Minimally invasive liver surgery: the Charité experience

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive liver surgery (MILS) emerged in the 1990s, evolving from benign to malignant indications.
• MILS now matches open surgery for oncological outcomes, with advantages in blood loss, pain, complications, and quality of life.

Purpose of the Study:

• To provide an overview of establishing a minimally invasive liver surgery program.
• To highlight the evolution and current status of MILS for liver resections.

Main Methods:

• Review of MILS development and application.
• Discussion of technical advancements and adoption of robotic surgery.
• Utilization of difficulty scores for patient selection.

Main Results:

• MILS is now feasible for most liver resections, including complex cases like colorectal liver metastases and hepatocellular carcinoma, even in cirrhotic patients.
• Overcoming initial limitations through experience and technological progress.
• Robotic surgery is expanding the scope of MILS.

Conclusions:

• MILS is a well-established surgical specialty with proven oncological efficacy and patient benefits.
• Programmatic establishment and experience are key to successful MILS implementation.
• Continuous innovation, including robotic approaches, further enhances MILS capabilities.