Reply
Journal
Liver Transplantation
Journal Volume
23
Journal Issue
6
Date Issued
2017
Author(s)
Abstract
Potential conflict of interest: Nothing to report. TO THE EDITOR: We thank Magistri et al. for their reassurance on our report of robotic donor hepatectomy.1 Regarding the concern addressed by their letter, we also believe that donor safety is always the first priority in living donor liver transplantation. With respect to the postoperative suffering associated with open surgery,2 it is our primary intention that a minimally invasive approach may contribute to donor recovery and reduce complications. Following pioneering procedures, minimally invasive approaches to donor hepatectomies have been springing up with experienced teams.3 Although the minimally invasive liver surgery has advanced to more delicate and complex fields, each novel surgical program needs a strict evaluation to prevent reckless attempts. We agree that the ergonomics of the robotic platform should not be regarded as a shortcut for inexperienced surgeons. Additionally, we provided our experience in establishing a solid training program for robotic major hepatectomy.5 The surgical technique using the vessel‐sealing device has been widely used in liver surgery,6 and the technique with the ultrasonic dissector in our reported video provided an efficient dissection without increased bile complication rates. A successful living donor liver transplantation lies in the good prognosis of the recipient. Our data suggested the feasibility of robotic liver donor surgery not only because of smooth donor recovery, but also because of proper graft function for the recipient. However, more experiences addressing graft function and donor‐related recipient complications should be collected to realize the benefits and disadvantages of minimally invasive liver donor surgery. Taken together, to ensure the possible safe evolution from open surgery, as addressed by Iuppa et al., the robotic liver donor procedure requires very careful evaluation and training.7 To open a robotic donor program for liver transplantation, a step‐by‐step development of the robotic liver surgery procedure should be constructed to address the steep learning curve regarding the familiarity of robotic hepatectomy and the control of difficult situations during donor surgery.
SDGs
Publisher
John Wiley and Sons Ltd
Type
letter