Value of the Laparoscopic Approach in the Surgical Management of Resectable Hepatocellular Carcinoma

"* Installations of the patient: the position of the patient will depend on both extent of resection and location of the lesion.~* Absence of laparotomy with the exception of the extraction of the resected specimen and absence of costal retractors.~* Use of laparoscopic specific devices:~ * Use of multiple (3-7) ports depending on the operator's preference and technical difficulty (mainly 5-6 ports for major liver resection).~ * Use of a laparoscopic camera system with 0° or 30°~ * Use of a dedicated laparoscopic ultrasound probe.~ * Use of specific laparoscopic devices for coagulation, parenchymal transection and sealing.~* Placement of the resected specimen in a plastic bag and extraction without fragmentation, depending on the surgeon's preferenceand the diameter of the resected specimen"

"* Installation of the patient: patients will be placed in supine position, the surgeon operating on the right side of the patient and the assistant standing on the left side.~* Incision: the type of incision will depend on both the nature of the resection and the operator's preference. Various incisions such as bi subcostal incision, J-shaped incision, right subcostal incision and midline incision can be used.~* Use of open surgical instruments and devices for coagulation and parenchymal transection. These may include the crush-clamp technique or ultrasonic dissection for parenchymal transection, bipolar coagulation, clips, sutures or open vascular stapler for hemostasis and biliostasis.~* Methylene blue injection through the cystic drain to rule out biliary leakage will be performed depending on the surgeon's preference."