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Laparoscopic resection of the kidney with ZERO ischemia

Laparoscopic resection of the kidney with ZERO ischemia
Professor Puchkov K.V. is performing an operation (2019).

Laparoscopic resection of the kidney with ZERO ischemia

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

Laparoscopic ischemic resection of the left kidney

Laparoscopic ischemic resection of the left kidney
Professor Puchkov K.V. is performing an operation (2019).

The film shows the technique of left-sided laparoscopic resection of the kidney in a malignant tumor (4 cm) located in the lower pole. Mobilization of the kidney and dissection of the renal artery and vein is performed using 5 mm instruments using the Thunderbeat (Olympus) and LigaSure system (MEDTRONIC COVIDIEN). A De Bekey vascular clamp (AESCULAP) is temporarily superimposed on the renal artery. Kidney resection is performed with a 5 mm Thunderbeat (Olympus) instrument within healthy tissue. Hemostasis in the area of the bed is carried out by the bipolar instrument of the Karl Storz Company. For the purpose of additional hemostasis, the wound is covered with a hemostatic plate Tachocomb (Austria). Next, the clamp is removed from the renal artery and blood flow is restored in the kidney. The time of thermal ischemia is 24 minutes. The tumor is immersed in a special plastic container MEDTRONIC COVIDIEN, which is removed through umbilical access. Operation time 1 hour 5 minutes.

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

Laparoscopic right resection of kidney with wound stitching

Laparoscopic right resection of kidney with wound stitching.
Professor Puchkov K.V. is performing an operation (2017).

In this film the laparoscopic resection of the right kidney for malignant tumour (4.5 cm), located in the area of the upper pole, is demonstrated. Mobilization of kidney and dissection of the renal artery and vein are done with the help of a 5 mm Harmonic Scalpel Ethicon instrument, as well as LigaSure (MEDTRONIC COVIDIEN) instrument. De Bekey vascular forceps are temporarily applied onto the renal artery. Kidney resection is performed by a 5 mm Harmonic Scalpel Ethicon instrument within the limits of healthy tissues. Hemostasis in the area of bed is done by a bipolar instrument of Karl Storz Company. An atraumatic interrupted suture is placed on the kidney wound, using “Vicryl” thread. For the sake of additional hemostasis the wound is stitched by hemostatic PerClot (Italy). Then the forceps are removed from the renal artery, and blood circulation is restored in the kidney. The time of ischemia is 32 minutes. The tumour is placed in a special container MEDTRONIC COVIDIEN and is removed through the umbilical access. Operation time 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.

Laparoscopic right resection of kidney with wound stitching

Laparoscopic right resection of kidney with wound stitching.
Professor Puchkov K.V. is performing an operation (2017).

In this film the technique of the right laparoscopic resection of kidney for malignant tumour (2 cm), that is located on the anterior surface, is demonstrated. In the abdominal cavity there is an extensive adhesion process, developed after open cholecystectomy. Mobilization of kidney and dissection of the renal artery and vein are done with the help of a 5 mm LigaSure (MEDTRONOC COVIDIEN) instrument. De Bekey forceps are temporarily applied onto the renal artery. Kidney resection is performed by a 5 mm monopolar instrument within the limits of healthy tissues. An atraumatic interrupted suture is placed on the kidney wound, using “Polysorb” thread. For the sake of additional hemostasis the wound is covered by hemostatic PerClot (Italy). Then the forceps are removed from the renal artery, and blood circulation is restored in the kidney. The ischemia time is 25 minutes. The tumour is placed into a special container MEDTRONIC COVIDIEN and is removed through the umbilical access. Operation duration is 1 hour 30 minutes.

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

Laparoscopic radical right nephrectomy with aortocaval lymphadenectomy

Laparoscopic radical right nephrectomy with aortocaval lymphadenectomy.
Professor Puchkov K.V. is performing an operation (2017).

In this film the technique of laparoscopic right nephrectomy for malignant tumour (7 cm) is presented. Before operation MSCT with water-soluble contrast agent has been done. And in the aortocaval space the increased lymphatic nodes up to 4 cm have been found out. Access to hilum of kidney is done by means of bringing down the hepatic angle of the large colon and tissue dissection between Toldt’s fascia and fascia Gerotae by means of a 5 mm LigaSure (MEDTRONIC COVIDIEN) instrument and Karl Storz Company instruments. Then mobilization of duodenum according to Kocher is performed, with exposure of the inferior vena cava and gonad vein. At the next stage aoptocaval lymphadenectomy is performed, using a 5 mm Harmonic Scalpel Ethicon instrument. Ureter is transected at the level of the common iliac artery. Then the renal artery is exposed and clipped. The renal vein is stitched and transected by a 45 mm Endo GIA MEDTRONIC COVIDIEN apparatus with vascular casette. The preparation and removed lymphatic nodes are placed into a special plastic container MEDTRONIC COVIDIEN, that is removed through the umbilical access. Operation time 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.

Laparoscopic left resection of kidney (the tumour is 2.5 cm in the kidney hilus)

Laparoscopic left resection of kidney (the tumour is 2.5 cm in the kidney hilus).
Professor Puchkov K.V. is performing an operation (2016).

In this film the technique of laparoscopic left resection of kidney for malignant tumour (2.5 cm), located in the kidney hilus, is presented , as well as excision of renal cyst (7 cm). Kidney mobilization and dissection of the renal artery are done with the help of a 5 mm LigaSure (MEDTRONIC COVIDIEN) instrument and Karl Storz Company instruments. At the first stage the renal cyst is exposed and resected –it is located along the external contour of the kidney. The bed is handled by a monopolar electrode in the mode of “spray” coagulation. Then a vascular De Bekey forceps are temporarily applied onto the renal artery. Kidney resection is performed by Harmonic Scalpel Ethicon instrument within the boundaries of healthy tissues. For the sake of additional hemostasis the wound is covered by Tachocomb plate (Austria) Then forceps are removed from the renal artery, and blood supply is restored in the kidney. Ischemia time is 18 minutes. The tumour is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed from the umbilical access. Operation duration is 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 left nephrectomy (tumour size is 12 cm, overweight is 62)

Laparoscopic left nephrectomy (tumour size is 12 cm, overweight is 62 ).
Professor Puchkov K.V. is performing an operation (2015).

In this film the technique of laparoscopic left nephrectomy for renal cancer (tumour size is 12 cm) is demonstrated. Access to kidney hilum is by means of bringing down the splenic angle of the large colon and dissection of tissues between Toldt’s fascia and fascia Gerotae by a 5 mm LigaSure (MEDTRONIC COVIDIEN) instrument and Karl Storz Company instruments. For making dissection easier in kidney hilum the descending part of the large colon is moved medially by soft 10 mm forceps. Ureter is transected by a 5 mm LigaSure instrument. The renal vein and artery are stitched and transected by Endo GIA MEDTRONIC COVIDIEN apparatus with a 45 mm cassette. The preparation is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed through the enlarged umbilical access. At the end of the film the removed preparation is shown (the sizes are as follows: 40x25 cm), and the way the abdominal wall looks like after the operation. Operation duration is 1 hour 30 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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