摘要
Thank you for inviting us to comment the review article entitled"Use of robotics in liver donor right hepatectomy"by Chen PD et al.(1),published on HBSN journal.In their interesting paper,the authors stated that despite the fact that minimally invasive surgery(MIS)has been documented with safety and feasibility in complex liver surgery the progress has been slow in regard to the application of MIS in donor graft hepatectomy.Pioneer surgeons have devoted themselves to develop pure MIS approach for donor hepatectomy,but the steep learning curve remains barrier for its wide adoption.The authors suggest that the introduction or robotic assisted surgery may contribute to a wider acceptance of MIS as the technique of choice for live donor hepatectomy.Despite a great attention to donor selection and continuous improvement in donor care the risks of donor hepatectomy remain real and the complication rate not insignificant(2).Traditional open liver resection results in post-operative pain and in at least 30%of the cases these pains were attributed to abdominal wall trauma(1,2).For these reasons and with the aim of facilitating donor recovery,transplant surgeons have been exploring the possibility of routinely applying MIS to live donor hepatectomy.To bridge the gap between open and pure MIS donor procurement,hand-assisted laparoscopic surgery was initially introduced in the 90'.It was not until 2002 that Soubrane O presented the first two cases of pure laparoscopic left lateral living donor hepatectomy,followed in the years to come by several successful attempts to extend the procedure to the procurements of full left and right hepatic lobes(1-6).
