Laparoscopic Liver Surgery
What is it?
The liver is a very large organ which takes up most of the upper right part of the abdomen. It has many important vital functions such as filtering the blood to eliminate toxic substances produced by the body, making products that help blod clot formation after injury to blood vessels, and regulating the body’s protein and sugar stores.
What causes it?
A laparoscopic surgeon may be called upon to operate on the liver for several reasons, the most common being the presence of a mass (tumor, abnormal growth). The masses sometimes cause pain or upper abdominal discomfort and some of them may bleed. Often, the masses do not cause any symptoms and are found on a CT scan done for other reasons. If the nature of this mass cannot be determined by blood tests or radiological exams (CT, MRI, nuclear medicine scan), it may be necessary to perform a laparoscopic biopsy (excision of a small piece of the mass) or even complete excision, either through an open or a laparoscopic approach. The different types of masses that can grow in the liver are:
- Hemangioma – An abnormal growth made up of blood vessels. It is not cancerous and requires excision only if it produces symptoms.
- Focal Nodular Hyperplasia – An abnormal growth of liver cells. It is not cancerous and requires excision only if it produces symptoms.
- Cyst – An accumulation of fluid. It rarely requires treatment, but if symptomatic, may require surgery to excise part of its wall and allow the fluid to drain.
- Abcess – An accumulation of bacteria which forms a collection of pus. This is usually treated with antibiotics and drains that are placed radiologically (CT-guided), but sometimes a laparoscopic drain must be placed.
- Adenoma – A benign (non-cancerous) mass which has the potential to bleed or turn into a cancer. It is usually recommended that adenomas be excised.
- Carcinoma – Cancer that originated from the liver cells or that comes from another cancer in the body (metastasis). Depending on how healthy the rest of the liver is, how extensive the cancer is, and what organ the metastasis came from, it may be recommended to receive chemotherapy or to undergo surgery to excise the cancer or to place special devices that burn the mass.
Treatment Options
A laparoscopic or minimally invasive approach involves specialized video equipment and instruments that allow a surgeon to operate on the liver through several tiny incisions, versus a large traditional incision for an open approach. The benefits of minimally invasive surgery include a shorter hospital stay, a faster return to normal activity and less scaring. A laparoscopic approach is not offered for treatment of all liver masses as some can only be excised safely through an open approach. This should be discussed with your surgeon.
This information is not intended to replace a visit with your physician. If you have further questions, please call 614-293-3230.