scholarly journals Laparoscopy-assisted versus open and pure laparoscopic approach for liver resection and living donor hepatectomy: a systematic review and meta-analysis

HPB ◽  
2018 ◽  
Vol 20 (8) ◽  
pp. 687-694 ◽  
Author(s):  
Fabricio F. Coelho ◽  
Wanderley M. Bernardo ◽  
Jaime A.P. Kruger ◽  
Vagner B. Jeismann ◽  
Gilton M. Fonseca ◽  
...  
Author(s):  
Mark Sturdevant ◽  
Ahmed Zidan ◽  
Dieter Broering

The application of minimally invasive liver surgery (MILS) in the field of living donor hepatectomy has been exceedingly slow, and its impact is limited to a handful of centers worldwide. Widespread adoption has been primarily hampered by the technical limitations of laparoscopy, namely rigid instrumentation, suboptimal optics, and a seemingly steep learning curve. These deficiencies are magnified in the donor hepatectomy operation wherein the parenchyma and vasculature must be handled atraumatically to produce a pristine allograft fit for implantation. Donor safety concerns and medicolegal ramifications are also cited as impediments to MILS in donor surgery. In 2013, our institution embraced a purely laparoscopic approach to living donor left lateral sectionectomy, and it quickly became our default technique. However, with donor hemi-hepatectomy, we gravitated to the robotic surgical system as our preferred modality. Herein, we describe our experience with minimally invasive donor hepatectomy, which we now universally offer to all living donors. Our extensive familiarity with robotic donor hepatectomy will provide the reader with an instructive perspective on the attributes and merits of the robotic approach. With appropriate collaboration and proctorship, we believe that the robotic platform will actualize a more rapid and widespread adoption than that experienced with the purely laparoscopic technique.


2008 ◽  
Vol 40 (4) ◽  
pp. 1165-1168 ◽  
Author(s):  
P. Feltracco ◽  
M.L. Brezzi ◽  
S. Barbieri ◽  
E. Serra ◽  
M. Milevoj ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Bin Zhang ◽  
Yu Pan ◽  
Ke Chen ◽  
Hendi Maher ◽  
Ming-Yu Chen ◽  
...  

Objective. To assess the feasibility, safety, and potential benefits of laparoscopy-assisted living donor hepatectomy (LADH) in comparison with open living donor hepatectomy (ODH) for liver transplantation. Background. LADH is becoming increasingly common for living donor liver transplant around the world. We aim to determine the efficacy of LADH and compare it with ODH. Methods. A systematic search on PubMed, Embase, Cochrane Library, and Web of Science was conducted in May 2017. Results. Nine studies were suitable for this analysis, involving 979 patients. LADH seemed to be associated with increased operation time (WMD = 24.85 min; 95% CI: −3.01~52.78, P=0.08), less intraoperative blood loss (WMD = −59.92 ml; 95% CI: −94.58~−25.27, P=0.0007), similar hospital stays (WMD = −0.47 d; 95% CI: −1.78~0.83, P=0.47), less postoperative complications (RR = 0.70, 95% CI: 0.51~0.94, P=0.02), less analgesic use (SMD = −0.22; 95% CI: −0.44~−0.11, P=0.04), similar transfusion rates (RR = 0.82; 95% CI: 0.24~3.12, P=0.82), and similar graft weights (WMD = 7.31 g; 95% CI: −23.45~38.07, P=0.64). Conclusion. Our results indicate that LADH is a safe and effective technique and, when compared to ODH.


2013 ◽  
Vol 1 (1) ◽  
pp. 53-60
Author(s):  
Talia B. Baker ◽  
Felicitas Koller ◽  
Juan Carlos Caicedo

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