Axial hernia

Laparoscopic partial (270 g) fundoplication according to Toupet with the cruroraphy and mesh implant

Laparoscopic partial (270 g) fundoplication according to Toupet with the cruroraphy and mesh implant.
Professor Puchkov K.V. is performing an operation (2018).

In this video the technique of correction of axial hernia of esophageal orifice of diaphragm ( 6 cm), using laparoscopy, is presented. Mobilization of gastroesophageal isthmus is performed by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument. The operation is performed fast and without blood loss. Attention should be paid to the consecutive transection of the diaphragmaticoesophageal ligaments and fundodiaphragmatic ligaments. Short gastric vessels are transected by LigaSure instrument, using inferior access, beneath the esophagus. A special attention should be paid to a careful cruroraphy with the additional prosthesis of this area by a special mesh implant 3D Mesh (Bard Davol Inc., U.S.A.). Implant fixation is carried out by a thread, along the circumference by 6 separate interrupted sutures, without using a herniostapler. At the final stage the partial fundoplication according to Toupet (270 g) is performed. Operation duration is 90 minutes.

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