Surgical ultrasound, also known as intraoperative ultrasound (IOUS), is an imaging technology that gives surgeons a real-time view inside the body during an operation. Unlike diagnostic ultrasounds performed on the skin, surgical ultrasound is used directly on an organ’s surface. This proximity provides live, high-resolution images to guide the procedure as it happens. The tool serves as a live map for the surgical team, rather than for pre-operative diagnosis.
How Surgical Ultrasound Works
Surgical ultrasound technology uses a small, handheld device called a transducer or probe. During a procedure, the surgeon places this sterile device directly onto the organ, where it emits high-frequency sound waves. These waves travel into the tissue and bounce off internal structures like blood vessels or tumors.
The transducer detects the returning echoes, which a computer processes to generate a live, two-dimensional image on a monitor. Because the probe is in direct contact with the organ, it avoids interference from skin and bone. This allows for the use of higher-frequency sound waves, resulting in clearer images than a standard external ultrasound can produce.
Applications in Different Surgical Fields
Surgical ultrasound is a common tool across several specialties. In neurosurgery, it is used to locate brain tumors, cysts, and blood vessels. Surgeons can precisely define a tumor’s boundaries, helping them remove the mass while preserving healthy brain tissue. The technology also compensates for “brain shift,” a phenomenon where the brain’s position changes after the skull is opened, making pre-operative MRI scans less accurate.
In hepatobiliary surgery, which involves the liver, gallbladder, and pancreas, the technology maps the complex network of blood vessels and bile ducts. This is important when removing liver tumors, as surgeons can identify and avoid these structures to perform safer resections. It is highly accurate for detecting liver lesions and can identify small tumors missed by pre-operative imaging.
Vascular surgeons use intraoperative ultrasound to assess blood flow through arteries and veins. During procedures like carotid endarterectomy, surgeons can use Doppler ultrasound to instantly confirm that blood is flowing properly through a newly placed graft or repaired vessel. This immediate feedback allows for on-the-spot corrections before the operation is complete.
Enhancing Surgical Accuracy and Decision-Making
Surgical ultrasound provides live feedback that allows surgeons to make informed decisions and adjust their strategy instantly. This is particularly effective for localizing targets that are difficult to see or feel, especially in minimally invasive surgeries where tactile feedback is limited.
A primary function of this technology is margin assessment. After removing a tumor, the surgeon can scan the edges of the resection area to check for any remaining cancerous tissue. This helps ensure a more complete removal of the malignancy, which is a factor in reducing the likelihood of recurrence.
The Patient Experience
From a patient’s perspective, the use of surgical ultrasound occurs entirely while they are under general anesthesia. The process does not add any sensation or discomfort, nor does it alter the post-operative recovery experience. Patients will not feel the ultrasound being performed, and it does not introduce any new elements to the standard healing process following surgery.
Ultrasound is widely recognized as a safe imaging method because it does not use ionizing radiation, unlike X-rays or CT scans. This eliminates any risk associated with radiation exposure for the patient and the surgical team. The decision to use this tool is made by the surgical team based on the specifics of the planned procedure.
In many cases, the potential use of intraoperative ultrasound may be discussed with the patient during pre-operative consultations as part of the overall surgical plan. Its inclusion is aimed at improving the safety and effectiveness of the operation. This can provide reassurance that the surgical team is equipped with advanced tools to achieve the best possible outcome.