title: Extracorporeal Pringle maneuver in robot-assisted liver surgery.
abstract: Hemorrhage is a major complication in laparoscopic liver surgery and inflow occlusion methods are difficult to be reproduced in this setting. This study investigated 10 consecutive patients who underwent robot-assisted liver resection. An extracorporeal Pringle maneuver was carried out encircling the hepato-duodenal ligament using an endowristed robotic arm and exteriorizing the tourniquet at the epigastrium allowing the on-table surgeon to independently control intermittent clamping. The extracorporeal Pringle maneuver was effective and without complications for all patients. The assistant was able to apply consecutive clampings whereas the console surgeon proceeded in parenchyma transection. Robot-assisted liver surgery can be made safer by the use of the extracorporeal Pringle maneuver.
authors: Department of Surgery, Division of General, Vascular, Minimally Invasive and Robotic Surgery, Hospital San Matteo degli Infermi, Spoleto, Italy. albertopatriti@gmail.com
authors: Alberto
authors: A
authors: Patriti
authors: Graziano
authors: G
authors: Ceccarelli
authors: Alberto
authors: A
authors: Bartoli
authors: Luciano
authors: L
authors: Casciola
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004867:Equipment Design; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008107:Liver Diseases / Q000601:surgery*; D012371:Robotics; D014111:Tourniquets; D016896:Treatment Outcome