Pringle Maneuver
Pringle Maneuver - Related Videos
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Here, we present a protocol to perform a modified laparoscopic anatomic hepatectomy using improved techniques and instruments.
14:28
Software for Analysis of Heart Rate and Blood Pressure Time-series Data from the Valsalva Maneuver
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The ValsalvaAnalyzer software includes functions to analyze continuous beat-to-beat electrocardiogram and blood pressure (BP) measurements recorded during the Valsalva maneuver (VM). The computed clinical biomarkers and estimated model outputs provide insight into sympathetic and parasympathetic regulation of heart rate and BP during the VM.
08:35
Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Cited by 16 •
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The assessment of microvascular function by oxygenation-sensitive cardiac magnetic resonance imaging in combination with vasoactive breathing maneuvers is unique in its ability to assess rapid dynamic changes in myocardial oxygenation in vivo and, thus, may serve as a critically important diagnostic technique for coronary vascular function.
06:00
Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection
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2025
We present a laparoscopic technique for anatomic S7+S8d resection with right hepatic vein transection, preserving the inferior right hepatic vein and segment S6. Relying on meticulous anatomical landmarks without intraoperative ultrasound, this approach offers a precise and parenchyma-sparing option for dorsally located right-liver tumors, particularly in settings with limited advanced navigation resources.
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Laparoscopic Anatomical Right Anterior Sectionectomy with a Hepatic Pedicle-first Approach: Technical Details and Representative Case Illustration
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2025
This article aims to present a novel Laennec's capsule-guided laparoscopic approach for right anterior sectionectomy, highlighting its potential to improve safety, precision, and reproducibility in complex liver resections.
FAQs
The maneuver targets the hepatoduodenal ligament, a compact structure containing the hepatic artery, portal vein, and bile duct. Compressing this bundle reduces the liver’s incoming blood supply from both major inflow vessels at once. With less blood entering the operative field, surgeons can better identify injured or transected tissue and apply hemostatic control during hepatic procedures.
Its effect is limited to blood entering through the portal triad. Hemorrhage originating from hepatic veins or the inferior vena cava can continue because these vessels are not controlled by compression of the hepatoduodenal ligament. Persistent bleeding despite reduced inflow therefore indicates that the source may involve the liver’s venous outflow rather than its arterial or portal inflow.
Extended clamping can deprive liver tissue of adequate blood flow, producing hepatic ischemia. When circulation is restored, reperfusion may cause additional tissue injury. This makes the maneuver a balance between reducing operative hemorrhage and limiting the duration of restricted inflow, particularly when liver tissue is already injured or undergoing transection.
The technique reduces inflow to a broad region by compressing the portal triad rather than addressing only one visible vessel or injured surface. That wider effect can improve the operative view when bleeding obscures the field. It does not, however, replace evaluation of hepatic veins or the inferior vena cava when hemorrhage persists from those structures.
The maneuver is used during liver resection, trauma care, and transplantation. In resection, reduced inflow can help manage bleeding from transected tissue. During trauma care, it supports hemorrhage control when the liver is injured. In transplantation, controlling inflow can improve surgical visualization and assist management of bleeding during complex hepatic procedures.
Temporary control of liver inflow reduces the amount of blood entering the operative field, which can improve visualization of the surgical anatomy. Better visibility helps surgeons identify the source of hemorrhage and manage hemostasis more effectively. The outcome is not guaranteed control of all bleeding, because venous sources outside the compressed portal triad may remain active.