Minimal access liver surgery: from the escalation, to the boundaries, searching for the rules

Minimal access liver surgery (MALS), is now routinely performed worldwide, and procedures like limited resections of antero-inferior segments and left lateral sectionectomy could be retained as standard once performed laparoscopically (1). It is a common believe that MALS procedures mean shorter and better postoperative outcome, and essentially more safety compared to the open approach. Furthermore, MALS procedures facing with complex disease presentations are increasingly proposed (2).