Minimally Invasive Liver Surgery for Primary and Secondary Liver Malignancies

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive (MIS) liver surgery has become a cornerstone in treating liver neoplasms.
• Significant advancements have occurred in MIS hepatectomy over the last two decades.

Purpose of the Study:

• To review the evolution of MIS hepatectomy techniques.
• To highlight the role of robotic surgery in liver resections.
• To discuss advanced intra-operative techniques and ablation methods for liver cancer.

Main Methods:

• Literature review focusing on MIS hepatectomy, robotic surgery, and intra-operative techniques.
• Discussion of Glissonian pedicle approach and indocyanine green (ICG) guided near-infrared fluorescence.
• Overview of ablation techniques such as microwave and histotripsy.

Main Results:

• MIS hepatectomy has evolved substantially, offering effective treatment for liver neoplasms.
• Robotic surgery plays an increasing role in MIS hepatectomy.
• Advanced techniques like Glissonian approach and ICG fluorescence enhance precision in liver resections.
• Ablation techniques provide alternative or complementary treatment options for liver cancer.

Conclusions:

• MIS hepatectomy, enhanced by robotic assistance and advanced intra-operative tools, represents a major progress in liver cancer treatment.
• The review covers key technical advancements and ablation modalities relevant to modern liver surgery.