Laparoscopic nephropexy

Laparoscopic nephropexy, using mesh implant

Laparoscopic nephropexy, using mesh implant.
Professor Puchkov K.V. is performing an operation (2017).

In this film the technique of laparoscopic nephropexy for nephroptosis, degree 3, is presented. Mobilization of the anterior surface of kidney and periosteum of the 12-th rib is performed by a 5 mm Harmonic Scalpel Ethicon instrument and Karl Storz Company instruments. Tissue dissection is performed fast and without blood loss. Only the anterior surface of kidney is exposed for fixation of mesh implant. It is done for the sake of prophilaxis to prevent nephrosclerosis formation after operation. Prolene mesh implant is fixed to the periosteum of the 12-th rib. Then it is fixed to the capsule of the kidney by placing an atraumatic interrupted suture, with extracorporeal knots, using monofilament thread. Stitching of fascia Gerotae is done, using continuous suture and ‘Monocril” thread. Operation duration is 30 minutes.

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

Laparoscopic plasty of pelvicoureter segment and nephropexy

Laparoscopic plasty of pelvicoureter segment and nephropexy
Professor Puchkov K.V. is performing an operation (2016).

In this video the technique of plasty of right pelvicoureter segment is presented. The access to the kidney hilum is by means of bringing down the hepatic angle of the large colon and dissection of tissues between fascia Gerotae and Toldt’s fascia with the help of a 5 mm LigaSure ( MEDTRONIC COVIDIEN) instrument and instruments of Karl Storz Company. Mobilization of the anterior surface of kidney and periosteum of the 12-th rib, of the lower pole of the right kidney; ureter is exposed at the level of transition to pelvis. At the first stage fixation of the soft mesh implant MEDTRONIC COVIDIEN to the periosteum of the 12-th rib and kidney capsule is done by placing an atraumatic suture, using separate interrupted stitches, with monofilament thread. After dissection pelvis (sizes 4x4 cm) is found out at the hilum of the kidney. Ureter is dissected from pelvis and is opened at the length of 2.5 cm in the longitudinal direction by endoscopic scissors. Resection of the enlarged area of pelvis is done. The next stage is formation of anastomosis, using interrupted and continuos suture, with “Polysorb” 4-0 thread. A stent is inserted into the pelvis through the ureter wound. And silicone drainage Ethicon is placed into the paranephral space and in the area of anastomosis. Mesh implant is covered by the parietal abdomen. Operation duration is 1 hour 50 minutes.

Laparoscopic nephropexy , using mesh implant

Laparoscopic nephropexy , using mesh implant. Professor Puchkov K.V. is performing an operation (2012).

In this film the technique of laparoscopic nephropexy for nephroptosis, degree 3, is demonstrated. Mobilization of the anterior surface of kidney and periosteum of the 12-th rib is performed with the help of a 5 mm Thunderbeat Olympus instrument, where the conception “one operation- one instrument” has been realized. Tissue dissection is done fast and without blood loss. Only the anterior surface of kidney is exposed for fixation of mesh implant, it is the kind of prophilaxis to prevent development of nephrosclerosis after operation. A special attention should be paid to a careful fixation of the soft mesh implant MEDTRONIC COVIDIEN to the periosteum of the 12-th rib and kidney capsule. An atraumatic suture is placed, using monofilament thread. Operation duration is 30 minutes.

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