Laparoscopic surgery for hepatic segmental tumors

On June 19, 2015, a medical team consisting of Professor Chen Jinhong, Associate Professor Jia Toliang, and attending physicians Lu Lu and Zhu Wenwei, under the guidance of Director Qin Lunxiu, successfully performed laparoscopic resection of liver metastasis for a patient with liver metastasis after colon cancer surgery. The patient’s lesions were located at the junction of the caudate lobe and segments VII and VIII of the liver, in which the tumor at the caudate lobe was deep and adjacent to blood vessels. Since the patient’s first colon cancer surgery was an open surgery with serious intra-abdominal adhesions, it was extremely difficult to perform laparoscopic surgery. Director Qin Lunxiu led the team to draw up a detailed treatment plan before the operation, and then operated carefully during the operation to complete the surgery successfully. On the same day, the team also performed laparoscopic resection of colon cancer and liver metastasis for a patient with liver metastasis. Both patients recovered well after the operation and were discharged from the hospital recently. The successful laparoscopic resection of liver caudate lobe tumor marks the fact that Huashan Hospital General Surgery Hepatobiliary Surgery Group has been able to carry out laparoscopic surgeries for all liver segmental tumors, which is one of the leading surgeries in China. Traditionally, liver surgery is considered as a “huge invasive” surgery, which is highly traumatic, with much bleeding, affecting liver function in some patients, resulting in long hospitalization and recovery time. In recent years, laparoscopic hepatic cancer resection has gradually emerged due to its “minimally invasive” nature, but it is mostly limited to resection of tumors in superficial areas such as liver segments II-VI. However, most of them are limited to resecting tumors in superficial areas such as liver segments II-VI. Due to the deep location of tumors in liver segments VII and VIII, it is difficult to expose them, and not many hospitals can perform this kind of surgery. The caudate lobe of the liver is located in front of the posterior inferior vena cava, behind the first hepatic valve, and below the three hepatic veins, i.e., sandwiched between the three hepatic portal structures, which is so deep and difficult to be exposed that it used to be considered as a forbidden area for open surgery. Until the 1990s, the number of reports on open resection of the caudate hepatic lobe gradually increased, but laparoscopic resection of caudate lobe tumors was rarely performed. So far, the maximum number of laparoscopic caudate lobe tumor resection cases in a single center worldwide is only 8 cases. Since the establishment of General Surgery Hepatobiliary Surgery Group in Huashan Hospital more than one year ago, 159 cases of complete laparoscopic liver tumor resections have been successfully performed, including right and left hemihepatectomy, resection of VII and VIII tumors, etc. The related experience has been presented at the National Academic Conference of China for many times. The related experiences have been exchanged in national academic conferences for many times, and have been highly praised by the peers. (Arrows show tumors at the junction of segments VII and VIII.) (Arrows show tumors in the caudate lobe.)