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Hepatocellular carcinoma (HCC) is the sixth most common type of cancer worldwide and the third leading cause of cancer-related death. It is the most common primary liver cancer and its incidence increases when associated with the development of cirrhosis. Liver resection is a curative therapy, when liver transplantation due to the patient age and alcohol abuse, associated diseases, and shortage of donors, is not feasible, During the last decades, progress in preoperative patient assessment, refinement of the indications for resection, improved surgical technique, and the development of new surgical devices have greatly enhanced the safety of open hepatectomy in normal and even in cirrhotic liver. After the first laparoscopic cholecystectomy performed about 30 years ago, laparoscopic approach has been applied more and more frequently to the full spectrum of abdominal surgery, becoming the gold standard in the surgical treatment of much pathology such as biliary lithiasis and gastro-esophageal reflux. Since the first laparoscopic hepatectomy reported in 1991, laparoscopic liver surgery developed more slowly. There are many reasons for the slow diffusion of the laparoscopic hepatic surgery, such as the presumed technical difficulties, the complicated management of the bleeding during parenchymal transection, the lack of dedicated tools and the presumed risk of gas embolism. However, despite this initial slow development, laparoscopic liver surgery is now performed worldwide, even in cirrhotic patients. After the 2 Consensus Conferences (LouisvilleUSA, 2008 and Morioka-Japan, 2014) the advantages connected with the mininvasive approach are evident, important and significant, especially in the treatment of HCC in cirrhotic liver.

Introduction of the special issue: “Advances in Minimally Invasive Cirrhotic Surgery”