Background : Laparoscopic liver donor surgery is not only difficult to perform, but is also known to be a high-level surgery that requires the safety of donors. So it is evaluated as possible in an experienced transplant center. Even though our hospital is a small volume center with less than 20 liver transplants per, we have steadily prepared laparoscopic donor surgery. In this study, we would like to evaluate the outcomes of three pure laparoscopic right hemi-hepatectomy of living donors.

Methods : From May 2015 to March 2021, we performed 26 deceased donor liver transplantation. 37 cases of living donor liver transplantation at our center. Among these, we reviewed the medical records of three pure laparoscopic right Hemi-hepatectomy of living donor and their recipients, including their clinical demographic, operative outcomes.

Results : The three laparoscopic right hemi-hepatectomy of living donor took over 10 hours. higher BMI, anatomical variations, bigger graft caused pringle maneuver time, warm ischemic time, operative time to take longer. But there was not any significant problem during surgery and any critical complications in the subsequent recovery course. However, significant complications including septic shock, middle hepatic vein obstruction, postoperative bleeding, bile leak, and primary non-function have happened in the recipient. We managed and solved those complications including re-transplantation, and all three recipients were recovered and survived.

Conclusions : Small volume centers can take longer to overcome the running curve of laparoscopic donor surgery. However, constant effort to overcome that running curve will be able to shorten that time to perform successful laparoscopic surgery.