Retrocervical endometriosis of vagina
Search by category
Laparoscopic resection of vaginal wall and rectal wall in case of endometriosis infiltration
The author: Puchkov K.V.
Laparoscopic resection of vaginal wall and rectal wall in case of endometriosis infiltration The operation is performed by Professor Puchkov K.V. (2017).
The patient was admitted with the infiltrating endometriosis that invades to the anterior wall of rectum without deformity of the lumen, it also invades to the posterior fornix of vagina. In this video the technique of exposure of endometriosis infiltrate from the surrounding tissues with using of the monopolar electrode and Liga Sure instrument («MEDTRONIC COVIDIEN») has been demonstrated. The affected area of vagina was resected and removed with the infiltrate. The anterior intestinal wall alongside with the vaginal area and infiltrate were resected by the linear endoscopic («MEDTRONIC COVIDIEN») stitching device in the transverse direction. The specimen was removed from the abdominal cavity through the vagina. The wound was stitched by the single-knot suture, using Monocril 2-0 thread.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic radical hysterectomy with aortoileac and pelvic lymphadenectomy (operation according to Wertheim) with the resection of rectum
The author: Puchkov K.V.
Laparoscopic radical hysterectomy with aortoileac and pelvic lymphadenectomy (operation according to Wertheim) with the resection of rectum. Professor Puchkov K.V. is performing an operation (2017).
The patient was 48 years old, had retrocervical infiltrating endometriosis, invading to the uterine cervix, sacroiliac ligament on the left side, vaginal wall and rectum, with the development of moderately differentiated adenocarcinoma of an endometrioid type with the focus of planocellular metaplasia of fornix of vagina, invading to the cervix and vaginal wall (in rectum the tumor had not been found out). In this video the technique of radical hysterectomy with aortoileac and pelvic lymphadenectomy with transsection of sacrouterine and cardinal ligaments near the pelvic wall and removal of the upper one-third of vagina is demonstrated. Hysterectomy was performed with the help of a 5 mm LigaSure («MEDTRONIC-COVIDIEN») instrument. When performing aortoileac and pelvic lymphadenectomy, the technique of removing of nodes simultaneously by a 5 mm ultrasonic dissector, called Harmonic Scalpel, produced by Ethicon Company, was demonstrated. The use of ultrasound gives a possibility “to weld” thin lymphatic ducts, it is a kind of prophylaxis to prevent development of lymphatic cysts. This technique of operation gives a possibility not to use the drainage system. Lymphatic nodes were placed in separate plastic bags and were removed from the abdominal cavity alongside with the uterus. The author had shown a safe technique of exposure of tumorous infiltrate and exposure of ureter until the area where it confluences into the urinary bladder by means of a 5 mm thin hook. The zone of rectum exposure was 2/3 of its circumference, then the edge resection of colon was performed with using of a 45 mm EndoGIA («MEDTRONIC COVIDIEN») intestinal reloads, leaving the affected area in the tumorous infiltrate. Vagina was exposed as low as possible in the caudal direction and was transected at the distance of 4 cm from the cervix within the limits of healthy tissues (1/3 of it was removed). In this video a special attention is paid to the restorative stage-stitching of vagina, that was done by the interrupted suture, using “Monocril” thread. The operation time was 2 hours 50 minutes.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina
The author: Kanis M.
Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina.
Professor Kanis M. is performing an operation (France, 2017). Professor Bochoroshvili R.G. is commenting on (France, 2017).
The patient is with infiltrating endometriosis, invading to the vaginal wall without involvement of rectum into the process. In this video the technique of exposure of the endometrioid infiltrate by means of bipolar forceps and endoscopic scissors without the preliminary exposure of the ureter is presented. And the technique of resection of the posterior vaginal wall with further stitching, using “Monocril” 1-0 thread, is demonstrated, as well.
Laparoscopic approach in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina
The author: Kanis M.
Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina. Professor Kanis M. is performing an approach (France) (2012)
A 30 year-old patient was operated for infiltrating endometriosis, invading to the posterior wall of vagina and involving the anterior wall of rectum. In this video the technique of exposure of the endometriosis infiltration with using of the bipolar forceps and endoscopic scissors is demonstrated. The infiltration was exposed and the resection of the affected area of the vaginal wall with using of a needle-shaped monopolar electrode was performed. Then was placing an atraumatic interrupted Z-shaped suture, using “Monopolar” 2-0 thread. “Shaving” of the endometriosis foci was done, using the ”cold” way with a 5 mm endoscopic scissors.
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 the treatment of retrocervical endometriosis, stage IV. Resection of rectum and specimen extraction via vagina (N.O.S.E. technique)
The author: Puchkov K.V.
Laparoscopic approach in the treatment of retrocervical endometriosis, stage IV. Resection of rectum and specimen extraction via vagina (N.O.S.E. technique)Professor Puchkov K.V. is performing an operation (2011).
The patient was operated for infiltrating endometriosis, invading to the vaginal and rectal wall, with lumen stenosis more than 50 %. In this video the safe technique of excision of infiltrating endometriosis of the pelvic and exposure of the endometriosis infiltrate with a thin monopolar hook and a 5 mm Harmonic Scalpel («Ethicon») instrument with the preliminary moving ureters aside laterally is demonstrated. For the better visualization of the surgical site temporary fixation of ovaries by transabdominal stitches was done. The technique of resection of the area of the vaginal posterior wall and colon transsection with the linear endoscopic stitching device was presented. Then exteriorization of the affected area via the colpotomic opening took place, and dissection of the colon near the infiltrate and transvaginal introduction of the head of the stitching device into the adducting part was done. The final stage was stitching of vagina and formation of the circular “end-to-end” anastomosis of the large colon with a 31 mm («MEDTRONIC COVIDIEN») device.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.