Retrocervical endometriosis of the urinary tract
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Laparoscopic reimplantation of the ureter in surgical treatment of endometriosis infiltration
The author: M.Malzoni
Laparoscopic reimplantation of the ureter in surgical treatment of endometriosis infiltration. Professor M.Malzoni (2018) is performing an operation
The patient, aged 30, has infiltrating endometriosis, invading to the anal wall and the right ureter. In this video the technique of the exposure of endometrioid infiltrate by means of the bipolar forceps and endoscopic scissors with the preliminary exposure of the right ureter up to the stenosis level is presented. Then the transection of the colon by the linear endoscopic stitching apparatus is immediately performed when infiltration is noticed. Then, using a 5-mm Thunderbeat Olympus instrument, dissection of the urinary bladder is performed. When the urinary bladder is inflated, the right wall of it is fixed to the lumbar muscle. The ureter and the urinary bladder are opened, and the ureter stent is inserted into the lumen. Then anastomosis is performed between the urinary bladder and the ureter by the interrupted suture, using “Polysorb” thread.
Laparoscopic “shaving” of the walls of urinary bladder in case of infiltrative endometriosis
The author: Puchkov K.V.
Laparoscopic “shaving” of the walls of urinary bladder in case of infiltrative endometriosis. Professor Puchkov K.V. is performing an operation (2017).
A patient is operated on for infiltrative endometriosis, invading the walls of urinary bladder. MRT images have shown it. During cystoscopy they have not found out the involvement of mucous membrane. The film demonstrates the technique of exposure of endometrioid infiltrate out of the surrounding tissues by means of a 5 mm monopolar electrode. An affected part of urinary bladder is dissected within the boundaries of submucous layer and is stitched by “Polysorb” 3-0 thread. Duration of this stage is 6 minutes.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic dissection of the external genital endometriosis of the pelvic abdomen. Ureterolysis. Ureter duplication on the left
The author: Puchkov K.V.
Laparoscopic dissection of the external genital endometriosis of the pelvic abdomen. Ureterolysis. Ureter duplication on the left. Professor Puchkov K.V. is performing an operation (2017).
A 25 year-old patient is operated on for the external genital endometriosis, stage 3. In this video the technique of dissection of centres on the abdomen, using instruments of Karl Storz Company, is presented. Attention should be paid to the preliminary opening of the abdomen by means of a monopolar electrode near the centre, giving a possibility to carbonic acid gas to penetrate into the retroperitoneal space. Gas presence gives a possibility to perform more safe dissection of affected tissues. Simultaneously traction of the endometrioid centre in opposite direction is performed, giving a possibility to see clearly the structures of the retroperitoneal space. Using the soft forceps, the exposure of the tubular structures is done subperitoneally, they are moved aside from the endometrioid centre. During the tissue dissection the ureter duplication has been found out. One should bear in mind the variants of anatomy to prevent the injury of ureters during the dissection of the endometrioid centres. Antiсommisural “Mesogel” barrier is introduced into the pelvic area. The operation duration is 50 minutes.
The details of this technique you can read on the personal cite of Professor Puchkov K.V. To go to the link
Laparoscopic approach in surgical treatment of infiltrative endometriosis
The author: Bochorishvili R.G.
Laparoscopic approach in surgical treatment of infiltrative endometriosis Professor Bochorishvili R.G. is operating on (France) (2017).
The patient is 42, has infiltrating endometriosis, invading to the wall of the urinary bladder. In this video the technique of exposure of endometrioid infiltrate by means of bipolar forceps and endoscopic scissors, with the preliminary exposure of the right ureter is demonstrated. During cystoscopy invasion of endometrioid infiltrate to the mucous layer has been detected. Then resection of the affected area of the urinary bladder is done and atraumatic interrupted Z-suture is placed, using “Monocril” 2-0 thread. It is required to take control of suture-whether it is hermetic or not, and to place additional suture in the area of the urinary bladder.
Laparoscopic resection of the wall of the urinary bladder in case of infiltrating endometriosis
The author: Puchkov K.V.
Laparoscopic resection of the wall of the urinary bladder in case of infiltrating endometriosis. Professor Puchkov K.V . is performing an operation (2016).
A 28 year-old patient is operated on for infiltrating endometriosis, invading to the wall of rectum and urinary bladder. According to cystoscopy data on the mucous layer of the urinary bladder there is tumour-like excrescence of a black colour-2-3 cm-with the fluid component inside. In this video the technique of endometrioid infiltrate exposure from the surrounding tissues by means of a 5 mm monopolar electrode is demonstrated. An affected area of the urinary bladder is dissected with the help of 5 mm MEDTRONIC-COVIDIEN ultrasonic scissors. Then it is stitched by “Polysorb” 3-0 and “Monocril” 3-0 thread. Before laparoscopy beginning stent is inserted into the lumen of the left ureter. One should take control of the stitched wound-whether it is hermetic or not.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Diagnostic cystoscopy in case of invasive endometriosis of urinary bladder.
The author: Puchkov K.V.
Diagnostic cystoscopy in case of invasive endometriosis of urinary bladder. The operation is performed by Puchkov K.V. (2016)
A 51 year-old patient has infiltrative endometriosis, invading to the wall of urinary bladder, without involvement of mucous membrane. She complains that she has disuria. According to MRT images there is formation on the posterior wall of urinary bladder, having the size 3 cm.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic approach in treatment of the retrocervical endometriosis, stage 4. Uteterolysis
The author: Puchkov K.V.
Laparoscopic approach in treatment of the retrocervical endometriosis, stage 4. Uteterolysis. The operation is performed by Professor Puchkov K.V. (2015 )
A 31 year-old patient is operated on for retrocervical infiltrating endometriosis, invading to the wall of rectum and vagina, uterine cervix and sacrouterine ligaments. Both ureters are involved into the infiltration. In this video the safe technique of consecutive exposure of the right and left ureters by means of a 5 mm monopolar electrode and a 5 mm Liga Sure MEDTRONIC COVIDIEN instrument is demonstrated. For the better visualization of the surgical site compulsory temporary fixation of ovaries, using transabdominal stitching, is done. Using the soft forceps, the tubular structures are exposed subperitoneally, moving them aside from the endometrioid centre. While dissecting tissues on the left, the change of the anatomy of ureter positioning due to the infiltrative changes in this area has been clearly seen. During dissection it has been found out that the ureter is shifted to the right, coming into close contact with the right ureter. One should bear in mind possible changes of anatomy in this area in order not to injure ureters during the dissection of the endometrioid centres.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.