Introduction : Recently, as the interest in pure laparoscopic donor right hepatectomy has increased, several studies showing the feasibility and safety have been reported (1–9). However, all of these studies are focused only on the operator and not on the assistant who manipulate the scope, scopist. The aim of this study is to demonstrate technical tips and pitfalls in manipulating flexible scope for pure laparoscopic donor right hepatectomy.

Methods : A total of 166 living donors underwent pure laparoscopic hepatectomy between November 2015 and December 2017. Among these, 8 donors who underwent other than right hepatectomy or extended right hepatectomy were excluded. The medical records of 158 included donors were retrospectively reviewed.

Results : There are three kinds of laparoscopic view that can be made by flexible scope. First, the bird eye view is a view that is used throughout the surgery and can be viewed from the top down as in open surgery, providing stability and comfort. Second, the low angle view is used when there is not enough space on the top and difficult to access the bird eye view. Third, the lateral view is the view used when approaching from the side. Different technique for suitable view is required along the procedure.

Conclusions : In conclusion, skillful manipulation of flexible scope with harmony between the operator and the scopist is important for successful pure laparoscopic donor right hepatectomy.