Laparoscopic/Robotic Liver Ablation for Liver Tumor
Local therapy with thermal ablation is a secondary alternative treatment option for various tumors in patients who are not suitable for liver resection. Marginal liver reserve, the need to remove excessive amount of normal liver in order to clear a small tumor (<3cm), and patient’s inability to tolerate major operation due to medical issues are the most common reasons to recommend ablation instead of liver resection.
Dr. Iswanto Sucandy utilizes a microwave energy system to ablate and eliminate tumors. This procedure is performed via a laparoscopic single incision or several small incisions using robotic assistance. Using a videoscopic camera, we are able to visualize the liver surface directly and undertake the tumor ablation under a real-time ultrasound guidance. The ablation probe is carefully inserted into the center of the tumors avoiding the surrounding organs such as diaphragm, stomach, kidney, main bile duct, major vessels, small intestine, and colon to prevent injury to those structures.
Laparoscopically delivered liver ablations are associated with lower tumor recurrence when compared to those delivered percutaneously by an interventional radiologist (6% vs 14%). The laparoscopic or robotic approach also provides the opportunity to perform a direct inspection of the entire abdominal cavity and liver surface for small metastatic tumors otherwise not detected on high quality CT/MRI scans (18%). Many patients can be discharged after 6-12 hours observation.
Liver ablation is also frequently done in combination with tissue preserving liver resection to achieve tumor free status when additional tumors are present on the other liver lobe. Dr. Iswanto Sucandy and his team frequently perform combined minimally invasive robotic liver resection and liver ablations for primary and metastatic tumors with excellent outcomes.