Total Laparoscopic Living Donor Right Hepatectomy: World First Report

Ho-Seong Han, Jai Young Cho, Yoo-Seok Yoon, Dae Wook Hwang, Young Ki Young Ki Kim, Hong Kyung Shin, Woohyung Lee. Seoul National University Bundang Hospital, Seoul National University College of Medicine.

Background Right lobe living donor liver transplantation (LDLT) is the predominant form of adult-to-adult LDLT. Accordingly, cosmetic and functional demand by young donors is increasing. We developed world first total laparoscopic donor right hepatectomy (LDRH) in adult living donors.

Methods Total LDRH was performed in two young donors without vascular clamping. Modified extended right graft (right liver including all the middle hepatic vein branches) was retrieved from suprapubic transverse incision.

Results Pure laparoscopic donor surgery lasted about 10 hours without any transfusion. All the middle hepatic vein branches were preserved and reconstructed. There was no major complication in both donors and recipients. Postoperative hospital stay of donors was 10 and 8 days, respectively. After follow-up of more than one year, all donors and recipients live well with normal liver function.

Conclusion Total LDRH was feasible in selected adult donors. If this procedure will be more standardized, total laparoscopic donor surgery will be new option for adult LDLT, which meets demand by donors and diminish guilty feeling by recipients.

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