Anesthesia and enhanced recovery for robotic living donor hepatectomy – A narrative review

Over the last decades, minimally invasive surgery has advanced from the initiation of laparoscopic surgery in the 1990′s to robotic assisted techniques, gaining popularity in several surgical subspecialties. Living-donor hepatectomy, utilizing robotic surgery has matured and is slowly but steadily growing in specialized transplant centers world-wide. Both, living-donor hepatectomies as well as robotic surgery come with unique challenges for the anesthesia team. The literature on perioperative anesthesia care for this emerging subspecialty is currently limited. The aim of this narrative review is to provide a summary of the current literature on enhanced recovery after robotic living donor hepatectomy and describe the 3 year experience and protocol in the first robotic living donor hepatectomy program in the United States.