Laparoscopic liver surgery

Abstract

Consolidation of laparoscopic liver surgery (LLS) has been slow due to its technique complexity, so liver has been one of the last abdominal organs treated by Minimal Invasive Surgery. First, only small resections of benign tumors located in easier segments were performed. Nowadays, every liver surgical technique made by open laparotomy, has been done by laparoscopic approach. LLS has several advantages to open approach: less blood loss, less postoperative pain, less analgesics, quicker oral intake, less hospital stay, less postoperative adherences and better cosmesis. We have performed a literature review talking about: types of LLS, its surgical tips and tricks and results published in each disease treated by LLS (liver metastasis, hepatocellular carcinoma). We could conclude that LLS is safe and feasible without increasing morbidity or mortality, and oncological results are comparable to those obtain by open approach. Minor hepatectomies in favourable segments (II al VI) are now the gold standard. Major hepatectomies or LLS in right posterior sector are not performed in many centers because they are technically demanding.