Recent advances in laparoscopic liver resection

Abstract

Since the first laparoscopic liver resection (LLR) was reported in 1991, both surgical techniques and conceptual frameworks have developed rapidly worldwide. Progress in hepatic anatomy - from the classical Couinaud segmentation to refined subsegmental and dynamic portal territory systems - has provided a stronger foundation for precision liver surgery. The “gate theory” and its application in LLR have further enhanced the safety and reproducibility of anatomic dissections. Technically, indications for LLR continue to expand, preoperative evaluation has become more precise, and there has been rapid development in multimodal intraoperative navigation, vascular reconstruction techniques, and robot-assisted surgery. Conceptually, emerging strategies such as anatomic resection based on portal territory and limited anatomic resection are becoming key directions for precision liver surgery. Overall, LLR is advancing toward standardization, precision, and individualization, and is increasingly recognized as a mainstream approach for hepatic resection.

Keywords

Laparoscopic liver resection / precision liver surgery / three-dimensional visualization / portal territory / limited anatomic liver resection

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