Laparoscopic Liver Resection – Procedure, Advantages & Results
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.
Successful Liver Tumor Removal:
The success of a liver tumor removal depends on the following factors:
Location of the tumor
Number of masses
Distribution of the masses
Amount of liver left after tumor removal
Resection of a large portion of the liver is possible because the remaining liver grows to compensate for the part that was removed.
The common advantages include:
Less postoperative pain
Shorter hospital stay
Faster return to solid-food diet
Quick return of bowel function
Quicker return to normal activities
Improved cosmetic results
Before the Surgery:
As part of diagnosis of liver diseases, you will be required to undergo blood work or imaging techniques like ultrasound, CT scans, MRI and nuclear medicine imaging. In some cases, an endoscopic ultrasound evaluation is helpful. Diagnosis also involves liver enzyme tests and special blood markers. Before the surgery, other blood tests, an EKG or a chest X-ray may be required.
The preoperative preparation includes medical evaluation, blood work and an EKG depending upon your age and the medical condition. After studying your condition, your surgeon will explain you the benefits and potential risks with this surgery. Depending on your condition, blood transfusion and or blood products may be required. Sometimes oral antibiotics will be prescribed and your surgeon or his staff will provide you instructions. It is recommended that you shower the night before or in the morning of the operation. After midnight, the night before surgery, you should not eat or drink anything except medications prescribed by your surgeon with a sip of water the morning of surgery. Diet medications should not be used for two weeks before the surgery and quit smoking. Drugs like aspirin, anti-inflammatory medications, blood thinners and vitamin E should be stopped temporarily for several days before surgery. Send us your inquiry to know the best liver cancer hospital in Delhi.
Expect During the Surgery:
As with the laparoscopic surgery, the surgeon uses a narrow tube like instrument called cannula to enter the abdomen. A tiny telescope connected to a video camera called as a laparoscope is inserted through the cannula which allows the surgeon to get a magnified view of the patient’s internal organs on a television monitor. Several other cannulas are inserted to allow the surgeon to work inside and remove the part of the liver. Often a larger port called a hand port is used. The entire procedure may be completed through the cannulas or by lengthening one of the small cannula incisions.
In some patients the laparoscopic method cannot be performed and the factors that increase the possibility of choosing or converting to the open procedure include:
A history of prior abdominal surgery causing dense scar tissue
Bleeding problems during the operation
Inability to visualize the organs
The decision to perform the open procedure is a judgement decision made by your surgeon either before or during the actual operation. When the surgeon that it is safest to convert the laparoscopic procedure to an open one this is a sound surgical judgement and not a complication. This decision to convert the laparoscopic procedure into open is strictly based on the patient safety.
Expect After the Surgery :
Post surgery, it is important to follow your doctor’s instruction. Though most people feel better in a few days, remember that your body needs time to heal.
You will be encouraged to out of bed after the surgery and walk. This will help to diminish the soreness in your muscles.
You will probably be able to return back to most of your normal activities like driving, showering, working, walking upstairs and engaging in sexual intercourse in one to two weeks time.
You should call and schedule a follow-up appointment within two weeks post your operation.