A hepatectomy, or “liver resection,” is an operation in which a portion of the patient’s liver is surgically removed. For many years the Division of Transplant Surgery has been performing liver resections for both malignant and benign tumors.
Our experienced surgeons specialize in removing large tumors that are located deep within the liver near the major vascular and biliary structures. This may require removing the entire right or left lobe, or even larger portions of the liver.
In certain cases, blood vessels and bile ducts must be disconnected and then reconstructed in order to safely remove the tumor. Since we perform similar reconstructions every day with liver transplants, we are able to apply the same techniques to liver resections as needed.
For the majority of hepatectomies, an open technique is required, but every effort is made to minimize the size of the incision.
If the tumor is located in the periphery of the liver, a laparoscopic approach is preferred. In this approach, the operation is performed through multiple small incisions using video assistance and advanced cautery technics. During the surgery, ultrasound allows mapping of the tumor and nearby vascular and biliary structures. The wedge of liver containing the tumor is separated from the tissue around it, enclosed in a bag, and removed through one of the small incisions. The laparoscopic approach has several potential advantages, including less postoperative pain and a shorter time in the hospital.
With larger tumors, a hybrid procedure (open/laparoscopic) can be employed. The liver is mobilized laparoscopically, and the tumor is then removed through a limited midline incision. (This incision does cut through abdominal muscle fibers, but it is smaller than the typical incision used in an open surgery.) In select cases, a hand-port can be used, allowing the surgeon to combine the advantages of laparoscopic technics with the dexterity of hand assistance. Depending on the location of the tumor, a specialized approach can be used to safely remove the tumor and facilitate the fastest possible recovery.