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Comparative Study
. 2025 Jul 1;282(1):108-115.
doi: 10.1097/SLA.0000000000006705. Epub 2025 Mar 26.

Fully Robotic Left Lobe Donor Hepatectomy Is Safer Compared to Open

Dieter C Broering  1 , Yasser Elsheikh  1 , Yasir Alnemary  1 , Daniel Borja-Cacho  2 , Mark L Sturdevant  3 , Saleh Alabbad  1 , Massimo Malago  1 , Dimitri A Raptis  1 ; OTCE Collaborative (Group Authorship, Supplementary Material)
Affiliations
Comparative Study

Fully Robotic Left Lobe Donor Hepatectomy Is Safer Compared to Open

Dieter C Broering et al. Ann Surg. .

Abstract

Objective: To compare the outcomes of fully robotic versus open left lobe donor hepatectomies, focusing on donor safety.

Background: Right lobe hepatectomies are traditionally preferred for adult liver transplants due to their larger graft size but may involve increased risks for donors. Left lobe hepatectomies are considered safer for donors but are less commonly used due to concerns about the small-for-size syndrome in adult settings.

Methods: We conducted an analysis of 339 living liver donors from a prospectively maintained registry at a single institution from November 2011 to June 2023, comparing 72 open and 267 robotic left lobe hepatectomies. Primary outcomes included donor complication rates until hospital discharge, whereas secondary outcomes focused on hospital stay and recipient complications.

Results: Robotic hepatectomy was associated with significantly less blood loss (mean 77 (SD: 68) vs 316 (SD: 168) mL, P <0.001), lower donor morbidity 6% vs 18%, P =0.003), and shorter hospital stay (3 vs 5 d, P <0.001). Adult recipients receiving robotically retrieved donor grafts were associated with a lower overall morbidity rate (40% vs 59%, P =0.033) compared to open.

Conclusions: Robotic left donor hepatectomy significantly improves donor safety compared with the open approach, supporting its use as a less invasive and donor-centered option in living donor liver transplantation. This study, the largest known series of left lobe donor hepatectomies, demonstrates the robotic approach's superiority, potentially setting a new standard in the field of living donor liver transplantation.

Keywords: left donor hepatectomy; left lobe; living donor liver transplantation; morbidity; mortality; robotic; survival; technique.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Mascarenhas R, Gurakar A. Recent advances in liver transplantation for the practicing gastroenterologist. Gastroenterol Hepatol. 2009;5:443–450.
    1. Wahab MA, Hamed H, Salah T, et al. Problem of living liver donation in the absence of deceased liver transplantation program: Mansoura experience. World J Gastroenterol WJG. 2014;20:13607–13614.
    1. Miller CM, Gondolesi GE, Florman S, et al. One hundred nine living donor liver transplants in adults and children: a single-center experience. Ann Surg. 2001;234:301–311.
    1. Malagó M, Testa G, Frilling A, et al. Right living donor liver transplantation: an option for adult patients. Ann Surg. 2003;238:853–863.
    1. Broering DC, Sterneck M, Rogiers X. Living donor liver transplantation. J Hepatol. 2003;38(suppl 1):S119–S135.

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