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Sioutas et al. Hepatoma Res 2021;7:26 Hepatoma Research
DOI: 10.20517/2394-5079.2020.111

Review Open Access

The evolution of minimally invasive surgery in liver

transplantation for hepatocellular carcinoma

1
Georgios S. Sioutas , Georgios Tsoulfas 2
1
School of Medicine, Democritus University of Thrace, Alexandroupolis 68100, Greece.
2
First Department of Surgery, Papageorgiou University Hospital, Aristotle University of Thessaloniki, Thessaloniki 54622,
Greece.
Correspondence to: Prof. Georgios Tsoulfas, First Department of Surgery, Aristotle University of Thessaloniki, 66 Tsimiski
Street, Thessaloniki 54622, Greece. E-mail: tsoulfasg@gmail.com

How to cite this article: Sioutas GS, Tsoulfas G. The evolution of minimally invasive surgery in liver transplantation for
hepatocellular carcinoma. Hepatoma Res 2021;7:26. https://dx.doi.org/10.20517/2394-5079.2020.111

Received: 24 Sep 2020 First Decision: 19 Nov 2020 Revised: 22 Nov 2020 Accepted: 26 Nov 2020 Available online: 9 Apr
2021

Academic Editor: Ho-Seong Han Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Hepatocellular carcinoma (HCC) is a malignant neoplasm associated with significant mortality worldwide. The
most commonly applied curative options include liver resection and liver transplantation (LT). Advances in
technology have led to the broader implementation of minimally invasive approaches for liver surgery, including
laparoscopic, hybrid, hand-assisted, and robotic techniques. Laparoscopic liver resection for HCC or living donor
hepatectomy in LT for HCC are considered to be feasible and safe. Furthermore, the combination of laparoscopy
and LT is a recent impressive and promising achievement that requires further investigation. This review aims to
describe the role of minimally invasive surgery techniques utilized in LT for HCC.
Keywords: Minimally invasive surgery, liver transplantation, laparoscopic hepatectomy, laparoscopic donor
hepatectomy

INTRODUCTION
Hepatocellular carcinoma (HCC) is a malignant neoplasm, typically arising in the setting of cirrhosis and
[2]
chronic liver disease . Globally, HCC leads to approximately 800,000 deaths every year , being the fifth
[1]
most common malignant neoplasm and the third cause of death related to cancer worldwide . It is usually
[3]
diagnosed in advanced stages, with a median survival after diagnosis of 6-20 months . Although
[4]
locoregional therapy may lead to cure for small lesions in selected patients, complete surgical resection is

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
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