Laparoscopic right hepatectomy for living donation
Living donor liver transplantation has become a widely accepted alternative to cadaveric transplantation. The laparoscopic approach has demonstrated its safety and reproducibility for the left lateral section harvesting in the last decade, but remains controversial for right liver harvesting due to concerns about donor and graft safety. The selection of an eligible donor means the evaluation of, in one hand, the technical feasibility, and in the other hand, the operative risk for the donor. Such issues imply an extensive workup procedure. The operation is divided in three main steps: right pedicle dissection, parenchymal transection including bile duct division, and graft extraction. To enhance donor safety, these steps are performed in rotation between two senior surgeons in our team. Conversion criteria and technical aspects are precisely defined preoperatively to enhance donor safety.