SILS

Simultaneous laparoscopic cardiomyotomy with partial fundoplication and cholecystectomy

Simultaneous laparoscopic cardiomyotomy with partial fundoplication and cholecystectomy
Surgeon: professor K.V. Puchkov (2018).

The operation is performed for achalasia cardia and chronic calculous cholecystitis. The film shows the technique of dissecting of esophageal-gastric junction with the 5 mm LigaSure (MEDTRONIC COVIDIEN) instrument. Cardiomyotomy was performed by the original method with a thin monopolar electrode in a reduced power mode. Attention is paid to the dissection of all muscle layers up to the submucosal layer at a distance of at least 8 cm. The defect is covered by the anterior wall of the stomach with fixation with a continuous intracorporal suture. At the end of this stage, the anterior crurography is performed. Then, in the video shows the technique of laparoscopic cholecystectomy in chronic calculous cholecystitis. At this stage, special attention is paid to careful dissection of tubular structures in the area of the Kahlo triangle. After dissection of the cystic duct and artery, as well as visualization of the lateral wall of the common bile duct, the selected structures cut between the clips. A 10 mm applicator is inserted from the working access in the left hypochondrium. The gallbladder is removed from the abdominal cavity in a plastic container.

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

Laparoscopic cholecystectomy, Kalo triangle dissection

Laparoscopic cholecystectomy, Kalo triangle dissection.
Professor Puchkov K.V. is performing an operation (2018).

The video shows the technique of laparoscopic classical cholecystectomy for chronic calculous cholecystitis. At this stage, special attention is paid to careful dissection of tubular structures in the area of the Kahlo triangle with a monopolar electrode (this stage is specifically shown without mounting). After dissection of the cystic duct and artery, as well as visualization of the lateral wall of the common bile duct, the selected structures cut between the clips. A 10 mm applicator is inserted from the working port in the left hypochondrium (it was used to perform cardiomyotomy for achalasia cardia). The gallbladder is removed from the abdominal cavity in a plastic container. You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.

You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.

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

Laparoscopic cholecystectomy, using the single access (S.I.L.S.Port COVIDIEN).
Professor Puchkov K.V. is performing an operation (2018).

In this video the technique of laparoscopic cholecystectomy for chronic calculous cholecystitis, using the single port (SILS port COVIDIEN), is presented. The sizes of the gallbladder are as follows: 14x7 cm. The doctor is commenting on positioning of the port. Taking into consideration big sizes of the gallbladder, its puncture is being done and evacuation of 100 mL of thick bile is taking place. The technique of transcutaneous fixing stitches, a careful exposure of the cystic duct and artery by a 5 mm monopolar hook and mini retract COVIDIEN instrument and clipping of all these structures by a 5 mm automatic applicator is presented. The dissected gallbladder is removed from the abdominal cavity in a plastic container.

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

Laparoscopic adnexectomy, using the single access (S.I.L.S.) and LigaSure MEDTRONIC instrument

Laparoscopic adnexectomy, using the single access (S.I.L.S.) and LigaSure MEDTRONIC instrument.
Professor Puchkov K.V. is performing an operation (2017).

In this video the technique of laparoscopic adnexectomy, using the single port (SILS port COVIDIEN), is presented. A 50 year-old patient has been operated on for serous cystadenoma of ovary. Cyst sizes are as follows: 8x6 cm. The technique of port (SILS COVIDIEN) introduction into the abdominal cavity is demonstrated. Visualization of the surgical site is done due to a 5 mm elongated laparoscope (KARL STORZ Company). For fast and successful operation performing Clermont Ferrand (KARL STORZ Company) uterine manipulator and a 5 mm LigaSure MEDTRONIC instrument are used. For this operation one twisting instrument- a 5 mm soft forceps –are required. The preparation is placed into a special plastic container by KARL STORZ Company, that is removed alongside with the port via the umbilical area. The duration of the laparoscopic stage is 4 minutes.

Laparoscopic adnexectomy with the single access (S.I.L.S.), using LigaSure MEDTRONIC instrument

Laparoscopic adnexectomy with the single access (S.I.L.S.), using LigaSure MEDTRONIC instrument.
Professor Puchkov K.V. is performing an operation (2017).

In this video the technique of laparoscopic adnexectomy, using the single port (SILS port COVIDIEN), is presented. A 52 year-old patient is being operated on for serous cystadenoma. The sizes of the cyst are as follows: 9x7 cm. There is an indication to perform on an operation, using the single port. Visualization of the surgical site is done with the help of a 5 mm elongated laparoscope, produced by KARL STORZ Company. For fast and successful operation performing Clermont Ferrand (KARL STORZ Company) uterine manipulator is used. For this operation one twisting instrument is required-it is 5 mm soft forceps. The preparation is placed into a special plastic container (produced by KARL STORZ Company) that is removed alongside with the port through the umbilical area. The duration of the laparoscopic stage of operation is 3 minutes.

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

Laparoscopic cholecystectomy, using the single access-SILS (concrement is 6 cm, contents volume 400 mL)

Laparoscopic cholecystectomy, using the single access-SILS (concrement is 6 cm, contents volume 400 mL)
Professor Puchkov K.V. is performing an operation (2017).

The technique of laparoscopic cholecystectomy, using the single port (SILS port COVIDIEN) for chronic calculous cholecystitis and gallbladder hydrops, is presented. The sizes of the gallbladder are as follows: 20x10 cm (the volume is 400 mL), the size of a stone is 6 cm. Taking into consideration big sizes of the gallbladder, its preliminary puncture is done, as well as evacuation of its 400 mL contents. The technique of transcutaneous fixing stitches is shown, as well as a careful exposure of the cystic duct and artery by a 5 mm monopolar hook and by mini retract COVIDIEN instrument, and clipping of these structures by means of a 5 mm automatic applicator. The removed gallbladder is pulled out from the abdominal cavity in a plastic container. The way the removed gallbladder and concrements look like is shown in this video.

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

Laparoscopic adnexectomy on the right, using the single access (S.I.L.S. Port COVIDIEN)

Laparoscopic adnexectomy on the right, using the single access (S.I.L.S. Port COVIDIEN).
Professor Puchkov K.V. is performing an operation (2016).

In this video the technique of laparoscopic adnexectomy, using the single port (SILS port COVIDIEN), is presented. A 54 year-old patient has been operated on for serous cystadenoma. The sizes of the cyst are the following: 8x7 cm. In this video the technique of ligating and dissection of infundibulopelvic ligament of ovary by a 5 mm LigaSure MEDTRONIC COVIDIEN instrument is demonstrated. The preparation is placed into a special plastic container (KARL STORZ Company) and is removed alongside with the port through the umbilical area. Operation duration is 9 minutes.

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