Robotic Donor Hepatectomy is emerging as an excellent alternative to open donor transplant which were the norm till a few years ago. The precision, dexterity and improved visualization available with Robotic Surgery makes it easy for surgeons to complete the transplant with minimal hassle. The landscape of transplantation is evolving rapidly. Robotic systems and surgical instruments used in these transplants are becoming more sophisticated. This reduces the learning curve for new surgeons adopting Robotics in transplantation. In this article, we will learn more.
In recent years, there has been a spurt in liver ailments. Incidences of liver cirrhosis is on the rise due to prevalence of non-alcoholic fatty liver disease, which is again due to obesity, poor dietary choices, diabetes, dyslipidaemia and a sedentary lifestyle. Sadly, there is also a rise in alcoholic liver disease, which is due to increased alcohol-consumption for social and recreational purposes. In addition to fatty liver disease, there are various other conditions that can damage the liver. As the damage continues, it progresses towards Liver failure. Again, Liver failure may happen quickly and suddenly (acute) or develop gradually over time (chronic).
Major causes of liver damage:
Although the above causes will be treated using medication, in some people, the damage progresses rapidly. The body starts losing its regenerative capacity to repair the damage and heal the organ. Once the damage has crossed the point of repair, a liver transplantation is the only option left to save the patient.
The process of transplantation is similar in both DLT and LDLT. The bile ducts, hepatic artery, and hepatic portal vein in the person with diseased liver are carefully disconnected. After the new liver (or liver-segment) is transplanted into the recipient’s body, all these connections are made again, after which the new liver starts working immediately.
Open liver donor operation which was the norm in the past comes with disadvantages like pain, infections, slower recovery, noticeable scars, incisional hernia and long hospital stays. All these drawbacks are overcome in Robotic Surgery.
Chronologically, before the advent of Robotic Surgery, we have Laparoscopic transplants, which is a Minimally Invasive process, that are still used for the cost-benefit compared to Robotic Surgery. However, this too comes with its own, technical limitations.
In contrast, the da Vinci Surgical System (from Intuitive Surgical) that is used for Living Donor Hepatectomy ( LDLT) is very sophisticated and offers superior features that are a boon in the surgeon’s hands.
Preparing for the transplant is similar to that for any surgery. The below guidelines will apply both for the live donor and the recipient.
A similar robotic procedure will be done beforehand to harness the liver-segment and gall-bladder in case of LDLT, or the whole liver and gall-bladder in case of DLT. The harnessed liver or liver-segment and gall-bladder, will be brought into the OT where transplant into the recipient will happen.
Robotic Hepatectomy, or Robotic Liver Transplants have a bright future, and are an evolving domain. According to some leading doctors of the world, a large percentage of liver transplants in the future will be done robotically. Further,
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1. What is Robotic Liver Transplant?
Robotic liver transplant, also known as robotic hepatectomy, is a minimally invasive surgery to replace a diseased liver with a healthy one. It uses robotic arms for greater precision and control compared to traditional open surgery.
2. What are the Advantages of Robotic Liver Transplant?
3. Who is a candidate for Robotic Liver Transplant?
If you need a liver transplant and are looking for a minimally invasive option, you might be a candidate for robotic surgery. Talk to your liver doctor to see if it’s right for you.
4. What are the types of Liver Transplants?
There are two main types of liver transplants:
5. How is Robotic Liver Transplant performed?
The transplant surgeon uses robotic arms to make small incisions and carefully disconnect the diseased liver and reconnect the new liver.
6. What is the future of Robotic Liver Transplants?
Robotic liver transplants are becoming more common and may offer even greater benefits in the future. Advancements in AI and machine learning could improve donor matching and new drugs could reduce the need for long-term anti-rejection medication.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
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