There is no doubt that due to the increased frequency of cancers of the colon, and the increase in the frequency of hepatitis B and hepatitis C, there is a large increase in primary and secondary neoplasms (cancers) of the liver. Indeed, liver cancer is the third most common cancer in the developed world. This, indeed, is a trend that is expected to increase in the next decade.
In the last two decades we have witnessed major developments in the field of surgery of the liver and bile ducts. These developments have been driven by large advances in the field of pharmacology and oncology, as well as the application of techniques that have been derived from the transplanted liver, but also from the minimally invasive (laparoscopic) techniques. Finally, a very important impetus to the surgery of the liver and bile ducts have given and some new technologies, such as radio frequency (RFA), microwave (mw) and the nano-knife.
Routine surgeries
The application of modern techniques of anaesthesia, and operative – for the open digital angiography, it has led us to be considered routine surgeries, with a low rate of complications, rapid recovery of the patient from the surgery and with an average time of stay in the hospital 4 – 5 days.
These techniques include anesthetic techniques, with the use of επισκληÏιδίου catheter analgesia, as well as protocols for the rapid recovery (fast-track protocols), which leads to a rapid mobilisation of the patient.
Also, the use of radio frequencies and microwaves (RFA and microwave) allows for the transdermal (skin) or intra-operative (within the surgery) -either with open surgery or laparoscopically – destruction of the cancerous tumors of the liver.
This technique is based on the placement of a pin in the center of the tumor and raise the temperature in the core of the volume, that leads to destruction, without damaging the adjacent liver, with very encouraging results.
In this area a very modern technology, which is applied to the Hospital HEALTH, is the nano-knife, a technique that leads to complete necrosis of tumors, even when these filter vessels or surrounding large vascular structures such as the portal vein or the hepatic veins.
The minimally invasive techniques
Finally, a very great impetus to the surgery of the liver and biliary has given the use of minimally invasive techniques, techniques which are applied by the Department in the Hospital HEALTH.
These include laparoscopic, and robotic techniques. In particular, in a proportion of patients can be achieved fully laparoscopic digital angiography or laparoscopically assisted thermal destruction of tumors using radio frequency or microwave, without, however, violating any of the oncological principle. The same can be achieved in a proportion of patients and with the use of robots and robotic surgery.
All of the above techniques, combined with careful preoperative imaging (ct, mri, διεγχειÏητικό ultrasound), as well as with a personalized approach from a team of oncologists, radiologists, pathologists and surgeons of the liver, it can provide the patients with malignancies in the liver and in the bile duct a significant cure rate, which in our Hospital is comparable with the best centers of North America.
Source
Surgery of liver – biliary: new techniques for the management
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