Many institutions have started or are planning to start a purely laparoscopic right hepatectomy (PLRH) for adult living donor recipients but the experience is relatively very limited. The present review will look at the current status of PLRH and go over some of the technical details important for a safe operation. Necessary elements and different strategies to start a safe and reproducible PLRH program will be discussed.
Several publications with a relatively large number of cases have been published in the last few years. The initial results of PLRH seem to be comparable to open donor hepatectomy when performed by surgeons with sufficient expertise laparoscopic and donor hepatectomy.
With the ongoing accumulation of experience in laparoscopic liver surgery and living donor liver transplantation, it is most likely that PLRH will be performed more widely than the present time. Institutions should implement a step-by-step approach with proctorship, standardization of surgical procedures and a balanced selection criterion for donors for a safe transition from open method to a PLRH program.
aDepartment of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
bDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Correspondence to Choon Hyuck David Kwon, Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, 9500 Euclid Ave. Desk A100, Cleveland, OH 44195, USA. Tel: +1 216 444 1708; fax: +1 216 445 7653; e-mail: firstname.lastname@example.org