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Early Experiences with Developing the Techniques of Pure Laparoscopic Explant Hepatectomy without Fragmentation in Living Donor Liver Transplantation

S. Hong1, C. Kim1, S. Lee2, S. Suh2, S. Hong1, E. Han1, Y. Choi3, N. Yi2, K. Lee3, K. Suh1

1Surgery, Seoul National University College of Medicine, Seoul, Korea, Republic of, 2Seoul National University College of Medicine, Seoul, Korea, Republic of, 3Seoul National University, Seoul, Korea, Republic of

Meeting: 2022 American Transplant Congress

Abstract number: 1440

Keywords: Laparoscopy, Liver transplantation

Topic: Clinical Science » Liver » 57 - Liver: Surgery Innovative Techniques*

Session Information

Session Name: Liver: Surgery Innovative Techniques*

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Minimally invasive surgery is increasingly performed in liver surgery including even donor hepatectomy. However, the development of minimally invasive techniques in liver transplantation has been held back due to concerns regarding technical difficulties with not only reconstruction of the hapatic vein, portal vein, hepatic artery, and bile duct, but also explant hepatectomy. This study aimed to present our early experiences with developing successful pure laparoscopic explant hepatectomy without fragmentation and eventually graft implantation as well.

*Methods: We reviewed 10 patients who went under minimally invasive living donor liver transplantation from June 2020 to May 2021, which was just before the first successful pure laparoscopic LDLT including graft implantation, and all of them were performed by the same surgeon.

*Results: First 9 patients went under pure laparoscopic explant hepatectomy without liver fragmentation followed by graft implantation using open incision. For the last patient, pure laparoscopic methods was initially used to implant liver graft, but we used open midline incision during portal vein anastomosis procedure due to bleeding and arrythmia. The first 6 patients required open conversion while mobilizing the liver or dissecting the hilum. Pure laparoscopic explant hepatectomy was successfully completed in the next 4 patients. The patients’ livers were explated via laparoscopic methods and the livers were taken out via upper midline incision. The times required to remove the livers were 105, 105, 80, 220 minutes, respectively.

*Conclusions: With initial several experiences, pure laparoscopic explant hepatectomy was able to be safely performed.

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To cite this abstract in AMA style:

Hong S, Kim C, Lee S, Suh S, Hong S, Han E, Choi Y, Yi N, Lee K, Suh K. Early Experiences with Developing the Techniques of Pure Laparoscopic Explant Hepatectomy without Fragmentation in Living Donor Liver Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/early-experiences-with-developing-the-techniques-of-pure-laparoscopic-explant-hepatectomy-without-fragmentation-in-living-donor-liver-transplantation/. Accessed May 11, 2025.

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