Liver Surgery
What is liver surgery?
Liver surgery refers to surgical treatments for the liver; an organ located underneath the ribs on the right side of the body. The liver performs the important functions of storing and filtering the blood, as well as creating bile for digestion, and converting sugar into energy.
Liver surgery is typically recommended as a cancer treatment and will focus on the removal of the part of the liver where cancer has spread.
Am I a good candidate for liver surgery?
Liver resection candidates must have a tumour that is confined to their liver, or where tumours outside the liver can also be treated, and a liver that has enough healthy tissue remaining for normal function following the removal of the diseased parts.
How does liver surgery work?
The two main types of liver resection are laparoscopic liver resection surgery and open liver resection surgery. Laparoscopic liver resection is minimally invasive and is favoured over open surgery if possible. It involves the removal of benign or malignant liver tumours through three or four small incisions about the size of a keyhole. An open liver resection involves an incision being made below the ribcage and across the right side of the upper abdomen, in order to remove the tumour. This is a procedure that can take from three to six hours, depending on the location and nature of the tumours.
Liver Tumour Ablation
Radiofrequency ablation and microwave ablation can be effective treatments for patients whose tumours are less than 4cm in diameter, or who could have difficulty with more invasive surgery.
Irreversible electroporation (sometimes called NanoKnife) can be suitable when the efficacy of radiofrequency ablation and microwave ablation is limited by the size, location and number of a lesion (abnormal tissue).The main limitations with ablation techniques or electroporation is that they are not useful for larger tumours, when the x-ray doctor can’t see the tumour to place the needles accurately or when the tumour is near large blood vessels.
Radiofrequency ablation and microwave ablation utilise x-ray image guidance to insert a needle into a liver tumour, usually through the skin. High-frequency electrical currents (radiofrequency ablation) or microwaves (microwave ablation) are then used to create heat which can destroy the liver cancer cells. This type of liver surgery has a success rate of over 85 per cent in destroying small liver tumours completely. If the tumour cannot be seen through the skin and muscles, sometimes ablation is used at the same time as surgery to find the tumour, or combined with surgery to remove other parts of the liver; this helps to keep normal healthy liver.T
he procedure of irreversible electroporation involves the insertion of single-use needles into the liver, before high voltage, short electrical pulses are used to create pores (small holes) in the cancer cells. The objective is to destroy the cancer cells without damaging the liver's structure.
Following radiofrequency ablation, microwave ablation and irreversible electroporation, patients often return home the same day or next day after the procedure. Normal activities can be resumed within a few days.
Recovery from liver surgery
Following a laparoscopic liver resection, most people can leave the hospital after one or two days. There is less pain and scarring with this minimally invasive procedure than there is with open resection. A hospital stay of five days could be advised after an open resection, and it could take several months before normal activities can be resumed.
Around three months after surgery, a CT scan will usually be done to check that the tumour hasn't returned.