Semin Liver Dis 2013; 33(03): 189-203
DOI: 10.1055/s-0033-1351781
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Precision in Liver Surgery

Jiahong Dong
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
ShiZhong Yang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Jianping Zeng
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Shouwang Cai
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Wenbin Ji
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Weidong Duan
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Aiqun Zhang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Weizheng Ren
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Yinzhe Xu
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Jingwang Tan
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Xiangyang Bu
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Ning Zhang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Xuedong Wang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Xianqiang Wang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Xiangfei Meng
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Kai Jiang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Wanqing Gu
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
,
Zhiqiang Huang
1  Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China
› Author Affiliations
Further Information

Publication History

Publication Date:
13 August 2013 (online)

Abstract

Continuous theoretical and technological progress in the face of increasing expectations for quality health care has transformed the surgical paradigm. The authors systematically review these historical trends and propose the novel paradigm of “precision surgery,” featuring certainty-based practice to ensure the best result for each patient with multiobjective optimization of therapeutic effectiveness, surgical safety, and minimal invasiveness. The main characteristics of precision surgery may be summarized as determinacy, predictability, controllability, integration, standardization, and individualization. The strategy of precision in liver surgery is to seek a balance of maximizing the removal of the target lesion, while maximizing the functional liver remnant and minimizing surgical invasiveness. In this article, the authors demonstrate the application of precision approaches in specific settings in complex liver surgery. They propose that the concept of precision surgery should be considered for wider application in liver surgery and other fields as a step toward the ultimate goal of perfect surgery.