Laparoscopic anatomical hepatic resection. Report of four left lobectomies for solid tumors.

Four patients underwent a laparoscopic left hepatic resection for solid tumor, two for metastasis from colonic cancer, and two for focal nodular hyperplasia (final diagnosis). The procedure was performed according to the rules of conventional hepatic surgery and cancer surgery. No blood transfusion was necessary. No surgical complication occurred. In malignant disease, laparoscopy allows a good staging and the performance of a real no-touch technique; the specimen is removed in a plastic bag without contact to the abdominal wall. In symptomatic benign disease the esthetic benefit of the laparoscopic approach is real. In asymptomatic benign disease, laparoscopy could allow large biopsies in the case of uncertain diagnosis or dangerous resection. It allows safe resections in the case of small, well-located tumors. This approach requires sophisticated material and extensive experience in both laparoscopy and hepatobiliary surgery.