This novel approach seems technically challenging but feasible using equipment and accessories currently available for conventional laparoscopic and interventional endoscopy with low intra-abdominal contamination and sepsis. New procedure-specific instruments and equipment need to be developed to allow the surgeon safer access and more degrees of instrument freedom.

Result: During the study period, 15 donors with RPV variations underwent pure laparoscopic living donor right hemi-hepatectomy. 4 donors (26.7%) had type II portal vein, 7 donors (46.7%) had type III portal vein, and 4 donors (26.7%) had type IV portal vein. Multiple right hepatic ducts were encountered in 13 donors (86.7%). No open conversions or peri-operative blood transfusion were required. Post-operative morbidity occurred in one donor (6.7%), in the form of cystitis. No postoperative biliary or vascular complications occurred. No readmissions were required during the follow up. Conclusion: The current series proves the safety and feasibility of laparoscopic approach for donors with RPV variations. This series is a step towards further expansion of the current indications of laparoscopic adult living donor hepatectomy.

There is a huge gap between organ donation and the current demand for organ transplantation. With a very low donation rate of 0.26 per million in India, a high number of patients die due to lack of organ transplantation. Strategies such as increasing organ donation from the paediatric population can improve the void in the national donor pool. Increasing awareness among the general population, propitious support for families during the donation process, more dedicated clinical staff, development of better screening and assessment processes are some multifaceted methods to improve organ donation. We herein report a case of an 18-month-old girl child who donated her heart, liver, kidneys and cornea to five patients following her demise. This case emphasises that with advanced surgical techniques and meticulous organ procurement even from a very young donor, results can be rewarding.

Introduction: Insulinoma is MEN-1 are multifocal with no site predilection. Current guidelines do not favour particular surgical approach. Consequently, its anatomical location or individual centers experience which guides enucleation, partial or total pancreatectomy. Method: We encountered four patients of Insulinoma in MEN-1 from July 2017 to June 2018. Clinical symptoms, biochemical investigation and CECT abdomen was performed to clinch the diagnosis. MRCP was performed to determine its relation with main pancreatic duct and 68-Ga DOTANOC PET-CT was done to delineate other endocrine lesions. Enucleation was performed in all 4 patients with utilization of intra-operative continuous glucose monitoring (CGM) to ascertain removal of dominant lesion. An upward CGM spike was used to define excision of dominant lesion and confirmed in all patients. Demographics, pre-operative investigations, peri-operative parameters and outcomes of patients were reviewed. Result: All patients were female with median age was 36 years (range 28-45). The median serum Insulin and C-