Fully Robotic Dual-Graft Living Donor Liver Transplantation: A Case Report

Area of Science:

• Minimally Invasive Surgery
• Transplantation Surgery
• Robotic Surgery

Background:

• Robotic surgery offers enhanced precision and visualization in complex procedures.
• Living donor liver transplantation (LDLT) is a vital option for end-stage liver disease.
• Dual-graft LDLT is complex and rarely performed, even in open surgery.

Purpose of the Study:

• To report the world's first fully robotic dual-graft LDLT.
• To demonstrate the feasibility of robotic assistance in complex LDLT scenarios.
• To evaluate outcomes in patients requiring dual grafts when single grafts are insufficient.

Main Methods:

• A 62-year-old patient with end-stage liver disease underwent a fully robotic dual-graft LDLT.
• Two related donors underwent pure robotic donor hepatectomy for left-lobe grafts.
• Surgical details included operation duration, warm ischemia times, and graft weights.

Main Results:

• The recipient operation lasted 12 hours with warm ischemia times of 46 and 36 minutes for the two grafts.
• Total implanted graft weight was 524g, with a graft-to-recipient weight ratio of 0.74%.
• The patient experienced no early complications and was discharged with excellent graft function.

Conclusions:

• Fully robotic dual-graft LDLT is feasible in carefully selected patients.
• This approach can be a viable solution when a single donor graft is insufficient.
• Robotic technology enhances the safety and precision of complex liver transplantation.