Laparoscopic hepatectomy

  Advances in laparoscopic techniques have allowed for minimally invasive surgical treatment of some liver procedures, with better outcomes at a smaller cost. Compared with the original open liver surgery, laparoscopic hepatectomy has significant advantages without reducing postoperative outcomes.  1, the protection of abdominal wall function open liver resection surgery can not achieve a small incision, generally do the right subcostal incision or larger “human” incision, not only the length of at least 20-30 cm, postoperative pain is severe, long duration; and completely cut off the rectus abdominis muscle (that is, the abdomen of people who practice bodybuilding that eight fast abdominal muscles), partly cut off the external abdominal The incision scar heals after suturing, and it takes 6 months to reach the maximum strength, which is only about 70% of the original abdominal wall strength. Most patients walk bent over for months after surgery, and of course the aesthetics are poor. In contrast, laparoscopy only requires four to five 1 cm-sized holes in the abdominal wall, which can remove the resected liver specimen at a site that does not damage the strength of the abdominal wall, or at a hidden site that does not affect the aesthetics, which minimizes the damage to the abdominal wall function, and the abdominal wall function quickly recovers almost completely within 1 to 2 weeks, with minimal pain, comfort and aesthetics.  2, the overall function of the small impact, reducing the requirements for the basic conditions of the patient’s body before surgery liver surgery patients are mostly due to liver disease resulting in postoperative nutritional deficiencies and weakness, in addition to the need for recovery of the excised liver wound, the healing of large abdominal wall incisions requires a lot of raw materials for tissue repair, while laparoscopic surgery abdominal wall healing is simple and rapid, the valuable postoperative nutrition will be used for the repair of internal organs, and its overall recovery speed The overall recovery is also accelerated. Some of the patients who could not recover from open surgery may have access to surgical treatment due to laparoscopic surgery.  3, less psychological trauma viscera are not sensitive to pain, the abdominal wall and skin are very sensitive to pain, and pain has a strong emotional impact, so laparoscopic surgery reduces abdominal wall trauma, while also reducing pain, speeding up recovery and protecting the psychology of the patient. A positive and optimistic psychology is conducive to promoting the overall recovery of the person as a whole, protecting the immune function and contributing to the smooth implementation of various postoperative adjuvant treatments, and also playing a positive role in preventing disease recurrence.  Which patients can undergo laparoscopic hepatectomy?  About half of the liver surgeries can be performed laparoscopically, and the general condition for laparoscopy is that the tumor is not large and the location is not deep. Benign liver diseases such as hemangiomas, limited intrahepatic bile duct stones, tumors within 5 to 6 cm or larger. Laparoscopic treatment can be sought for liver lesions located on the left side of the liver, or on the right side but on the margin. Patients with liver tumors are also reminded that surgery is the only radical treatment for liver tumors. Non-surgical means such as interventional and radiofrequency cannot achieve radical treatment, and surgical treatment is recommended for all patients who can tolerate surgical treatment.  Since laparoscopic liver resection technology is not easy to master and requires high instrumentation, it can only be safely performed by a small number of surgeons in mega hospitals at present. It is recommended that patients with liver diseases requiring surgical procedures can go to large hospitals to consult the possibility of laparoscopic liver resection and enjoy the benefits brought by technological advances.