Liver Resection

What is a Liver Resection?

Liver resection is “resecting or removing a portion of the liver”. This can often range from being a straight forward wedge resection to fairly complex resections where the whole lobe of the liver needs to be removed. The illustration enumerates the various types of resections that are commonly done. The key is to remove the tumor and yet be able to leave behind enough functional liver. Usually 30-40% volume of liver left behind is considered sufficient volume. The Liver is one of the few organs in the body that regenerates back to almost 100% in volume in approximately 3 months. This allows for the liver to return to complete function, and also allows for repeated resections if deemed necessary in cases of recurrence.

Can liver resections be done laparoscopically?

Yes. A good number of these cases can be done using the minimally invasive techniques, i.e. by making very small incisions (5- 10 mm) for introducing instruments to allow dissection. However it is important to note that not all cases lend themselves to a laparoscopic resection and that decisions have to be made on a case by case basis. Dr. Singh is one of the few surgeons in the United States doing these major surgeries laparoscopically and was invited to speak at the 93rd Annual Clinical Congress of the American College of Surgeons on Laparoscopic Liver Resections.

Can liver resections be done using Robotic Technology?

Yes. Robotic technology offers all the advantages of minimally invasive surgery without the technical challenges of a conventional laparoscopic approach.  Plus, robotic technology shows the surgical field in 3-D, which allows greater precision than the 2-D laparoscopic view. Once again, decisions are made on a on a case by case basis upon reviewing the scans and making sure we are not compromising on the quality of the cancer operation. At the Liver and Pancreas Center, we are using the Da Vinci Robotic Surgical System to perform these surgeries.

Advantages of Laparoscopic Surgery include:

• Small incisions means smaller scars
  
• Significantly less pain and postoperative discomfort
  
• Shorter hospital stay
  
• Shorter recovery time
  
• Returning back to full activities sooner

It most often performed for:

• Cancers of the liver
  
• Liver metastases
  
• Colorectal liver metastases
  
• Neuroendocrine liver metastases
  
• Bile duct cancers extending in to the liver
  
• Non-cancerous masses if symptomatic

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