Randomized control trial on graft retrieval via upper midline incision vs Pfannenstiel incision following Modified robotic donor hepatectomy

Minimally invasive donor hepatectomy (MIDH) has become increasingly popular due to its demonstrated benefits of decreased postoperative morbidity and faster recovery relative to open techniques. Among minimally invasive methods, robotic donor hepatectomy offers unparalleled surgical control, allowing meticulous dissection of critical structures such as the hepatic artery, portal vein, and biliary ducts with enhanced precision and safety.

 While the intra-abdominal phase has been extensively optimized through robotic systems, graft retrieval still necessitates a mini-laparotomy incision. The upper midline incision provides excellent operative exposure and is standard in many Asian centers. Conversely, the Pfannenstiel incision, located transversely in the lower abdomen, offers cosmetic and respiratory advantages by preserving upper abdominal musculature.

Thus, this study aims to evaluate donor postoperative pain, quality of life, wound complications, cosmetic outcomes, procedural costs, hospital stay, and graft function between UMI and PFI after modified robotic donor hepatectomy, providing evidence-based recommendations for optimal graft retrieval incision selection in modern minimally invasive liver transplantation practice.