Laparoscopic hepatic resection

Laparoscopic liver resection (LLR) has evolved over the last two decades to offer patients the potential benefits of less post-operative pain, shorter hospital stay and improved cosmesis. Blood loss and morbidity appear to be less, while oncologic outcomes are similar to those achieved by open techniques in trials analyzing non major liver resections. Liver surgery embraces a broad array of procedures from simple to complex, and although many surgeons perform minor resections, the widespread adoption of LLR for major resections remains somewhat limited; mostly due to fear of bleeding or oncological concerns. This paper explores the development of LLR over the last 20 years, focusing on the people involved in the advances and the technical and educational improvements they instituted. Surgeons should begin LLR in a stepwise approach beginning with small peripheral lesions in favorable segments before progressing to more complex hepatic resections.