Overview
Small tumors, clean margins, easy recovery.
A wedge liver resection removes a small piece of liver around a tumor without following the segmental blood supply — the cut is shaped by where the tumor sits, not by anatomic planes. Because so little liver is removed, recovery is quick, complication rates are low, and the operation is well suited to a minimally invasive approach. For small superficial liver tumors with a clean margin, wedge resection is the operation of choice and is oncologically equivalent to larger anatomic resections.
This is the workhorse operation for colorectal liver metastases, in which patients often have multiple small lesions distributed across the liver. Several wedges can be done in a single operation, sometimes combined with ablation of deeper lesions. The strategy is parenchyma-sparing surgery — take the disease, leave the healthy liver — so the patient can have repeat operations or further treatment if new spots appear later, as they often do in metastatic colorectal cancer.
Who is a candidate?
Anyone with a small superficial liver tumor (or a few of them) that can be removed with a clean margin without injuring major vessels. Colorectal liver metastases are the most common indication. Selected hepatocellular carcinomas, neuroendocrine metastases, and small benign tumors are also good candidates. We use cross-sectional imaging and intraoperative ultrasound to confirm tumor location and margin before deciding between wedge resection, sectionectomy, ablation, or a combination.
How we perform it
You are asleep under general anesthesia. We place three to five small ports for the laparoscope or robot. Intraoperative ultrasound confirms each lesion and shows the depth of the underlying vessels. Using energy sealing devices — and sometimes a vascular stapler — we cut a wedge of liver around the tumor with a margin of normal tissue. Small bleeding points and bile ducts on the cut surface are sealed individually. When multiple lesions are present, additional wedges or ablations are done in the same setting.
Recovery
Most patients stay 1–3 days in the hospital depending on the number and depth of wedges and any combined procedures. You walk and eat the day of or day after surgery. We follow up at 2 weeks, repeat labs and imaging at 6 weeks, and resume systemic therapy when indicated — typically about three to four weeks after surgery. Most patients return to normal activity within two to three weeks.
Why Florida Surgical
Dr. Shaw is fellowship-trained in hepato-pancreato-biliary (HPB) and surgical oncology. We use intraoperative ultrasound on every liver case and have specific experience with multiple-lesion wedge strategies and combined wedge-plus-ablation approaches for colorectal liver metastases. Because we partner closely with medical oncology in Coral Springs and throughout South Florida, your operative plan stays coordinated with the rest of your cancer treatment.
Frequently asked questions
How is wedge resection different from a sectionectomy?
A wedge resection is non-anatomic — we cut around the tumor with a margin of normal tissue, without following the segmental blood supply. A sectionectomy or segmentectomy follows anatomic boundaries and removes a whole anatomic section. Wedge resection is faster, removes less liver, and is well suited to small superficial tumors.
Is this an oncologically sound operation for cancer?
Yes, when the tumor is small, peripheral, and a clean margin can be achieved. For colorectal liver metastases in particular, wedge resections are oncologically equivalent to larger anatomic resections when margins are clean. The most important thing is the margin, not the size of the resection.
Can I have several wedge resections in one operation?
Yes. Patients with multiple small liver lesions — most commonly colorectal metastases or neuroendocrine metastases — can have several wedge resections in a single operation, sometimes combined with ablation of additional lesions. This is parenchyma-sparing surgery at its most useful.
What is the recovery like?
Most patients go home in one to three days. Light activity at one week, normal work at two weeks, and exercise at 3–4 weeks. Recovery is shorter than for an anatomic resection.
Is laparoscopic or robotic always used?
We use a minimally invasive approach whenever possible because wedge resections are particularly well suited to it. Open surgery is reserved for very large lesions, deep central tumors, or when significant prior surgery makes minimally invasive access difficult.