Can't Liver Tumors Over 5 Centimeters Be Removed Laparoscopically? New imaging technology eliminates worries

Is a liver cancer tumor too large to be removed laparoscopically? This threshold has apparently been broken! A 62-year-old woman surnamed Huang was sent to the emergency room a while ago because of hematuria, and found that the right kidney had a 7-centimeter blister, referred to the Department of Nephrology at the Veterans General Hospital in Taichung, and found that there was a 13-centimeter liver tumor at the same time by the magnetic resonance angiography imaging, after the evaluation of the surgeon, decided to open the surgery by laparoscopy, and the postoperative recovery was good, to avoid the traditional surgery of the big wounds and the risk of infection.

Dr. Luo Shaoqiao (left) with the patient Huang. (Photo courtesy of Taichung Veterans General Hospital)

Laparoscopic surgery for liver tumors is becoming popular

Liver cancer is a common malignant tumor in Taiwan, and traditional surgery to remove liver tumors can result in a very large abdominal wound, often up to a 30-centimeter long inverted L-shaped wound, and the patient will need to be in the hospital for about six to eight days after the surgery. In addition, because the wound is located in the upper abdomen, the postoperative wound is very painful, almost all patients have to rely on the help of anesthesiologists to receive postoperative hard spinal injection of patient-controlled pain relief in order to reduce the pain.

On the other hand, patients who undergo laparoscopic hepatic tumor resection can not only avoid the discomfort of nasogastric tube placement, but also get out of bed without relying on hard spinal injections for postoperative pain relief, and most of the patients can have their urinary catheters removed immediately after surgery, and the rate of postoperative wound infections and incisional hernias are also greatly reduced. This is why laparoscopic resection of liver tumors has become popular in recent years.

Laparoscopic resection of liver tumors, "size" is no longer the only key

However, most of the laparoscopic resections of liver tumors are still based on the principle that "the tumor must be less than 5 cm and located superficially in the liver". In this regard, Dr. Luo Shaoqiao, a general surgeon at the Veterans General Hospital in Taichung, said that laparoscopic surgery for liver tumors is no longer based on the size or location of the tumor as the only consideration, and the main question is whether or not to retain enough remaining liver tissue during the surgery and completely remove the lesion; at present, laparoscopic surgery has been able to carry out a wide range of hepatic resections and a short recovery time.