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Updated: May 23, 2026
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Technical notes: a self-designed, simple, secure, and safe six-loop intracorporeal Pringle's maneuver for
Ying-Jui Chao1, Chih-Jung Wang, Yan-Shen Shan
1Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng-Li Road, Tainan 70428, Taiwan.
Surgical Endoscopy
|March 23, 2012
Summary
A novel six-loop intracorporeal Pringle’s maneuver simplifies laparoscopic liver resection. This technique enhances safety and reduces blood loss during the procedure.
Area of Science:
- Minimally Invasive Surgery
- Hepatobiliary Surgery
- Surgical Innovation
Background:
- Laparoscopic liver resection requires effective methods for controlling hepatic inflow.
- Traditional Pringle's maneuver can be challenging to perform intracorporeally.
- A simple, secure, and safe technique is needed to facilitate laparoscopic liver resection.
Purpose of the Study:
- To design and evaluate a novel six-loop intracorporeal Pringle's maneuver.
- To assess the safety and efficacy of this technique in laparoscopic liver resection.
Main Methods:
- A custom six-loop catheter was fabricated using T-tube and nelaton catheter components.
- The device was inserted through the foramen of Winslow to occlude hepatic inflow.
- The maneuver involved 15-minute clamping and 5-minute release cycles during liver transection with Harmonic scalpel.
Main Results:
- Twenty patients underwent laparoscopic liver resection using the technique between November 2009 and August 2011.
- Average operative time for liver resection was 33.1 minutes, with an average Pringle's maneuver time of 36.2 minutes.
- Mean blood loss was 102.5 ml, with uneventful postoperative courses and an average hospital stay of 4.4 days.
Conclusions:
- The self-designed six-loop intracorporeal Pringle's maneuver is a safe and effective method.
- This technique facilitates simpler and safer laparoscopic liver resections.
