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Laparoscopic partial Toupet fundoplication (270 gr.) with recurrent HH after Nissen fundoplication with an additional prosthetic mesh implant

Laparoscopic partial Toupet fundoplication (270 gr.) with recurrent HH after Nissen fundoplication with an additional prosthetic mesh implant
Surgeon: professor K.V. Puchkov (2019).

The patient is 49 years old; a year ago he underwent laparoscopic Nissen fundoplication on HH. After 4 years there was a recurrence of the HH over the esophagus, the place of cruroraphy is wealthy.
The video shows a reoperation technique for relapsed HH by laparoscopic approach. Mobilization of the gastroesophageal junction is performed with a 5 mm monopolar electrode and LigaSure MEDTRONIC COVIDIEN instrument. There is marked adhesions in the area of operation. The Nissen cuff is untenable. Particular attention is paid to the careful separation of the esophagus and the upper part of the stomach from adhesions, the elimination of the fundoplication cuff. Surgery is carried out quickly and bloodless. Next step - the top cruroraphy and partial Toupet fundoplication (270 gr.). The line of stitches is strengthened with the help of additional prosthetics of this zone with a special 3D with the Parietex Composite mesh and its fixation according to the author's safe technique with a flexible Relia Tack MEDTRONIC COVIDIEN bend hernia stapler. Implant fixation is performed by absorbable takers. The duration of the operation is 1 hour and 40 minutes.

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

Laparoscopic partial (270 gr.) Toupet fundoplication with cruroraphy and mesh implant.

Laparoscopic partial (270 gr.) Toupet fundoplication with cruroraphy and mesh implant.
Surgeon: professor K.V. Puchkov (2019).

The video shows the technique of correction of the paraesophageal hernia of the diaphragm (5 cm) by the laparoscopic approach. Mobilization of the gastroesophageal junction is performed with 5 mm LigaSure MEDTRONIC COVIDIEN instrument. Surgery is carried out quickly and bloodless. Attention is paid to the sequential intersection of the esophageal - phrenic and fundal-phrenic ligaments. Short gastric vessels intersect with the LigaSure instrument, under the esophageal space. Particular attention is paid to thorough cruroraphy with additional prosthetics of this zone with a special mesh implant of the 3D grid Parietex Composite and its fixation according to the safe author's technique with a flexible Relia Tack MEDTRONIC COVIDIEN bend hernia stapler. The implant is fixed by absorbable tackers, at 4,6,9,11 hours along the inner edge of the mesh at an angle to the esophagus. The paper entry vector is perpendicular to the pedicle of the diaphragm and from the pericardium to the esophagus. At the final stage, a partial Toupet fundoplication is performed (270 gr.). The duration of the operation is 80 minutes.

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 correction of diastasis recti and umbilical hernia, cholecystectomy

Laparoscopic correction of diastasis recti and umbilical hernia, cholecystectomy
Surgeon: professor K.V. Puchkov (2018).

Overweight patient. Gallbladder size 22 cm x 6 cm. Massive adhesions. The calculus size about 5.5 cm. Diastasis 18x5 cm, the size of the hernia gate is 4 cm. During the first stage, cholecystectomy is performed. Further, in the video it shows the technique of correction of diastasis recti and umbilical hernia by suturing them with the V-lock non-absorbable 2-0 thread (MEDTRONIC COVIDIEN) on an atraumatic needle. This stage is performed through trocars inserted for cholecystectomy. The final stage is the closure of the suture line with a ParietexComposite mesh (20x16 cm) and its fixation with transperitoneal sutures and a ProTack (MEDTRONIC COVIDIEN) hernia stapler. The duration of the whole simultaneous operation is 1 hour 30 minutes, the stage of correction of diastasis is 40 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 a spigelian hernia

Laparoscopic correction of a spigelian hernia.
Professor Puchkov K.V. is performing an operation (2017).

The operation was performed for a 52-year-old patient. Diagnosis: reversible spigelian hernia on the left side (about 6 cm). A rare form of abdominal hernia, first described by a Belgian surgeon Adrian van Spigel. The video shows the laparoscopic technique of closing the hernia gate with a ParietexComposite mesh (14 cm x14 cm) and fixing it with transperitoneal sutures and ProTack (MEDTRONIC COVIDIEN) hernia stapler. You can read more about the technique on Professor Puchkov Konstantin Viktorovich’s personal website.

Laparoscopic correction of postoperation ventral hernia-the kind of mesh implant in three months

Laparoscopic correction of postoperation ventral hernia-the kind of mesh implant in three months.
Professor Puchkov K.V. is performing an operation (2016).

3 months ago a female patient was operated on laparoscopically for postoperation ventral hernia by means of composite mesh Parietex Composite (20x20 cm), and fixation of it was done by transperitoneal stitches and a herniostapler ProTack MEDTRONIC COVIDIEN (Professor Puchkov K.V. had operated her). In case of repeated operation for genital prolapse there is an indication to set mesh on the side of the abdominal cavity. There is no adhesion near the previous mesh implant.

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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