Background : As minimal invasive surgery is increasingly performed, the procedure is starting to expand throughout the world. Among them, minimal invasive surgery for the recipient is started to be performed in leading centers.

Methods : Retrospective data acquisition was performed from Samsung Medical Center database. Among living donor liver transplantation, minimal invasive recipient surgeries were included. Hybrid surgery which is performed as laparoscopic explant hepatectomy combined with open procedures were included as well as totally laparoscopic living donor liver transplantation. Donor and recipient information as well as time consumed during each procedures were calculated. Donor and recipient complication during the 30-day postoperative period were collected

Results : During the period of July 2023 to November 2023, 8 cases of minimal invasive living donor liver transplantations were performed. Among Five laparoscopic transplantations, one open conversion case was included. For totally laparoscopic approach, partial clamping of the inferior vena cava was performed to maintain venous return to the heart, and not to disturb the vital sign of the recipient during anhepatic phase. Portal flow control was performed at the latest time to minimize bowel congestion. The mean operation time of hybrid cases was 314±38 minutes while that of totally laparoscopic cases was 477±169 minutes. One hepatic artery stenosis which required balloon angioplasty occurred in one patient. One patient experienced Pfannenstiel site bleeding.

Conclusions : Minimal invasive liver transplantation is technically feasible and can be performed within acceptable time. However, further refinement of procedure is required to minimize operation time. Further research is required to observe long-term results.