Laparoscopic Liver Resection

The field of laparoscopic liver surgery has rapidly evolved over the past two decades, with more than 3,000 cases now reported worldwide. The most important issue regarding laparoscopic hepatectomy for HCC is appropriate knowledge of the procedure’s indications. It is dangerous to broaden the indications without evidence, because such expansion could jeopardize the twin goals of laparoscopic surgery; minimal invasiveness and safety. The indications for laparoscopic hepatectomy are basically the same. Minimally invasive liver resection is gaining acceptance worldwide. However, the laparoscopic approach often is reserved for small segmental resections due to the fear of significant blood loss. The expansion of laparoscopic liver surgery will depend on the ability of expert surgeons and technological advances to address the management of bleeding and hemostasis with any new approache as those for open hepatectomy in terms of the preoperative assessment of liver function.