Laparoscopic donor hepatectomy: Are there obstacles on the path to global widespread?

Laparoscopic liver resection in living donors is a relatively novel surgical approach that has the potential to enhance donor safety and facilitate faster recovery. Following an initial development period during which donor safety was not effectively validated, the minimally invasive approach now yields better outcomes, provided that these procedures are performed by experienced surgeons. The key factors include donor selection criteria, the clinical infrastructure, and the learning curve for surgeons. This review outlines the current status of the development of laparoscopic liver resection in living donors and discusses the obstacles to the advancement of this surgical technique. • Minimally invasive donor hepatectomy offers reduced blood loss, faster recovery, less pain, and superior cosmetic results. • Adoption faces challenges like resource limitations, lack of standardized techniques, and steep learning curves for surgeons. • Surgeons require 15–60 procedures to gain proficiency, with high-volume centers achieving better outcomes. • Studies confirm comparable safety and effectiveness to open methods, encouraging more living donations. • Future advancements include robotic surgery, augmented reality, and standardized global training programs.