Achievements, Challenges and Promises of Minimally Invasive Liver Transplantation

TL;DR

This review discusses the progress, challenges, and future potential of minimally invasive techniques in liver transplantation.

Contribution

The paper provides a comprehensive overview of recent developments and gaps in minimally invasive liver transplantation.

Findings

Minimally invasive liver transplantation has shown rapid progress in the last two decades.

Technological advancements like 3D visualization and robotic systems are central to these developments.

There is a growing number of publications and adoption of these techniques globally.

Abstract

The integration of minimal invasive (MIS) techniques in liver transplantation (LT) emerged as a natural progression following advances in laparoscopic and robotic hepato-pancreato-biliary surgery. However, it poses specific challenges that are inherent to LT. Chronologically, it is a recent topic that only emerged 2 decades ago in donors and recently in recipients, but it has showed a meteoric rise with tremendous progress over the last years. This review aimed to provide a comprehensive yet synthetic overview of the available data on minimal invasive liver transplantation (MILT), for both donor hepatectomy (DH), recipient hepatectomy and graft implantation. Developments were numerous: top-notch technical skills have not only been reported but have foremost been performed worldwide by an increasing number of groups. Technology also played a central role, as exemplified by the integration of 3D visualization techniques, the utilization of indocyanine green (ICG) near-infrared fluorescence camera system or the use of robotic technology. Research efforts finally illustrated this progress with a rapid rise of number of publications and adoption. The present analysis of the available data permitted to identify gaps that may be valuable to explore by future research projects.

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