Intraoperative ultrasound in minimally invasive thoracic surgery for the detection of pulmonary tumors: First intrathoracic application of TE9 and laparoscopic probe Lap 13-4cs (Mindray)

Article type: Research Article

Authors: Schauer, Martin Ignaz^{a; *} | Jung, Ernst Michael^b | Hofmann, Hans-Stefan^a | Ried, Michael^a

Affiliations: [a] Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany | [b] Institute for Radiology, University Medical Center Regensburg, Regensburg, Germany

Correspondence: [*] Corresponding author: Martin Ignaz Schauer, MD, Department of Thoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, Germany. Tel.: +49 941 944 9810; Fax: +49 941 944 9811; E-mail: Martin.Schauer@UKR.de.

Abstract: AIM:To apply intraoperative ultrasound (IO-US) for the first time using a laparascopic probe to detect malignancy-susceptible solitary pulmonary nodules (SPN) and assess macrovascularization using color-coded doppler sonography or power doppler. Description of technical feasibility. METHODS:Technical description on intrathoracic endoscopic ultrasound. A positive ethics vote from the local ethics committee and written patient consent were available. Intraoperative ultrasound was performed using a laparascopic probe (Lap 13-4cs, Mindray) on the T9 ultrasound machine (Mindray, China). B-scan was used to detect the SPN. Color-coded doppler sonography (CCS) and power doppler were used to assess macrovascularization. Primary end point was the description of the technical performance of the Io-US. Secondary endpoints were the functions of Io-US in characterizing SPN. RESULTS:Io-US was successfully applied using (n = 2) cases in video-assisted thoracic surgery. All SPN were successfully detected intraoperatively with the intrathoracically placed laparascopy probe using B-mode and examined using CCS or power Doppler (100%). Resection was sonography-guided with marking of the tumor area in all cases without complications. Histological workup revealed malignancy in both cases. CONCLUSION:Intrathoracic application of laparascopically guided Io-US was technically feasible. In addition to B-mode detection, Io-US using power doppler and color-coded doppler sonography provided initial evidence for characterization of SPN based on macrovascularization.

Keywords: Intraoperative ultrasound in thoracic surgery, CEUS in thoracic surgery

DOI: 10.3233/CH-231718

Journal: Clinical Hemorheology and Microcirculation, vol. 85, no. 1, pp. 87-92, 2023