Robotic living donor right hepatectomy

Abstract

Robotic living donor hepatectomies are technically challenging operations. Accepted benefits of this minimally-invasive surgery include less postoperative pain, enhanced postoperative recovery with faster return to pre-donation status, and reduced postoperative morbidity. In 2018, our transplantation institute started performing totally robotic living donor hepatectomies in well-selected donors. Here we present a video of one representative robotic donor right hepatectomy. The patient is a 26-year-old healthy nurse who successfully completed our living donor evaluation process. She underwent a robust informed consent process and went on to donate her right liver to her father who had decompensated endstage liver disease secondary to primary sclerosing cholangitis. Her right liver volume was 760 ml leaving her with a calculated liver remnant of 38%. The estimated graft to body weight ratio was 0.98. This totally robotic right donor hepatectomy was performed without intraoperative issues or complications. The estimated blood loss was 100 mL. The patient's postoperative course was uneventful and she was discharged home in excellent condition on postoperative day 6. She participated in a 5-mile run at 2 weeks post liver donation. Eight weeks post liver donation, she returned to fulltime obstetric nursing. Her father has recovered well and enjoys excellent liver graft function with no postoperative issues from his liver transplantation.