Introduction : Laparoscopic major hepatectomy is gradually increasing with two consensus meetings. However, purely laparoscopic donor right hepatectomy (PLDRH) is still being performed carefully, because donor safety and quality grafts must be obtained. Herein, we report our Initial experience of the first 16 cases of PLDRH.

Methods : From March 2019 to December 2019, 43 patients underwent donor right hepatectomy except for 7 patients who used left graft. Sixteen of them underwent PLDRH. PLDRH was performed using flexible scope and 5 ports. We retrospectively reviewed 16 cases of PLDRH.

Results : Their mean age was 40.4 ± 14.4 years and 8 (50.0%) were female. The average BMI was 22.8 (19.1~25.4) and the average graft volume was 778.8 (608~1300) mL. The mean graft steatosis was 2.6%. There was no patient with portal vein variation, but duct variation was found in 4 patients. The average operation time was 327.3 (250~380) minutes and the time from hepatic artery clamping to graft out was 18.9 (11~31) minutes. There was no intraoperative transfusion and no open conversion in all patients. The average hospital stay was 11.3 days after surgery. One duct stricture developed as a surgical complication which was treated with ERBD insertion and there was one spontaneous pneumothorax during the operation. There was no re-operation or re-admission. Recipients also recovered well and there was a bile leak in one patient of the recipients.

Conclusions : PLDRH still remains a challenging procedure requiring important experiences in both laparoscopic liver surgery and open living donor right hepatectomy. However, once we get used to both,