Abstract / Summary
Pringle maneuver is a critical technique for controlling hepatic inflow and minimizing blood loss during laparoscopic liver resection. However, traditional methods of performing this maneuver can be cumbersome in laparoscopic settings. This study introduces a simple self-locking surgical tubing tourniquet designed for laparoscopic Pringle maneuver. The tourniquet was constructed extracorporeally using a length of surgical tubing with a linear incisive side hole, which enabled self-locking and maintenance of consistent pressure. Between March 2023 and March 2026, this device was utilized in 46 patients undergoing laparoscopic liver resection. The occlusive effectiveness of hepatic inflow was retrospectively analyzed in terms of ease of use, intraoperative blood loss, liver function changes, postoperative complications, and postoperative length of stay. All 46 patients underwent safe laparoscopic liver resections. Pringle maneuver was performed using an intermittent 15-min portal clamp with a 5-min clamp-free interval. The estimated intraoperative blood loss was 172.22 ± 120.32 mL (range, 50–400 mL), with no transfusion required. The mean operative duration was 259.28 ± 83.02 min (range, 120–420 min), and there were no conversions to open surgery. The mean hepatic inflow occlusion time was 32.11 ± 12.48 min. Postoperative peak levels were 336.72 ± 230.38 U/L for alanine aminotransferase, 316.17 ± 279.55 U/L for aspartate aminotransferase, and 19.01 ± 8.66 µmol/L for total bilirubin. Liver function parameters returned to near-normal levels before discharge with standard hepatoprotective therapy. No complications exceeding Clavien-Dindo Grade II were observed. No portal vein thrombosis or arterial aneurysm was identified postoperatively. The mean postoperative length of stay was 5.22 ± 2.02 days. The simple self-locking surgical tubing tourniquet represents a feasible and safe tool for Pringle maneuver in laparoscopic liver resection.