Morcelation

Laparoscopic myomectomy. Removal from the abdominal cavity by means of morcelation

Laparoscopic myomectomy. Removal from the abdominal cavity by means of morcelation.
Professor Puchkov K.V. is performing an operation (2018).

The patient is 40 years old. In her anamnesis it was mentioned that several years ago she was operated on for laparoscopic supracervical hysterectomy (the weight of her uterus was 2 kg); the uterus was removed from the abdominal cavity by means of morcelation. In this video the technique of the laparoscopic myomectomy is demonstrated where myomas (4 nodes, having the size 2-5 cm) have been dissected on the abdomen of the right lateral canal, in the left ileal area and pre-bladder space. Removal of nodes from the abdominal cavity is done with the help of electromechanical morcelation Rotocut G1 (Karl Storz Company) into the plastic container. The conclusion is as follows: it is necessary to observe carefully the abdominal cavity and to do proper lavage of it after morcelation.

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

Electronucleation of prostate with morcellation

Electronucleation of prostate with morcellation
Professor Martov A.G. is performing an operation (2016).

Laparoscopic supracervical hysterectomy, using the single access (S.I.L.S. Port COVIDIEN)

Laparoscopic supracervical hysterectomy, using the single access (S.I.L.S. Port COVIDIEN).
The operation is performed by Puchkov K.V. (2010).

In this video the technique of laparoscopic supracervical hysterectomy, using the single port (SILS port COVIDIEN), in case of the multiple myomas of uterus and adenomyosis, is demonstrated. The port is located in the umbilical area (the area for the further morcellation and evacuation of the uterus). The technique of ligation and transsection of the round uterine ligaments, ovarian ligaments and the uterine artery by means of a 5 mm instrument (LigaSure MEDTRONIC COVIDIEN) and a monopolar electrode (Karl Storz Company) are presented. To make the work in the area of the small pelvis easier, a uterine manipulator is inserted into the uterine cavity. Excision of body of uterus from the cervix is done by means of a monopolar loop (Karl Storz Company). Abdomen peritonizatuion and stitching of the sacrouterine ligaments are done with the help of Endo Stitch (MEDTRONIC COVIDIEN) instrument. The body of uterus is grasped by the bullet forceps and is removed from the umbilical access by means of mechanical morcellation. Duration of the operation is 35 minutes.

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

Laparoscopic myomectomy. Morcelloma removal from the abdominal cavity

Laparoscopic myomectomy. Morcelloma removal from the abdominal cavity.
The operation is performed by Professor Puchkov K.V. (2008).

A 37 year- old patient was operated several years ago in the U.S.A. for laparoscopic myomectomy (the node was 10 cm) with its removal from the abdominal cavity by means of morcellation. In this video the technique of laparoscopic myomectomy with the excision of morcellatory myomas (14 nodes, having the sizes 2-8 cm) on the pelvic abdomen, mesentery of small and large intestines, round uterine and ovarian ligaments. Excision of nodes is done by means of 5 mm endoscopic scissors and a 10 mm instrument LigaSure COVIDIEN.

Conclusion: It is necessary to perform a careful revision and lavage of the abdominal cavity after morcellation.

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