First clinical experience with single-port robotic living donor hepatectomy

Living donor hepatectomy requires maximum safety while aiming to minimize surgical invasiveness. Single-port (SP) robotic platforms may offer the potential to reduce abdominal wall trauma and improve cosmesis compared with multiport robotic approaches; however, clinical experience in living liver donation is currently lacking. This report describes the first 3 consecutive living donor left lateral sectionectomies performed using a SP robotic system at a high-volume robotic donor hepatectomy center in 2026. All procedures were completed robotically without conversion, the operation duration decreased from 430 to 272 minutes, estimated blood loss was 25 mL in all cases, and no donor experienced complications, transfusion, reoperation, or readmission. The hospital stay was 2 to 3 days. All grafts were transplanted successfully without any biliary or major vascular complications. This initial experience suggests feasibility and identifies key technical challenges, including adaptation to SP instrument ergonomics, stapler insertion, and angulation constraints, as well as alternative hemostatic options in the absence of dedicated instruments. Further evaluation is required to determine whether fewer ports translate into measurable improvements in pain, cosmesis, or recovery in healthy liver donors.