Minimally Invasive HPB Surgery - Dr. Claudius Conrad

Minimally Invasive
HPB Surgery

Standard open surgery can treat conditions in the liver, pancreas and biliary tract, known as hepato-pancreato-biliary (HPB) disease. But the large incision required and the trauma of aggressive tissue manipulation can also pose a burden on the body, leading to lengthy and painful recoveries. 
Minimally invasive HPB surgery began as a way to provide the same safe, effective treatment with less trauma, making smaller openings for access.

At St. Elizabeth’s Medical Center in Boston, Dr. Claudius Conrad performs both open and minimally invasive surgery for HPB cancers. He has the extensive expertise needed to determine the best course of treatment, basing his recommendation on individual anatomy and each case’s unique disease characteristics.

For a minimally invasive approach, he operates by hand with specialized laparoscopic tools or by controlling the arms of a surgical robot. The wider range of surgical options allows Dr. Conrad to consider cases other surgeons may have turned down, with each case evaluated independently for the best surgical and oncological outcome.

Benefits of Laparoscopic or Robotic HPB Surgery

Minimally invasive surgery is as effective and safe as open surgery when performed by an experienced surgeon at a well-equipped medical center.

Potential advantages include:

Easier on the body Smaller incisions, less blood loss and possibly less burden on the immune system (a benefit still under study)
Fewer complications following surgery, including less chance of wound infection
Shorter hospital stay (by as much as 30 percent): Patients often go home the next day
Quicker recovery and faster return to activities
Faster return to additional cancer therapy (if needed), such as chemotherapy
Ability to spend more time at home, for cancers that shorten life expectancy

Laparoscopic Liver Surgery

In addition to advantages shared with other minimally invasive HPB procedures, laparoscopic liver surgery can lower the risk for abdominal hernia. But only a small group of surgeons at top medical centers take this approach due to the liver’s challenging location and anatomy.

Dr. Conrad specializes in minimally invasive surgery on the liver — particularly for cancer that has metastasized there, often from the colon or rectum. He also performs laparoscopic hepatectomies for cancer that starts in the liver — a less common condition — and benign liver tumors and cysts.

A minimally invasive approach may not be possible if the liver tumor is too large or entangled with the vena cava vein. Scarring from previous surgeries can also pose a challenge. Accurately evaluating the situation and recommending the right approach is a key part of the skill set each minimally invasive liver surgeon needs. Learn what to expect from an HPB surgery consultation.

Laparoscopic Whipple Procedure with Dr. Conrad

Also called pancreaticoduodenectomy, the Whipple procedure treats certain types of pancreatic cancer. Dr. Conrad removes the head of the pancreas, the gallbladder, the first part of the small intestine (duodenum), some of the stomach and nearby lymph nodes.

Taking a laparoscopic approach offers similar benefits to other less invasive HPB surgeries, but adds challenge to an already complex operation, and is not always appropriate for each patient.

Other minimally invasive pancreatic surgeries performed by Dr. Conrad include:

Distal pancreatectomy for cancer in the body or tail of the pancreas
Pancreatic enucleation focusing just on the tumor itself
Pancreatosplenectomy to remove the spleen and pancreatic head or tail

Minimally Invasive HPB Surgeries

Dr. Conrad also performs:

Bile duct surgery for cancer such as cholangiocarcinoma
Duodenoampullectomy to remove the duodenum and the ampulla, while preserving the pancreatic and bile ducts
Splenectomy to remove the spleen