Diagnostic laparoscopy and laparoscopic ultrasonography with local anesthesia in hepatocellular carcinoma

Figure 1 Oblique sonogram of right lobe of the liver showing a predominantly hypoechoic mass. V: gallbladder. RI: right kidney.

Figure 2 A: Endoscopic liver image of cirrhosis. Ultrasonic probe is placed in contact to a fibrotic depressed whitish area near the gallbladder; B: Laparoscopic sonogram revealing a tumor under liver surface.

Figure 3 Sonogram showing a 16-mm hypoechoic hepatic nodule in segment IV, histologically diagnosed of HCC.

Figure 4 A: Laparoscopy displaying the left lobe of the liver with medium-sized nodules and without evidences of neoplasm; B: The endoscopic sonogram confirming the intrahepatic presence of uninodular HCC.

Figure 5 Sonogram revealing a hypo-isoechoic tumor in the center of the right lobe of the liver.

Figure 6 A: Upper aspect of right lobe of the liver. The surface is not perfectly smooth owing to the presence of alternately reddish areas slightly elevated with respect to lighter colored ones; B: Laparoscopic sonogram showing a very well defined tumor near a vascular structure.