Microsurgical hepatic artery reconstruction during living-donor liver transplantation by using head-mounted surgical binocular system.

We have described our experience with arterial reconstruction during living-donor liver transplantation by using Varioscope AF3--a head-mounted surgical binocular system with automatic focusing and continuous zoom magnification from 3.6x to 7.2x. From July 1996 to December 2006, 91 grafts were implanted in 89 living-donor liver transplantation recipients, including two that required retransplantation. For microsurgical reconstruction of the graft hepatic artery, a conventional operating microscope was used in the first 10 transplants and Varioscope, in the subsequent 81. The time required to complete arterial reconstruction while using a conventional operating microscope and Varioscope was 78.6 +/- 44.6 min and 35.5 +/- 15.5 min, respectively. No arterial complications, including hepatic artery thrombosis, occurred in any of the 89 patients during the observation period. In living-donor liver transplantation, successful hepatic artery reconstruction can be safely carried out using Varioscope.