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Fundoplication
Laparoscopic partial Toupet fundoplication (270 gr.) with recurrent HH after Nissen fundoplication with an additional prosthetic mesh implant
Автор: Puchkov K.V.
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 g) fundoplication according to Toupet with the cruroraphy and mesh implant
Автор: Puchkov K.V.
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 partial fundoplication according to Toupet (270 g) in case of relapse of hiatal hernia after fundoplication according to Nessen
Автор: Puchkov K.V.
Laparoscopic partial fundoplication according to Toupet (270 g) in case of relapse of hiatal hernia after fundoplication according to Nessen.Professor Puchkov K.V. is performing an operation (2017).
A 44 year-old male patient was laparoscopically operated on a year ago for hiatal hernia, and fundoplication according to Nessen was performed. In a year a cuff slipped off, and configuration of esophagus and stomach was disturbed, i.e. malformation took place, a “small stomach” was formed, and stable heartburn developed, and he had the feeling of constantly full stomach. This video is presenting the technique of repeated operation in case of relapse of hiatal hernia, performed laparoscopically. Mobilization of gastroesophageal isthmus is done by a 5 mm monopolar electrode and LigaSure MEDTRONIC-COVIDIEN instrument. And cicatricial process at the operation area is clearly seen. Nissen’s cuff migrated 5 cm distally. A special attention is paid to a careful exposure of esophagus and superior part of the stomach, making free from adhesions, liquidation of fundoplication cuff. Operation is performed fast and without blood loss. The cruroraphy is performed and partial fundoplication according to Toupet (270 g). Operation duration 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 resection of leiomyoma of esophagus and partial (270 g) fundoplication according to Toupet.
Автор: Puchkov K.V.
Laparoscopic resection of leiomyoma of esophagus and partial (270 g) fundoplication according to Toupet. Professor Puchkov K.V. is performing an operation (2014).
In this film the technique of removal of leiomyoma of esophagus -7 cm- without opening the lumen of the organ is presented. Simultaneously correction of hiatal hernia (7 cm) by means of laparoscopic way is done. Mobilization of gastroesophageal isthmus is done with the help of 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 ligamemnts, as well as to fundodiaphragmatic ligaments, and to transection of short gastric vessels, using inferior access-beneath the esophagus. A special attention is paid to a careful cruroraphy and performing a partial fundoplication.
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 g) fundoplication according to Toupet
Автор: Puchkov K.V.
Laparoscopic partial (270 g) fundoplication according to Toupet. Professor Puchkov K.V. is performing an operation (2012).
In this video the technique of correction of hiatal hernia (5 cm) laparoscopically is presented. Mobilization of the gastroesophageal isthmus is done with the help of a 5 mm Thunderbeat Olympus instrument, where the conception “one operation-one instrument” has been realized. The operation is performed fast and without blood loss. Attention should be paid to the consecutive transection of gastrodiaphragmatic and fundodiaphtragmatic ligaments, and transection of short gastric vessels, using inferior access (beneath the esophagus). A special attention is paid to a careful cruroraphy and performing of the partial fundoplication.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic partial (270g) fundoplication according to Toupet, using Harmonic Scalpel
Автор: Puchkov K.V.
Laparoscopic partial (270g) fundoplication according to Toupet, using Harmonic Scalpel. Professor Puchkov K.V. is performing an operation (2010).
In this video the technique of correction of hiatal hernia (8 cm), performed laparoscopically, is presented.Mobilization of gastroesophageal isthmus is done by means of a 5 mm Harmonic Scalpel Ethicon instrument. The operation is done fast and without blood loss. The consecutive transection of gastroesophageal and fundodiapgragmatic ligaments is presented, as well as transection of short gastric vessels, using inferior access, beneath the esophagus. A special attention is paid to cruroraphy and performing of unilateral partial fundoplication according to Toupet (270 g) with the help of interrupted intracorporeal sutures. Operation duration is 50 minutes.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
