The indication and modification of hand assisted laparoscopic microwave coagulonecrotic therapy

Laparoscopic microwave coagulonecrotic therapy (LMCT) for hepatocellular carcinoma is applicable for the patient whose liver damage is Child B or better. The indication is limited to the tumor smaller than 4 cm in diameter and located just beneath the surface. Hand-assistance helps to approach the tumor adjacent to the diaphragm. The hand-manipulation of the liver presents the view of the upper side of the liver to the scope. Puncturing with the electrode and scanning with ultrasound is more precise and easier than that without hand-assistance. We recommend the use of hand-assistance for laparoscopic microwave ablation to the tumor under the dome. The four cases treated by LMCT are presented, including the recurrent cases after the other treatment such as percutaneous ablation therapy and/or trans-arterial embolization.