Simultaneous operations in general surgery

Simultaneous laparoscopic partial resection of stomach and fundoplication with cruroraphy

Simultaneous laparoscopic partial resection of stomach and fundoplication with cruroraphy.

Laparoscopic stage - Professor Puchkov K.V. is performing an operation (2017), endoscopic diagnostics- D-r Tishchenko E.S. is performing.
Operation is performed for leiomyoma of the antral part of the stomach (2.5 cm at the distance of 3 cm from the pyloric part) and for hiatal hernia. In the video intraoperation gastroscopy is presented, with the marking of the resection area, then the technique of dissection of the area of the greater curvature of stomach by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument is presented, as well. At the next stage resection of the stomach part is done by the linear stitching Endo GIA MEDTRONIC COVIDIEN apparatus in the transverse direction under the guidance of gastroscopy. .The preparation is placed into the plastic container and is removed from the abdominal cavity. Then mobilization of gastroesophageal isthmus is done by a 5 mm LigaSure instrument, then cruroraphy and bylateral partial fundoplication according to Toupet (270 g) with the help of interrupted intracorporeal sutures is performed. Operation duration is 1 hour 20 minutes.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Simultaneous operation for congenital hypertrophic pylorostenosis and right inguinal hernia in a newly-born infant, aged 19 days

Simultaneous operation for congenital hypertrophic pylorostenosis and right inguinal hernia in a newly-born infant, aged 19 days.
Professor Poddubny I.V. is performing an operation (2016).

In this film the technique of laparoscopic pyloromyotomy, performed for congenital hypertrophic pylorostenosis in a newly-born infant, is presented. 3 types of troacars have been used, as well as Karl Storz instruments. As a baby has had combined pathology-right inguinal hernia, simultaneous laparoscopic hernioplasty, using the same troacars, has been performed.

Simultaneous laparoscopic cholecystectomy and resection of hepatic cyst

Simultaneous laparoscopic cholecystectomy and resection of hepatic cyst.
Professor Puchkov K.V. is performing an operation (2016).

In this film the technique of classical laparoscopic cholecystectomy in case of calculous cholecystitis, using 4 ports, is presented. The author is demonstrating the virtuosity when showing the technique of working with a 5 mm monopolar electrode in the area of Calot’s triangle. Dissection of the cystic duct and artery is performed without blood loss. The duration of cholecystectomy stage is 6 minutes. Then, using these ports, and a 5 mm Ligasure MEDTRONIC COVIDIEN instrument, resection of the cyst of the right lobe of liver (8 cm) is done. The cyst is opened by a monopolar electrode, and its contents (350 mL) is evacuated with the help of electroejection. Then, on the boundary with the hepatic tissue resection of walls of the cyst is done by means of a 5 mm LigaSure MEDTRONIC COVIDIEN instrument. Destruction of the cystic wall near its bed is done with the help of a 5 mm monopolar instrument in the mode of non-contact coagulation “spray” of the Company Karl Storz. The gallbladder and cystic walls are placed into a special plastic container MEDTRONIC COVIDIEN, then are removed through the umbilical access. Operation time is 20 minutes.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Simultaneous laparoscopic cholecystectomy and supracervical hysterectomy, using the single laparoscopic access

Simultaneous laparoscopic cholecystectomy and supracervical hysterectomy, using the single laparoscopic access.
Professor Puchkov K.V. is performing an operation (2013).

In this video the technique of laparoscopic cholecystectomy, using the single port (COVIDIEN SILS port) in case of calculous cholecystitis, is presented. The sizes of the gall bladder are the following: 14x7 cm. The technique of trancscutanous fixing stitching, exposure of the vesicular duct and arteries, using COVIDIEN mini retract instrument and clipping of these structures by a 10 mm automatic applicator have been demonstrated. Hysterectomy is performed by means of a 10 mm Liga Sure MEDTRONIC COVIDIEN instrument. Dissection of the uterine body from its cervix is performed by Karl Storz monopolar loop. Abdomen peritonization and stitching of the sacrouterine ligaments are done with the help of Endo Stitch COVIDIEN instrument.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Simultaneous laparoscopic correction of the umbilical hernia and ovarian cyst

Simultaneous laparoscopic correction of the umbilical hernia and ovarian cyst.
Professor Puchkov K.V. is performing an operation (2012)

A 50 year-old patient is operated on for the irreducible umbilical hernia-7 cm, paroophoritic cyst of the left ovary-5 cm. In this video the laparoscopic technique of adhesion dissection and removal of hernia contents by means of a 5 mm Liga Sure MEDTRONIC COVIDIEN instrument is demonstrated, as well as removal of the paroophotitic cyst, kept in a special plastic container. Closure of the hernial ports is done with the help of Parietex Composite mesh (14x14cm) and fixation of it by means of transperitoneal stitching and ProRack MEDTRONIC COVIDIEN herniostappler. At the end of the operation anticommisural gel is introduced into the abdominal cavity.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.

Simultaneous laparoscopic cholecystectomy and right nephrectomy

Simultaneous laparoscopic cholecystectomy and right nephrectomy.
Professor Puchkov K.V. is performing an operation (2011).

In this video the technique of classical laparoscopic cholecystectomy for chronic calculous cholecystitis, using 4 ports, is demonstrated. Then, using those ports and a 10 mm LigaSure MEDTRONIC COVIDIEN instrument, right nephrectomy with lymphadenectomy for renal cancer is performed. Attention should be paid to the technique of duodenum mobilization according to Kocher, to fat dissection along the inferior vena cava and transection of the gonadal vein. Then the lower surface of fascia Gerotae is exposed, and transection of ureter takes place. After that the consecutive stitching and transection of the renal artery and vein are done by means of the endoscopic stitching apparatus. The kidney is exposed en block with preserving the adrenal gland. The preparation is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed via 4 cm incision.

You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.