title: New technique of extracorporeal hepatic inflow control for pure laparoscopic liver resection.
abstract: We have developed a new technique of the Pringle maneuver by clamping outside the abdominal wall for pure laparoscopic liver resection (pure Lap). Our technique successfully controls bleeding and enables pure Lap to be completed without any events, even for a large tumor. Between 2008 and 2010, we compared consecutive patients who received pure Lap with (n=11) and without (n=7) this Pringle maneuver. Although tumor size in the Pringle group was significantly larger than in the no-Pringle group (3.35±1.64 vs. 1.11±0.29 cm, respectively), intraoperative bleeding was not significantly different (165.5±188.5 vs. 177.9±364.4 mL, respectively). In contrast, operation time in the Pringle group was significantly longer than in the no-Pringle group (343.1±99.5 vs. 199.6±63.2 min, respectively). Pure Lap for large tumors is feasible when employing a new Pringle maneuver outside the abdominal wall.
authors.affiliation: Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo, Hokkaido, Japan Department of Surgery, Children's Hospital & Research Center Oakland, Oakland, CA.
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Makoto
authors.initials: M
authors.lastname: Meguro
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Hui
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D034861:Abdominal Wall; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D003250:Constriction; D005240:Feasibility Studies; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies