Overview
Removing what's diseased. Preserving what works.
The liver is a remarkable organ — it tolerates removal of up to two-thirds of its volume and regenerates over the following weeks. That biology is the foundation of liver surgery. By removing tumors with adequate margins while leaving enough healthy liver behind, we can offer curative resection for many primary and metastatic liver cancers.
Liver resections range from small wedge resections and single-segment removals to major hemihepatectomies. The right operation depends on tumor location, size, number, and the underlying health of the liver. We use minimally invasive approaches (robotic or laparoscopic) for most peripheral and select major resections, and open surgery when the anatomy calls for it. Every plan is built around the principle of margin-negative resection with the safest possible parenchymal preservation.
Who is a candidate?
Candidacy depends on tumor characteristics, the patient's overall health, and the function of the underlying liver. Most patients without cirrhosis can tolerate resection of up to 70% of liver volume. Patients with cirrhosis or significant fatty liver tolerate less; we calculate future liver remnant volume on imaging and sometimes use techniques like portal vein embolization to grow the remnant before surgery. Multi-disciplinary review with medical oncology is standard for colorectal liver metastases and most primary liver cancers.
How we perform it
Under general anesthesia, the operation is performed through 4–5 small incisions (robotic or laparoscopic) or a single open incision, depending on the resection. We use intraoperative ultrasound to confirm tumor location, plan the resection line, and identify any additional lesions not seen on preoperative imaging. The liver is divided using energy devices and clamps that minimize blood loss. Margins are confirmed before closure. The whole operation takes 2–6 hours depending on extent.
Recovery
Hospital stay is typically 3–7 days. We use early ambulation, multimodal pain control, and gradual diet advancement. At home, recovery is gradual: most patients feel back to baseline by 4–6 weeks. The liver regenerates noticeably over the first three months on follow-up imaging. Surveillance imaging starts at 3 months and continues at planned intervals depending on the disease being treated.
Why Florida Surgical
Liver surgery sits at the intersection of technical skill, judgment about what to resect, and tight coordination with medical oncology. Dr. Shaw is fellowship-trained in surgical oncology with focused expertise in cancers of the liver and biliary system. We use modern imaging, intraoperative ultrasound, and minimally invasive techniques as the default — moving to open surgery when the case demands. Multidisciplinary review is built into every plan.
Frequently asked questions
How much of my liver will I have left?
Surgery is planned so that you retain at least 30 percent of healthy liver function. The liver regenerates rapidly — within three months, the remaining liver typically grows to compensate for what was removed.
Can colorectal liver metastases be cured?
Yes, in selected patients. About 25 to 50 percent of patients who undergo curative resection of colorectal liver metastases are alive without disease at 5 years — a much better outcome than chemotherapy alone. Patient selection and multidisciplinary management matter.
Is robotic liver surgery as good as open?
For appropriate patients and tumors, yes — published outcomes for minor and select major hepatectomies done robotically are equivalent to open with less pain and faster recovery. We choose the approach based on tumor location and patient factors, not on a default.
Will I need chemotherapy?
Most patients with malignant liver tumors also receive chemotherapy at some point — before, after, or both. The sequencing is decided jointly with medical oncology based on tumor type and stage.
What if my tumor is too big to remove safely?
Sometimes we can use portal vein embolization or staged hepatectomy to grow the future liver remnant before surgery. Other patients benefit from systemic therapy first to shrink the tumor. A small number of patients are offered liver-directed therapies (ablation, embolization, radioembolization) instead of resection.