Laparoscopic nephrectomy

Laparoscopic nephrectomy and nephroureterectomy

Laparoscopic nephrectomy and nephroureterectomy.
Professor Poddubny I.V. is performing an operation (2015).

Три троакара, положение ребенка – на боку.
Three troacars have been used. The position of a child is on its side. In this video the technique of laparoscopic nephrectomy and nephroureterectomy in kids-2 fragments of operations- is presented in short. The first is a 4 month-old baby with the multicystous transformation of the left kidney (nephrectomy), and the second one is a 9 month-old baby with arteriolosclerotic kidney, vesicoureteral reflux after previously performed nephrostoma surgery. The stages of kidney exposure, transection of the vascular vascicle by LigaSure apparatus, exposure and transection of ureter at the area where it returns into the urinary bladder are presented in the film.

Laparoscopic right nephrectomy

Laparoscopic right nephrectomy
Professor Puchkov K.V. is performing an operation (2013).

This video presents the technique of laparoscopic right nephrectomy for benign tumour (6 cm). An access to kidney hillus is done due to bringing down the hepatic angle of the large colon and dissection of tissues between Toldt’s fascia and fascia Herotae by a 5 mm LigaSure instrument (MEDTRONIC COVIDIEN) and instruments of Karl Storz Company. The duodenum mobilization is performed according to Kocher, with the exposure of inferior vena cava and the gonadal vein. Ureter is transected. Then the renal artery is exposed and clipped. The renal vein is stitched and transected by Endo GIA1 apparatus MEDTRONIC COVIDIEN, using a 45 mm vascular casette. Preparation is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed through the umbilical access. Operation time 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.

Simultaneous laparoscopic cholecystectomy and right nephrectomy

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.

Laparoscopic radical right nephrectomy with aortocaval lymphadenectomy and preserving of the adrenal gland

Laparoscopic radical right nephrectomy with aortocaval lymphadenectomy and preserving of the adrenal gland.
Professor Puchkov K.V. is performing an operation (2005).

A 60 year-old male patient is being operated on for renal cell carcinoma (RCC) T1b N1 M0 G2. On the image of MSCT with contrast enhancement 2 enlarged lymphatic nodes up to 2 cm have been found out in the aortocaval space. In this video the technique of laparoscopic radical right nephrectomy with aortocaval lymphadenectomy and preserving of the adrenal gland (tumour is localized in the lower pole of kidney) is demonstrated. Access to kidney hilum is due to bringing down the hepatic angle of the large colon and dissection of tissues between Toldt’s fascia and fascia Gerotae. This stage is performed by 5 mm monopolar scissors and a 10 mm LigaSure (COVIDIEN) instrument. Then duodenum mobilization according to Kocher is done, with exposure of the inferior vena cava and the gonadal vein. During the next stage aortocaval lymphadenectomy with visualization of the left renal vein and preliminary clipping of the right renal artery is performed, using 5 mm monopolar scissors and a 10 mm LigaSure (COVIDIEN) instrument. Ureter is transected at the level of the common iliac artery. Then the renal vein is exposed, clipped and transected. At the final stage nephrectomy is performed with preserving of the right adrenal gland. The preparation and removed lymphatic nodes are placed into a special plastic container COVIDIEN that is removed through the access in the right iliac area (15 years ago the patient was undergone open appendectomy). Operation duration is 1 hour 40 minutes.

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