Washington University surgeons perform first-ever robotic liver transplant in the US

Liver transplant surgery relies on a 'specialized team for good outcomes'

Liver transplantation is regarded as a technically tough procedure.

Excessive bleeding is one of the factors contributing to the complexity of liver surgery. Additionally, the presence of small blood vessels makes it challenging to adequately stitch them up when removing a diseased liver. Consequently, the procedure is considered too intricate to be performed in a less invasive manner.

“Liver transplantation is one of the most complex abdominal operations and heavily relies on a specialized team for good outcomes,” explained Khan. 

Moreover, a conventional liver transplant typically entails "open" surgery, necessitating surgical incisions of approximately three to four inches vertically and 12 to 16 inches horizontally, positioned just below the rib cage.

These multiple incisions enable surgeons to extract the patient's unhealthy diseased liver and substitute it with a donated liver.

The minimally invasive robotic surgery

The eight-hour-long surgery was performed by advanced machinery, while Khan controlled the robot’s movements using joystick-like controls.

To enhance visibility, high-resolution cameras were employed, enlarging the surgical site and presenting 3D images on expansive monitor panels.

Thanks to the advanced robotic instrumentation, minimally invasive surgery was made possible, allowing for precise and delicate manipulations that were previously unachievable with traditional procedures.

The surgeons performed the procedure by making several half-inch keyhole incisions and a solitary six-inch vertical incision between the abdominal muscles. These incisions were made for the removal of the diseased organ and the placement of the new liver, which is approximately the size of a football, within the abdominal cavity.

The less invasive approach facilitated a swifter recovery process. Within a span of just under a month, the recipient of the transplant not only regained the ability to walk effortlessly but also gradually resumed activities such as golfing and swimming. Typically, patients require at least six weeks before they can move without experiencing pain in most cases.

The surgical team believes that as they continue to gain more hands-on expertise, the future holds the potential for faster execution of robotic liver transplants.

Prior to this achievement, the team had already accomplished over 30 successful robotic kidney transplants. However, this particular instance marked their inaugural robotic liver transplant procedure.