Related Experiment Video
Updated: Dec 25, 2025
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
A novel simple intra-corporeal Pringle maneuver for laparoscopic hemihepatectomy: how we do it
Jingwei Cai1, Junhao Zheng1, Yangyang Xie1
1Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Institute of Minimally Invasive Surgery, Zhejiang University, No. 3 East Qingchun RoadZhejiang Province, Hangzhou, China.
Introduction:
To prevent and control hemorrhage is the key to successfully perform laparoscopic hemihepatectomy (LHH). Pringle's maneuver (PM) is the standard hepatic inflow occlusion technique. Our study was to describe a novel simple way to perform totally intra-corporeal laparoscopic PM and to explore the feasibility of combining PM and selective hemihepatic vascular occlusion technique in LHH.
Methods:
We extracted and analyzed the data of patients who consecutively underwent LHH to validate this new surgery technique. Between January, 2016 and December, 2017, 34 patients were included. Data of pre-operation, operation and post-operation were collected, including some demographic data, operative time, operative blood loss, transfusion rate, hepatic hilum occlusion rate and time, pathologic results, short-term complication, and postoperative hospitalization days.
Results:
Only one patient (3.0%) in our series required conversion to laparotomy as a result of the severe adhesion. The average operative time was 216.9 ± 60.3 min. The mean hepatic inflow occlusion time was 25.3 ± 14.5 min. The average estimated blood loss was 192.9 ± 152.2 ml. All patients received R0 resection.
Conclusion:
The novel hepatic inflow occlusion device is a safe reliable and convenient technique for LHH that is associated with favorable perioperative outcomes and low risk of conversion.
