Purpose: Outcomes in hepatocellular cancer (HCC) have improved in Australia over the last 30 years, with 5-year survival rates climbing from 6.8% in 1993 to 22% in 2018, owing to developments in medical and surgical management. However, in this period, incidence of HCC has also climbed from 3 to over 8 in 100,000, underscoring the importance of improving treatment efficiency and effectiveness. To this end, we aim to compare perioperative outcomes of HCC surgery before and after 2014 when a minimally-invasive approach became established at our institution. Methods: We present a single-center retrospective cohort study of patients undergoing HCC resection. Pre-operative, operative and post-operative data were collected through medical record review. Results: We studied 155 consecutive HCC resections: 62 from 2005-2013 and 93 from 2014-2023. Since 2014, our patients have been older (63 vs 59 years, p=0.047), more comorbid, and carried a higher anaesthetic risk (56% vs 13% ASA 3-5, p<0.001). Laparoscopic resection has been performed more frequently since 2014 (47% vs 19%, p<0.001), whilst rates of conversion to laparotomy remained unchanged at 13% (p=1.000). Despite more liver-sparing surgery, rates of major postoperative complication (Clavien-Dindo 3b-5) remained stable (8.6% vs 10%, p=0.876). Since 2014, median postoperative hospitalisation has been shorter (10 vs 8 days, p=0.016), with laparoscopic surgery being an independent predictor of faster discharge (B=-3.7, p<0.001). Conclusions: Since 2014, despite increasing patient and surgical complexity, outcomes have remained stable or improved, likely attributable to a combination of more laparoscopic surgery and evidence-based, protocolised post-operative care.