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Surgery

Dumont-UCLA Liver Cancer Center among few offering minimally invasive liver resections

11/01/2007

Technological advances and decades of experience have allowed the Dumont-UCLA Liver Cancer Center to emerge as one of the few programs in the world offering minimally invasive laparoscopic surgery for complex anatomic liver resections.

Developed in the 1990s, laparoscopic surgeries are performed through incisions of 1.5 centimeters or less by introducing lights, cameras and surgical instruments through narrow tubes inserted into the abdomen. Elimination of large incisions reduces risk and limits surgical trauma to the body, allowing patients to recover faster. Laparoscopic approaches to liver surgery were among the last to emerge because of the organ’s complex anatomy and the risk of dangerous bleeding from adjacent blood vessels. Laparoscopic wedge resections of the liver, in which diseased tissue is removed while the rest of the liver remains intact, are now commonly performed at UCLA and increasingly at other centers. However, UCLA has one of the few liver cancer programs that also offers laparoscopic surgery for more extensive anatomic resections, in which potentially compromised tissue adjacent to tumors is removed in addition to the diseased tissue.

Liver resections require surgeons to carefully consider the specific anatomy of the liver, particularly the vascular and biliary systems. Only highly experienced surgeons capable of navigating delicate structures and reverting quickly to an open incision procedure in the event of an emergency are equipped to perform laparoscopic anatomic resections of the liver.

New technology

Advances in technologies and techniques for using surgical instruments have combined to make laparoscopic liver resections possible in the hands of the most experienced surgeons, such as those at UCLA. These technologies include the following:

  • Endocutter and Endo-Gia surgical staplers are inserted through the narrow opening of an endoscope to seal off arteries, veins and branches of the biliary network while cutting into the liver to remove diseased tissue. In addition to reducing complications, the staplers decrease operative time.
  • The Harmonic Scalpel, or “hot” blade, is a metal probe that cauterizes by using heat from ultrasonic vibrations rather than electric current. The system avoids the hazards of traditional cauterization with electricity that are particularly acute in laparoscopic procedures.
  • The Habib 4X laparoscopic device uses radiofrequency as an alternative energy source to allow surgeons to safely cauterize the path of the incision before the actual dissection and removal of diseased tissues.
  • The Helix Hydro-Jet system uses jets of water at 600 psi to strip away liver tissue while leaving delicate vascular and biliary structures intact, allowing surgeons to see and address those structures individually.

The Dumont-UCLA Liver Cancer Center

The Dumont-UCLA Liver Cancer Center offers comprehensive care for liver cancer patients, providing a powerful combination of clinical treatment and medical research. Physicians in the multidisciplinary consortium draw on the collective expertise of UCLA hepatologists, oncologists, radiologists, radiation therapists, pathologists and surgeons.

At present, the best treatment for liver cancer is surgical, including both resection and transplantation, depending on the location of the tumors and the underlying liver disease. UCLA’s liver surgery team includes highly experienced surgeons, anesthesiologists, nurses, case managers and administrators who specialize in performance and management of liver operations and peri-operative care. This team also staffs the Dumont-UCLA Liver Transplant Center, the largest liver transplant center in the world.

In addition to surgical treatment, patients at the Dumont-UCLA Liver Cancer Center have access to all of the diagnostic and therapeutic options used in the treatment of liver cancer, including chemotherapy (standard and experimental), loco regional therapy (chemo-embolization, radiofrequency ablation, ethanol ablation, cryosurgery and experimental), radiation therapy and the latest imaging equipment and techniques.

Both the cancer and transplant centers are part of the Pfleger Liver Institute at UCLA.

Patient referral

Physicians may refer patients to the Dumont-UCLA Liver Cancer Center by calling (310) 825-5318. Emergency or urgent transfers can be arranged 24 hours a day by calling (310) 825-5318 and requesting the liver nurse coordinator on call.

More information is available online at Dumont-UCLA Liver Cancer Center.

Physicians

Ronald W. Busuttil, M.D., Ph.D.
Professor and executive chair, Surgery
Chief, Liver and Pancreas Transplantation
Director, Dumont-UCLA Liver Cancer Center

John Duffy M.D.
Clinical instructor, Surgery

Erik Dutson, M.D.
Assistant clinical professor, Surgery
Director, Minimally Invasive and Bariatric Surgery Fellowship
Co-director, Center for Advanced Surgical and Interventional Technology  

Johnny Hong, M.D.
Assistant professor, Surgery





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