Laparoscopic Liver Resection

What is Laparoscopic Liver Resection?

Laparoscopic liver resection or laparoscopic hepatectomy is a minimally invasive surgery to remove a part of the liver or the whole liver. A laparoscope is a thin fibre-optic device fitted with a camera and lens. Images from the camera are transmitted to a large monitor for your doctor to view the inside of your body.

The liver is one of the vital organs which regulates various functions and supports the normal functioning of other organs in the body. Some of the key functions of the liver include:

• Converts sugar into energy
• Helps in digestion of fats
• Helps in the excretion of waste products
• Protects against infections
• Produces blood clotting factors
• Regulates sex hormones and cholesterol level
• Supplies vitamins and minerals
• Metabolism and elimination of various drugs

Indications

Laparoscopic liver resection is commonly indicated for colon cancer that has spread to the liver. It is also used to remove benign liver tumours or hepatocellular carcinoma. Single or multiple tumours involving the different lobes of the liver can be resected with a high success rate, depending on the stage of the primary tumour.

Preparing for the Surgery

Your doctor will assess your symptoms and take a medical history. Inform your doctor if you are allergic to anaesthesia. The procedure for a liver resection will be explained to you. Imaging tests and blood tests may be ordered. Specific instructions for bowel preparation (to prevent constipation after the surgery) will be provided by your doctor. Avoid eating or drinking 6-8 hours prior to the procedure.

Laparoscopic Liver Resection Procedure

The procedure is performed under general anaesthesia and involves the following steps:

• Three to five small incisions are made in your abdomen.
• Gas is introduced into the abdomen to expand it for better visibility.
• The laparoscope is inserted and images of the internal organs are visualized on a monitor.
• Special small surgical instruments are used to remove a part of the liver.
• The resected liver is removed through a small incision made at the umbilical region.
• In the case of complete resection, liver transplantation is required.
• The incisions are covered with a bandage.

After the Procedure

An IV line is used to deliver pain medications and antibiotics to manage pain and infection. Initially, you will follow a liquid diet. You will be instructed to avoid lifting heavy weights for a few weeks. Walking multiple times a day is beneficial for recovery.

Liver resection may be followed by chemotherapy or radiation therapy to kill any cancer cells left after surgery. Since the liver is capable of regeneration, the resected liver will gain its original size in a few months.

Complications

Some complications of laparoscopic liver resection can include:

• Bleeding
• Blood clots
• Infection
• Bile leakage
• Kidney problems
• Scar tissue formation

Advantages

The advantages of laparoscopic liver resection include:

• Smaller incision
• Minimal pain
• Reduced risk of infection
• Small surgery scars
• Blood transfusion rarely required
• Shorter recovery period