Reaching the Colorectal Liver Masses

Excerpt

For most of our medical and surgical colleagues, the mere suggestion of liver surgery invokes images of yellow patients on ventilators who just barely escaped the jaws of the surgical vise and are lucky to be able to live and tell their story. Only the young and the physically strong are considered viable candidates for such a brutally heroic effort to (just) stall their cancer, and then only if they truly desire to go forward. In the minds of many, still, the balance between surviving the operation and the cancer is estimated to be a tight equilibrium. On top of that, there is a prevailing sense of having to protect these emotionally and physically friable patients from the hands of such aggressive surgeons. The modern truth could not be farther removed from these perceptions. Liver surgery has seen tremendous advances in the last decade, but some or most of these advances have hardly penetrated the medical and surgical community. Minimally invasive liver surgery, modern anesthesia techniques, novel stapler technologies, and energy devices have made liver surgery what it is nowadays: a safe and well-tolerated surgical modality with low morbidity and mortality. Complications still occur, needless to say, but with mortality rates of 1–2% in most modern series and less than 15% major morbidity, the horror images of times-gone-by hardly seem justified.1,2 …