Laparoscopic Surgery For Liver Cyst
Symptomatic or complicated liver cysts sometimes require surgical intervention and laparoscopic fenestration is the definitive treatment for these cysts. We performed minimally invasive surgery, hybrid natural orifice transluminal endoscopic surgery (NOTES) without scarring, for a huge liver cyst.
Since the first report of laparoscopic treatment of hepatic cysts in 1991, this approach has gained wide acceptance and is frequently performed. Laparoscopy should therefore be considered for the treatment of hepatic cysts because of its low morbidity and cosmetic advantages in young patients. However, the development of laparoscopic liver resection has been hindered by technical difficulties related to maintaining hemostasis of the transection plane, controlling hemorrhage, and visualizing and working with the deeper regions of the liver.
Regarding cyst location, cysts located in the peripheral portion of the anterolateral segments of the liver are considered suitable for laparoscopy. However, lesions located in the posterosuperior segments of the liver are considered poor candidates for laparoscopic resection because of limited visualization and the difficulty of controlling bleeding. Although laparoscopic left lateral sectionectomy is a routine approach, laparoscopic major liver resection is still preserved for experienced surgeons. Therefore, laparoscopy was often avoided when possible malignant hepatic cysts were detected in the posterosuperior segments of the liver because major liver resection is sometimes required for such lesions.