Objective To systematically review the current status, technical evolution, and safety strategies of minimally invasive techniques in liver transplantation, and to analyze the core challenges and future directions of their application for both donors and recipients. Method High-quality domestic and international research literature, including multi-center registry studies and meta-analyses, was integrated to comparatively analyze the clinical efficacy, safety, and limitations of open, laparoscopic, and robotic surgeries. Results For donors, minimally invasive donor hepatectomy is relatively mature. Laparoscopic surgery, as an early exploratory technique, provides minimally invasive benefits but is limited by a steep learning curve and a higher risk of early biliary complications. Robotic surgery demonstrates superior performance in reducing open conversion rates and recipient biliary complications, but it faces considerable controversies, including high costs, prolonged operative time, and potential selection bias. For recipients, minimally invasive transplantation remains in the early feasibility exploration stage. Full robotic surgery is performed only in a few top-tier centers for highly selected patients with low model for end-stage liver disease score and no severe portal hypertension, with its technical and economical barriers and long-term safety yet to be validated. Conclusions Minimally invasive techniques significantly improve donor perioperative outcomes, but their widespread adoption is constrained by stringent selection criteria, high medical costs, a steep learning curve, and a lack of high-quality long-term efficacy evidence. Future development relies on evidence accumulation from prospective multi-center registry studies and the establishment of standardized, localized training systems. At present, minimally invasive techniques are not the standard of care but represent an important therapeutic option that offers superior clinical outcomes for a select group of well-screened donors and recipients.
Citation：
ABUDUKAIYOUMU· Aierken, AIMITAJI· Abulaiti, HE Xiaoyu, JIANG Tiemin. Advances in clinical application of minimally invasive techniques for liver transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(6): 838-845. doi: 10.7507/1007-9424.202604076
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Copyright ? the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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