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Background <p>Robotic living donor hepatectomy offers potential advantages but has been limited to high-volume centers, primarily in Asia and the Middle East. We report our experience establishing a robotic living donor right hepatectomy program in a U.S. center with low LDLT volume and no prior laparoscopic donor hepatectomy experience and analyze early outcomes.</p> Methods <p>This retrospective cohort study analyzed 37 living donor right hepatectomies (13 robotic [including one open conversion], 24 open) performed between June 2022 and February 2024.</p> Results <p>The robotic group had longer operative times (median [range], 451 [374–568] minutes vs 368 [276–421] minutes; <i>P</i> &lt; 0.001) but less blood loss (median [range], 200 [50–700] mL vs 900 [300–2500] mL; <i>P</i> &lt; 0.001). One case required unplanned open conversion due to gas embolism. Two hematomas/bleeding (Clavien–Dindo grade IIIB) occurred in the robotic group, but no biliary complications. Comprehensive Complication Index, liver function tests, and hospital stays were similar between the two groups, with no 90-day graft failure/mortality.</p> Conclusion <p>With extensive surgical experience in both open donor hepatectomy and robotic surgery, along with meticulous preparation as a team, U.S. centers with lower LDLT volume and no laparoscopic experience can safely implement robotic living donor right hepatectomy, achieving comparable short-term outcomes to the open approach. Further research on long-term outcomes and donor quality of life is necessary.</p>

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Early outcomes of robotic vs open living donor right hepatectomy in a US Center

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月8日

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  • Yuzuru Sambommatsu,
  • Vinay Kumaran,
  • Daisuke Imai,
  • Kush Savsani,
  • Aamir A. Khan,
  • Amit Sharma,
  • Muhammad Saeed,
  • Adrian H. Cotterell,
  • Marlon F. Levy,
  • Seung Duk Lee,
  • David A. Bruno

摘要

Background

Robotic living donor hepatectomy offers potential advantages but has been limited to high-volume centers, primarily in Asia and the Middle East. We report our experience establishing a robotic living donor right hepatectomy program in a U.S. center with low LDLT volume and no prior laparoscopic donor hepatectomy experience and analyze early outcomes.

Methods

This retrospective cohort study analyzed 37 living donor right hepatectomies (13 robotic [including one open conversion], 24 open) performed between June 2022 and February 2024.

Results

The robotic group had longer operative times (median [range], 451 [374–568] minutes vs 368 [276–421] minutes; P < 0.001) but less blood loss (median [range], 200 [50–700] mL vs 900 [300–2500] mL; P < 0.001). One case required unplanned open conversion due to gas embolism. Two hematomas/bleeding (Clavien–Dindo grade IIIB) occurred in the robotic group, but no biliary complications. Comprehensive Complication Index, liver function tests, and hospital stays were similar between the two groups, with no 90-day graft failure/mortality.

Conclusion

With extensive surgical experience in both open donor hepatectomy and robotic surgery, along with meticulous preparation as a team, U.S. centers with lower LDLT volume and no laparoscopic experience can safely implement robotic living donor right hepatectomy, achieving comparable short-term outcomes to the open approach. Further research on long-term outcomes and donor quality of life is necessary.