Robotic donor hepatectomy: Are we there yet?

Area of Science:

• Surgical Innovation
• Transplantation Surgery
• Minimally Invasive Surgery

Background:

• Donor safety is critical in living donor liver transplantation (LDLT).
• Conventional open donor hepatectomy (DH) has high morbidity rates (25%-40%), with wound complications and scarring being significant donor concerns.
• Laparoscopic DH presents technical challenges and a steep learning curve, hindering widespread adoption of minimally invasive donor hepatectomy (MIDH).

Purpose of the Study:

• To review the evolution of minimally invasive donor hepatectomy (MIDH).
• To highlight the current status of robotic donor hepatectomy (RDH).
• To discuss existing challenges and the future role of robotic DH in LDLT.

Main Methods:

• Review of existing literature on minimally invasive donor hepatectomy (MIDH).
• Analysis of the advantages of robotic surgical systems over conventional laparoscopy for DH.
• Discussion of challenges related to standardization, outcomes, and learning curves in robotic DH.

Main Results:

• Robotic surgical systems enhance visualization and dexterity, potentially overcoming limitations of laparoscopic surgery.
• Robotic DH facilitates a smoother transition from technical feasibility to reproducibility compared to laparoscopy.
• Despite advancements, critical questions regarding standardization, comparative outcomes, and learning curves for robotic DH persist.

Conclusions:

• Robotic DH represents a promising advancement in MIDH, potentially improving donor safety and reducing complications.
• Further research is needed to address standardization, establish clear outcome comparisons, and define the learning curve for robotic DH.
• Robotic technology is poised to play an increasingly important role in the future of LDLT programs.