The puncture model and clinical application of laparoscopic ultrasound-guided liver tumor ablation

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Abstract

Laparoscopic ultrasound (LUS) -guided ablation of liver tumors is an important method for the treatment of hepatic neoplasms. This technique involves needle insertion from the lateral side of the ultrasound probe, and selecting the appropriate puncture point presents certain challenges. The right-angle wedge model can effectively demonstrate this puncture process. This study aims to analyze the clinical efficacy of microwave ablation for liver tumors under LUS guidance and to provide a quantitative description of the right-angle wedge model. A total of 13 patients with small liver carcinoma participated in this study. None of these patients experienced significant complications postoperatively, such as bleeding, jaundice, or intestinal injury. Comparisons between preoperative and postoperative day two laboratory indicators revealed a significant increase in alanine aminotransferase levels [32 (15, 62.5) U/L vs. 135 (81, 319.5) U/L], which was statistically significant (P=0.02). Follow-up magnetic resonance imaging (MRI) enhancement one month after surgery indicated that all tumors had been completely ablated. Furthermore, through our research on the right-angle wedge model, we established that by knowing the position of the LUS probe, scanning plane, and angle of needle insertion, it is possible to calculate specific points from which target locations can be reached. In conclusion, LUS-guided liver tumor ablation is conducted safely and effectively under dual visualization provided by both laparoscopy and LUS throughout the procedure. Considering the need for puncture from the side of the LUS probe, this technique requires a solid three-dimensional understanding; based on our models and research, we are able to identify precise puncture points that facilitate rapid completion of both puncture and ablation procedures.

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