The First Case of Pure 3D Laparoscopic Living Donor Hepatectomy in Kazakhstan = The First Case of Pure 3D Laparoscopic Living Donor Hepatectomy in Kazakhstan

다국어 초록 (Multilingual Abstract)

Aims: Laparoscopic living donor hepatectomy is performed selectively in some countries because of the small sized structures and anatomic variations which requires more precise technique. In Kazakhstan about 200 cases of living donor liver transplantation were performed starting from December 2011.We now present the first case of laparoscopic living donor hepatectomy in Kazakhstan using a 3D laparoscopic device with colleagues from Seoul National University Hospital, Korea by professor KwangWoong Lee.
Methods: A 23-year-old male volunteered for living donor to his older brother who had combined hepatitis B, D and C related cirrhosis without any history of antiviral treatment. The recipient age was 36 and His model for end-stage liver disease score was 22. Brief morphologic characteristics of donor and recipient were as follows: donor - height 177 cm, weight 74 kg, BMI 23.64 kg/m²standard liver volume 1348 ml; recipient - height 172 cm, weight 78 kg, BMI 26.44 kg/m², standard liver volume 1350ml.Donor graft volume was 820ml and left remnant liver volume was 32%.
Results: The surgery was performed in October 2016 with 5 port insertion using an ultrasonic dissector, Cabitron Ultrasonic Aspirator, and clips. The liver was extracted via 10 cm sized suprapubic incision. V5 and V8 were reconstructed to the right hepatic vein using the PTFE graft. The Donor’s operation time was 295 minutes and estimated bleeding was 700ml. The recipient had sanguinous drain and bleeding control was performed postoperative day 1 due to bleeding from hilar plate. Both donor and recipient were discharged after 15 and 28 days and the donor was not eventful.
Conclusions: 3D laparoscopic hepatectomy has been progressively developed along the past decade. High quality studies allied with high-level surgical training are required to base surgical practice and to disseminate the benefits of to many centers as possible. Future applicability of new technologies such as robot assistance and 3D surgery is still under investigation in Kazakhstan.