St. Luke's Surgical Oncologists Perform Minimally Invasive Surgery to Remove Liver Tumors

Major liver resections performed to completely remove enclosed tumors

Bethlehem, PA (04/06/2009) - Recently, two major laparoscopic liver resections were performed at St. Luke's Hospital-Bethlehem Campus by fellowship-trained surgical oncologists Roderick Quiros, MD and Darius Desai, MD of St. Luke's Cancer Care Associates.

While laparoscopic surgery has been utilized extensively for other types of surgical procedures, it has seldom been employed for major liver operations.

"We've performed laparoscopic wedge biopsies of the liver for some time now. In those cases, small pieces of liver were removed to allow the pathologist to examine the tissue and make a diagnosis," says Dr. Quiros. "However, our recent resections involved removal of much larger portions of the liver termed 'lobes' or 'segments' of the liver. In these two cases, the large resections were required in order to completely remove the enclosed tumors."

The techniques to remove large portions of the liver have been developed, for the most part, in major liver transplantation centers, according to Dr. Desai. "Building on these developments, we are now able to apply them to patients with both liver cancer and benign liver tumors," he says.

Best for Localized Tumors

Laparoscopic liver resection is most appropriate for patients with localized tumors. Tumors can originate in the liver itself or can present as metastatic disease. The surgery is also dependent on the number, extent, and size of the lesions present, as well as the patient's having adequate liver function.

The anatomic and functional complexity of the organ makes liver surgery challenging. The liver is very vascular in nature, according to Dr. Quiros. The liver receives a dual blood supply, and drains the blood directly into the vena cava, which in turn feeds directly into the heart. The liver also is comprised of a tree-like network of bile ducts that coalesce into a main trunk or duct that drains into the gastrointestinal tract.

Less Pain, Shorter Hospital Stay and Faster Recovery

Selecting the right patient is the key to being able to complete the procedure laparoscopically, according to the surgeons. "The benefits to patients are significant. With the laparoscopic approach, we are able to use small incisions, resulting in less pain after surgery, a shorter hospitalization, and a faster recovery," says Dr. Quiros. "In our patients' cases, hospitalization has lasted about three days."

In addition to laparoscopic liver surgery, Drs. Quiros and Desai use the laparoscopic approach routinely for colorectal cancers and for some gastric, pancreatic, and adrenal malignancies.
According to Lee B. Riley, MD, PhD, Medical Director, St. Luke's Cancer Center, this advanced surgical procedure complements other advanced treatments available at St. Luke's for liver cancer, including radiofrequency ablation, chemoembolization, cryoablation and SIR-spheres.