Organopreserving operation

Laparoscopic resection of right renal cyst (the size is 10 cm) (Bosniak 3)

Laparoscopic resection of right renal cyst (the size is 10 cm) (Bosniak 3)
Professor Puchkov K.V. is performing an operation (2017).

In this film the technique of laparoscopic resection of complex renal cyst (Bosniak 3), having the size 10 cm. Access to the cyst is done by means of bringing down the liver angle of the large colon and dissection of tissues between Toldt’s fascia and fascia Gerotae by a 5 mm LigaSure (MEDTRONIC COVIDIEN) instrument and instruments of Karl Storz Company. At the next stage the cyst is maximally excised out of the renal parenchyma, using a 5 mm LigaSure instrument and monopolar electrode. The remaining area -4 cm- is coagulated by bipolar , until dry coagulated eschar is formed. The preparation is placed into a special plastic container MEDTRONIC COVIDIEN and is removed through the umbilical access. Operation time is 1 hour.

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 hepatic cyst

Laparoscopic resection of hepatic cyst.
Professor Puchkov K.V. is performing an operation (2015).

In this film the technique of laparoscopic resection of the cyst of the right lobe of liver (12 cm) is presented. The cyst is opened by a monopolar electrode, and its contents (600 mL) are evacuated by an electroejector. Then, on the border on the hepatic tissue resection of cystic walls is done by means of a 5 mm LigaSure MEDTRONIC-COVIDIEN instrument. Destruction of the cystic wall near its bed is done with the help of a 5 mm monopolar instrument in the mode of non-contact “spray” coagulation, manufactured by Karl Storz Company. The cyst is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed via the umbilical access. Operation duration is 25 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 cyst of adrenal gland on the right

Laparoscopic resection of cyst of adrenal gland on the right
Professor Puchkov K.V. is performing an operation (2014).

Organopreserving operation is performed for cyst of the adrenal gland, having the diameter 16 cm, located in the medial pedicle. An access to the adrenal gland is done by means of bringing down the hepatic angle of the large colon and dissection of tissues between Toldt’s fascia and fascia Gerotae with the help of a 5 mm Harmonic Scalpel Ethicon instrument and instruments of Karl Storz Company. Then mobilization of duodenum according to Kocher is performed, with the exposure of the inferior vena cava and suprarenal vein. Then the cyst is opened, its contents are evacuated , the walls of it are resected within the boundaries of healthy tissues. Destruction of cyst wall near its bed is done by a bipolar instrument. The cyst is placed into a plastic container and is removed from the abdominal cavity. Operation time 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 partial left adrenalectomy

Laparoscopic partial left adrenalectomy.
Professor Puchkov K.V. is performing an operation (2014).

Organopreserving operation is performed for cyst of the adrenal gland, the diameter is 11 cm, it is located in the lateral pedicle. The access to the adrenal gland is via the spleen angle of the large colon, and dissection of tissues is between fascia Gerotae and fasdia told with the help of 5 mm endoscopic monopolar scissors. The further dissection of tissues in the area of the adrenal gland, transection of the vascular structures and tissue of the adrenal gland is performed by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The use of modern ligating systems gives a possibility not to do additional hemostasis of the stump of the adrenal gland and not to leave drainage in the abdominal cavity. The cyst is placed into the plastic container and is removed from the abdominal cavity. 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.

Laparoscopic dissection of the endometrioid cyst of the left ovary and dissection of the external genital endometriosis

Laparoscopic dissection of the endometrioid cyst of the left ovary and dissection of the external genital endometriosis.
Professor Puchkov K.V. is performing an operation (2014).

A 22 year-old patient is operated on for endometrioid cyst of the left ovary (7 cm) and external genital endometriosis, stage 3. Having the aim to preserve the ovulatory potential, the final hemostasis near the cyst bed is done with the help of PerClot hemostatic preparation (Italy). In this video the technique of dissection of the centres on the abdomen by means of Karl Storz Company instruments is demonstrated. One should pay attention to the preliminary opening of the abdomen near the centre, giving a possibility to the carbonic acid gas to penetrate into the retroperitoneal space. Gas presence helps to perform safer dissection of the affected tissues. Simultaneously traction of the endometrioid centre is done in the opposite direction, giving a possibility to visualize clearly the structures of the retroperitoneal space. The cyst is opened, and its contents are evacuated. Then enucleation of the cyst membrane is performed, and point hemostasis is done by a bipolar instrument. The final hemostasis is performed by PerClot preparation (Italy). To prevent adhesion development the anticommisural “Mesogel” barrier is introduced into the small pelvis area. Operation duration 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 right resection of kidney for malignant tumour (4 cm)

Laparoscopic right resection of kidney for malignant tumour (4 cm)
Professor Puchkov K.V. is performing an operation (2012).

In this video the technique of laparoscopic right resection of kidney for malignant tumour (4 cm) is demonstrated. Kidney mobilization and dissection of the renal artery and veins are done by means of a 5 mm Thunderbeat Olympus instrument, when the conception “one operation-one instrument” has been realized. Tissue dissection is performed fast and without blood loss. Then De Bekey vascular forceps are transiently applied onto the renal artery. Kidney resection is performed by means of a 5 mm Thunderbeat Olympus instrument within the boundaries of healthy tissues. The wound is stitched by V-lock (MEDTRONIC COVIDIEN) system, using monofilament resorbable polydioxanone thread, that is oriented in space with the set angle. It gives a possibility to thread to slide freely in one direction and not to be shifted in the opposite direction. This system gives a possibility to stitch the kidney wound layer by layer and fast with the proper hemostasis. Then the forceps are removed from the renal artery, and blood supply is restored in the kidney. Ischemia time is 25 minutes. The tumour is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed through the umbilical access. Operation duration is 45 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 adrenalectomy, using Thunderbeat system and PerClot hemostatic

Laparoscopic partial adrenalectomy, using Thunderbeat system and PerClot hemostatic.

Professor Puchkov K.V. is performing an operation (2012).

The operation is performed for benign tumour of the adrenal gland (the diameter is 6 cm), it is located in the lateral pedicle. In this film the technique of organopreserving operation, dissection of tissues by endoscopic scissors with the exposure of the inferior vena cava and adrenal vein is presented. Transection of the vascular structures and tissue of the adrenal gland is performed by a 5 mm Thunderbeat Olympus instrument. The operation is performed fast and without blood loss. Operation duration is 25 minutes. Additional hemostasis is done by PerClot system (Italy).

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