Laparoscopic (Keyhole) Liver Surgery

Laparoscopic liver surgery, also known as keyhole liver surgery, is increasingly being performed for the treatment of:

  1. liver cancer
  2. liver cysts

Generally, laparoscopic liver surgery offers patients a more comfortable and painless treatment compared to open surgical procedure.

Liver Cancer

Laparoscopic liver surgery may help to treat liver cancer in two different ways (resection or ablation of liver tumours):

Laparoscopic liver resection

  • Laparoscopic wedge resection of the liver
    • Laparoscopic wedge resection specifically removes the tumors situated on the surface of the liver, or at the periphery of the liver
  • Laparoscopic left lateral sectionectomy of the liver
    • The left lateral lobe of the liver consists of two segments. Tumours in the left lateral lobe of liver can be fully removed by laparoscopic resection. This is considered the standard of care in dedicated liver surgical centres.

Laparoscopic liver ablation

Laparoscopic liver ablation can also be used to treat liver cancer, including:

  • Radiofrequency ablation (RFA), which aims at destroying the liver cancer.
  • Microwave ablation (MWA), is used for larger tumours (up to 6 cm size)

Liver Cysts

Liver cysts are not usually considered cancerous, although a small number of cysts can be cancerous. However, cysts may cause pain, discomfort, and abdominal bloating. Laparoscopic liver surgery may help to treat symptoms of the liver cysts through the removal of parts of the cysts, causing drainage of the cysts into the internal cavity of the abdomen.

Advantages of Laparoscopic Liver Surgery

The main advantage of keyhole liver surgery is to decrease the width and number of incisions required during the surgery. While liver tumors and cysts are commonly removed by an open wound surgery known as Chevron incision. This is usually a long incision around the right abdomen, equating to 15-20 cm or more.

In contrast, the keyhole liver surgery requires a few minor incisions, through which a laparoscope and other instruments, such as camera, can be inserted. Laparoscopic instruments enable surgeons to check the liver for tumors and define their exact location without the need to perform a large incision (cut).

Other advantages of keyhole liver surgery include:

  • Decreases wound infections that may occur with large wounds
  • Reduces the recovery time
  • Reduces the need for analgesics as the post-operative pain is also much less

Complications of Laparoscopic Liver Surgery

Complications of laparoscopic liver surgery are similar to open surgery, as it is technically the same operation except through smaller incisions. Complications of laparoscopic liver surgery include the following:

  • Anaesthesia related complications – deep vein thrombosis
  • Bleeding
  • Injury of adjacent organs

Laparoscopic liver surgery is increasingly feasible for many liver tumours. This allows quick recovery, with smaller incisions for patients. Do consult with an experienced laparoscopic liver surgeon for possible laparoscopic options