Laparoscopic/robotic living donor hepatectomy

Liver transplantation is the best treatment modality for end-stage liver disease. Due to the shortage of organs from deceased donors, living liver transplantation is being actively performed, mainly in East Asia. Because living donors are not forced to undergo surgery in a pathological situation, it is essential to consider not only the necessity of strict management of morbidity/mortality but also the quality of life, such as cosmetic effects.
This necessity has emerged, and minimal invasive surgery for donors has been implemented. The first laparoscopic donor hepatectomy using a graft of the left lateral section was first reported by Cherqui in 2002. After then, minimal invasive donor hepatectomy develops in two directions. The first is the evolution of minor hepatectomy such as left lateral section to major hepatectomy such as Left/Right graft. The second is the development from hybrid stages such as laparoscopic-assisted or hand-assisted laparoscopic surgery (HALS) to pure laparoscopic or robotic surgery. Thanks to these innovations and developments, robot-assisted donor right hepatectomy and pure laparoscopic donor right hepatectomy were reported in 2012 and 2013, respectively.
Recently, comparative studies between pure laparoscopic and conventional open laparoscopic donor hepatectomy have been published, and there were no statistically significant differences in the outcomes of laparoscopic donors and open donors and their recipients. In addition, the safety and reproducibility of robotic donor hepatectomy have been demonstrated through comparative studies.
Laparoscopic/robotic donor hepatectomy will continue to increase and develop because of its proven safety in the outcome, rapid recovery, and cosmetic effects.