Total robotic liver transplant: the final frontier of minimally invasive surgery

Adeel S. Khan, Meranda Scherer, Roheena Panni, Darren Cullinan, Greg Martens, Ivan Kangarga, Christopher R. King, Richard Benzinger, Jason R. Wellen, William C. Chapman, Majella B. Doyle

Research output: Contribution to journalArticlepeer-review

Abstract

The use of robotic surgery in transplantation is increasing; however, robotic liver transplantation (RLT) remains a challenging undertaking. To our knowledge, this is a report of the first RLT in North America and the first RLT using a whole graft from a deceased donor in the world. This paper describes the preparation leading to the RLT and the surgical technique of the operation. The operation was performed in a 62-year-old man with hepatitis C cirrhosis and hepatocellular carcinoma with a native Model for End-Stage Liver Disease score of 10. The total console time for the operation was 8 hours 30 minutes, and the transplant hepatectomy took 3 hours 30 minutes. Warm ischemia time was 77 minutes. Biliary reconstruction was performed in a primary end-to-end fashion and took 19 minutes to complete. The patient had an uneventful recovery without early allograft dysfunction or surgical complications and continues to do well after 6-months follow-up. This paper demonstrates the feasibility of this operation in highly selected patients with chronic liver disease. Additional experience is required to fully understand the role of RLT in the future of transplant surgery. Narrated video is available at https://youtu.be/TkjDwLryd3I.

Original languageEnglish
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - 2024

Keywords

  • liver transplant
  • minimally invasive liver transplant
  • minimally invasive surgery
  • robotic liver transplant
  • robotic transplant

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