Description:
The most common indication for laparoscopic liver resection is a solitary liver metastasis from a colorectal cancer, but it may also be used for hepatocellular carcinoma (HCC) and for benign liver tumours or cysts.
Open surgical resection, to remove the affected part of the liver, is the standard treatment for patients with localised colorectal liver metastases and HCC. This procedure is performed through a large incision across the abdomen. A number of alternative therapies have also been developed, including hepatic artery infusion chemotherapy, percutaneous ethanol injection, cryoablation, microwave coagulation therapy, laser-induced thermotherapy, and radiofrequency ablation.
Benign liver tumours are usually treated only if they are causing symptoms. The standard treatment is open surgical resection.
Laparoscopic liver resection is performed under a general anaesthetic. The abdomen is insufflated with carbon dioxide and a number of small incisions are made to provide access for the laparoscope and surgical instruments. The resected liver is enclosed in a bag and removed, through a small incision in the umbilical area.
Hand-assisted laparoscopic liver resection allows the surgeon to place one hand in the abdomen while maintaining the pneumoperitoneum required for laparoscopy. An additional small incision is made which is just large enough for the surgeon’s hand and an airtight ‘sleeve’ device is used to form a seal around the incision.
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