title: Video-assisted living donor hemihepatectomy through a 12-cm incision for adult-to-adult liver transplantation.
abstract: OBJECTIVE
  There has been remarkable progress in recent technical innovations for laparoscopic hepatectomy. However, a laparoscopic procedure rarely has been indicated for donation of the liver in living-related liver transplantation (LRLT). Here, we described the technique and the outcome of video-assisted donor hepatectomy (VADH) for adult-to-adult LRLT.
  
  
  METHODS
  For 13 donors in adult-to-adult LRLT, 3 types of major hepatectomy--right hemihepatectomy (3), and left hemihepatectomy, with or without the caudate lobe (10)--were performed through video-assisted procedures; surgical manipulation via ports or via a 12-cm incision and viewing through a laparoscope or through incision were combined and used.
  
  
  RESULTS
  VADH was completed in 13 donors, with a median operation time of 363 +/- 33 minutes and a median blood loss of 302 +/- 191 mL. No complications specific to video-assisted procedures, postoperative bile leak, or bleeding were observed. The restoration of the liver function was smooth, and the use of an analgesic (median: 1.2 times) was reduced, compared with the historical control (median: 3.8 times) that underwent a standard donation of the liver. Currently, all donors are healthy and have returned to their previous activities. The grafts have been functioning well, excluding 3 recipients who succumbed to serious complications unrelated to the video-assisted procedure.
  
  
  CONCLUSIONS
  We have shown a new method of VADH through a 12-cm laparotomy for adult-to-adult LRLT. This technique is as feasible as standard open donor hepatectomy, with less pain and with improved postoperative symptoms.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan. ikuro@med.niigata-u.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Kurosaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Chie
authors.initials: C
authors.lastname: Kitami
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yokoyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takaoki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oya
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007813:Laparotomy / Q000379:methods; D019520:Living Donors; D008297:Male; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*