Promise of laparoscopic liver resection for liver cancer explored in unique program

September 16, 2003

PITTSBURGH, Sept. 16 - Recognizing that less invasive surgeries should be among the treatment options available for patients with liver cancer, the University of Pittsburgh Medical Center (UPMC) is holding the first-ever workshop devoted exclusively to laparoscopic liver surgery, Sept. 18-19.

The course will attract among the best surgical oncologists, liver surgeons and liver transplant surgeons from across the United States and will be teleconferenced live to UPMC's Mediterranean Institute for Transplantation and Advanced Specialized Therapies in Palermo, Italy. Attendees at both locations will be able to view two laparoscopic liver resection surgeries and interact with the surgeons during those cases involving patients with benign liver tumors.

About 3,000 liver resection operations are performed in the United States each year whereby surgeons cut away segments of the liver that contain tumors. In some cases, 75 percent of the liver may be surgically removed. However, fewer than 5 percent of theses cases are done using minimally invasive techniques. According to some estimates, less than 100 laparoscopic liver resections were performed last year in this country.

These numbers are expected to increase as more and more surgeons consider the approach for their patients.

Laparoscopic liver resection involves three or four Band-Aid-sized incisions, whereas the traditional open liver resection operation requires the same large incision that is used for liver transplantation. Patients undergoing the minimally invasive technique can be discharged from the hospital in two days versus seven to 10 days with the more invasive surgery, and can expect a much quicker recovery. Typically, those who undergo open liver resection need six to eight weeks to fully recover.

UPMC surgeons have performed 32 laparoscopic liver resections in the last two years. About 80 percent of these have been for patients with benign liver masses, while the remaining cases have been for malignant tumors. Whether removing benign or malignant tumors, surgeons at UPMC and elsewhere consider the laparoscopic approach only if the tumors are located on the outer boundaries of the liver and are accessible using the small instruments that must fit through the keyhole incisions.

"We have adopted the approach into our mainstream thinking for treatment. It's an approach that we readily consider for our patients with liver cancer," says David A. Geller, M.D., professor of surgery at the University of Pittsburgh School of Medicine and co-director of the UPMC Liver Cancer Center, a program of the University of Pittsburgh's Thomas E. Starzl Transplantation Institute.

Course directors of the workshop are Dr. Geller and Philip R. Schauer, M.D., assistant professor of surgery at the University of Pittsburgh School of Medicine, director of Endoscopic Surgery and co-director of the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery at UPMC.

The surgeries that will be observed by those attending the course will be performed at UPMC Presbyterian by Dr. Geller and J. Wallis Marsh, M.D., professor of surgery at the University of Pittsburgh School of Medicine and a surgeon with the UPMC Liver Cancer Center and the Starzl Transplantation Institute. Four floors up from the operating room, the attendees in Pittsburgh will be viewing the surgeries from the Charles G. Watson Education Center, a state-of-the-art facility that allows real-time interaction with the surgeons. Across the Atlantic Ocean and six time zones away, surgeons in Italy will be observing and interacting with the surgeons in Pittsburgh via satellite.

In addition to exploring the promise of laparoscopic liver resection, the workshop also will cover laparoscopic radio frequency ablation of liver tumors and other laparoscopic techniques.
Guest faculty are Ravi S. Chari, M.D., FRCSC, FACS, of Vanderbilt University in Nashville, Tenn.; Paul D. Hansen, M.D., of Legacy Health System in Portland, Ore.; and Dr. Hans-Peter Meinzer of the Deutsches Krebsforschungszentrum in Heidelberg, Germany. Dr. Meinzer will demonstrate a novel 3-D CT imaging technology.

The course is being sponsored by the UPMC Liver Cancer Center of the Thomas E. Starzl Transplantation Institute and the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery.

Lisa Rossi
Clare Collins
PHONE: 412-647-3555
FAX: 412-624-3184

University of Pittsburgh Medical Center

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