MEDTRONIC-COVIDIEN

Laparoscopic organ preserving resection of two pheochromocytes from a single left adrenal gland

Laparoscopic organ preserving resection of two pheochromocytes from a single left adrenal gland.

Professor Puchkov K.V. is performing an operation (2019).

Patient 24 years old, in the single left adrenal gland were found two tumors about 2 cm each in diameter, they located in the medial pedicle and in the body of the organ. At the age of 20, he was examined about hypertensive crises. In 2015, bilateral adrenal lesions were diagnosed: on the right a tumor - up to 5 cm, on the left side - 2 lesions: 1 and 1.5 cm. Right-sided adrenalectomy was performed, the histological conclusion was: malignant pheochromocytoma. The patient refused bilateral adrenalectomy. In the future, according to CT data, the growth of lesions of the left adrenal gland is noted. In the analyzes: daily urine metanephrins: maximum metanephrine 8.897 mg/day, normetanephrine 319.3 mg/day. In the preoperative period, he received «Cardura». A laparoscopic organ-sparing surgery was performed - removal of two formations with full preservation of the adrenal tissue. Access to the adrenal gland was done by mobilising the splenic angle of the colon and dissecting the tissue between the Tolds fascia and Herota fascia. The intersection of the vascular structures and adrenal tissue is performed by alternating ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The operation is carried out quickly and bloodless. The tumor is cut off from the body of the adrenal gland and placed in a plastic container in which was removed from the abdominal cavity. For the hemostasis «Tachocombe» was used at the sites of tumor removal. The operation time was 40 minutes. Histology - pheochromocytoma of solid-alveolar structure with polymorphoncellular composition.

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

Laparoscopic cosmetic correction of diastasis recti and umbilical hernia (punctures in the bikini area)

Laparoscopic cosmetic correction of diastasis recti and umbilical hernia (punctures in the bikini area)
Surgeon: professor K.V. Puchkov (2019).

The patient is 22 years old. Two childbirth in history. It has high aesthetic requirements for surgery. Diastasis recti 17x4.5 cm. Reversible umbilical hernia 3 cm. The film shows the technique of cosmetic correction of diastasis recti and umbilical hernia by suturing them with the V-lock system (MEDTRONIC COVIDIEN) on an atraumatic 2-0 non-absorbable needle. This stage is performed through trocars inserted in the bikini area. The final stage is the closure of the suture line with a Parietex Composite composite mesh (20x16 cm) and its fixation with transperitoneal sutures and a combination of absorbable and nonabsorbable AbsorboTack tacker bags using the ProTack MEDTRONIC COVIDIEN hernia stapler. The duration of the operation is 40 minutes.

You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.

Laparoscopic correction of diastasis recti through the scar after Caesarean section

Laparoscopic correction of diastasis recti through the scar after Caesarean section
Surgeon: professor K.V. Puchkov (2019).

The patient suffered a Caesarean section 2 years ago. Diastasis recti 16x4 cm. The film shows the technique of cosmetic correction of diastasis of the rectus abdominis muscles by suturing them with the V-lock system (MEDTRONIC COVIDIEN) on an atraumatic needle with a non-absorbable 2-0 thread. This stage is performed through trocars inserted in the scar zone after the Caesarean section. The final stage is the closure of the suture line with a Parietex Composite mesh (20x16 cm) and its fixation with transperitoneal sutures and a combination of absorbable and nonabsorbable AbsorboTack tacker bags using the ProTack MEDTRONIC COVIDIEN hernia stapler. The duration of the operation is 50 minutes.

You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.

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 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 right-sided enucleation of adrenal tumor for pheochromocytoma

Laparoscopic right-sided enucleation of adrenal tumor for pheochromocytoma.

Professor Puchkov K.V. is performing an operation (2018).

Patient 53 years old was admitted to the hospital, it was found a 3 cm tumor of the right adrenal gland, located in the medial pedicle. The patient noted a history of hypertensive crises. A laparoscopic organ-sparing surgery was performed - right-sided enucleation of the tumor. Access to the adrenal gland was done by dissecting the tissue between the Tolds fascia and Herota fascia. The intersection of the vascular structures and adrenal tissue was performed by alternating the ligation systems — 5 mm Thunderbeat Olympus instrument and 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The tumor was cut off from the body of the adrenal gland and placed in a plastic container in which was removed from the abdominal cavity. The operation time was 30 minutes.
The operation was carried out quickly and bloodless. Additional hemostasis was carried out by the PerClot system (Italy). At the end of the film, the removed specimen is shown - adrenal pheochromocytoma (3 cm).
Histology - adrenal pheochromocytoma.

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

Laparoscopic cholecystectomy in case of massive adhesions (calculus 5.5 cm, volume of content 400 ml)

Laparoscopic cholecystectomy in case of massive adhesions (calculus 5.5 cm, volume of content 400 ml)
Surgeon: professor K.V. Puchkov (2018).

The film shows the technique of laparoscopic cholecystectomy for chronic calculous cholecystitis and massive adhesions. The size of the gallbladder is 22cm x 4 cm (volume 400 ml), the size of the stone is about 5.5 cm. A technique for isolating the gallbladder from adhesions using a 5 mm instrument (LigaSure MEDTRONIC COVIDIEN) and a monopolar electrode is shown. Only the bottom of the gallbladder was free from adhesions. Careful extraction of the cystic duct and artery of 5 mm with a monopolar hook and mini retract tool COVIDIEN and clipping of these structures with a 10 mm Aesculap DS applicator with titanium latch clips was performed. Gallbladder is removed from the abdominal cavity in a plastic container.

You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.