Surgical Endoscopy

, Volume 32, Issue 1, pp 513–513 | Cite as

Totally laparoscopic living donor left hepatectomy for liver transplantation in a child

  • Helayel Almodhaiberi
  • Seok-Hwan Kim
  • Ki-Hun KimEmail author



Minimally invasive surgery has been validated to be a new standard in living donor hepatectomy for adult-to-pediatric transplantation with less morbidity [1]. Laparoscopic donor hepatectomy can reduce the major concerns about pain and morbidity associated with open surgery and a slow return to daily activities of donors [2]. Herein, we present one case of totally laparoscopic living donor left hepatectomy including the middle hepatic vein (MHV).

Donor and Method

A 37-year-old mother volunteered to donate to her 3-year-old son with biliary atresia (PELD score 7). Total donor liver volume was 833 cm3 and left liver, including MHV, was 290 cm3. Graft to recipient body weight ratio was 2.07. Our operative technique has been published previously [2]. The left hepatic artery and portal vein were dissected and encircled with two vessel loops. Pringle’s maneuver was used during parenchymal transection. The transection of the liver was performed using an alternating combination of laparoscopic ultrasonic aspirator (CUSA) and THUNDERBEAT™ (Olympus, Japan). The MHV was identified and parenchymal transection was performed right side to it. Several small tributaries from segment V and VIII were identified and divided. Finally, left bile duct was identified and divided after performing intraoperative cholangiography using a mobile C-arm.


Totally laparoscopic living donor left hepatectomy was performed successfully without intraoperative complications and transfusion. The operation time was 300 min, the estimated blood loss was less than 125 ml and Graft weight was 314 g. Oral intake was resumed on the first postoperative day (POD). On POD 4, CT scan showed no pathological findings. The patient was discharged on POD 8 without complications.


The authors conclude that the laparoscopic living donor left hepatectomy is a safe and feasible procedure but should be performed in selected patients with a favorable anatomy.


Laparoscopic donor hepatectomy Living donor liver transplantation 


Compliance with ethical standards


Helayel Almodhaiberi, Seok-Hwan Kim, Ki-Hun Kim have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (WMV 273836 kb)


  1. 1.
    Soubrane O et al (2015) Laparoscopic living donor left lateral sectionectomy: a new standard practice for donor hepatectomy. Ann Surg 262(5):757–763CrossRefPubMedGoogle Scholar
  2. 2.
    Kim KH et al (2011) Comparison of open and laparoscopic live donor left lateral sectionectomy. Br J Surg 98(9):1302–1308CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Division of Hepatobiliary and Liver Transplantation, Department of General SurgeryPrince Sultan Military Medical CityRiyadhSaudi Arabia

Personalised recommendations