Technical guidelines for minimally invasive surgery in liver transplant recipients(2025)

Liver transplantation is an effective treatment for end-stage liver disease. Liver transplantation is technically complex and associated with significant trauma. In recent years,minimally invasive surgical techniques,such as laparoscopy and robotic surgery,have rapidly developed and been widely applied across various surgical fields. Minimally invasive surgery offers advantages including reduced trauma,less bleeding,and faster postoperative recovery,and has become a mainstream trend in surgical development. In the field of liver transplantation,laparoscopic and robotic donor hepatectomy techniques for living donor liver transplantation have made significant progress. However, due to difficulties in exposing the anastomotic sites of the donor liver and challenges in vascular anastomosis,the application of minimally invasive techniques in donor liver implantation has progressed relatively slowly. With advancements in laparoscopic and robotic surgical techniques and related instruments,laparoscopic donor liver implantation has gradually become feasible. Currently,multiple liver transplant centers worldwide have begun to progressively perform laparoscopic or robot-assisted liver transplantation in recipients,demonstrating potential advantages in reducing surgical trauma and accelerating postoperative recovery. However,there is currently a lack of guidelines or consensus on the application of minimally invasive surgery in liver transplant recipients. Therefore,Branch of Organ Transplantation of Chinese Medical Association,Surgery Group of Chinese Society of Surgery of Chinese Medical Association,and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association invited experts in the field to discuss clinical issues. Combining published guidelines,consensus statements,and research advancements,they formulated the "Technical guidelines for minimally invasive surgery in liver transplant recipients（2025）", aiming to provide reasonable guidance and references for clinical practitioners in the field of liver transplantation.

肝移植是治疗终末期肝病的有效手段，但其手术技术复杂，创伤较大。近年来，腹腔镜和机器人辅助手术快速发展并被广泛应用于各个外科领域。但由于供肝吻合部位的术野暴露困难和血管吻合难度高，微创技术在供肝植入方面应用的发展相对缓慢。随着腹腔镜、机器人外科技术及相关手术器械的发展，腹腔镜下供肝植入逐渐成为可能，并初步显示出潜在的减轻手术创伤、加快患者术后康复的优势。然而，目前尚缺乏关于肝移植受者微创入路手术应用的指南或共识。因此，中华医学会器官移植分会、中华医学会外科学分会外科手术学组、中国医师协会器官移植医师分会邀请相关领域专家针对临床问题展开讨论，结合已发表的相关指南、共识和研究进展，制订了《肝移植受者微创手术技术指南（2025）》，以期为肝脏移植领域的临床工作者提供合理的指导和参考。.