Hong Kong pioneers world’s first robotic living-donor liver transplant

Hong Kong doctors have performed the world’s first robotic living-donor liver transplant as part of a pioneering microsurgery programme, researchers have revealed.
Sharing the results of the clinical trial on Wednesday, the University of Hong Kong (HKU) team said surgeons at Queen Mary Hospital had completed 48 procedures since June 2025, with no long-term or post-operative complications.
Microsurgery, which requires surgeons to operate under high-powered magnification on structures as fine as 0.1mm, is frequently used to join blood vessels, lymphatic vessels and nerves.
Dr Velda Chow Ling-yu, a clinical associate professor at the HKU medical school’s department of surgery, said the technology aimed to overcome the limitations of conventional microsurgery.
“The biggest difficulty of microsurgery is hand tremors, which can worsen if the surgeon operates under stress or fatigue,” she said at a press briefing.
“Surgeons also often need to maintain fixed, strained positions for long periods to align with the microscope and patient.”
Because doctors need to learn to control hand tremors and perform surgery under adverse conditions, microsurgery training typically takes a longer time.
About a year ago, the team began a clinical trial of robot-assisted microsurgery at Queen Mary Hospital in Pok Fu Lam, the first application of its kind in Asia.
Using the system, the surgeon sits in an ergonomic chair and controls the robotic arms via two joystick-like controllers instead of standing over the patient.
Wearing a pair of 3D goggles, the surgeon looks at a display screen to get a highly magnified, three-dimensional view of the microscopic surgical site.
As the surgeon moves the controllers, the system translates the hand movements into precise real-time actions, while filtering out tremors to ensure stability.

Following a training course for the surgeons, 48 patients underwent robot-assisted microsurgery, including reconstructive procedures after tumour removal, lymphatic surgery and trauma operations.
In April, the technology was also used in a living-donor liver transplant for the first time globally.
None of the patients experienced post-operative complications and all vascular anastomoses were patent, indicating successful blood flow through the surgical connections.
Chow said the robotic microsurgical system had been helpful in filtering tremors and improving ergonomics.
It could shorten the learning curve and enable more efficient training, potentially reducing the waiting time for surgery.
Although further data were needed to quantify its benefits, she noted that similar robotic systems used in the West had enhanced precision and reduced complications.
Professor Albert Chan Chi-yan, a clinical professor in surgery and director of the hospital’s liver transplant centre, said a challenge of the surgery was reconnecting the hepatic artery which was extremely tiny, with a diameter of just 1 to 2mm.
“If the reconnected hepatic artery becomes blocked, the new liver will fail to function, which can lead to liver failure and the need for another transplant … but not every patient gets a second chance,” he said.
“Conventional surgery relies on the surgeon’s skill and the ability to control hand tremors, but the use of a robot would correct that through highly stable, stitch-by-stitch precision, boosting the surgery’s success rate and reducing the risk of arterial blockage.”
Chan said the team aimed to make microsurgical robots a routine part of liver transplants in public hospitals and was exploring their use in bile duct reconstruction.
“While we are very experienced in conducting living-donor liver transplants, our team has always hoped to strive for excellence, further elevating our technical level and improving the success rate of the surgery,” he said.