Removal of retrocervical endometriosis

Laparoscopic approach in surgical treatment of infiltrative endometriosis

Laparoscopic approach in surgical treatment of infiltrative endometriosis
Professor Bochorishvili R.G. is operating on (France) (2017).

The patient is 42, has infiltrating endometriosis, invading to the wall of the urinary bladder. In this video the technique of exposure of endometrioid infiltrate by means of bipolar forceps and endoscopic scissors, with the preliminary exposure of the right ureter is demonstrated. During cystoscopy invasion of endometrioid infiltrate to the mucous layer has been detected. Then resection of the affected area of the urinary bladder is done and atraumatic interrupted Z-suture is placed, using “Monocril” 2-0 thread. It is required to take control of suture-whether it is hermetic or not, and to place additional suture in the area of the urinary bladder.

Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina

Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina.
Professor Kanis M. is performing an operation (France, 2017). Professor Bochoroshvili R.G. is commenting on (France, 2017).

The patient is with infiltrating endometriosis, invading to the vaginal wall without involvement of rectum into the process. In this video the technique of exposure of the endometrioid infiltrate by means of bipolar forceps and endoscopic scissors without the preliminary exposure of the ureter is presented. And the technique of resection of the posterior vaginal wall with further stitching, using “Monocril” 1-0 thread, is demonstrated, as well.

Laparoscopic approach in the treatment of retrocervical endometriosis, stage IV. Nerve-preserving resection of rectum with the circular “end-to-end” anastomosis

Laparoscopic approach in the treatment of retrocervical endometriosis, stage IV. Nerve-preserving resection of rectum with the circular “end-to-end” anastomosis
Professor Puchkov K.V. is performing an operation (2017).

The patient was admitted with endometriosis infiltration, it invades to the rectal wall in three areas, the lumen stenosis that more than 50 %. In this video the safe technique of exposure of the right and left lower hypogastric nerves with using of 5 mm monopolar electrode is presented. Using a 5 mm Liga Sure («MEDTRONIC COVIDIEN») instrument, dissection of the rectum and vaginal dome was performed. For the better visualization of the surgical site the temporary fixation of ovaries was created with transabdominal sutures. We recommend performing a transsection of colon with the linear endoscopic stitching device right behind the infiltrate. We remove the specimen out of the abdomen and the head of the stitching device was inserted into the proximal part of colon. Final stage- creation of the circular ”end-to-end” anastomosis, using a 31 mm («MEDTRONIC COVIDIEN») stapler.

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 retrocervical endometriosis with colon resection

Laparoscopic resection of retrocervical endometriosis with colon resection
Professor Puchkov K.V. is performing an operation (2015).

In this video the safe technique of exposure of endometriosis infiltrate with using of a thin monopolar hook and a 5 mm LigaSure («MEDTRONIC COVIDIEN») instrument, with the preliminary leading ureters aside laterally is presented. Transection of colon by a linear endoscopic stitching device was demonstrated. The final stage – forming of circular large intestinal “end-to-end” anastomosis, using a 31 mm («MEDTRONIC COVIDIEN») device.

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

Laparoscopic approach in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina

Laparoscopic access in the treatment of retrocervical endometriosis with the involvement of the posterior wall of vagina.
Professor Kanis M. is performing an approach (France) (2012)

A 30 year-old patient was operated for infiltrating endometriosis, invading to the posterior wall of vagina and involving the anterior wall of rectum. In this video the technique of exposure of the endometriosis infiltration with using of the bipolar forceps and endoscopic scissors is demonstrated. The infiltration was exposed and the resection of the affected area of the vaginal wall with using of a needle-shaped monopolar electrode was performed. Then was placing an atraumatic interrupted Z-shaped suture, using “Monopolar” 2-0 thread. “Shaving” of the endometriosis foci was done, using the ”cold” way with a 5 mm endoscopic scissors.

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

Laparoscopic approach in the treatment of the retrocervical endometriosis with the rectal involvement

Laparoscopic approach in the treatment of the retrocervical endometriosis with the rectal involvement.
Professor Malzoni M. is performing an operation (2012)

A 32 year-old patient was operated for the infiltrating endometriosis, invading to the rectal wall. In this video the technique of the exposure of the endometriosis infiltrate with using of the bipolar forceps and endoscopic scissors with the preliminary exposure of the left ureter is demonstrated. “Shaving” of the endometriosis focus by the ”cold” way, using 5 mm endoscopic scissors had been performed. Coagulation of the endometriosis foci of the pelvic abdomen was done with using of the bipolar forceps.

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

Laparoscopic approach in the treatment of retrocervical endometriosis, stage IV. Resection of rectum and specimen extraction via vagina (N.O.S.E. technique)

Laparoscopic approach in the treatment of retrocervical endometriosis, stage IV. Resection of rectum and specimen extraction via vagina (N.O.S.E. technique)
Professor Puchkov K.V. is performing an operation (2011).

The patient was operated for infiltrating endometriosis, invading to the vaginal and rectal wall, with lumen stenosis more than 50 %. In this video the safe technique of excision of infiltrating endometriosis of the pelvic and exposure of the endometriosis infiltrate with a thin monopolar hook and a 5 mm Harmonic Scalpel («Ethicon») instrument with the preliminary moving ureters aside laterally is demonstrated. For the better visualization of the surgical site temporary fixation of ovaries by transabdominal stitches was done. The technique of resection of the area of the vaginal posterior wall and colon transsection with the linear endoscopic stitching device was presented. Then exteriorization of the affected area via the colpotomic opening took place, and dissection of the colon near the infiltrate and transvaginal introduction of the head of the stitching device into the adducting part was done. The final stage was stitching of vagina and formation of the circular “end-to-end” anastomosis of the large colon with a 31 mm («MEDTRONIC COVIDIEN») device.

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