HPB V09 Pringles manoeuvre- How we do it!

Abstract

Abstract Background Minimally invasive liver resection (MILR) is a complex surgical procedure requiring extensive training and expertise. One of the critical challenges in MILR is the control of bleeding from the transection plane. Intraoperative blood loss and blood transfusion requirements are associated with increased operating time, postoperative morbidity, mortality, and reduced disease-free survival. Pringles manoeuvre is an established strategy to facilitate liver resection whilst maintaining haemostasis from the transection plane. Several techniques for performing the Pringle manoeuvre in MILR have been described. However, an optimal method has not been identified yet. Methods In our video presentation, we describe a novel technique for Pringle's manoeuvre in MILR using a deceptively simple Foley catheter device. Results A Foley catheter can provide uniform constriction of the hilar structures owing to its silastic properties. Its atraumatic tip allows its safe passage behind hilar structures without other instrument use. It does not require additional ports, is less traumatic, and is easy to apply. A foley catheter is also relatively inexpensive and readily available in operation theatres. Conclusions Pringle's manoeuvre using a Foley catheter is a simple, safe, easily reproducible, and cost-effective technique. We encourage this method of hepatic inflow occlusion in modern minimally invasive liver surgery.