Liver Surgery Technique and Outcome Presented at Southeastern Regional Surgical Conference

Virtual Masterclass on Liver Surgery

Recently, Dr. Iswanto Sucandy and his colleagues participated in the annual 2020 Southeastern Surgical Congress held in Sheraton New Orleans, Louisiana, as abstract presenter, surgical technique video presenter, and session moderator. Southeastern Surgical Congress is the largest regional academic organization for general surgeons, only second after the American College of Surgeons.  The Surgical Congress reached its highest attendance of almost 700 registrants.  The best and the highest quality abstracts and liver surgical technique videos were selected based on their scientific merits.

Dr. Iswanto Sucandy and his colleagues was selected to present the technique of partial robotic liver resection using temporary vascular occlusion/inflow control and robotic bile duct injury repair after a laparoscopic cholecystectomy for acute cholecystitis/gangrenous cholecystitis.  The presentations were very well received and the session was very well attended with healthy discussion on how to do the operation best.  This also served as an educational opportunity for the younger trainees such as general surgery residents and hepatobiliary surgery fellows.

Dr. Iswanto Sucandy and his colleagues also was invited to discuss the impact of age on robotic major hepatectomy outcomes.  As we are aware that American populations are aging,  more and more elderly patients requiring major cancer operation such as liver surgery to remove liver cancer.  Due to advanced age, many liver surgeons are reluctant to offer major liver resection to these patients due to concern of bed outcomes.  This issue has been well recognized by our liver surgery team in Tampa, therefore we conducted a study to address this specific question.  In our study of 93 patients with robotic major liver resection for liver tumors, we did not see any worsening outcomes or increasing postoperative complications due to age alone.  Minimally invasive liver surgery technique plays a major role in reducing the postoperative complications, thus allowing this operation to benefit more people diagnosed with liver tumors.  Prior to the introduction of minimally invasive liver surgery method, elderly patients diagnosed with liver tumors were only given palliative option, in most cases.  Therefore, this study revolutionized our approach to liver surgery or liver cancer care in the United States.

It is important to note, however, that the patients need to be well selected by an experienced liver surgeon such as Dr. Sucandy to ensure safety of the operation.  High volume liver surgery centers have been linked to superior outcomes and lower postoperative complications when compared to low volume centers.  This results have been published extensively.  In our Tampa liver surgery center, we perform more than 120 liver resections/liver surgery annually for various types of liver tumors or liver cancers.  A smaller number of liver surgeries are performed for symptomatic benign liver mass, such as large liver cyst or liver hemangioma creating abdominal pain, discomfort, nausea, and weight loss.  Therefore, we expect superior outcomes based on our high volume status.

Dr. Iswanto Sucandy and his colleague from University of Tennessee also moderated a short oral presentation of various unique and interesting liver surgery cases.  This included novel surgical treatment of liver tumors, bile duct cancer, Klatskin tumor, gallbladder cancer,  severe acute cholecystitis, bile duct stone, liver hemangioma, and liver transplantation.