Minimally invasive treatment of colorectal liver metastases.

Minimally invasive approaches are increasingly used in the treatment of colorectal liver metastases (CRLMs) and for increasingly complex cases. Herein, we review the spectrum of modalities used in the minimally invasive treatment of CRLM, focusing on one of the newest approaches, robotic liver resection, and on local regional therapies, both operative and percutaneous. Oncologic outcomes after minimally invasive therapies are also evaluated. Although there are no randomized trials comparing minimally invasive liver resection to open resection, an increasing quantity of nonrandomized data suggest favorable outcomes with a minimally invasive approach. The future of minimally invasive treatment of CRLM will likely include specifying training and credentialing criteria as well as an enlarging role for the combined surgical treatment of CRLM and extrahepatic colorectal metastases.