Minimally Invasive Surgery for Liver Cancer
- About a third of patients diagnosed with liver cancer may be good candidates for having minimally invasive surgery.
- This surgery approach, which involves operating through a small incision, typically means less pain, shorter hospital stays, and quicker recovery.
- Techniques include Laparoscopic and Robotic Liver Resection, NanoKnife, Cryoablation, Microwave Ablation, and Irreversible Electroporation.
- Success varies by cancer type, stage, patient health, and surgical expertise but surgery can often lead to positive outcomes and sometimes even a cure.
These are procedures that use specialized instruments and techniques to perform the surgery through a small incision.
Read MoreWhat is minimally invasive surgery?
Minimally invasive surgery for liver cancer involves using advanced techniques to remove tumors with less physical trauma compared to traditional open surgery.
The surgeon can often make smaller cuts, smaller incisions, which means less pain, and quicker recovery times for patients.
There are several types of minimally invasive surgery used for liver cancer:
- Laparoscopic Liver Resection (LLR): Removal of part of the liver through small incisions using specialized tools
- Robotic Liver Resection (RLR): Similar to LLR, but performed robotically, allowing for precise movements and better visualization
- NanoKnife Ablation: Uses electrical currents to treat inoperable tumors less than three centimeters
- Cryoablation and Microwave Ablation: Destroys cancer cells using extreme temperatures
- Irreversible Electroporation: Targets tumor cells without harming surrounding tissue
What is minimally invasive surgery like?
All of the techniques are a similar experience for the patient.
Typically, a patient will be placed under general anesthesia, although in some cases their surgeon may give them epidural anesthesia that only numbs the lower body but doesn’t put the patient to sleep — this is similar to what’s used during labor and delivery of babies.
All types of minimally invasive surgery can significantly reduce hospital stay and recovery times. Most patients require only an overnight stay.
However, Dr. Newman points out that sometimes the surgeon may need to make a slightly bigger incision to remove a larger piece of the liver.
“In those situations, maybe because of pain control, you might have to be in the hospital for two nights, three nights sometimes,” he says. “But in general, if we can do it minimally invasively, it certainly is an easier recovery than with a large open incision.”
“The most important thing when trying to assess liver surgery is to have a doctor who is familiar with all different approaches and understands the best approach for your individual situation,” he adds.
What results can I expect?
Success rate can vary widely depending on:
- Type and stage of liver cancer
- Specific technique used
- Patient’s overall health
- Expertise of the surgical team
Generally, minimally invasive surgery for liver cancer is associated with positive outcomes like shorter hospital stays, less postoperative pain, quicker recovery, and results that are about the same as traditional open surgery.
Surgery can sometimes be a potential cure for liver cancer, especially when the cancer is detected early and is localized within the liver.
Am I a good candidate for this surgery?
Not everyone diagnosed with liver cancer is a good candidate for having minimally invasive surgery.
Your doctor will consider this approach if:
- If the tumor is small, typically less than 5 cm
- There are a few, isolated tumors
- Tumors located in places that are easily reachable
- The patient has good general health with adequate liver function
- The patient does not have significant cirrhosis or other liver diseases
What are the pros and cons?
Like any medical treatment, minimally invasive surgery comes with advantages and disadvantages.
Pros include:
- Less Pain
- Quicker Recovery
- Reduced Hospital Stay
- Less Blood Loss
- Lower Infection Risk
Cons include:
- Limited to size and location of tumor
- Requires specialized skills and equipment, which may not be available
- Surgeon may need to switch to an open procedure if complications arise.
- Not suitable for those with extensive liver disease or multiple large tumors
- Risk the cancer might return
Will I need additional treatment after surgery?
Some patients need additional treatments even after having surgery. This depends on the stage of cancer, whether or not any cancer remains, and the patient’s overall health.
Common additional treatments include:
- Chemotherapy to prevent recurrence
- Radiation therapy to eliminate remaining cancer cells
- Drugs that specifically target cancer cell mechanisms without affecting normal cells, used in cases where the tumor has specific genetic markers
- Immunotherapy to boost the body’s immune system
- Ablation Therapies with techniques like radiofrequency ablation or microwave ablation to address small tumors that remain or recur.
According to Dr. Newman, the need for added treatment depends on a detailed assessment by your care team.
“.. it’s very important to realize that we have made a lot of progress in the last couple of decades both in the terms of the surgical approaches that we can do now more minimally invasively which allows you to recover faster,” he says.
“And in terms of the medications and drugs that we can use to treat afterwards in the form of chemotherapy or very newer drugs that are called targeted agents…” he adds.
Related: Durvalumab to the Rescue In Liver Cancer
Questions to ask your doctor
- Am I a good candidate for minimally invasive surgery?
- What procedures are you considering for my case?
- How long is the recovery?
- Will I need additional treatment before or after surgery?
- What are the costs associated with my treatment and how much will be covered by insurance versus out of pocket?
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