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. 2022 Sep;36(9):e14775.
doi: 10.1111/ctr.14775. Epub 2022 Aug 10.

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

Binoj Sivasankara Pillai Thankamony Amma  1 , Johns Shaji Mathew  1 , Christi Titus Varghese  1 , Krishnanunni Nair  1 , Shweta Mallick  1 , Biju Chandran  1 , Ramachandran Narayana Menon  1 , Unnikrishnan Gopalakrishnan  1 , Dinesh Balakrishnan  1 , Preethi Sara George  2 , Sudheer Othiyil Vayoth  1 , Surendran Sudhindran  1
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Open to robotic right donor hepatectomy: A tectonic shift in surgical technique

Binoj Sivasankara Pillai Thankamony Amma et al. Clin Transplant. 2022 Sep.

Abstract

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.

Keywords: donor hepatectomy; liver transplantation: living donor; minimally invasive surgery.

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