Special Issue Introduction

Special issue webinar:
Minimally Invasive Surgery for HCC
With many reports on encouraging outcomes for hepatocellular carcinoma (HCC), laparoscopic liver resection has been accepted as an attractive alternative to open liver resection for treatment for HCC. However, still laparoscopic liver resection is still considered as difficult procedure, especially for major resection. In the 1st and 2nd consensus meeting on laparoscopic liver resection meeting, it was stated that major resection still has a risk associated with its novelty. And there are several limits in technical aspects. When the tumor is located at postero-superior area, it is still difficult to perform laparoscopic liver resection. Cirrhosis is still a limiting condition for this surgery. There is also the limit in control bleeding when it occurs. However, with the accumulation of the experiences on laparoscopic liver resection, this procedure is more easily performed than before. Anatomic liver resection has been reported to have oncological benefit. And there are reports that remnant liver ischemia after liver resection has an adverse effect on survival. This procedure should be performed very precisely and meticulously. Recently, there is a new trend to perform robotic-assisted liver resection. Robotic-assisted liver resection has advantages of ergonomic conveniences and short learning curve. However, there is still a shortage of adequate equipment such as CUSA.
With the evident advantage associated with minimal invasive surgery, minimally invasive liver surgery will be performed more frequently in the future.