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Saturday, August 21, 2010

Ultrasound for Surgeons (Vademecum) [ILLUSTRATED]




In recent years, technology has revolutionized the practice of surgery. As part of this change, surgeon-performed ultrasound has become one of themost integral parts of the surgeon’s clinical practice. It is not surprising to observe this current surge of interest in ultrasound by general surgeons because surgeons are highly motivated to provide the best possible care for their patients, including the use of the latest technologic advances in diagnosis and treatment. Furthermore, ultrasound equipment is compact, affordable and user-friendly so that extensive training is not required to master focused ultrasound techniques. Cost containment initiatives by patients, clinicians and third-party payers have encouraged the use of modalities, such as ultrasound, that save time and money. Considering the unique qualities of ultrasound -noninvasive, portable, rapid and easily repeatable, ultrasound is especially suitable to the surgeon’s practice. The FAST has replaced central venous pressure measurements for the detection of hemopericardiumand diagnostic peritoneal lavage for the detection of hemoperitoneum. Bedside ultrasound detects a pleural effusion so well in critically ill patients that fewer lateral decubutis X-rays are ordered. Ultrasound directed biopsy of breast lesions is a common office procedure. Laparoscopic ultrasound allows for tumor staging without formal celiotomy while ultrasound is an adjunct tomany hepatic and pancreatic procedures. Endoscopic and endorectal ultrasoundhave added a new dimension to the assessment and treatment of many gastrointestinal lesions. Color-flow duplex imaging and endoluminal ultrasound have significantly expanded the diagnostic and therapeutic aspects ofvascular imaging.

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