Webinar - When the First Surgery is Not the Last: Adhesions and Long-Term Strategy in HPB Surgery

For many hepatobiliary surgeons, the success of an operation is measured by the outcome of the procedure itself. Yet for an increasing number of patients, the first operation is only one step in a much longer treatment journey.

Patients with colorectal liver metastases, hepatocellular carcinoma and other complex hepatobiliary diseases frequently require staged procedures, repeat liver resections or further abdominal surgery. In these situations, postoperative adhesions can significantly influence future operative difficulty, prolong operating times, increase conversion rates and complicate subsequent surgical access. Despite their impact, adhesions often remain an under-recognised consideration during the initial surgical planning process.

Recognising this important challenge, IHPBA and Baxter are partnering to present an educational webinar exploring the long-term implications of adhesions in liver surgery and practical strategies that may help optimise future surgical options.

A practical, case-based discussion

Presented by Dr Francesca Ratti, Senior Staff Surgeon at the IRCCS San Raffaele Scientific Institute and Assistant Professor of Surgery at Vita-Salute San Raffaele University in Milan, the webinar will examine adhesions through real-world clinical scenarios rather than theory alone.

Drawing on her extensive experience in minimally invasive liver surgery and complex hepatobiliary oncology, Dr Ratti will discuss how surgical history, disease setting and operative strategy influence both the development and consequences of adhesions. Participants will explore when adhesion prevention should become part of the surgical plan and how anti-adhesion technologies may contribute to facilitating future abdominal access in carefully selected patients.

Learning from real-world data

An important feature of the webinar will be insights from the Italian Registry of Minimally Invasive Liver Resections, examining how previous surgery, whether open or minimally invasive, can affect operative complexity, conversion rates and decision-making during repeat liver procedures.

The discussion will also focus on patients undergoing two-stage hepatectomy, repeat liver resections and multidisciplinary treatment pathways where future reintervention is anticipated, providing attendees with practical considerations that can be incorporated into everyday clinical practice.

Practical takeaways for surgeons

By combining registry evidence, clinical reasoning and practical operative experience, this webinar aims to provide surgeons with a structured framework for:

• Identifying patients at increased risk of adhesion-related challenges.
• Recognising clinical situations where adhesion prevention strategies may be appropriate.
• Understanding how previous open and minimally invasive surgery can influence future operative planning.
• Incorporating long-term surgical strategy into decision-making for patients likely to require repeat abdominal procedures.

Join IHPBA and Baxter

Join IHPBA and Baxter on Thursday, 3 September 2026, for this timely webinar exploring how long-term planning and thoughtful adhesion management can help optimise outcomes for patients requiring repeat hepatobiliary surgery.

Register for the Webinar

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