Minimally Invasive Hepatectomy
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Background and Objectives:
Minimally invasive hepatectomy (MIH) has transformed liver surgery, expanding from simple benign lesions to complex malignant disease. This lecture evaluates its perioperative, oncological, and technical outcomes, with particular emphasis on robotic hepatectomy (RH).
Materials and Methods:
Clinical studies comparing MIH with open hepatectomy (OH) and radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) were conducted using data collected between 2003 and 2017. The outcomes of laparoscopic hepatectomy (LH) and RH were assessed across different procedure difficulty levels. A difficulty scoring system for RH was validated, and a multicenter propensity score-matched study compared robotic and laparoscopic right or extended right hepatectomy (R/ERH) using data from 29 international centers.
Results:
Compared with OH, MIH resulted in less blood loss, fewer transfusions and complications, and shorter hospitalization. MIH also achieved superior long-term survival to RFA for early-stage HCC. RH and LH showed comparable outcomes in low- and moderate-difficulty cases, while RH reduced conversion rates and hospital stay in high-difficulty procedures.
Conclusions:
These findings support MIH as an effective treatment for HCC and highlight the role of robotic platforms in facilitating complex liver resections and advancing minimally invasive hepatobiliary surgery.
Clinical Associate Professor (Honorary) in Department of Surgery,
The Chinese University of Hong Kong
Dr Charing Ching-Ning CHONG is an Honorary Clinical Associate Professor in the Department of Surgery at The Chinese University of Hong Kong. A specialist in hepatobiliary, pancreatic, minimally invasive, robotic surgery, and endoscopic ultrasound, Dr Chong has built an academic career that integrates clinical excellence, innovation, medical education, and translational research.
With specialist training in Hong Kong and overseas centres of excellence including Johns Hopkins Hospital, Asian Medical Center, the University of Illinois Chicago, and Eastern Hepatobiliary Surgery Hospital, Dr Chong has been at the forefront of introducing and advancing robotic and minimally invasive HPB surgery in Hong Kong. She has led initiatives in robotic surgery, endoscopic ultrasound, multidisciplinary cancer care, and the development of novel surgical technologies through collaborations with engineers and scientists.
An internationally recognized HPB surgeon, Dr Chong has authored more than 200 peer-reviewed publications, with an h-index of 41 and over 6000 citations. Her research has been published in leading journals including JAMA Surgery, Endoscopy, Surgical Endoscopy and Gastrointestinal Endoscopy, with major contributions in robotic surgery, endoscopic ultrasound-guided tissue acquisition, hepatobiliary malignancies, and surgical innovation. She has secured competitive funding as principal investigator for multiple randomized controlled trials and translational research projects.
She is a member of several professional organizations including the International Hepato-Pancreato Biliary Association (IHPBA), International Association of Surgeons, Gastroenterologists and Oncologists and Hong Kong Society of Robotic Surgery and Asian EUS Group.
Dr Chong is equally passionate about medical education and talent development. She has played major roles in curriculum development, accreditation exercises, undergraduate and postgraduate surgical training. Having mentored numerous medical students, trainees, and research fellows, she is committed to nurturing future clinician-scientists who can thrive at the intersection of medicine, engineering, entrepreneurship, and digital health.
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