Samsung Seoul Hospital Surpasses 500 Laparoscopic Liver Transplant Surgeries
Accumulating Surgical Experience and Advancing Techniques
Expanding Patient Eligibility... High Satisfaction Achieved
Professors Jae-Won Cho, Kyu-Sung Choi, Jong-Man Kim, and Jin-Soo Yoo, Department of Transplant Surgery, Organ Transplantation Center, Samsung Medical Center.
[Asia Economy Reporter Lee Gwan-joo] Laparoscopic living donor hepatectomy has become the standard for liver transplant surgery. Initially, it was more difficult and less safe compared to traditional open surgery, but as surgical experience accumulated and techniques advanced, laparoscopic surgery, which reduces pain and leaves smaller scars, has gained attention.
Samsung Medical Center announced on the 7th that the research team led by Professors Jae-won Cho, Kyu-sung Choi, Jong-man Kim, and Jin-soo Yoo from the Organ Transplantation Center’s Transplant Surgery Department analyzed and published 506 cases of laparoscopic surgeries they performed in the recent issue of the international journal "Liver Transplantation."
Laparoscopic surgery involves making 4 to 5 small incisions of 1 to 2 cm on the abdomen, inserting surgical instruments through these ports to resect the donor’s liver, and removing it through an incision made in the pelvic area. Compared to traditional open surgery, it is known to reduce donor pain and minimize scarring, thereby improving quality of life, but the surgical difficulty is correspondingly higher.
At Samsung Medical Center, laparoscopic surgery was initially applied only to some patients. According to the research team, among 289 liver transplant patients from 2013 to 2016, 215 underwent open surgery, while only 74 patients (about 25%) had laparoscopic surgery.
During the transitional period from 2017 to 2019, the ratio reversed. Of 300 liver transplant surgeries performed during this period, open surgeries decreased to 54 cases, while 246 cases (82%) were performed laparoscopically. Since 2020, all 166 liver transplant surgeries have been conducted laparoscopically.
The research team analyzed that this change was due to increased surgical experience and advanced techniques, which expanded the pool of eligible patients. Liver transplant surgery requires precise dissection of bile ducts and blood vessels to prepare the donor liver for transplantation. Donors with anatomical variations typically have a higher risk of bleeding, so open surgery was generally preferred. In the early days of laparoscopic surgery at Samsung Medical Center, only 8.1% of laparoscopic patients had bile duct variations, and 4% had vascular variations such as portal vein anomalies.
Currently, laparoscopic surgery is the default choice regardless of anatomical variations. This is because safety indicators have improved and surgical proficiency has increased. The average surgery time has also been reduced by about half, from 449 minutes in the first year of introduction in 2013 to 209 minutes as of last year. Donor satisfaction with the surgery is higher compared to open surgery. The need for narcotic painkillers is about one-third, and the average hospital stay is 8 days, shorter than the 10 days for open surgery.
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