Background : Although the pure minimally invasive donor hepatectomy (PMIDH) has been increasingly performed, it is still reported by experienced surgeons. Here we reported the early experience of PMIDM by novice surgeon.

Methods : From April 2019 to November 2021, PMIDHs were performed for 35 patients by single novice surgeon (H.D.H) at Yonsei University College of Medicine. Clinical characteristics, perioperative outcomes of donors and clinical features of recipients were analyzed.

Results : 33 of 35 donors had pure laparoscopic liver resection. Right, left hemihepatectomies and left lateral sectionectomies were performed for 30, 2 and 3 donors, respectively. Mean total operation time was 451.20 ± 67.57 minutes and median operative bleeding was 200 mL (30 ~ 1600mL). Median hospital stay was 7 (6 ~ 13) days. In terms of laparoscopic donor right hemihepatectomy, mean total operation time was 452.21 ± 56.49 minutes. Median amount of bleeding during operation was 200 mL (50 ~ 1600mL). Mean estimated total liver volume was 1199.07 ± 206.53 (896.30~1584.90) and mean real graft weight was 747.69 ± 133.34 (501~1077). The robotic donor right hemihepatectomy was performed for one donor. Total operation time was 663 minutes with 550 mL of operative bleeding. There was no conversion to open surgery. Only the first donor had transfusion during operation. There was no severe perioperative complication more than grade III according to classification of Clavien-Dinido surgical complication.

Conclusions : Although the PMIDH may need high level of surgical skill, it appears to be a safe and feasible procedure by junior surgeon in properly selected donors.