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Laparoscopic partial (270 g) fundoplication according to Toupet with the cruroraphy and mesh implant

Laparoscopic partial (270 g) fundoplication according to Toupet with the cruroraphy and mesh implant.
Professor Puchkov K.V. is performing an operation (2018).

In this video the technique of correction of axial hernia of esophageal orifice of diaphragm ( 6 cm), using laparoscopy, is presented. Mobilization of gastroesophageal isthmus is performed by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The operation is performed fast and without blood loss. Attention should be paid to the consecutive transection of the diaphragmaticoesophageal ligaments and fundodiaphragmatic ligaments. Short gastric vessels are transected by LigaSure instrument, using inferior access, beneath the esophagus. A special attention should be paid to a careful cruroraphy with the additional prosthesis of this area by a special mesh implant 3D Mesh (Bard Davol Inc., U.S.A.). Implant fixation is carried out by a thread, along the circumference by 6 separate interrupted sutures, without using a herniostapler. At the final stage the partial fundoplication according to Toupet (270 g) is performed. Operation duration is 90 minutes.

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

Laparoscopic correction of direct inguinal hernia in a female

Laparoscopic correction of direct inguinal hernia in a female.
Professor Puchkov K.V. is performing an operation (2017).

In this film the technique of laparoscopic correction of direct right inguinal hernia in a female is presented. Mobilization of hernial sac, lipoma and dissection of the round ligament is done with the help of a 5 mm Harmonic Scalpel Ethicon instrument. The exposure of the inguinal ligament, of connected tendineous aponeurosis, internal inferior epigastral artery, pubic tubercle and round uterine ligament is demonstrated. Plasty of hernial ports is done by means of Bard 3d Max LIGHT Mesh, that is the facilitated analogue of 3DMaxmesh, it has 50% lesser weight, provides bigger scope of vision of the surgical site without losing firmness of the implant. The unique 3D design of this prosthesis has been elaborated specially for laparoscopic hernioplasty. The material of mesh implant is non-covered polypropylene. The shape and contours of the implant completely correspond to this anatomic area, that provides maximum close-fitting and minimizes the probability of shifting of the prosthesis. Fixation of the prosthesis is done by a herniostapler ProTack MEDTRONIC COVIDIEN. Peritonization of abdomen is done by ‘Monocril” thread. Operation duration is 24 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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