Advances and challenges in laparoscopic surgery in the management of hepatocellular carcinoma

Core Tip

Core tip: Hepatocellular carcinoma is the most common primary malignant tumor of the liver and fifth most common malignancy worldwide. Surgical resection is the therapeutic treatment of choice and its laparoscopic version has come into play since 1992. Several matched comparative studies reported its superiority over open resection regarding operating theatre time and hospital stay, blood loss, need for transfusion and postsurgical opioid analgesics, postoperative pain, morbidity, R0 resection, time to recuperation, time to oral intake and stress response. The high costs of the procedure are offset by the decrease in the length of the operation and hospital stay, while in experienced hands conversion rates and morbidity are even more diminished. Laparoscopic and robotic liver resection is a continuously evolving field of minimally invasive liver surgery with a very promising future.