The history of Laparoscopic Ultrasound

The results of LUS are dependent of the equipment and the expertise of the investigator. Equipment for LUS have been available since 1964 but only case reports about the use of LUS were published until 1992, where electronical transducers attached to small diameter probes were introduced. Since 1995 clinical controlled studies have been published and the equipment is now considered to be sufficient for routinely clinical use. The most important technical improvements seems to have been the flexibility of the probes combined with small linear or curved arry transducers with choices of frequency between 5 to 7.5 MHz.

Prototypes of LUS probes (Fukuda 1984)

There are no traditions for systematical clinical evaluation of approvements of the instruments. Thus evidence for use of a rigid contra semiflexible probe, or semiflexible contra multifexible probe or use of Doppler contra non-doppler or use of electronical contra mechanical transducers have not been evaluated. Only one study have evaluated a rigid probe contra a flexible probe in two groups of each 100 consecutive patients admitted for LAP cholecystectomy. There were no difference in detecting the common bile duct stones and the sensitivity and specificity was higher than peroperative cholangiography in both groups. The dedicated flexible probe, however, was found to have significant higher discovery rate concerning bile duct abnormalities and was recommended . An important indicator for choise of instrument is the number of publications of controlled studies using the small diameter probes with flexible tips and electronical transducers. It is important however to evaluate new approvements such as biopsy guidance facilities, especially concerning clinical benefit and safety, but also to be able to distinguish between unnessecary fancy changes and important clinical approvements.

History of LUS. The most important developments in the history of LUS are listed with the year the new development were published. Important steps in the history are highlited .

Rigid LUS probe 1992 ( Garden et al.)             Flexible LUS probe 1985 (Fukuda)

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