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Simultaneous laparoscopic hysterectomy, right hemicolectomy with intracorporeal anastomosis creation and extraction of specimen via vagina (N.O.S.E. technique)
The author: Puchkov K.V.
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.
Simultaneous laparoscopic cholecystectomy and right nephrectomy
The author: Puchkov K.V.
Simultaneous laparoscopic cholecystectomy and right nephrectomy.
Professor Puchkov K.V. is performing an operation (2011).
In this video the technique of classical laparoscopic cholecystectomy for chronic calculous cholecystitis, using 4 ports, is demonstrated. Then, using those ports and a 10 mm LigaSure MEDTRONIC COVIDIEN instrument, right nephrectomy with lymphadenectomy for renal cancer is performed. Attention should be paid to the technique of duodenum mobilization according to Kocher, to fat dissection along the inferior vena cava and transection of the gonadal vein. Then the lower surface of fascia Gerotae is exposed, and transection of ureter takes place. After that the consecutive stitching and transection of the renal artery and vein are done by means of the endoscopic stitching apparatus. The kidney is exposed en block with preserving the adrenal gland. The preparation is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed via 4 cm incision.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
