Minimally Invasive management of Liver, Pancreas, and Biliary Cancers

World renowned surgical expertise 

Shorter hospital stay and better recovery with less trauma

Oncologically equivalent or superior



Individualized analysis of tumor biology for each patient

Close collaboration with medical oncologists, primary care physicians, imaging specialists, and support teams

Personalized treatment approach driven by holistic patient experience 

What is Minimally Invasive Surgery?

What is Minimally Invasive Surgery?

Minimally invasive surgery is a new approach that asks the question: how can we provide the same or better surgical result while minimizing trauma to the patient?

In traditional surgery, the large incision and retraction of connective tissue (see figure 1) are the most traumatic aspects to recover from, even with complex procedures that involve removing a part of the liver or the comprehensive Whipple procedure.

Instead of making a large incision, minmally invasive technology takes advantage of a few strategically placed ports (see figure 2) to operate inside the pateint without causing the trauma of an open procedure. The technique involves a multi-disciplinary team, led by a surgeon who is skilled in laparoscopy or robot-assisted surgery, and can dramatically shorten the recovery time after a complex surgery.

Is it safe?

Safety should be the surgeon's first concern.

Minimally invasive procedures have comparable or better safety profile to traditional open procedures, with equivalent or improved cancer outcomes. Safety begins with the question: is this patient a good candidate for minimally invasive technique?
To answer this question, your surgeon and his team should evaluate your medical history, tumor biology, and anatomy with novel techniques such as 3D rendering of the lesion to determine if you are a good candidate.

In the hands of a highly skilled minimally invasive surgeon, not only is the technique safe but can lead to 30% reduction in length of stay in the hospital, reduced blood loss, wound infection rates, and faster return to additional therapy (e.g. chemotherapy).

How is it different from traditional surgery?

The main difference is, as suggested by the name, the level of invasiveness.
On a more nuanced level, the minimally invasive and multidisciplinary approach to a procedure requires a new way of thinking about cancer care. The highly skilled surgeon, in conjunction with expert radiologists and medical oncologists, use advanced imaging to render an improved understanding of the patient's anatomy as well as his/her specific tumor biology.

During the procedure, the surgeon's instruments work inside the patient through strategically placed ports, achieving the goal while avoiding the trauma of a large incision with additional damage to the surrounding tissue. Laparoscopic cameras (ideally 3D cameras) give a magnified view of the area the surgeon needs to work on. Because the surgeon can feel the tissues only indirectly via the instruments (laparoscopy) or not at all (robotics), an advanced skill level by the surgeon is required.

How do I know if it's right for me?

It's important to make this decision in conjunction with a surgeon who is specifically trained in minimally invasive surgery (MIS). However, the surgeon should not only think about the invasiveness of the surgery but also about the entire therapy in the context of multidisciplinary care. Therefore, the surgeon should work closely with medical oncologists, radiation oncologists, etc. to integrate the surgery into a comprehensive treatment plan. Each patient and each case is different. An important part of the surgeon's training and experience is recognizing the indications for approaching a procedure with MIS technique. Through a multidisciplinary evaluation process, the surgeon and patient work together to arrive at a decision to plan for the procedure.

Will this affect my cancer care?

A laparoscopic approach to HPB cancers has shown to lead to excellent oncologic results if performed by an experienced surgeon in the right hospital environment. Today, scientists are studying whether the lesser trauma of a minimally invasive approach preserves more of the patient's immune system during surgery, which further helps to fight the cancer.