The gastrointestinal (GI) surgery division is scripting a slow but definitive change in the way liver surgeries will be conducted in future. In the past 10 years, doctors at the hospital have performed nearly 150 liver surgeries using laparoscopic technique when most major public and private health centers across the country continue to use the “open surgery” method.
Compared to an open surgery, in which a large cut is made on the abdomen to resect the diseased portion of a liver, the laparoscopic liver resection (LLR) involves making smaller incisions of 510mm. This helps in faster recovery and better cosmetic result.
Team said extensive training and knowledge of liver anatomy was needed for laparoscopic surgery of liver. “Liver is a very complex organ. It has multiple sub-section and two supply channels for blood. Any mistake can be fatal, hence extensive training is required.
Team said attempted the first LLR in 2006-07 on a 45-yearold man suffering from liver cancer. About post-operative success, the doctors said many patients who got operated upon more than five years ago are still doing well. This includes a 13-year-old Delhi girl who suffered from liver cancer and another 21year-old boy from Agra who had cancer of the gall bladder. The latter got married recently and is living a healthy life.
With experience, the doctors are also learning new ways to improve the clinical outcome as well as cosmetic results. For example, in a recent case, they used a bikini cut to resect a diseased liver. The bikini cut is a horizontal cut that begins on one side of the abdomen and ends on the other, just above the line of the patient’s pubic hair and is used for caesarean section delivery . Doctors said utilizing the old cut helped reduce the resultant scar.
Of the 150 LLR done out of that, 80 involve gallbladder cancer cases wherein the disease had spread to liver, necessitating partial resection of the organ while the rest of the cases were of small and large tumor in the liver, among others.
The LLR technique is also being used for taking out part of the liver from a living donor for transplant cases. “Splitting the liver to remove a tumor or part of the organ itself is fraught with risks because there are multiple blood vessels. Any mistake can cause bleeding and death. Also, the organ is heavy and resection using fine laparoscopic instruments is challenging.