Ann Liver Transplant.  2021 Nov;1(2):140-145. 10.52604/alt.21.0023.

Minimal-incision donor right hepatectomy for living donor liver transplantation

• Ha TY
• Jung DH
• Song GW
• Park GC
• Hwang S

• KMID: 2560864
• DOI: http://doi.org/10.52604/alt.21.0023

Abstract

For living donors, the second most important concern after the donor safety is the cosmetic aspect of abdominal incision. The present study aimed to present the technical details of minimal-incision laparotomy (MIL) in a case of living donor right hepatectomy with an eight minutes video clip. The recipient was a 57-year-old patient with alcoholic liver cirrhosis and the donor was his 28-year-old daughter of the recipient. The epigastrium area was narrow and the subcostal cartilages were elongated beyond the level of the umbilicus, so a 12-cm-long right subcostal incision was made. The right liver was mobilized with gentle traction. The right hepatic parenchyma was transected according to standard procedures and liver-hanging with a Penrose drain. A 780 g-weighing right liver graft was harvested and pulled out through the skin incision. The liver graft was converted to a modified right liver graft with patch and conduit venoplasties of the outflow veins. Both the recipient and donor recovered uneventfully and have been doing well for 12 years after transplantation. We believe that MIL is a compromise option between conventional skin incision and total laparoscopic hepatectomy regarding cosmetics of the skin incision and donor safety, although it is a demanding procedure for donor surgeons.

Keyword

Living donor liver transplantation; Wound cosmetics; Donor safety; Wound scar; Minimal skin incision