• Seoung Yoon Rho, Jae Geun Lee, Dong Jin Joo, Myoung Soo Kim, Soon Il Kim, Dai Hoon Han, Jin Sub Choi, and Gi Hong Choi.
• Department of Surgery, Division of Hepato-biliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea.
• Ann. Surg. 2022 Feb 1; 275 (2): e433-e442.

ObjectiveTo investigate the feasibility and safety of RLDRH.Summary Of Background DataData for minimally invasive living-donor right hepatectomy, especially RLDRH, from a relatively large donor cohort that have not been reported yet.MethodsFrom March 2016 to March 2019, 52 liver donors underwent RLDRH. The clinical and perioperative outcomes of RLDRH were compared with those of CODRH (n = 62) and LADRH (n = 118). Donor satisfaction with cosmetic results was compared between RLDRH and LADRH using a body image questionnaire.ResultsAlthough RLDRH was associated with longer operative time (minutes) (RLDRH, 493.6; CODRH, 404.4; LADRH, 355.9; P < 0.001), mean estimated blood loss (mL) was significantly lower (RLDRH, 109.8; CODRH, 287.1; LADRH, 265.5; P = 0.001). Postoperative complication rates were similar among the 3 groups (RLDRH, 23.1%; CODRH, 35.5%; LADRH, 28.0%; P = 0.420). Regarding donor satisfaction, body image and cosmetic appearance scores were significantly higher in RLDRH than in LADRH. After propensity score matching, RLDRH showed less estimated blood loss compared to those of CODRH (RLDRH, 114.7 mL; CODRH, 318.4 mL; P < 0.001), but complication rates were similar among the three groups (P = 0.748).ConclusionsRLDRH resulted in less blood loss compared with that of CODRH and similar postoperative complication rates to CODRH and LADRH. RLDRH provided better body image and cosmetic results compared with those of LADRH. RLDRH is feasible and safe when performed by surgeons experienced with both robotic and open hepatectomy.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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