Laparoscopic radiofrequency ablation (RFA) of liver tumors

Theodore H. Welling


The prevalence of patients with hepatic malignant tumors is rising and thus treatment strategies to specifically treat hepatic tumors continue to evolve. Local-regional treatment to the liver utilizing surgical resection continues to have the greatest efficacy in patients who are candidates. Therefore, thermal ablation of hepatic tumors in patients who are not candidates for resection remains a cornerstone of local-regional treatment for both primary liver cancers and metastatic tumors to the liver. While ablation is second in efficacy to surgical hepatic resection, ablation can aim toward curative intent in many circumstances when properly deployed. Thus, thermal or heat ablation using either radiofrequency ablation or microwave ablation, are part of the standard of care armamentarium for which hepatobiliary surgeons should be skilled at performing. Ablation can be performed with minimal invasiveness and is most commonly performed percutaneously using radiographic guidance. However, surgical ablation is still occasionally required and can thus be pursued utilizing laparoscopy in these clinical scenarios. This review will summarize the indications, benefits, and potential pitfalls for laparoscopic ablation of liver tumors.