Robotic surgery and liver transplantation: A single-center experience of 501 robotic donor hepatectomies

Schulze, Maren; Elsheikh, Yasser; Boehnert, Markus; Alnemary, Yasir; Alabbad, Saleh; Bröering, Dieter C.

doi:10.1016/j.hbpd.2022.05.006

Cited by 24 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the importance of better cosmesis and lesser wound complications for these live donors, many of whom are young, cannot be overlooked, provided such rare adverse effects do not explode into catastrophes and procedural safety is maintained through the learning curve. In fact, with the growing and cumulative experience of robotic donor hepatectomy units across the world, its advantages over open donor hepatectomy appear to be convincing 16–18,21 …”

Section: Discussionmentioning

confidence: 99%

“…Driven by genuine motivation, the first minimally invasive LDRH was accomplished, interestingly by robot‐assisted surgery in 2011 11 . However, nearly a decade since, extensive series of LDRH by MIS, either laparoscopic or robotic, have been restricted to very few high‐volume centres 12–18 . A non‐negotiable prerequisite for transition from open to MIS for LDRH is an amalgamation of explicit knowledge of liver anatomy acquired by long experience of open donor hepatectomy with considerable laparoscopic technical proficiency.…”

Section: Introductionmentioning

confidence: 99%

“…Advantages of robotic surgery notwithstanding, donor safety remains the primary concern. Recent series of robotic LDRH have demonstrated some of its advantages over its open counterpart 16–18,21 . However, more data detailing the event risks of robotic live donor right hepatectomy (r‐LDRH) is required prior to its widespread adaption.…”

Section: Introductionmentioning

confidence: 99%

“…With improved dexterity and a putatively shallower learning curve compared to laparoscopy, a robotic platform might make navigation to MIS easier for surgeons proficient in open LDRH (o-LDRH). 16,17,19,20 Advantages of robotic surgery notwithstanding, donor safety remains the primary concern. Recent series of robotic LDRH have demonstrated some of its advantages over its open counterpart.…”

mentioning

confidence: 99%

“…11 However, nearly a decade since, extensive series of LDRH by MIS, either laparoscopic or robotic, have been restricted to very few high-volume centres. [12][13][14][15][16][17][18] A nonnegotiable prerequisite for transition from open to MIS for LDRH is an amalgamation of explicit knowledge of liver anatomy acquired by long experience of open donor hepatectomy with considerable laparoscopic technical proficiency. Perhaps, the difficulty of attaining this combination of two audacious and disparate skills may have submerged MIS for LDRH under a self-imposed moratorium by transplant surgeons.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Open to robotic right donor hepatectomy: A tectonic shift in surgical technique

Amma

Mathew

Varghese

et al. 2022

Clinical Transplantation

View full text Add to dashboard Cite

Robotic right live donor hepatectomy (r‐LDRH) has been reported with reduced morbidity compared to open donor right hepatectomy (o‐LDRH) in few recent series. Nevertheless, its routine use is debated. We present a large series comparing pure r‐LDRH with o‐LDRH. Consecutive r‐LDRH performed from June 2018 to June 2020 (n = 102) were compared with consecutive donors undergoing o‐LDRH (n = 152) from February 2016 to February 2018, a period when r‐LDRH was not available at this center. Propensity score matched (PSM) analysis of 89 case‐control pairs was additionally performed. Primary endpoints were length of high dependency unit (HDU) and hospital stay and Clavien‐Dindo graded complications among donors. Although r‐LDRH took longer to perform (540 vs. 462 min, P < .001), the postoperative peak transaminases levels (P < .001), the length of HDU (3 vs. 4 days, P < .001), and hospital stay (8 vs. 9 days, P < .001) were lower in in donors undergoing r‐LDRH. Clavien‐Dindo graded complications were similar (16.67% in r‐LDRH and 13.16% in o‐LDRH). The rates of early allograft dysfunction (1.6% vs. 3.3%), bile leak (14.7% vs. 10.7%), and 1‐year mortality (13.7% vs. 11.8%) were comparable between r‐LDRH and o‐LDRH recipients. PSM analysis yielded similar results between the groups. These data support the safety and feasibility of r‐LDRH in select donors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Open to robotic right donor hepatectomy: A tectonic shift in surgical technique

Amma

Mathew

Varghese

et al. 2022

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

Essential updates 2022/2023: A review of current topics in robotic hepatectomy

Adachi,

Hara,

Matsushima

et al. 2024

Annals of Gastroent Surgery

View full text Add to dashboard Cite

The liver requires careful handling intra‐operatively owing to its vital functions and complexity. Traditional open hepatectomy, while standard, is invasive and requires long recovery periods. Laparoscopic hepatectomy is a less invasive option, with its own challenges. The rise of robotic surgery, such as the da Vinci® system, improves precision and control, addressing the limitations of conventional methods, but brings new concerns, such as costs and training. This review focuses on the latest advancements in robotic hepatectomy from 2022/23 articles, delving into topics like “robotic surgery in liver transplantation,” “robotic hepatectomy for hilar cholangiocarcinoma,” “robotic vascular reconstruction following hepatectomy,” “robotic repeat hepatectomy,” and “prospective trials in robotic hepatectomy.” To retrieve articles, a focused literature search was conducted using PubMed for articles from 2022/23 with a 5‐year filter, excluding reviews. Initially, abstracts were screened, and relevant articles on robotic surgery were examined in full for inclusion in this review. Although all the above items are cutting‐edge, and many of the references are necessarily at the level of case reports, recent articles are still accompanied by surgical videos, which are useful to readers, especially surgeons who are considering imitating the procedures. In summary, we examined the recent advancements in robotic liver resection. The inclusion of videos that present new techniques aids in knowledge transfer. We anticipate the continued growth of this field of research.

show abstract

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

Kim,

Yoon,

Kim

et al. 2024

Hepatol Int

View full text Add to dashboard Cite

Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation. As a result of this clinical situation, there is a growing need for guidelines that are specific to the Asia-Pacific region. These guidelines provide comprehensive recommendations for evidence-based management throughout the entire process of liver transplantation, covering both deceased and living donor liver transplantation. In addition, the development of these guidelines has been a collaborative effort between medical professionals from various countries in the region. This has allowed for the inclusion of diverse perspectives and experiences, leading to a more comprehensive and effective set of guidelines. Keywords Living donor liver transplantation • Deceased donor liver transplantation • Multidisciplinary • GradeSpecial consideration: LDLT in ACLF In a study of 112 LDLT recipients with ACLF, defined by the APASL definition, post-LT outcomes were excellent (92.9% at 5 years) [69]. In a study on high-model end-stage liver disease (MELD) (score ≥ 30) LDLT recipients with ACLF (n = 190), defined by the World Congress of Gastroenterology [70], the 5-year survival rate was 72.1% [71]. In a study of 117 LDLT recipients who had ACLF, as defined by the EASL-CLIF definition, post-transplant survival after LDLT was 92.9%, 85.4%, and 75.6% at 1 year, while mortality rate without LT was 28.5%, 77.7%, and 93.4% at 90 days, for ACLF grades 1, 2, and 3, respectively [72]. These data indicate that LDLT can be a life-saving treatment option for patients with ACLF.LDLT differs significantly from DDLT, as the timing of LDLT can be determined by the transplant team. There are advantages and disadvantages of LDLT in the setting of ACLF. The benefit of LDLT in patients with ACLF is its ability to provide rapid transplantation to critically ill patients [73], without waiting for deceased donor allocation. The ideal time for LT can be selected by transplant team when willing living donor is available. If ideal time for LT can be selected in the dynamic course of ACLF, this may improve post-LT outcome. The disadvantages of LDLT include the need for healthy, willing liver donor, and the use of partial grafts for critically ill patients. A graft-to-recipient weight ratio (GRWR) is a factor associated with post-LT outcomes in LDLT [74]. The donor risk index is a factor associated with post-LT outcomes for patients with ACLF who received DDLT [66,75]. This indicates that DDLT, which uses whole liver grafts, might be a better compared to LDLT, which uses partial grafts, in ACLF. In addition, there are uncertainties regarding the criteria for living donor graft quality that is required for critically ill patients with ACLF. In studies that reported...

show abstract

Robotic surgery and liver transplantation: A single-center experience of 501 robotic donor hepatectomies

Cited by 24 publications

References 23 publications

Open to robotic right donor hepatectomy: A tectonic shift in surgical technique

Open to robotic right donor hepatectomy: A tectonic shift in surgical technique

Essential updates 2022/2023: A review of current topics in robotic hepatectomy

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

Contact Info

Product

Resources

About