ObjectiveTo 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. MethodHigh-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. ResultsFor 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. ConclusionsMinimally 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.
ObjectiveTo evaluate and analyze the clinical effect of ambulatory surgery applied to laparoscopic cholecystectomy (LC).MethodsThe patients who underwent LC in the First Affiliated Hospital of Xinjiang Medical University from June 2017 to February 2019 were collected, then were assigned to ambulatory surgery applied to LC group (ALC group) and conventional LC group (CLC group) according to the admission process mode. The patients in the ALC group received LC in the ambulatory ward and the patients in the CLC group received LC in the conventional ward. The preoperative waiting time, postoperative gastrointestinal recovery time, postoperative 6 h pain score, total hospitalization time, total hospitalization cost, patient satisfaction, and postoperative complications were compared between the two groups.ResultsA total of 433 patients underwent LC were included in this study, including 176 patients in the ALC group and 257 patients in the CLC group. There were no significant differences in the age, gender, type of gallbladder diseases, etc. between the two groups (P>0.05) except body mass index (P<0.05). There was no perioperative death in the two groups. One patient converted to laparotomy in the CLC group. Compared with the CLC group, the preoperative waiting time, postoperative gastrointestinal recovery time, and the total hospitalization time were shorter, the postoperative pain score was lower, the total hospitalization cost was less, and the satisfaction rate of patients was higher in the ALC group (P<0.05). There was 1 case of incision infection and 1 case of ascites in the operation area in the ALC group and CLC group, 1 case of fever in the ALC group and 3 cases of fever in the CLC group, respectively. There was no difference in the overall incidence of complications between the two groups (P>0.05). During the follow-up of 6 to 26 months, there was no readmission in both groups.ConclusionPatients who undergone LC based on ambulatory surgery mode recover quickly, and hospitalization cost is less, satisfaction rate is higher.