This allows the anesthesiologist to catch up with the resuscitation. Then remove the lower quadrant packing first, followed by left upper quadrant and finally right upper quadrant. If the spleen is actively bleeding, splenectomy should be performed. Assess the liver laceration and identify the bleeding vessel. Direct suture ligation should be performed using 3-0 or 4-0 absorbable suture. A patch of omentum can be used to fill the gap created by the laceration. If bleeding continues, then perform the Pringle maneuver (apply a noncrushing clamp through the foramen of Winslow).[3] The clamp can be safely applied up to 1 hour.