Video of laparoscopic operations
of the best surgeons of the world
Video of operations

MainMINIMALLY INVASIVE PROCEDURESOncologyOvarian cancer Laparoscopic radical hysterectomy


The Geography of Members


Laparoscopic radical hysterectomy

Search by category

Laparoscopic radical hysterectomy with aortoileac and pelvic lymphadenectomy, peritoneumectomy, extirpation of greater omentum and transvaginal resection of rectum

Laparoscopic radical hysterectomy with aortoileac and pelvic lymphadenectomy, peritoneumectomy, extirpation of greater omentum and transvaginal resection of rectum.
Professor Puchkov K.V. is performing an operation (2016).

ВIn this video the modern approach to treatment of cancer of ovary-neoadjuvant chemotherapy with the further interval cytoreduction (performing a radical operation with the removal of all affected tissues and lymphatic nodes) is demonstrated laparoscopically. This method implies performing a laparoscopic diagnostics at the first stage, and at this time blood is taken for the cytologic investigation; during this stage the assessment of the condition of the abdominal cavity and small pelvis, greater omentum, lymphatic nodes, pelvic abdomen is done, samples for biopsy of tumour and ovary are taken, as well as samples for biopsy from liver and diaphragm metastases. Then, in 7-10 days the second stage starts: neoadjuvant chemotherapy is done thrice. After control MRT and MLCT treating laparoscopy is performed, aimed at the radical removal of the initial center of tumour-panhysterectomy with the extirpation of greater omentum, aortocaval and pelvic lymphadenectomy, pelvic peritoneumectomy and removal of detected metastases. After the final histological investigation further chemotherapy is done

A 32 year-old patient has had cancer of ovaries pT3bNxM0 (canceromatous of the abdomen, metastases into the omentum, acsites). In case of laparoscopic diagnostics the following things have been found out: about 100 mL of muddy fluid, and millet-shaped mass have been observed, having the sizes 2-1.5 cm, on the parietal and visceral abdomen of the abdominal cavity and small pelvis, diaphragm. The greater omentum has millet-shaped mass up to 10 mm. The left ovary presents a round –shaped mass, with the even surface of the whitish colour, having the sizes 85x70 mm, that is adhered to the sigmoid colon. In the wall of the sigmoid colon that is located near the left ovary, there is an infiltrate -50x20 mm. On the abdomen of the retrouterine space there are multiple excrescences, reminding of a cauliflower. Swab has been taken from the abdominal cavity, samples from the tumour, greater omentum and metastases from the parietal abdomen have been taken for biopsy.

During the histological investigation highly differentiated endometrioid adenocarcinoma of solid structure has been found out, as well as metastases in all preparations. Cytology has presented metastatic effusion.

After chemotherapy- has been done thrice- laparoscopic radical hysterectomy with aortoileac and pelvic lymphadenectomy, peritoneumectomy, extirpation of the greater omentum and resection of rectum with aortoileac and pelvic lymphadenectomy have been performed. Operation is performed with the help of a 5 mm Liga Sure MEDTRONIC COVIDIEN instrument and Ethicon Harmonic Scalpel. For fast and successful operation performing Clermont Ferrand (KARL STORZ) uterine manipulator is used. Dissected lymphatic nodes are placed into separate plastic packets and are removed from the abdominal cavity alongside with the uterus and omentum. The rectum is exposed, preserving mesorectal fascia and is transsected by Endo GIA MEDTRONIC COVIDIEN apparatus (a 60 mm intestinal cassette).The proximal end is exteriorized transvaginaly, and an affected area is removed with the immersion of the head of a stitching apparatus into the lumen of the colon. The stump is placed into the abdominal cavity. Vagina is stitched by interrupted suture, using “Monocril” thread. The final stage is a formation of circular “end-to-end” anastomosis of large colon by means of a 31 mm MEDTRONIC COVIDIEN apparatus. Operation time is 3 hours 10 minutes.

In 10 days after the radical operation chemotherapy is continued.

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



We invite medical specialists and medical students to register! Registration is for free!