HAVANA, August 11  The four surgeons in the video, masked and somber, bend over their patient, a vital-signs monitor beeping in the background.

“Screwdriver,” says one. “Pliers.” Then finally, in relief, another surgeon whispers, “I think it’s good.”

One more surgery with a happy ending. Except the patient is not human. It’s a cellphone.

The video? It’s a commercial for a business called La Clínica del Celular — the Cellphone Clinic. And it’s located in Havana.

In Cuba, advertising — that hallmark of capitalism — is back.

Advertising for private businesses — those billboards sporting an unsmiling Che Guevara don’t count — disappeared from Cuba, along with private enterprise, in the early years of the revolution.

The new ads, for small businesses such as the cellphone-repair clinic, hair salons, and the private restaurants known as paladares, are becoming ubiquitous — if not exactly legal — in the weekly paquete, Cuba’s underground market for foreign TV shows, movies, sports and Internet content.

Because of the severe lack of web access on the island, many people subscribe to thepaquete, a weekly package of programming bought and sold on thumbdrives, or, for those who can afford them, external hard drives.

And with the demand for the paquete rising, advertising was not far behind. Ads in the form of smartly produced videos and photos are common, publicizing the new small enterprises the government of Raúl Castro has allowed since 2010.

The paquetes even feature privately published magazines, in graphic format, which carry advertising themselves. Venus promotes itself as a Cuban variety magazine for women, while Vistar carries cultural and entertainment news.

(The government is aware of the paquete, and has launched its own version, the mochila, or backpack, because it is afraid to “lose the cultural war,” according to an article by Joel Mayor, a Cuban journalist who wrote a piece on the phenomenon in a state-run local newspaper, El Artemiseño.)

The paquete sells for between 2 to 3 CUCs — the Cuban currency roughly equivalent to dollars — per week, and buyers can watch, among hundreds of offerings, recent episodes ofGame of Thrones, Veep, The Mindy Project and the History Channel’s The Vikings.

Along with promotion and advertising businesses, the demand for video ads has led to the rise of another long-lost art in Cuba: the production of commercials.

Cuban designer Vanessa Pino and her brother Angel own a small promotion company in Havana with an English-language name: ToDoDesign. Her clients, she says, are business owners who “realize the importance of having a good design when it comes to identity and brand” for their ads.

ToDoDesign produces fliers, creates visual identities for businesses, customizes promotional items like T-shirts or souvenirs, and subcontracts the production of promotional videos at the client’s request, Pino said. The production company charges clients from 50 CUCs to as much as 500 CUCs, and sometimes even more if the company hires a local artist. What is harder to ascertain is how much the distributors of the paquetes are charging the businesses to advertise.

Most of these new production agencies work without legal status, but until now the government has not taken action to shut them down. The state media, though, remains under the strict control of the Communist Party and so far there is no sign of an opening to a more-commercial model.

The return of advertising to Cuba, even if under the radar, is auspicious, says a U.S.-based newspaper designer and long-time Cuba observer.

“One of the most notable aspects of the rebirth of the media in Eastern European countries after the fall of communism was the appearance of advertising,” said Mario García, a Cuban-American adjunct professor at Columbia University who has designed more than 700 newspapers around the world, including the Miami Herald and el Nuevo Herald.

“You had people there who had only seen propaganda in their televisions, radios, newspapers and magazines,” García said. “Nothing was advertised except the virtues of communism. Now, suddenly there was supermarket advertising (all that food on the screen), fashion ads for store openings everywhere, and promotions for everything, from shampoo to ice cream. For those waking up from the boring media generally associated with Communist regimes, that was much more interesting than the stories published in newspapers and magazines.”

Arnulfo Espinosa, a graphic designer who teaches at the University of Havana, said advertising has been slowly returning to the island, mostly promotional mentions during sports on state television in the 1990s that later disappeared again: “What is happening now is only the latest reappearance.”

One thing that has helped the rebirth: The reappearance in the 1990s, despite the country’s economic travails, of classes in marketing, public relations and communications in Cuban universities.

The work of the self-employed designers and publicists can be legit — as long as they have a permit from a government agency, the Cuban Association of Social Communicators.

There are no laws, however, allowing for media and advertising in Cuba — or laws regulating audiovisual creators, which some designers have complained have led to productions in “bad taste.”

“I think that there are professionals in Cuba capable of doing the tasks required in advertising,” Espinosa said. “But in every case there is a lack of technical skill and, especially, a lack of team culture and business administration.”