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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
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"Hooking method" for hepatic inflow control: a new approach for laparoscopic Pringle maneuver
Yi Zhou1,2, Yifan Wang1, Jinliang Ma1
1Department of Hepatic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
World Journal of Surgical Oncology
|August 22, 2023
Summary
This study introduces a new hooking method for laparoscopic Pringle maneuver, crucial for controlling bleeding during liver surgery. The method proved safe and effective in 17 patients, showing minimal complications and blood loss.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- The laparoscopic Pringle maneuver is essential for managing bleeding during laparoscopic hepatectomy.
- Controlling hepatic inflow is critical for patient safety and surgical success in liver resections.
Purpose of the Study:
- To introduce and evaluate a novel laparoscopic Pringle maneuver, termed the hooking method.
- To assess the safety and efficacy of the hooking method for hepatic inflow occlusion during laparoscopic hepatectomy.
Main Methods:
- A prospective analysis of 17 patients undergoing laparoscopic hepatectomy from January 2022 to January 2023.
- Application of the hooking method for intermittent occlusion of hepatic inflow in all patients.
- Collection and analysis of intraoperative and postoperative clinical data.
Main Results:
- The hooking method was successfully applied in all 17 patients, including four cases with adhesions requiring a modified technique.
- Median occlusion time was 34 minutes, with a mean operation time of 210 minutes and mean blood loss of 145 ml.
- Low complication rates (11.8%) with no severe outcomes (Clavien-Dindo grade IIIa or higher), portal vein thrombosis, or hepatic artery aneurysm.
Conclusions:
- The hooking method effectively combines advantages of intracorporeal and extracorporeal Pringle maneuvers.
- It is a simple, safe, and effective technique for hepatic inflow control in laparoscopic hepatectomy.
- This method shows promise for totally intracorporeal laparoscopic Pringle maneuvers.
