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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Minimally Invasive Donor Hepatectomy
Guhan Venkatakrishnan1, Krishnanunni Nair1, Binoj S Pillai Thankamony Amma1
1Department of Gastrointestinal Surgery and Solid Organ Transplantation, Amrita Institute of Medical Sciences and Research Centre, Amrita University, Kochi, Kerala, India.
Journal of Clinical and Experimental Hepatology
|March 28, 2025
Summary
Minimally invasive donor hepatectomy (MIDH) offers faster recovery but has challenges. Robotic techniques show promising outcomes, comparable to open surgery, aiding the transition for surgeons.
Area of Science:
- Surgical Innovation
- Transplant Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive donor hepatectomy (MIDH) uses laparoscopic or robotic techniques for graft retrieval.
- Current evidence suggests faster recovery and improved quality of life with MIDH compared to open donor hepatectomy.
- MIDH adoption is limited, with challenges in widespread application.
Purpose of the Study:
- To explore challenges transplant surgeons face when transitioning from open to minimally invasive donor hepatectomy.
- To detail the standard technique for robotic donor hepatectomy.
- To suggest strategies for overcoming the learning curve associated with MIDH.
Main Methods:
- This is a narrative review.
- Comparison of laparoscopic and robotic donor hepatectomies.
- Analysis of advantages, disadvantages, and outcomes of different MIDH approaches.
Main Results:
- Grafts from MIDH may have shorter vein lengths than those from open hepatectomy.
- Laparoscopic MIDH is associated with higher recipient biliary complication rates.
- Robotic MIDH demonstrates biliary complication rates comparable to or better than open donor hepatectomy.
Conclusions:
- Robotic donor hepatectomy offers comparable or superior outcomes to open procedures, particularly regarding biliary complications.
- Addressing the learning curve and challenges is crucial for wider MIDH adoption.
- MIDH, especially robotic-assisted, presents a viable alternative to open donor hepatectomy.
