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Laparoscopic hysterectomy without appendages (the uterus weight is 2500g)

Laparoscopic hysterectomy without appendages (the uterus weight is 2500g)
Professor Puchkov K.V. is performing an operation (2017).

In this video the technique of uterus removal without appendages for the giant myoma (the weight is 2500 g), using the laparoscopic method, by means of a 5 mm LigaSure MEDTRONIC COVIDIEN instrument, is presented. Some myomas are located in the retroperitoneal area and intraligamentarily. As a result of disturbance of nutrition of one of the nodes there is adhesion between the uterine wall and sigmoid colon. Taking into consideration the sizes of uterus, all troacars have been introduced in the right and left subcostal area, for optics- along the midline, 2 cm lower than the xiphoid process. Attention is paid to the consecutive transsection of the round uterine ligaments, fallopian tubes and uterine vessels. A special attention is paid to the closure of vagina and stitching of sacrouterine ligaments for the sake of prevention of stump prolapse development. The removal of uterus from the abdominal cavity is done by means of electromechanical Rotocut G1 morcelation (Karl Storz Company). The operation duration is 90 minutes.

The details of this technique you can read on the personal cite of Professor Puchkov K.V. To go to the link

Laparoscopic hysterectomy without appendages

Laparoscopic hysterectomy without appendages
The operation is performed by Professor Puchkov K.V. (2016).

In this video the classic technique of removal of uterus without appendages ( she has a right fallopian tube), using laparoscopic way, by means of a 5 mm MEDTRONIC COVIDIEN instrument, is demonstrated. The operation is performed fast and without blood loss. Attention should be paid to the consecutive transsection of round ligaments, fallopian tubes and uterine vessels. Handling of the vascular bundle is performed strictly at the level of the ascending branch of the uterine artery. Colpotomy starts from the upper wall of vagina and continues downwards. Stumps of the uterine arteries are lowered along the vagina downwards. A special attention is paid to stitching of vagina walls and sacrouterine ligaments to prevent the prolapse of uterine servix. Operation duration is 29 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 hysterectomy, right hemicolectomy with intracorporeal anastomosis creation and extraction of specimen via vagina (N.O.S.E. technique)

Simultaneous laparoscopic hysterectomy, right hemicolectomy with intracorporeal anastomosis creation and extraction of specimen via vagina (N.O.S.E. technique)
Professor Puchkov K.V. is performing an operation (2013).

A 51 year-old woman was operated for myoma of uterus in combination with adenomyosis and hyperplasia of endometrium, carcinoid of the ascending colon, stage 2. In this film the technique of hysterectomy and ligation of the ascending branch of the uterine artery with a 10 mm LigaSure («MEDTRONIC COVIDIEN») instrument and «Karl Storz Company» instruments was demonstrated. Hemicolectomy was performed in lateral to medial approach with a 5 mm Harmonic Scalpel Ethicon instrument, with dissection of mesocolon along the superior mesenteric vein. Transection of the iliac colon and ascending colon was performed with Endo GIA («MEDTRONIC COVIDIEN») device with a 60 mm length. Anastomosis was performed intracorporeally, “side-to-side” by mechanic and manual stitching. Then the affected part of the colon was removed from the abdominal cavity through the colpotomic opening. The final stage – vagina was stitching by interrupted resorbable suture.

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

Laparoscopic hysterectomy without appendages

Laparoscopic hysterectomy without appendages.
Professor Puchkov K.V. is performing an operation (2012)

The patient has myomatous node-14 cm, that is located in the uterine cervix. And there is compression of ureters by myoma, and dilatation of renal pelvis there. In this video the laparoscopic technique of uterus removal without appendages by means of a 5 mm Thunderbeat Olympus instrument is demonstrated. Due to this instrument the conception “one operation- one instrument” has been realized. The operation is performed fast and without bloodloss. One should pay attention to the consecutive transsection of the round ligaments, fallopian tubes and uterine vessels. The exposure of the node is done without opening of the pelvic fascia, that provides excluding of ureters injury. A special attention should be paid to the closure of vagina stump and stitching of the sacrouterine ligaments to prevent the genital prolapse.

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

Laparoscopic supracervical hysterectomy without appendages

Laparoscopic supracervical hysterectomy without appendages.
Professor Puchkov K.V. is performing an operation (2012)

In this video the laparoscopic technique of removal of body of uterus without appendages by means of a 5 mm Thunderbeat Olympus instrument is presented. Due to this instrument the conception “one operation-one instrument” has been realized. The operation is performed fast and without bloodloss. Attention is paid to the consecutive transsection of the round ligaments, fallopian tubes and uterine vessels. Excision of uterus from the cervix is done with the help of a special monopolar loop (KARL STORZ Company), giving a possibility to transsect the tissue fast and properly. A special attention is paid to the closure of uterine cervix and stitching of the sacrouterine ligaments to prevent uterine cervix prolapse.

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

Laparoscopic panhysterectomy, using the single access (S.I.L.S. Port COVIDIEN)

Laparoscopic panhysterectomy, using the single access (S.I.L.S. Port COVIDIEN).
Professor Puchkov K.V. is performing an operation (2010).

In this video the technique of laparoscopic panhysterectomy, using the single port (SILS port COVIDIEN), in case of multiple myomas of uterus and adenomyosis, is presented. The port is placed in the umbilical area (the area for further morcellation and evacuation of uterus). The technique of ligation and transsection of the round ligaments of uterus, ovarian ligaments and the uterine artery by means of a 10 mm instrument (Liga Sure COVIDIEN) and a monopolar electrode (produced by Karl Storz Company) is presented here. To make the work in the area of small pelvis easier, a uterine manipulator is inserted into the uterine cavity. Excision of the body of uterus from the cervix is done by a monopolar loop (Karl Storz Company). The body of uterus is grasped by the bullet forceps and is removed via vagina. Vagina stitching, stitching of the sacrouterine ligaments and peritonization of the pelvic abdomen are done with the help of Endo Stitch (MEDTRONIC COVIDIEN) instrument, using “Polysorb” 2-0 thread. At the end of the operation the way the apparatus looks like and the stitched umbilical wound are shown. The duration of the operation is 55 minutes.

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

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