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Abdominal Ultrasound for Surgeons
Ellen J. Hagopian • Junji Machi
Editors
Abdominal Ultrasound
for Surgeons
Editors
Ellen J. Hagopian, MD, FACS
Department of Surgery
Jersey Shore University Medical Center
Neptune, NJ
USA
Department of Surgery
Robert Wood Johnson Medical School
New Brunswick, NJ
USA
Department of Surgery
New York Medical College
Valhalla, NY
USA
Junji Machi, MD, PhD, FACS
Department of Surgery
John A. Burns School of Medicine
University of Hawaii and Kuakini Medical Center
Honolulu, HI
USA
Noguchi Medical Research Institute
JADECOM-NKP GME Center
Tokyo Bay Urayasu-Ichikawa Medical Center
(Noguchi Hideyo Memorial International
Hospital)
Urayasu, Chiba
Japan
Videos to this book can be accessed at http://www.springerimages.com/videos/978-1-4614-9598-7
ISBN 978-1-4614-9598-7
ISBN 978-1-4614-9599-4
DOI 10.1007/978-1-4614-9599-4
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Preface
Surgical ultrasound has been a tool of the abdominal surgeon for a number of years. Ultrasound
has been referred to as the stethoscope of the surgeon as it allows the unseen to be seen and is
recognized as a vital component in many surgical procedures. Even with advances in preoperative imaging, such as computed tomography and magnetic resonance imaging, the evidence is
clear that ultrasound is a practical and indispensable tool of the surgeon preoperatively, intraoperatively, and postoperatively. However, despite its well-recognized value, education and
practice remain the major obstacles to the use of perioperative or intraoperative ultrasound.
Furthermore, even for those using ultrasound in practice, advances not only in surgical procedure but also in ultrasound technology have emphasized the need to update the surgeon, fellow,
and resident to the current status of surgical ultrasound. This book is intended to serve as the
beginning or continuation of an education in ultrasound for the surgeon.
In the chapters that follow, experts in the field will detail the facts, lessons, and tricks to
master this indispensable tool. The current and future applications of surgical ultrasound will
be detailed to further underscore its need by the surgeon. Unlike other imaging methods, ultrasound is highly examiner dependent. Particularly in surgical ultrasound, surgeons must scan by
themselves in order to maximize its benefits. We are certain that once learned, ultrasound can
help improve surgeon-sonographers’ practices, outcomes, and patient care. We hope this book
provides the key to its use and execution to unlock the valuable insight that ultrasound can
provide to the surgeon in practice or in training.
Ellen J. Hagopian, MD, FACS
Neptune, NJ, USA
Junji Machi, MD, PhD, FACS
Honolulu, HI, USA
v
Contents
Part I
The Basics
1
Introduction: The Importance of Ultrasound in a Surgical Practice . . . . . . . . .
Kevin Ryan Parks and Ellen J. Hagopian
3
2
Physical Principles of Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Beth A. Schrope and Neha Goel
7
3
Instrumentation in Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Halit Eren Taskin and Eren Berber
17
4
Scanning Techniques in Transabdominal and Intraoperative/
Laparoscopic Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reid B. Adams
5
Imaging Characteristics and Artifacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Michael J. Giuffrida and Gary Gecelter
Part II
31
61
Anatomy, Application, and Intervention: Transabdominal,
Intraoperative, Laparoscopic
6
Abdominal Wall Anatomy, Pathology, and Intervention . . . . . . . . . . . . . . . . . . .
Jose M. Velasco and Faaiza Vaince
71
7
Percutaneous Ultrasound Guidance Techniques and Procedures . . . . . . . . . . . .
Jose M. Velasco and Keith Hood
89
8
Trauma Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Kazuhide Matsushima and Heidi L. Frankel
9
Abdominal/Retroperitoneal Vascular Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . 121
Daniel R. Calderon and David C. Han
10
Laparoscopic Ultrasound in Staging of GI Malignancies . . . . . . . . . . . . . . . . . . 129
Ewen M. Harrison and O. James Garden
11
Endoscopic Ultrasound in the Upper Gastrointestinal Tract . . . . . . . . . . . . . . . 151
Dominique Dempah, Moaz Abulfaraj, and Maurice E. Arregui
12
Intraoperative and Laparoscopic Ultrasound
During Pancreatic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
W. Scott Helton and J. Bart Rose
13
Intraoperative Ultrasound During Laparoscopic Cholecystectomy . . . . . . . . . . 177
Ezra N. Teitelbaum and Nathaniel J. Soper
14
Intraoperative Ultrasound During Biliary Tract Surgery . . . . . . . . . . . . . . . . . . 187
Ewen M. Harrison and O. James Garden
vii
viii
Contents
15
Intraoperative and Laparoscopic Ultrasound During Liver Surgery. . . . . . . . . 201
Gabriella Pittau, Michele Tedeschi, and Denis Castaing
16
Techniques in Laparoscopic and Intraoperative Ultrasound Guidance. . . . . . . 219
David J. Niemeyer, Kerri A. Simo, and David A. Iannitti
17
Ultrasound Techniques for Liver Tumor Ablation . . . . . . . . . . . . . . . . . . . . . . . . 229
Paul D. Hansen, W. Cory Johnston, and Chet Hammill
18
Computer-Assisted Navigation for Ultrasound “3-D Ultrasound” . . . . . . . . . . . 243
John B. Martinie and Sharif Razzaque
19
Endoluminal Ultrasound: Anatomy, Technique, and Intervention
of the Anorectum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Joseph L. Frenkel and John H. Marks
Part III
Ultrasound in Surgical Practice
20
Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Christopher J. Kim and Junji Machi
21
Abdominal Ultrasound: Credentialing and Certification . . . . . . . . . . . . . . . . . . 279
R. Stephen Smith, William R. Fry, and Richard A. Hoppman
22
Coding and Billing for Ultrasound Examinations . . . . . . . . . . . . . . . . . . . . . . . . 283
Junji Machi
23
Future Perspective in Abdominal Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Junji Machi, Fuminori Moriyasu, Shigeki Arii, Masahiko Yano,
and Emi Saegusa-Beecroft
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Contributors
Moaz Abulfaraj, MD, FRCSC Department of General Surgery,
St. Vincent Hospital Indianapolis, Carmel, IN, USA
Reid B. Adams, MD, FACS Department of Surgery, The University of Virginia Cancer
Center, University of Virginia Health System, Charlottesville, VA, USA
Shigeki Arii, MD, PhD Department of Hepato-Biliary-Pancreatic Surgery,
Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Maurice E. Arregui, MD, FACS Department of General Surgery, St. Vincent’s Hospital,
Indianapolis, IN, USA
Eren Berber, MD, FACS Department of General Surgery, Cleveland Clinic,
Cleveland, OH, USA
Daniel R. Calderon, MD Department of Surgery, Penn State Hershey Medical Center,
Penn State Heart and Vascular Institute, Hershey, PA, USA
Denis Castaing, MD HPB Surgery and Liver Transplantation,
AP-HP, Hopital Paul Brousse, Centre Hépato-biliaire, Villejuif, France
University Paris-Sud, UMR-S 785, Villejuif, France
Inserm, Unité 785, Villejuif, France
Dominique Dempah, MD Department of Surgery, St. Vincent’s Hospital,
Indianapolis, IN, USA
Heidi L. Frankel, MD, FACS, FCCM Department of Surgery,
University of Southern California Keck School of Medicine, Los Angeles, CA, USA
Joseph L. Frenkel, MD Division of Colorectal Surgery, Lankenau Medical Center
and Lankenau Institute for Medical Research, Mainline Health Systems,
Wynnewood, PA, USA
William R. Fry, MD, FACS, RVT, RDMS Department of Surgery,
University of South Carolina School of Medicine, Columbia, SC, USA
O. James Garden, CBE, FRCSEd, FRSE Department of Clinical Surgery,
The University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK
Gary Gecelter, MD, FACS, FACG Department of Surgery, St. Francis Hospital,
Roslyn, NY, USA
Michael J. Giuffrida, MD Department of Surgery, St. Francis Hospital, Roslyn, NY, USA
Neha Goel, MD Department of Surgery, Columbia University Medical Center,
New York, NY, USA
ix
x
Ellen J. Hagopian, MD, FACS Department of Surgery, Jersey Shore University
Medical Center, Neptune, NJ, USA
Department of Surgery, Robert Wood Johnson Medical School,
New Brunswick, NJ, USA
Department of Surgery, New York Medical College, Valhalla, NY, USA
Chet Hammill, MD Department of Surgical Oncology, Gastrointestinal and Minimally
Invasive Surgery, The Oregon Clinic, Portland, OR, USA
Providence Cancer Center, Portland, OR, USA
David C. Han, MD, MS, FACS, RPVI Department of Surgery, Penn State Hershey
Medical Center, Penn State Heart and Vascular Institute, Penn State College of Medicine,
Hershey, PA, USA
Paul D. Hansen, MD Department of Surgical Oncology, Gastrointestinal and Minimally
Invasive Surgery, The Oregon Clinic, Portland, OR, USA
Providence Cancer Center, Portland, OR, USA
Ewen M. Harrison, MB, ChB, PhD, FRCS Department of Clinical Surgery,
The University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK
W. Scott Helton, MD, FACS Section of Hepatobiliary Surgery, Virginia Mason Medical
Center, Seattle, WA, USA
Keith Hood, MD Department of General Surgery, Rush University Medical Center,
Chicago, IL, USA
Richard A. Hoppmann, MD Department of Internal Medicine,
University of South Carolina School of Medicine, Columbia, SC, USA
David A. Iannitti, MD Hepatobiliary and Pancreas Surgery,
Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA
W. Cory Johnston, MD Department of Surgical Oncology, Providence Cancer Center,
Portland, OR, USA
Christopher J. Kim, MD Department of Surgery, Regional Medical Center of San Jose,
San Jose, CA, USA
Junji Machi, MD, PhD, FACS Department of Surgery, John A. Burns School of Medicine,
University of Hawaii and Kuakini Medical Center, Honolulu, HI, USA
Noguchi Medical Research Institute, JADECOM-NKP GME Center,
Tokyo Bay, Urayasu-Ichikawa Medical Center,
(Noguchi Hideyo Memorial International Hospital), Urayasu, Chiba, Japan
John H. Marks, MD, FACS, FASCRS Division of Colorectal Surgery,
Lankenau Medical Center and Lankenau Institute for Medical Research,
Mainline Health Systems, Wynnewood, PA, USA
Department of General Surgery and Digestive Oncology, University Nice Sophia-Antipolis,
Centre Hospitalier University, Nice, France
John B. Martinie, MD Department of Surgery, Carolinas Medical Center,
Charlotte, NC, USA
Kazuhide Matsushima, MD Department of Surgery, University of Southern California,
Los Angeles, CA, USA
Fuminori Moriyasu, MD, PhD Department of Gastroenterology and Hepatology,
Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
Contributors
Contributors
xi
David J. Niemeyer, MD Hepatobiliary and Pancreas Surgery,
Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA
Kevin Ryan Parks, BA Department of Surgery, Jersey Shore University Medical Center,
Neptune, NJ, USA
Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
Gabriella Pittau, MD HPB Surgery and Liver Transplantation,
AP-HP, Hopital Paul Brousse, Centre Hépato-biliaire, Villejuif, France
Sharif Razzaque, PhD InnerOptic Technology, Inc., Hillsborough, NC, USA
J. Bart Rose, MD, MAS Section of Hepatobiliary Surgery,
Virginia Mason Medical Center, Seattle, WA, USA
Emi Saegusa-Beecroft, MD, PhD Department of Surgery, JABSOM, University of Hawaii
and Kuakini Medical Center, Honolulu, HI, USA
Beth A. Schrope, MD, PhD, FACS, RDMS Department of Surgery,
New York Presbyterian/Columbia University Medical Center, New York, NY, USA
Columbia University College of Physicians and Surgeons, New York, NY, USA
Kerri A. Simo, MD Hepatobiliary and Pancreas Surgery, Department of General Surgery,
Carolinas Medical Center, Charlotte, NC, USA
R. Stephen Smith, MD, RDMS, FACS Department of Surgery,
University of South Carolina School of Medicine, Columbia, SC, USA
Nathaniel J. Soper, MD Department of Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
Halit Eren Taskin, MD Division of Endocrinology and Metabolism Institute,
Cleveland Clinic, Cleveland, OH, USA
Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
Michele Tedeschi, MD HPB Surgery and Liver Transplantation,
AP-HP, Hopital Paul Brousse, Centre Hépato-biliaire, Villejuif, France
Ezra N. Teitelbaum, MD Department of Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
Faaiza Vaince, MD Department of General Surgery, Rush University Medical Center,
Chicago, IL, USA
Jose M. Velasco, MD Department of Surgery, NorthShore University HealthSystem,
Skokie Hospital, Skokie, IL, USA
Department of General Surgery, Rush University Medical Center, Chicago, IL, USA
Masahiko Yano Ultrasound Systems Division, Ultrasound Systems
Development Department, Toshiba Medical Systems Corporation,
Otawara-Shi, Tochigi, Japan

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