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Editor's Note |

Is Any Method of Vascular Control Superior in Hepatic Resection of Metastatic Cancers? Longmire Clamping, Pringle Maneuver, and Total Vascular Isolation—Editor's Note

Claude H. Organ Jr, MD
Arch Surg. 2001;136(5):574. doi:10.1001/archsurg.136.5.574.
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The Pringle maneuver was initially developed and used by J. Hogarth Pringle, FRCS, from the Glasgow Royal Infirmary.1 Following a series of unsuccessful operations on the liver, Pringle turned to the laboratory in search of a solution to control hepatic bleeding. He used rabbits as had his predecessor Ponfick. Four of these animals were anesthetized with chloroform, the abdomen was opened, and the portal vessels clamped with a narrow forceps. During this period, the surface of 1 lobe of the liver was freely cut into at several places but no bleeding followed, and at the termination of 1 hour this lobe was removed. There were no significant changes in the small bowel. In all 4 rabbits the hemorrhage was completely controlled; the animals recovered from the operation and developed no abnormal symptoms. The rabbits were killed on the third or fourth day, temporary obstruction of the portal circulation did not appear to have injured the animals, and the experiments were discontinued. Pringle then applied the technique in 2 clinical cases; the technique provided perfect control of the bleeding areas of the liver and a clear field for operating.

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