
Collapse
Affiliation(s)
- Osamu Shimooki
- Department of General Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Naoko Ito
- Department of Surgery, Iwate prefectural Kuji Hospital, 10-1 Asahicho, Kuji, Iwate, 028-0014, Japan
| | - Masanori Hakozaki
- Department of Surgery, Iwate prefectural Kuji Hospital, 10-1 Asahicho, Kuji, Iwate, 028-0014, Japan
| | - Yukihiro Minakawa
- Department of Surgery, Iwate prefectural Kuji Hospital, 10-1 Asahicho, Kuji, Iwate, 028-0014, Japan
| | - Chihiro Tono
- Department of Surgery, Iwate prefectural Kuji Hospital, 10-1 Asahicho, Kuji, Iwate, 028-0014, Japan
| | - Tadashi Abe
- Department of Surgery, Iwate prefectural Kuji Hospital, 10-1 Asahicho, Kuji, Iwate, 028-0014, Japan
| |
Collapse
|
2
|
Gao S, Jiang Y, Li M, Wang Y, Shen Y, Flegal MC, Nephew BC, Fischer GS, Liu Y, Fichera L, Zhang HK. Laparoscopic Photoacoustic Imaging System Based on Side-Illumination Diffusing Fibers. IEEE Trans Biomed Eng 2023; 70:3187-3196. [PMID: 37224375 PMCID: PMC10592404 DOI: 10.1109/tbme.2023.3279772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop a flexible miniaturized photoacoustic (PA) imaging probe for detecting anatomical structures during laparoscopic surgery. The proposed probe aimed to facilitate intraoperative detection of blood vessels and nerve bundles embedded in tissue not directly visible to the operating physician to preserve these delicate and vital structures. METHODS We modified a commercially available ultrasound laparoscopic probe by incorporating custom-fabricated side-illumination diffusing fibers that illuminate the probe's field of view. The probe geometry, including the position and orientation of the fibers and the emission angle, was determined using computational models of light propagation in the simulation and subsequently validated through experimental studies. RESULTS In wire phantom studies within an optical scattering medium, the probe achieved an imaging resolution of 0.43 ±0.09 mm and a signal-to-noise ratio of 31.2±1.84 dB. We also conducted an ex vivo study using a rat model, demonstrating the successful detection of blood vessels and nerves. CONCLUSION Our results indicate the viability of a side-illumination diffusing fiber PA imaging system for guidance during laparoscopic surgery. SIGNIFICANCE The potential clinical translation of this technology could enhance the preservation of critical vascular structures and nerves, thereby minimizing post-operative complications.
Collapse
|
3
|
Celentano V, Beable R, Ball C, Flashman KG, Reeve R, Holmes A, Fogg C, Harper M, Higginson A. The Portsmouth protocol for intra-operative ultrasound of the small bowel in Crohn's disease. Colorectal Dis 2020; 22:342-345. [PMID: 31652389 DOI: 10.1111/codi.14888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/30/2019] [Indexed: 12/27/2022]
Abstract
AIM Bowel preservation is paramount in Crohn's disease surgery as affected patients are typically young adults at risk of having several abdominal surgical procedures during their lifetime. Intra-operative assessment of the extent and location of Crohn's disease is not standardized and is left to a mixture of the surgeon's experience, tactile feedback, macroscopic appearance and preoperative imaging. The aim of this study was to describe the technical steps of a standardized protocol for intra-operative ultrasound assessment of the small bowel in patients undergoing surgery for ileocolic Crohn's disease. METHOD After laparoscopic mobilization of the bowel, a periumbilical incision is performed for extracorporeal division of the mesentery and the resection and anastomosis. A gastrointestinal consultant radiologist, with expertise in Crohn's disease imaging and abdominal ultrasound, performs full intra-operative assessment of the small bowel by applying a sterile ultrasound probe directly to the bowel, prior to resection being performed by the surgeon. The bowel is assessed through the wound protector with a sterile technique and the length, location and number of segments is documented together with further quantitative assessment using the METRIC (MR enterography or ultrasound in Crohn's disease) scoring guide. RESULTS A step-by-step protocol for intra-operative ultrasound evaluation of the entire small bowel is described. CONCLUSIONS A standardized approach to intra-operative evaluation of the extent and location of Crohn's disease is desirable. Intra-operative ultrasound may provide added value for assessment of proximal and multifocal Crohn's disease.
Collapse
Affiliation(s)
- V Celentano
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.,University of Portsmouth, Portsmouth, UK
| | - R Beable
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - C Ball
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - K G Flashman
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - R Reeve
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - A Holmes
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - C Fogg
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - M Harper
- University of Portsmouth, Portsmouth, UK
| | - A Higginson
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| |
Collapse
|
4
|
Carver D, Bruckschwaiger V, Martel G, Bertens KA, Abou-Khalil J, Balaa F. Laparoscopic retrieval of a sewing needle from the liver: A case report. Int J Surg Case Rep 2018; 51:376-378. [PMID: 30268064 PMCID: PMC6170216 DOI: 10.1016/j.ijscr.2018.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/20/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023] Open
Abstract
Ingested foreign bodies are a common presentation. Ingested foreign bodies can migrate/penetrate to the liver. Patients can present with symptoms including epigastric abdominal pain. In some cases hepatic foreign bodies can be extracted through a laparoscopic approach.
Introduction Less than 1% of ingested foreign bodies will require surgical management. An uncommon complication of ingested foreign body is migration to the liver. We present a case of laparoscopic removal of an intrahepatic foreign body. Presentation of case 32-year-old female presented with a four month history of epigastric abdominal pain following suspected foreign body ingestion. CT scan demonstrated a metallic object lying in the left lateral segment of the liver. The patient was brought to the operating room where the object was removed laparoscopically and was found to be a sewing needle. Discussion Hepatic foreign bodies are an uncommon entity and typically result from a transcutaneous or ingested (e.g., gastrointestinal) source. Symptoms are often vague and can develop remote from the time of ingestion. Surgical management is warranted for symptomatic intrahepatic foreign bodies. Conclusion Laparoscopy is an effective surgical method for removal of intrahepatic foreign bodies in some cases.
Collapse
Affiliation(s)
- David Carver
- University of Ottawa, The Ottawa Hospital, Canada
| | | | | | | | | | - Fady Balaa
- University of Ottawa, The Ottawa Hospital, Canada.
| |
Collapse
|
5
|
Osaki M, Omata T, Takayama T. Assemblable Hand for Laparoscopic Surgery with Phased Array and Single-Element Ultrasound Probes. JOURNAL OF ROBOTICS AND MECHATRONICS 2013. [DOI: 10.20965/jrm.2013.p0863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
During laparoscopic surgery, large internal organs should often be manipulated while being internally visualized. For this purpose, we study an assemblable two-fingered hand implemented with an ultrasound probe. The fingers are separately introduced into the abdominal cavity through small incisions and are assembled into a hand sufficiently large to grasp or manipulate the large organ. Two types of ultrasound probes are employed; a phased array probe of a commercially available ultrasound diagnosis system, and a single-element probe. Using the latter probe, the hand is assembled through 12 mm trocars and is assessed in an in vivo experiment. Ultrasound echo sensing is found to retrieve diagnostic information regarding specific internal organs. It also visualizes the finger and its back during grasping, which can improve the safety of hand grasping and manipulation. Furthermore, ultrasound echo sensing can assist the measurement of the relative position and orientation of the two grasping fingers.
Collapse
|
6
|
Abstract
Intraoperative ultrasound provides spatial resolution of the pancreas superior to computed tomography, magnetic resonance imaging, and transabdominal sonography. This pictorial essay will review common benign and malignant pancreatic processes including the following: pancreatic ductal adenocarcinoma, pancreatitis, endocrine tumors, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, serous cystadenoma, and solid pseudopapillary tumor. The use of intraoperative ultrasound in specific surgical situations will be discussed, which include the following: (1) identification of insulinoma(s) which are not detectable preoperatively, (2) identification of the pancreatic duct to determine dissection planes for chronic pancreatitis surgery (eg, Puestow procedure) and for tumor resection, and (3) staging purposes for malignant disease.
Collapse
|
7
|
Kondo R, Yoshida K, Hamanaka K, Hashizume M, Ushiyama T, Hyogotani A, Kurai M, Kawakami S, Fukushima M, Amano J. Intraoperative ultrasonographic localization of pulmonary ground-glass opacities. J Thorac Cardiovasc Surg 2009; 138:837-42. [PMID: 19660350 DOI: 10.1016/j.jtcvs.2009.02.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 12/20/2008] [Accepted: 02/02/2009] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Ground-glass opacities are typically difficult to inspect and to palpate during video-assisted thoracic surgery. We therefore examined whether ultrasonographic assessments could localize ground-glass opacities and help to achieve adequate resection margins. METHODS An intraoperative ultrasonographic procedure was prospectively performed on 44 patients harboring ground-glass opacities of less than 20 mm in diameter to localize these lesions and to achieve adequate margins. We also examined whether there were any complications resulting from the intraoperative ultrasonogram, such as lung injury, heart injury, or arrhythmia. We excluded patients with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure is more difficult to interpret when residual air is present in the lung. RESULTS A total of 53 ground-glass opacities were successfully identified by intraoperative ultrasonography without any complications. Of the 20 mixed ground-glass opacities that we examined, 15 were found on palpation. However, only 4 (12.1%) of the 33 pure ground-glass opacities could be palpated. In all instances in which complete collapse of the lung was achieved (30/53 of these cases), high-quality echo images were obtained. Additionally, a strong correlation was found between the resection margins measured by ultrasonogram and the margins determined by histologic examination in the resected lung specimens (r(2) = 0.954, P < .001). CONCLUSIONS Intraoperative ultrasonography can both safely and effectively localize pulmonary ground-glass opacities in a completely deflated lung. This procedure is also useful for the evaluation of surgical margins in a resected lung. Hence, ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of solitary lung ground-glass opacity.
Collapse
Affiliation(s)
- Ryoichi Kondo
- Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Long EE, Van Dam J, Weinstein S, Jeffrey B, Desser T, Norton JA. Computed tomography, endoscopic, laparoscopic, and intra-operative sonography for assessing resectability of pancreatic cancer. Surg Oncol 2005; 14:105-13. [PMID: 16125619 DOI: 10.1016/j.suronc.2005.07.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pancreas cancer is the fourth leading cancer killer in adults. Cure of pancreas cancer is dependent on the complete surgical removal of localized tumor. A complete surgical resection is dependent on accurate preoperative and intra-operative imaging of tumor and its relationship to vital structures. Imaging of pancreatic tumors preoperatively and intra-operatively is achieved by pancreatic protocol computed tomography (CT), endoscopic ultrasound (EUS), laparoscopic ultrasound (LUS), and intra-operative ultrasound (IOUS). Multi-detector CT with three-dimensional (3-D) reconstruction of images is the most useful preoperative modality to assess resectability. It has a sensitivity and specificity of 90 and 99%, respectively. It is not observer dependent. The images predict operative findings. EUS and LUS have sensitivities of 77 and 78%, respectively. They both have a very high specificity. Further, EUS has the ability to biopsy tumor and obtain a definitive tissue diagnosis. IOUS is a very sensitive (93%) method to assess tumor resectability during surgery. It adds little time and no morbidity to the operation. It greatly facilitates the intra-operative decision-making. In reality, each of these methods adds some information to help in determining the extent of tumor and the surgeon's ability to remove it. We rely on pancreatic protocol CT with 3-D reconstruction and either EUS or IOUS depending on the tumor location and operability of the tumor and patient. With these modern imaging modalities, it is now possible to avoid major operations that only determine an inoperable tumor. With proper preoperative selection, surgery is able to remove tumor in the majority of patients.
Collapse
Affiliation(s)
- Eliza E Long
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | | |
Collapse
|
9
|
Pollinger HS, Greene FL. The optimal imaging modality for hepatocellular carcinoma: is there a gold standard? CURRENT SURGERY 2004; 61:141-6. [PMID: 15051252 DOI: 10.1016/j.cursur.2003.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
|
10
|
Abstract
Recent years have seen notable advances in imaging technologies. Three-dimensional computer-rendered techniques with rapid image acquisition have led to the development of virtual reality imaging. Virtual reality imaging allows interactive intraluminal navigation through any hollow viscus, simulating conventional endoscopy. This technique of virtual endoscopy has been applied to many organs, including the urinary tract. Virtual reality endoscopy is beginning to challenge the gold standard of conventional endoscopic evaluation. Recent advances in laparoscopic surgery are largely attributable to technological improvements in imaging equipment. Laparoscopic ultrasound has become a common adjunct in laparoscopic surgery. In particular, advances in video cameras and digital imaging technology have decreased the steep learning curve associated with laparoscopic procedures. Telerobotic systems offer several advantages to laparoscopic surgery, such as all six degrees of freedom, dexterity enhancement, tremor filtering, and stereovision. In addition, technological breakthroughs allow many procedures to evolve from open operations involving lengthy hospital stays to imaging-guided minimally invasive procedures performed on an outpatient basis. Finally, Internet-based imaging is changing the way in which urology services are delivered, by allowing rapid communication between remote locations.
Collapse
|
11
|
Forsberg F, Piccoli CW, Liu JB, Rawool NM, Merton DA, Mitchell DG, Goldberg BB. Hepatic tumor detection: MR imaging and conventional US versus pulse-inversion harmonic US of NC100100 during its reticuloendothelial system-specific phase. Radiology 2002; 222:824-9. [PMID: 11867808 DOI: 10.1148/radiol.2223001786] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare conventional ultrasonography (US) and magnetic resonance (MR) imaging with contrast agent-enhanced US for detection of VX-2 liver tumors in rabbits. MATERIALS AND METHODS Conventional gray-scale liver US was performed in 65 rabbits, 38 of which had VX-2 hepatic tumor implants. Twenty minutes after contrast agent injection, gray-scale pulse-inversion harmonic US images of the liver-specific phase were obtained. Following sacrifice of the animals, T1- and T2-weighted MR imaging was performed at 4-mm intervals. Pathologic analysis was performed as the reference standard. The capability of each imaging modality to correctly depict tumor presence or absence and the number of tumors was compared. RESULTS Conventional US correctly depicted the presence or absence of tumors in 54 rabbits, for an accuracy of 83%, sensitivity of 71%, and specificity of 100%. With contrast-enhanced US, accuracy increased to 92% (60 correct cases); sensitivity, to 87%; and specificity, to 100%. MR imaging facilitated 56 correct diagnoses, for an accuracy of 86%, sensitivity of 82%, and specificity of 93%. There was a marginally significant difference between US with and US without contrast agent (P =.07) but not between MR imaging and contrast-enhanced US (P > or = .34). When the numbers of correctly detected tumors were compared, contrast-enhanced US performed significantly better than MR imaging (P =.02) and conventional US (P =.04). CONCLUSION There was no significant difference between contrast-enhanced US and MR imaging in the detection of hepatic tumors, whereas contrast-enhanced US had the highest accuracy (92%) of the three modalities studied.
Collapse
Affiliation(s)
- Flemming Forsberg
- Department of Radiology, Division of Ultrasound, Thomas Jefferson University Hospital, Suite 763J, Main Bldg, 132 S 10th St, Philadelphia, PA 19107, USA.
| | | | | | | | | | | | | |
Collapse
|
12
|
Tsioulias GJ, Wood TF, Chung MH, Morton DL, Bilchik A. Diagnostic laparoscopy and laparoscopic ultrasonography optimize the staging and resectability of intraabdominal neoplasms. Surg Endosc 2001; 15:1016-9. [PMID: 11443448 DOI: 10.1007/s004640080094] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2000] [Accepted: 01/30/2001] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite technical improvements, preoperative imaging studies often fail to predict intraoperative findings. We investigated the potential use of diagnostic laparoscopy (DL) and laparoscopic ultrasonography (LUS) for the assessment of disease in patients with abdominal neoplasms. METHODS Fifty consecutive patients with abdominal neoplasms underwent spiral computed tomography with oral and intravenous contrast using 5-mm contiguous sections. In addition, eight patients underwent ultrasonography, six underwent magnetic resonance imaging, and eight underwent positron emission tomography. All patients then underwent DL and LUS using a 7.5-MHz ultrasound probe. RESULTS There were 29 men and 21 women with a mean age of 63 years (range, 35-84). Most had a diagnosis of colorectal cancer (19 cases), melanoma (12 cases), or hepatoma (five cases). In nine cases (18%), DL revealed peritoneal metastatic implants not shown on preoperative images. In 18 cases (36%), LUS was more accurate than preoperative imaging. Combined DL and LUS findings radically changed the operative management in 16 patients (32%). CONCLUSION As compared with preoperative imaging, the combination of DL and LUS provides more accurate information regarding staging and resectability. Moreover, it helps to determine the extent of operation and reduces the number of unnecessary laparotomies. DL and LUS should be used as an adjunct to preoperative imaging studies in patients with primary or metastatic intraabdominal neoplasms.
Collapse
Affiliation(s)
- G J Tsioulias
- John Wayne Cancer Institute, Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA
| | | | | | | | | |
Collapse
|
13
|
Cuschieri A. Role of video-laparoscopy in the staging of intra-abdominal lymphomas and gastrointestinal cancer. SEMINARS IN SURGICAL ONCOLOGY 2001; 20:167-72. [PMID: 11398209 DOI: 10.1002/ssu.1029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is good category II/III evidence that video-laparoscopic staging is valuable in certain gastrointestinal (gastric, esophageal, pancreatic, and hepatobiliary) and intra-abdominal lymphomas, but no category I evidence (based on prospective randomized trials). The evidence available is all retrospective, but of sufficient consistency to indicate that laparoscopic staging adds to the primary (imaging) staging and often alters the clinical stage of the disease and hence the management of the individual patient. The advent of laparoscopic contact ultrasound (LCU) scanning has improved the staging accuracy for pancreatic and hepatobiliary neoplasms. The laparoscopic approach also offers a means of surgical palliation in certain patient groups. However, there are a number of unresolved issues concerning the use of video-laparoscopy. The most important concerns whether staging laparoscopy should be performed immediately before scheduled surgery or as a separate intervention. The cost-efficacy of these two management options needs to be evaluated in prospective studies. In some centres, laparoscopic staging is being conducted by gastroenterologists and hepatologists. This raises issues of safety and ability to undertake certain procedures that may be necessary during the laparoscopic staging.
Collapse
Affiliation(s)
- A Cuschieri
- Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, University of Dundee, Scotland.
| |
Collapse
|
14
|
Abstract
The use of laparoscopic ultrasonography (LUS) allows visualization of tissues beyond the two-dimensional laparoscopic picture, enhancing the amount and quality of information available to the surgeon. Linear-array transducers with frequencies of 7.5 to 10 MHz are typically used for LUS, employing B-mode scanning and color Doppler capability on probes with articulating tips. In general surgery, LUS has become a common adjunct to the intraoperative staging of upper gastrointestinal malignancy to determine resectability, avoiding unnecessary laparotomy. In urology, LUS appears to be a promising adjunct for four current procedures: difficult pelvic lymphocele marsupialization, renal cyst decortication, nephrolithotomy and other renal stone surgery, and cryotherapy of renal masses. The role of LUS during varicocelectomy is limited, and enthusiasm for this procedure is waning. Laparoscopic ultrasonography is a critical adjunct to renal cryoablation, a developmental procedure that currently lacks long-term data but is promising as therapy for small, incidentally detected renal masses. It appears that as laparoscopic urologic procedures continue to expand, so will the application of this promising operative imaging modality.
Collapse
Affiliation(s)
- S F Matin
- Department of Urology, The Cleveland Clinic Foundation, Ohio 44195, USA
| | | |
Collapse
|
15
|
Literature Watch. J Endourol 1999; 13:131-3. [PMID: 10213109 DOI: 10.1089/end.1999.13.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|