The Use And Benefits of 3D Digital Microscope In Hepatic Artery Reconstruction During Living Donor Liver Transplant

Background: To compare the intraoperative process of hepatic artery anastomosis using conventional microscope and novel 3D digital microscope and to share our institute’s experience for better surgical training.Method: A retrospective cohort study with 46 hepatic artery reconstructions in living donor liver transplant patients via operational microscope (Control group) and 3D digital microscope Mitaka Kestrel View II (Study group). We then discuss and share our institution’s experience to improve surgical training. Results: Both operation instruments provide effective and comparable results. There was no statistical significance regarding operational objective results between conventional microscope and exoscope. Both instruments have no hepatic artery size limit, and both have complete vessel patency rate. Conclusions: There was no statistical differences regarding hepatic artery anastomosis between microscope and exoscope cohorts. However, exoscope provided better ergonomics in the operation room and lessen musculoskeletal strain, allowing surgeons to work in a more neutral and comfortable posture and allow first assistant to learn and assist more effectively. Using exoscope with micro-forceps and modified tie technique make artery reconstruction easier.