Liver Surgery& Associated Treatments
This page provides an overview of liver treatment techniques and surgical procedures. If you have any question about the surgery types, please get in touch with our friendly reception team. We're here to help you with clear information, comfort, and excellence in care.
In a hepactectomy procedure, part of the liver is removed. The liver has 8 segments and quite a complex anatomy. Blood vessels, entering the liver, split up in left and right branches, so we refer to a left or right "hemi-liver". There are more refined divisions, to indicate the exact segments of the liver. Here at The Surgeons Collective, one of our priorities is to help you understand these complexities of the liver and the human body, so you can make well informed decisions about your surgery.
Liver resection, as shown in the image below, involves the removal of one or several sections. Each of the classic liver resection procedures has its own name.
We will discuss these liver segments with you, as part of a consultation about the most suitable liver treatment type. Sometimes, only one liver segment needs to be removed for small types of lesions, and we call it a segmentectomy. A subsegmental liver resection is a procedure that is done with keyhole surgery, as a very local resection, for small and superficial liver lesions.
If you suffer from cancer of the bile ducts, your surgeon may suggest a combined procedure: it would consist of a liver resection and a reconstruction of the biliary drainage with a loop of intestine. This is known to be a very complex surgery type.
Whatever the level of complexity, you always deserve expert surgery, as well as excellence in care and support. One of our commitments at The Surgeons Collective in Perth is to offer you that combination, based on the hundreds of liver surgeries we have performed for our Perth patients at The Liver Centre WA.
At The Surgeons Collective in Perth, we build on our years of experience as The Liver Centre WA. Our team of surgeons, specialist doctors and dietitians is here to help you prepare for your treatment, and to help you recover, in the most comfortable and the most effective way.
We have developed a unique and extremely safe quality of surgery, building on our experience in the advanced surgical techniques that are used in liver transplantation. The expertise helps when we work with a patient who has been diagnosed with liver metastases. They are cancers of the colon and rectum causing secondary lesions in the liver, a migrated cancer that started in other areas of the body.
Liver transplantation is sometimes referred to as the recommended treatment options, by your hepatologist or your liver surgeon. Part of your assessment can be prepared in our private practice. Most of the assessment work would be done by Prof Delriviere, Prof Jeffrey or Dr Michael Wallace in the WA Liver Transplant Service at Sir Charles Gairdner Hospital. It is important to note that liver transplantations are only offered for patients who are entitled to Australian Medicare and in the public service hospitals. We do not perform live liver donation for liver transplantation in WA (adult to adult or adult to child).
A liver biopsy can be part of the process to deliver a detailed diagnosis and it is performed prior to your liver surgery. Local anaesthesia is used for this procedure (or light sedation by a specialist radiologist, using an ultrasound procedure).
The information from the biopsy is important, to define which section of the liver can be removed safely in the procedure.
We are a team of liver surgeons and liver specialists, committed to choosing and performing the most effective surgery type for you while we also look after your comfort. Excellence in surgical outcomes is our priority focus, as well as clear communication: we want to make sure that you fully understand the tests, your diagnosis and the treatment we recommend or suggest.
What patients appreciate about The Surgeons Collective, is our attention to genuine patient support and care, before, during and after your treatment.
Microwave ablation for liver tumours
Microwave ablation is one of the techniques that are sometimes used as part of a liver surgery procedure. Microwave technology is used to burn liver lesions, and if both sides of the liver have lesions, the hemi liver containing multiple lesions can be removed. In that case, the lesions in the other hemi liver will be burnt away using microwave ablation.
Techniques to expand the left side of the liver
In certain cases, removing liver sections could mean that less than 25% of liver volume remains after surgery, creating a dangerous situation. In this case, your liver surgeon may recommend one of the following techniques, to expand the remaining side of your liver:
SIRT or Selective Internal Radiation Therapy is sometimes referred to as Radio-Embolisation, and it may be recommended by your surgeon if you have an advanced liver tumour. The therapy is performed prior to the liver surgery, by an interventional radiologist. He injects radioactive beads via the hepatic artery, targeting the tumours. The technique is sometimes used to control tumours that can not be treated with surgery.
The radioactive beads irradiate the tumour for 3 months, locked in the small vessels of the tumour.
SIRT or Selective Internal Radiation Therapy applied in large doses to the right liver lobe, shrinks that section of the liver and also controls the tumour. In reaction to it, the left lobe of the liver will now expand. And as a result, a liver resection or liver surgery procedure can now be safely performed 3 months after the SIRT procedure. There are now guarantees that enough liver volume will be available after the surgery.
- Right Portal Vein Embolisation
A right portal vein embolisation is one of the other techniques to prepare you for liver surgery, growing one side of the liver. The interventional radiologist blocks the portal vein that feeds the right liver half, and as a result the blood flow now goes to the left side of the liver. The right side shrinks, the left side grows, over a timeframe of 4 to 6 weeks. Then, a new CT scan helps confirm that there is enough liver growth, and confirms that is is now safe to proceed with the liver surgery.
As part of the required tests to obtain an in-depth diagnosis, your liver surgeon may suggest a diagnostic staging laparoscopy. The keyhole surgery procedure collects extra information and images, on the extension of the primary tumour. It also helps identify any metastases oin the liver, or small cancer deposits in the abdomen. The procedure is used to establish that the planned surgery can be planned with the best possible long term outcomes.
Fenestration of liver cysts
Laparascopic fenestration can be performed for large benign liver cysts. In this procedure, a large part of the cyst capsule is removed, and it relieves the symptoms caused by compression of other organs by the cyst. Recurrence rates in this case are low.
Your treatment journey may include an intraoperative ultrasound to locate large vessels inside the liver or tumours, during your surgery. Ultrasounds provide valuable visual information about the location of a tumour, and the surgical anatomy of the liver.
A Trans Arterial Chemo Embolisation or TACE, is a procedure that delivers chemotherapy medication to the blood vessels that feed into the liver and into a liver tumour (the hepatic artery). In this procedure, beads are injected to block most of the arterial supply (the blood supply). Highly experienced and qualified radiologists work with our liver surgeons for this procedure, and it is sometimes used to control tumours that can not be surgically removed.
Why The Surgeons Collective
We're very aware that the information about our specialised liver surgery techniques, may feel overwhelming for you as a patient. As an essential part of role, we value clear communication, when we set about guiding and supporting you throughout your journey as a patient.
Patients find that before, during or after their surgery, our surgeons and specialists are always here to help, ready to provide extra clarification on each of the steps.
What matters to us is that you feel supported and cared for. We commit to organising expert surgery for you, and to work together as a team to provide you with genuine care as you go through this process.