Laparoscopic Liver Ablation

Abstract

Indications • Hepatocellular carcinoma • Tumor metastatic to the liver that can be completely treated or substantially debulked • Second-line therapy for patients who are not candidates for open debulking Essential Steps 1. Place ports: 10 mm supraumbilical, 12 mm subcostal along the anterior axillary line, and 5 mm paramedian along the midclavicular line. 2. Examine the abdomen to rule out extrahepatic metastatic disease. 3. Identify hepatic lesions with ultrasound. 4. Ablate lesion(s). 5. Close the abdominal fascia for 10-and 12-mm port sites. Note These Variations • Radiofrequency versus microwave ablation system Complications • Bleeding • Injury to the bile ducts • Bile leak • Hepatic abscess Template Operative Dictation Preoperative Diagnosis HCC/metastatic ___ cancer of the liver Procedure Laparoscopic liver ablation Postoperative Diagnosis Same Indications This ___-year-old male/female with a history of stage ___ carcinoma of ___. Computed tomography and positron emission tomography scan revealed metastatic lesions (describe location in liver). This led to the decision to proceed with a laparoscopic liver ablation.