Mr. Huang, 62 years old, is a chronic hepatitis B, cirrhosis patient, and unfortunately found to be suffering from liver cancer a year ago. However, Mr. Huang had severe fundal esophageal varices, and many hospitals refused to operate because of the high risk and recommended conservative treatment. After being referred, Mr. Huang came to my clinic for consultation. Combining the medical history and the patient’s current physical condition, I decided to use laparoscopic minimally invasive surgery to first dissect the varices of the fundic esophageal veins, then resect the liver cancer, and finally place local chemotherapy drugs. Now one year has passed, Mr. Huang’s liver cancer has not recurred nor metastasized, and his liver function has not further deteriorated. I. Liver tumors are different in nature and have different treatment plans. Liver is one of the good sites of tumor incidence, benign is rare among substantial liver tumors, and malignant tumors (including metastatic tumors) are more common than benign tumors. We usually pay more attention to the liver than the spleen, and we can find some liver tumors early in the physical examination, and even earlier than the appearance of symptoms, we may find some smaller hepatic hemangiomas, hepatic cysts, and primary hepatocellular carcinoma. For benign and malignant tumors of liver, the treatment is not simple “one size fits all”, but should be treated according to the specific situation. Hepatic hemangioma: Hepatic hemangioma is actually not a substantial tumor, but a kind of malformation lesion or lesion caused by damage of blood vessels. Liver hemangioma found in early stage with small volume can be left in surgery and followed up regularly. If the volume is large and the risk of rupture is high (e.g. greater than 5CM) or the pressure on the surrounding tissues affects the liver function, and there are uncomfortable symptoms such as swelling, stuffiness and pain, surgery can be considered. Liver cysts: Liver cysts are relatively common in clinical practice and are not really tumors. Most of the smaller liver cysts will not affect the liver function and will not cause discomfort, so they can be left untreated for the time being and followed up regularly. However, when the size of liver cysts is too large (e.g. larger than 10CM) or the pressure on the surrounding tissues is serious, uncomfortable symptoms such as distension, stuffiness and pain may occur; when liver cysts become infected, there will be fever, pain and other discomforts, and even damage to liver function. In such cases, surgical resection can be considered. 3, Liver cancer: For malignant tumors of liver, surgical resection is the first choice of treatment and the only means of cure. Other methods such as radiofrequency ablation, microwave ablation, high-intensity focused ultrasound, arterial chemoembolization, alcohol injection, cryotherapy, radiotherapy, molecular targeting therapy, immunotherapy and traditional Chinese medicine are actually palliative treatments, which are mainly used for patients who can not undergo surgical treatment for various reasons. The treatment plan for most benign liver tumors is similar to that of hepatic hemangioma and hepatic cyst, but benign tumors with malignant potential (e.g. hepatocellular adenoma) should be closely followed up and resected at an early stage if necessary. Minimally invasive can also cut liver cancer In many people’s understanding, liver cancer is a very serious “big disease”, and surgical resection must be “clean”, otherwise it is easy to recur or metastasize. Based on such cognition, most people worry that minimally invasive surgery is “not clean”, and think that open surgery is more guaranteed than minimally invasive surgery, and can cut more “cleanly”. In fact, this is not true. As long as the surgeon is skilled and experienced, liver cancer can also be resected minimally invasively, and the surgery can also be done in a very fine way, and the tumor can be cut “cleanly”, and the recurrence rate and metastasis rate are not higher than that of open surgery. In our department, among the cases of benign and malignant liver tumors surgically resected in the past two years, 1/4 of them were resected by minimally invasive surgery, which is much higher than that in other hospitals. For difficult and serious cases, before designing the surgical plan, we will conduct multidisciplinary collaboration and discussion based on the imaging examination, gather the wisdom and experience of everyone, and determine the surgical plan with the help of high-tech means such as three-dimensional software and 3D model printing. We also calculate whether the residual volume is enough before surgery to ensure the health and quality of life of the patient after surgery. In every case, we put our best efforts to make the surgery as best as possible.