ALPPS mortality drops with IDEAL-guided global registry collaboration

Once considered dangerously high-risk, ALPPS has evolved from >15% to <5% 90-day mortality in high-volume centers through a global registry, consensus guidelines, and the IDEAL framework. Since its 2012 debut, the procedure has been tracked in 1,349 cases across 46 countries, enabling evidence-based refinement. This structured approach contrasts with the chaotic adoption of earlier surgical innovations and the current scrutiny of robotic surgery. ALPPS now stands as a model for evaluating disruptive techniques.