Liver

Fondazione Poliambulanza is a notorious centre of excellence in the treatment of malignant tumors, in particular liver metastases. Once again, the multidisciplinary approach is the successful strategy. The so called Liver Team obviously counts on Surgeons treating liver, but also on a number of oncologists, gastroenterologists, radiation oncologists, interventional radiologist and anatomopathologists. Depending on their difficulty, cases are investigated weekely or daily, so as to ensure a rapid response together with a multidisciplinary approach.

The «liver team» prefers the mini invasive approach, performing operations in laparoscopy with the 3D technology, but as for the most complex situations, for example vascular resections, traditional laparoscopy remains the best option.

• Laparoscopic Liver Resection: it is mini invasive surgical technique to remove the metastases In this procedure surgical instruments are introduced in the abdomen through small incisions instead of deep scars. The mini invasive approach aims at reaching the same qualitative standards of traditional open surgery, while minimizing the post-operative pain and speeds up the recovery process.

• In Poliambulanza’s General Surgery Department operations in laparoscopy are made with the 3D technology, a new procedure available into very few hospitals. One of the disadvantages linked to traditional laparascopy is a restricted visions during the operation as well as difficulty in handling the instruments. On the contrary, using the 3D technology means going beyond such factors and towards a new surgical approach which merges a three dimensional view with mini invasive techniques.

• Traditional Liver Resection for Complex Metastases or Tumors: in cases of very complex tumors or numerous metastases, open surgery results to be effective and useful. The gold standard therapeutic option seems to be performing a two steps liver resection, for example the new ALPPS, standing for Associating Liver partitioning and portal vein ligation for Staged hepatectomy, or a liver resection including major-vessels resections.