Korean J Transplant.  2023 Nov;37(Suppl 1):S205. 10.4285/ATW2023.F-7973.

Successful implementation of pure laparoscopic right donor hepatectomy in a small center with limited experience: the role of proctorship program

• Lim M
• Choi GS
• Lee SK

• KMID: 2551825
• DOI: http://doi.org/10.4285/ATW2023.F-7973

Abstract

Background
Pure laparoscopic donor right hepatectomy (PLDRH) has recently been widely performed. However, most of the PLDRH cases are carried out in larger volume centers with extensive experience in laparoscopic liver surgery and transplantation. In this study, we report the outcomes of five cases performed in a small center with limited experience, under the guidance of a proctorship program.
Methods
Between August 2022 and May 2023, five cases of adult-to-adult living donor liver transplantation (LDLT) were performed at our center, and all donors underwent PLDRH. The operator was a young surgeon with experience in about 20 laparoscopic major hepatectomies but no prior experience in open donor hepatectomy. All operations were performed under the proctorship program and followed their protocol.
Results
In all five cases, modified right grafts were obtained using pure laparoscopic hepatectomy. The median operative time was 270 minutes (range, 255–445 minutes), and there were no instances of open conversion. The median estimated blood loss was 400 mL (range, 200–700 mL), and there were no perioperative or postoperative transfusions. All donors were discharged on day 7 postoperatively, and no postoperative complications were observed.
Conclusions
In our experience, even a young surgeon with no prior experience in open donor hepatectomy in a small center can safely perform PLDRH with the support of a proctorship program, overcoming the learning curve.