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Minimally Invasive Ablation of Liver Tumors

Local therapy with thermal ablation is an alternative treatment option for various liver tumors in patients who are otherwise not a candidate for liver resection. Marginal liver reserve, need to remove excessive amount of normal liver in order to clear a tumor, and patient’s inability to tolerate a major operation are the most common reasons for a liver surgeon to recommend ablation.

Thermal ablation to destroy liver tumors can be delivered using either radiofrequency or microwave technology. This procedure can be performed via :

  1. Laparoscopic approach (several small incisions to directly visualize the liver and perform the ablation under ultrasound guidance).
  1. Open approach (most commonly in combination with liver resection when additional tumors are present in the remaining liver).
  1. Percutaneous approach (direct puncture of the skin using CT scan guidance by an interventional radiologist).

In laparoscopic and open approach, liver surgeons visualize the tumors using an ultrasound device placed directly on the liver surface. The ablation probe to deliver thermal energy is then carefully advanced into the center of the tumors under ultrasound guidance. It is very important that the surgeons are aware of the surrounding organs (diaphragm, stomach, kidney, main bile duct, major vessels, small intestine, and colon) to prevent an inadvertent thermal injury while delivering the energy. Your liver surgeons may recommend percutaneous approach for small tumors that are located deep in the liver substance and for tumors that can not be well visualized on ultrasonography.

The team at the Florida Hospital Tampa Digestive Health Institute decides which approach is best for you based on the number, location, and characteristic of the tumors in the liver.

What to Expect After Ablation of Liver Tumors

  1. Postoperative recovery – Ablation of liver tumors is a very well tolerated procedure. Most patients have minimal pain after the ablation and require minimal pain medications. Clear liquid diet by mouth is initiated within several hours of completing the ablation.
  1. Length of procedure – 1-2 hours depending on the size and number of tumors.
  1. Duration of hospitals stay – Patients are generally observed overnight in the hospital to ensure complete recovery, minimal pain level, and absence of postprocedural complications. Blood work including liver function test is obtained in the morning prior to discharge to monitor liver condition.
  1. Can all liver tumors be ablated (instead of liver resection)? - Ablation technology works best for tumors < 4cm in size, therefore liver resection should be considered for larger tumors as the first line standard of treatment.
  1. Potential complications – Some patients experience a low grade fever after liver ablation. A very small percentage of patients develop liver abcess and require antiobotic treatment. The risk of bleeding from both the liver and abdominal wall is extremely low.
  1. Follow up care – Patients are seen in about 2 weeks after the liver ablation. In the office (Life hope medical building) , the surgeons will examine the incisions, evaluate postoperative progress, level of pain, diet tolerance, discuss any additional treatment if needed, and discuss long term follow up plan.

Pictures of Liver Tumor Ablation

Laparoscopic Ablation of Liver Tumor Under Direct Visualization Using Ultrasound Guidance

Liver Tumor Ablation Process Under Ultrasound Guidance

Hepatocellular Carcinoma After A Complete Microwave Ablation

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Sharona Ross, M.D. - Tampa Laparoscopic Surgeon
Located at 3000 Medical Park Dr, Suite 500 Tampa, FL 33613. View Map
Phone: (813) 615-7030