The role of laparoscopic surgery in the management of liver lesions

Laparoscopic liver surgery has been late to find popularity when compared to other surgical fields. This is understandable due to the well know technical difficulties when dealing with the liver parenchyma, the significant risk of bleeding and the doubts about its oncological efficiency. However thanks to encouraging results from a handful of enthusiastic surgeons it is now starting to gain notable expansion especially when minor resections are needed. In this these I aim to study the development of laparoscopic liver surgery analysing our experience and by reviewing the literature. For this I discuss separately the different aspects of this new approach starting with the feasibility of minor and major laparoscopic liver resections and discussing the surgical techniques adopted in our centre. I also discuss the risks of this approach demonstrating it safety in terms of intra and post operative outcome. The oncological efficiency has been at the centre of many debates in the last few years , here I discuss our oncological results in terms of resection margins, peritoneal seeding and port site metastasis. Last but not least in this dissertation, I discuss the financial aspect of this mini invasive approach showing that despite an increased intra operative cost in laparoscopic procedures, the overall cost is comparable when compared with open procedures. In conclusion, laparoscopic liver surgery was shown to be feasible , safe, oncologicaly efficient and cost effective when compared to open surgery.