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Konstantin SEMASH

National Medical Research Center of Transplantology and Artificial Organs named after V.I. Shumakov
Moscow, Russia
MD
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Laparoscopic living donor right hepatectomy (LLDH) fully exposing the right hepatic vein (conventional approach)
Introduction:
Laparoscopic living donor hepatectomy (LLDH) has gradually become a widespread technique in high volume transplant centers over the last decade.
Right LLDH is considered as a procedure which requires an expert level in both living donor liver transplantation and laparoscopic liver resection.
In order to fully expose and encircle the right hepatic vein before parenchymal transection implies the full mobilization of the right liver lobe as well as the clipping and cutting of the short hepatic veins in a same way as in a conventional open approach, using the hanging maneuver.
This approach could be more applicable as an initial experience in centers introducing the right LLDH.
Method: Right LLDH was demonstrated in a 31-year-old woman with standard liver anatomy. The procedure was performed using five ports with the patient placed in the French position. The graft was transplanted to a 10-year-old girl with Wilson’s disease (PELD score of 19).
Result: Operating time was 420 min. Blood loss was 120mL. Donor and recipient were discharged on postoperative day 6 and 28 respectively without any complications.
Conclusion: Right LLDH is a feasible procedure. The technique shown is reproducible.
Surgical intervention
22 days ago
764 views
10 likes
2 comments
10:38
Laparoscopic living donor right hepatectomy (LLDH) fully exposing the right hepatic vein (conventional approach)
Introduction:
Laparoscopic living donor hepatectomy (LLDH) has gradually become a widespread technique in high volume transplant centers over the last decade.
Right LLDH is considered as a procedure which requires an expert level in both living donor liver transplantation and laparoscopic liver resection.
In order to fully expose and encircle the right hepatic vein before parenchymal transection implies the full mobilization of the right liver lobe as well as the clipping and cutting of the short hepatic veins in a same way as in a conventional open approach, using the hanging maneuver.
This approach could be more applicable as an initial experience in centers introducing the right LLDH.
Method: Right LLDH was demonstrated in a 31-year-old woman with standard liver anatomy. The procedure was performed using five ports with the patient placed in the French position. The graft was transplanted to a 10-year-old girl with Wilson’s disease (PELD score of 19).
Result: Operating time was 420 min. Blood loss was 120mL. Donor and recipient were discharged on postoperative day 6 and 28 respectively without any complications.
Conclusion: Right LLDH is a feasible procedure. The technique shown is reproducible.