Robotic monosegment donor hepatectomy for pediatric liver transplantation: First report

Background LT for infants less than 5 kg remains a challenge with high technical complication rates, which is further compounded by large‐for‐size grafts requiring hyper‐reduction. The benefits of MIDH especially for standard left lateral segment (LLS) resection have been unequivocally demonstrated....

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Bibliographic Details
Published in:Pediatric transplantation 2022-02, Vol.26 (1), p.e14110-n/a
Main Authors: Rela, Mohamed, Rajalingam, Rajesh, Shetty, Guruprasad, Cherukuru, Ramkiran, Rammohan, Ashwin
Format: Article
Language:English
Subjects:
Adult
Biliary atresia
Female
graft reduction
Hepatectomy
Hepatectomy - methods
Humans
Infant
Laparoscopy
Liver Transplantation
Liver transplants
pediatric liver transplantation
Pediatrics
robotic donor hepatectomy
Robotic surgery
Robotic Surgical Procedures
Tissue and Organ Harvesting - methods
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Summary:Background LT for infants less than 5 kg remains a challenge with high technical complication rates, which is further compounded by large‐for‐size grafts requiring hyper‐reduction. The benefits of MIDH especially for standard left lateral segment (LLS) resection have been unequivocally demonstrated. However, given the fine margins of error, the highly challenging technical aspects of anatomical graft reduction test the limits of safety and may not be routinely feasible with the conventional laparoscopic approach. Case Report A 14‐month‐old girl weighing 4.4 kg with extrahepatic biliary atresia was referred to our unit for an LT. Her mother volunteered to donate and the calculated volume of the LLS was 342 ml, with an estimated GRWR of 7.6. Given the extremely high GRWR, a segment II monosegment graft was planned. A RMDH was performed, with a final GRWR of 4. The donor and recipient were discharged on the 5th and 12th post‐operative days, respectively. Conclusion We present the first‐ever report of an RMDH. Our report highlights the fact that robotic surgery can safely replicate a highly precise surgical operation, thereby safely pushing the limits of MIDH.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14110