Extra: Laparoscopic Pringle Manoeuvre

Instead of passing the tape with a grasper one can also use a goldfinger or 90° esophageal dissector to pass the tape from the left to the right side. (2)

Both ends of the tape are pulled out through a 5-mm port trocar. The tape is passed through a long rubber tourniquet that is pushed inside the abdominal cavity up to the level of the hepatic pedicle. This technique is very suitable for an intermittent Pringle Maneuver.

Laparoscopic Pringle for right posterior sectionectomy. Patient is placed in semiprone position.

Intracorporeal Pringle Maneuver

This method was described by Cherqui et al. (3) Similar as for extracorporeal Pringle a grasper goes behind the hepatic pedicle and an umbilical tape is placed. The ends of the tapes are put out of a trocar. Both ends of the umbilical tape are passed in a short rubber tourniquet (+/- 5 cm.). This tourniquet is pushed into the abdominal cavity up to the level of the hepatic pedicle. a Hemolock clip is pushed to tighten the tourniquet around the hepatic pedicle. The Hemolock clip can be removed using an ultrsonic sealing device.