Video of operations
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Vascular De Bekey forceps
Laparoscopic ischemic resection of the left kidney
Автор: Puchkov K.V.
Laparoscopic ischemic resection of the left kidney
Professor Puchkov K.V. is performing an operation (2019).
The film shows the technique of left-sided laparoscopic resection of the kidney in a malignant tumor (4 cm) located in the lower pole. Mobilization of the kidney and dissection of the renal artery and vein is performed using 5 mm instruments using the Thunderbeat (Olympus) and LigaSure system (MEDTRONIC COVIDIEN). A De Bekey vascular clamp (AESCULAP) is temporarily superimposed on the renal artery. Kidney resection is performed with a 5 mm Thunderbeat (Olympus) instrument within healthy tissue. Hemostasis in the area of the bed is carried out by the bipolar instrument of the Karl Storz Company. For the purpose of additional hemostasis, the wound is covered with a hemostatic plate Tachocomb (Austria). Next, the clamp is removed from the renal artery and blood flow is restored in the kidney. The time of thermal ischemia is 24 minutes. The tumor is immersed in a special plastic container MEDTRONIC COVIDIEN, which is removed through umbilical access. Operation time 1 hour 5 minutes.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic excision of nodular adenomyosis and myomectomy with transient occlusion of arteries
Автор: Puchkov K.V.
Professor Puchkov K.V. is performing an operation (2018).
In this video the technique of laparoscopic excision of nodular adenomyosis ( 9 cm), located on the posterior wall of uterus and myomectomy with the transient occlusion of arteries (internal iliac arteries) according to the author’s method of Professor Puchkov K.V. is demonstrated. A 34 year-old patient is operated on for mentioned above problems. At the first stage, immediately after bifurcation of the common iliac artery, pelvic abdomen is opened, and De Bekey vascular forceps are transiently applied onto the internal artery. It gives a possibility to avoid blood loss during the operation. Then nodular adenomyosis is dissected by a monopolar electrode within the boundaries of healthy tissues, without opening uterine cavity. The wound is stitched by V-lock system (MEDTRONIC COVIDIEN), having monofilament resorbable polydioxanone thread, 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 uterine wound fast and layer by layer with the proper hemostasis. Additionally the wound is strengthened by three interrupted Z-shaped stitches, using “Monocril” thread. At the second stage myomectomy is performed with stitching uterine wound, using interrupted suture. Then the forceps are removed from the internal iliac artery; and blood circulation is restored in uterus. Myomatous and adenomyosis nodes are removed from the abdominal cavity by means of electromechanical morcellation Rotocut G1 of Karl Storz Company. Anticommissural gel is applied onto the suture line.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic myomectomy (intramural node 11 cm) with temporary occlusion of the arterial supply
Автор: Puchkov K.V.
Laparoscopic myomectomy (intramural node 11 cm) with temporary occlusion of the arterial supply
Professor Puchkov K.V. is performing an operation (2018)
The video presents a technique of laparoscopic myomectomy with a temporary occlusion of the arterial supply (internal iliac arteries) according to the author's method (2007 year patent). The operation is performed for a 29-year-old patient with an intramural uterine myoma, ~ 11 cm in diameter. At the first stage, in the area of bifurcation of the common iliac artery, the pelvic peritoneum is opened and the De Bekey vascular clamp is temporarily imposed on the internal artery. This trick reduce blood loss during the surgery. Then, using the J-hook RK Technology OLYMPUS, the muscular tissue is dissected up to the myoma node in the transverse direction and the fibroids are exfoliated from the surrounding tissues with two 10 mm rigid clamps. The wound is sutured with the V-lock system (MEDTRONIC COVIDIEN), made of a monofilament absorbable polydioxanone thread with notches oriented in space at a given angle. This system allows to close the uterus wound quickly and layers by layers with good hemostasis. The final line of stitches is made with Monocryl 2-0 thread on an atraumatic needle. Next, the clamp is removed from the internal iliac artery and blood flow is restored in the uterus. The myoma node is extracted from the abdominal cavity using the OLYMPUS bipolar PK MORCELLATOR tool.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
Laparoscopic reconstructive metroplasty with the temporary occlusion of the arterial stream in case of healing failure of the uterine scar
Автор: Puchkov K.V.
Laparoscopic reconstructive metroplasty with the temporary occlusion of the arterial stream in case of healing failure of the uterine scar. The operation is performed by Professor Puchkov K.V. (2017).
In this video the technique of laparoscopic reconstructive metroplasty in case of healing failure of the uterine scar after the cesarean section is presented. The operation is performed according to the author’s method (the patent obtained in 2007) with the temporary occlusion of the arterial stream. At the first stage, immediately after the bifurcation of the common iliac artery the pelvic abdomen is opened, and De Bekey vascular forceps are temporarily applied onto the internal artery. It gives a possibility to avoid blood loss during the operation. Then the insolved scar is dissected in the transverse direction till the healthy tissue with the help of a monopolar electrode. The wound is stitched by separate atraumatic suture, using “Polysorb” 2-0 and “Monocril” 2-0 thread. Then the forceps are removed from the internal iliac artery, and bloodstream is restored in the uterus. The suture is covered by anticommisural gel.
The details of this technique you can read on the personal cite of Professor Puchkov K.V. To go to the link
Laparoscopic myomectomy (intraligament node is 12 cm) with the temporary occlusion of the arterial stream
Автор: Puchkov K.V.
Laparoscopic myomectomy (intraligament node is 12 cm) with the temporary occlusion of the arterial stream. Professor Puchkov K.V. is performing an operation (2017)
In this video the technique of laparoscopic myomectomy with the temporary occlusion of the arterial stream (the internal iliac arteries) according to the author’s own method (the patent, dated 2007) is presented. A 36 year-old patient is operated on for intraligament myoma of uterus-12 cm and 4 cm nodes are on the posterior wall. At the first stage, immediately after the bifurcation of the common iliac artery, the pelvic abdomen is opened, and De Bekey vascular forceps are temporarily applied onto the internal artery. It gives a possibility to exclude blood loss during the operation. Then, using a monopolar electrode, the muscle tissue is dissected up to the myomatous node, and using two 10 mm hard forceps the myoma is enucleated from the surrounding tissues, and one should take a visual control of the right ureter. The pelvic fascia is not opened. The wound is stitched by V-lock (MEDTRONIC COVIDIEN) system, made of the monofilament absorbable polydioxanone thread, oriented in space with the set angle. This system gives a possibility to stitch the wound fast and layer by layer with the proper hemostasis. Abdomen is stitched by atraumatic suture, using “Monocril” 2-0 thread, in the area of broad and sacrouterine ligament. Then, the forceps are removed from the internal iliac artery, and bloodstream is restored in the uterus. The myomatous nodes are removed from the abdomen cavity by means of electromechanical Rotocut G1 morcellation (Karl Storz COMPANY). Anticommisural gel is applied onto the wound line.
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 with wound stitching
Автор: Puchkov K.V.
Laparoscopic right resection of kidney with wound stitching. Professor Puchkov K.V. is performing an operation (2017).
In this film the laparoscopic resection of the right kidney for malignant tumour (4.5 cm), located in the area of the upper pole, is demonstrated. Mobilization of kidney and dissection of the renal artery and vein are done with the help of a 5 mm Harmonic Scalpel Ethicon instrument, as well as LigaSure (MEDTRONIC COVIDIEN) instrument. De Bekey vascular forceps are temporarily applied onto the renal artery. Kidney resection is performed by a 5 mm Harmonic Scalpel Ethicon instrument within the limits of healthy tissues. Hemostasis in the area of bed is done by a bipolar instrument of Karl Storz Company. An atraumatic interrupted suture is placed on the kidney wound, using “Vicryl” thread. For the sake of additional hemostasis the wound is stitched by hemostatic PerClot (Italy). Then the forceps are removed from the renal artery, and blood circulation is restored in the kidney. The time of ischemia is 32 minutes. The tumour is placed in a special container MEDTRONIC COVIDIEN and is removed through the umbilical access. Operation time is 1 hour 20 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 with wound stitching
Автор: Puchkov K.V
Laparoscopic right resection of kidney with wound stitching.
Professor Puchkov K.V. is performing an operation (2017).
In this film the technique of the right laparoscopic resection of kidney for malignant tumour (2 cm), that is located on the anterior surface, is demonstrated. In the abdominal cavity there is an extensive adhesion process, developed after open cholecystectomy. Mobilization of kidney and dissection of the renal artery and vein are done with the help of a 5 mm LigaSure (MEDTRONOC COVIDIEN) instrument. De Bekey forceps are temporarily applied onto the renal artery. Kidney resection is performed by a 5 mm monopolar instrument within the limits of healthy tissues. An atraumatic interrupted suture is placed on the kidney wound, using “Polysorb” thread. For the sake of additional hemostasis the wound is covered by hemostatic PerClot (Italy). Then the forceps are removed from the renal artery, and blood circulation is restored in the kidney. The ischemia time is 25 minutes. The tumour is placed into a special container MEDTRONIC COVIDIEN and is removed through the umbilical access. Operation duration is 1 hour 30 minutes.
You can read about this technique in detail on the personal cite of Professor Puchkov Konstantin Viktorovich. To go to the link.
