Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2012; 4(8): 187-192
Published online Aug 15, 2012. doi: 10.4251/wjgo.v4.i8.187
Laparoscopic liver resection: Current role and limitations
Rouzbeh Mostaedi, Zoran Milosevic, Ho-Seong Han, Vijay P Khatri
Rouzbeh Mostaedi, Vijay P Khatri, Department of Surgery, University of California, Davis Cancer Center, University of California, Davis Medical Center, Sacramento, CA 95817, United States
Zoran Milosevic, Clinic for Abdominal, Endocrine and Transplantation Surgery, Clinical Center Vojvodina, 21000 Novi Sad, Serbia
Ho-Seong Han, Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea
Author contributions: Mostaedi R and Khatri VP contributed to conception, writing, editing, and final approval of the version to be published; Milosevic Z reviewed the manuscript; Han HS critically reviewed the manuscript.
Correspondence to: Vijay P Khatri, MBChB, FACS, Professor of Surgery, Department of Surgery, University of California, Davis School of Medicine, 4501 X Street, Sacramento, CA 95817, United States. vijay.khatri@ucdmc.ucdavis.edu
Telephone: +1-916-7342172 Fax: +1-916-7035267
Received: December 13, 2011
Revised: July 31, 2012
Accepted: August 6, 2012
Published online: August 15, 2012

Laparoscopic liver resection (LLR) for the treatment of benign and malignant liver lesions is often performed at specialized centers. Technological advances, such as laparoscopic ultrasonography and electrosurgical tools, have afforded surgeons simultaneous improvements in surgical technique. The utilization of minimally invasive techniques for liver resection has been reported to reduce operative time, decrease blood loss, and shorten length of hospital stay with equivalent postoperative mortality and morbidity rates compared to open liver resection (OLR). Non-anatomic liver resection and left lateral sectionectomy are now routinely performed laparoscopically at many institutions. Furthermore, major hepatic resections are performed by pure laparoscopy, hand-assisted technique, and the hybrid method. In addition, robotic surgery and single port surgery are revealing early promising results. The consensus recommendation for the treatment of benign liver disease and malignant lesions remains unchanged when considering a laparoscopic approach, except when comorbidities and anatomic limitations of the liver lesion preclude this technique. Disease free and survival rates after LLR for hepatocellular carcinoma and metastatic colon cancer correspond to OLR. Patient selection is a significant factor for these favorable outcomes. The limitations include LLR of superior and posterior liver lesions; however, adjustments in technique may now consider a laparoscopic approach as a viable option. As growing data continue to reveal the feasibility and efficacy of laparoscopic liver surgery, this skill is increasingly being adopted by hepatobiliary surgeons. Although the full scope of laparoscopic liver surgery remains infrequently used by many general surgeons, this technique will become a standard in the treatment of liver diseases as studies continue to show favorable outcomes.

Keywords: Laparoscopic liver resection, Laparoscopic hepatectomy, Minimally invasive liver surgery, Hand-assisted technique, Hybrid technique