The Role of Laparoscopic Surgery in the Management of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and 6th most common cancer overall. This article reviews the role of laparoscopy in the multi-disciplinary management of HCC. Laparoscopic surgery involves multiple approaches for diagnosis and treatment of HCC, including intraoperative ultrasound and biopsy, as well as ablative strategies for tumors in difficult locations. In comparison to catheter-based therapies, hepatic resection offers similar survival with the benefit of direct visualization to identify additional tumors. Laparoscopic liver resections further show similar oncologic outcomes with reduced hospital length of stay and reduced morbidity compared to open approaches and may even be used to treat large tumors. Laparoscopic surgery may be involved in the diagnosis, treatment, and resection of HCC. Laparoscopic hepatic resections are safe with equivalent oncologic outcomes and may offer advantages over catheter-based therapies in selected patients. Advances in robotic surgery have served to expand the potential for minimally invasive approaches in the surgical treatment of HCC.