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Application of Hemostatic Devices in Laparoscopic Hepatectomy
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Laparoscopic donor hepatectomy.

Kuo-Hsin Chen1,2, Tiing Foong Siow1, U-Chon Chio1

  • 1Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Asian Journal of Endoscopic Surgery
|June 6, 2018
PubMed
Summary
This summary is machine-generated.

Minimally invasive donor hepatectomy, including laparoscopic techniques, is increasingly used for living donor liver transplantation. While showing promise for donor recovery, careful assessment of donor safety is crucial before wider adoption.

Keywords:
Laparoscopic donor hepatectomylaparoscopic hepatectomyliving donor liver transplantation

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Transplant Surgery

Background:

  • Laparoscopic liver resection is established for most indications, with increasing complexity and patient numbers.
  • Living donor liver transplantation is a vital option, especially where deceased donor organs are scarce.
  • Donor hepatectomy carries risks, prompting the development of minimally invasive approaches since the early 2000s.

Purpose of the Study:

  • To review the evolution and current status of minimally invasive techniques in living donor hepatectomy.
  • To assess the early outcomes and potential benefits of laparoscopic donor hepatectomy.
  • To highlight the ongoing concerns regarding donor safety in complex laparoscopic procedures.

Main Methods:

  • Review of literature on laparoscopic liver resection and living donor liver transplantation.
  • Analysis of surgical innovations and accumulated experience in minimally invasive donor hepatectomy.
  • Discussion of the complexity and potential complications related to graft size and surgical approach.

Main Results:

  • Minimally invasive approaches have progressed from pediatric to adult living donor liver transplantation, including pure laparoscopic/robotic right donor hepatectomy.
  • Early results suggest improved donor recovery and perioperative outcomes in expert centers.
  • The combination of complex resection and transplantation raises significant donor safety concerns.

Conclusions:

  • Laparoscopic donor hepatectomy shows promise but requires further evaluation due to inherent risks.
  • A high level of evidence is challenging to obtain in this specialized field.
  • An international registry is proposed to rigorously assess risks and benefits before widespread implementation.