Sign In: Going Back to Being a Surgeon 10 Years Ago Chapter 180: Subtotal gastrectomy
Wu Yuan and Liu Xuening put on their surgical gowns and caps before entering the operating room.
At this time, the patient Li Wenqiang was already lying on the operating table, and the anesthesiologist, equipment nurse and other personnel were already in place.
Wu Yuan stood on the main knife position, and Liu Xuening stood on the opposite side as the first assistant.
Li Wenqiang turned his head to look at Wu Yuan and asked, "Doctor, is this operation really okay?"
Wu Yuan: "There is a problem."
Li Wenqiang turned pale with shock, opened his mouth, but said nothing.
Wu Yuan: "In the future, you won't be able to eat so much, and you should drink less alcohol."
Li Wenqiang heaved a sigh of relief. What Wu Yuan said just now really shocked him. He thought the operation would never work.
Unexpectedly, Wu Yuan was talking about eating and drinking.
Li Wenqiang smiled: "Doctor Wu, it's okay. I decided to quit drinking in the future, and I will never drink again! What the hell, I heard people say that drinking can kill people, but I still don't believe it. This time I know it. Even if I don't drink to death, I will lose half my life."
Wu Yuan tidied up his gloves and said, "It's good to know, it's not easy for the old lady, so don't let her worry about it in the future."
Li Wenqiang nodded: "I see, doctor, I regret it, and I must pay attention in the future!"
Wu Yuan took a look at Li Wenqiang: "Aren't you going to get married? Your future daughter-in-law hasn't come yet?"
Li Wenqiang: "My daughter-in-law is still on a business trip, so I didn't dare to tell her, for fear that she would be worried."
Wu Yuan let out a "hmm".
Li Wenqiang: "Doctor, you need to cure me, I still want to live a better life."
Wu Yuan: "Don't worry, I will let you live a good life."
Wu Yuanchao signaled to the anesthesiologist, and then said to Li Wenqiang: "You go to sleep first, and you'll be fine when you wake up."
Li Wenqiang: "Okay!"
Liu Xuening looked at Wu Yuan, then at Li Wenqiang, and felt that Wu Yuan was really a strange surgeon.
Speaking so much to a patient.
However, Liu Xuening liked this kind of atmosphere, and felt that Li Wenqiang had completely trusted Wu Yuan.
For a surgeon, this is a rare doctor-patient relationship.
Liu Xuening even felt that she had really opened her eyes, so it turns out that a surgeon can still be like this?
Didn't you start the operation as soon as you came up?
However, Liu Xuening was more curious about Wu Yuan's surgical skills.
A doctor who is good at communicating with patients can only be regarded as an extra bonus. It really depends on how well he performs on the operating table.
The key point is that Wu Yuan is not a doctor of Yanjiang Dongcheng Doctor, but a doctor from the Affiliated Hospital of Yanjiang University.
A moment later, Li Wenqiang fell asleep, his breathing was very steady.
Wu Yuan glanced at the monitor, his blood pressure was still a little high.
Wu Yun sighed secretly, still drinking.
Wu Yuan said to the anesthetist: "Can you lower your blood pressure a little?"
The anesthesiologist: "Let me try."
To be honest, the communication between the surgeon and the anesthetist is also a problem.
Surgeons are skilled people, and so are anesthesiologists.
If the anesthetist is not happy with the request of the surgeon, it will be difficult to do so.
Fortunately, the anesthesiologist gave Wu Yuan some face, and added a kind of antihypertensive drug to the intravenous injection.
The dose is not large, just a little control will do.
A few minutes later, Li Wenqiang's blood pressure dropped a little. Wu Yuan checked the time and announced the start of the operation.
Wu Yuan: "My surgical plan is subtotal gastrectomy combined with vagotomy. The purpose of the operation is to clear the ulcer area, gastric perforation area, and avoid excessive gastric acid secretion in later stage patients."
Liu Xuening was taken aback, he didn't expect Wu Yuan to give such an explanation, and the explanation was very clear, which showed that he had a clear mind.
Wu Yuan: "Scalpel No. 3."
The equipment nurse handed the scalpel to Wu Yuan.
At the same time, in the observation room beside the operating room, Zhu Yulong, Guo Fangxin, Liu Qiaojun and others were all staring at the screen carefully.
Everything is difficult at the beginning, and it is right or wrong when it comes to surgery.
The most difficult part of surgery is by no means the first cut, but the middle part of the surgery.
However, if the first incision is not successful, it means that the surgeon is not very qualified and it is difficult to perform the subsequent operations well.
Guo Fangxin whispered to Zhu Yulong: "How many operations has this doctor Wu done?"
Zhu Yulong: "Many operations, especially pancreatitis surgery, he is very good at, and often temporarily transferred to the general surgery department to help."
Guo Fangxin: "Then I can feel more at ease."
Zhu Yulong thought to himself, do you think I'm stupid? Wu Yuan was recommended by me. I must have done some research and dared to do so only if I had some confidence.
At this moment, Liu Xuening had already carried out routine disinfection on the surgical area of the patient's abdomen, and spread a sterile towel.
Wu Yuan glanced at Liu Xuening: "I'm about to start."
Liu Xuening nodded, feeling inexplicably nervous.
At this moment, Liu Xuening noticed Wu Yuan's hand, to be precise, the hand holding the scalpel.
When moving the scalpel, it is so stable!
Observing everyone in the room, of course they also saw this scene.
"Wow, his hands don't seem to shake at all!"
"It's really too stable! It's like a stone arm."
"This is because the camera is a little far away, so the shaking is not obvious?"
A person suddenly pointed to the image on the screen and said, "It's under the knife! It's under the knife! The incision is so straight!"
At this time, Wu Yuan had already made a very straight incision about 20 cm long in the patient's abdomen.
Then Wu Yuan began to cut the skin and subcutaneous tissue layer by layer.
Finally, the abdominal cavity has been exposed.
Next, the formal subtotal gastrectomy will be performed.
To be honest, the difficulty of subtotal gastrectomy is quite high. Surgeons should not only remove the lesion and diseased tissue, but also ensure that the scope of gastrectomy is not too large.
Too much gastrectomy may affect the postoperative eating and nutritional status of the patient.
However, too little resection cannot be done. If the resection is too little, the remaining lesion tissue means that the gastric ulcer has not been removed, and the gastric acid is not reduced enough after the operation, which will lead to the recurrence of gastric ulcer.
So generally speaking, two-thirds or three-quarters of the stomach will be removed in a subtotal gastrectomy.
But for Wu Yuan, subtotal gastrectomy can be done better.
Why?
Because Wu Yuan has the talent of "Key Locking", he can more accurately find the position and edge of diseased tissues and lesions.
Combined with Wu Yuan's extremely fine control over his fingers, he can even minimize the part that needs to be removed, so that it will not be removed by mistake.
If you switch to other surgeons, you will definitely not be able to achieve this level, even those veteran surgeons.
Wu Yuan This is a plug-in effect, not a surgical technique.
At this time, in Wu Yuan's field of vision, the patient's chest cavity was all green, with red parts mixed in the middle.
Red is equivalent to diseased tissue and lesions, and it really is mainly concentrated in the stomach area.
Wu Yuan glanced at it for a while, and found that the red color also varies in depth and lightness.
This shows that some parts of the patient's stomach have been severely diseased.
Gastric ulcer is very easy to develop into cancer, so the diseased tissue must be removed.
Wu Yuan started to fight.
There are generally two types of gastrectomy.
Wu Yuan used the so-called "Billow's Second Form".
Simply put, after subtotal gastrectomy, the stump of the duodenum is closed, and the remaining part of the stomach is anastomosed with the upper part of the jejunum.
So this operation is not only difficult to remove, but the degree of anastomosis is also critical.
Wu Yuan didn't dare to be careless, and concentrated on performing the operation.
Using a scalpel, Wu Yuan first combed out the gastrocolic ligament with surgical scissors, and then found the greater omentum along the gastrocolic ligament to the left and right.
Wu Yuan: "Scalpel No. 5."
Wu Yuan specially chose a small scalpel in order to perform more precise operations.
In the observation room, everyone looked at everything on the screen in amazement.
The screen was displayed very clearly, and Wu Yuan's movements were fast and accurate, as if he had easily cut off the omentum.
"So fast! This doctor Wu's technique is really extraordinary!"
"I feel like he didn't move much, just cut it off like this, what's going on?"
Liu Qiaojun was very knowledgeable, and said: "His hands really didn't move much, but his fingers moved, which shows that Dr. Wu's surgical skills are very solid, you need to learn more."
Although Liu Qiaojun is the director of the Department of Thoracic Medicine, he has a background in surgery. However, his hand was injured and he couldn't go on the operating table, so he transferred to the Department of Thoracic Medicine.
It is precisely because of this that he is so interested in surgery.
Seeing Wu Yuan in such a state at this time, Liu Qiaojun was actually very surprised, which could not only be explained by good basic skills.
Wu Yuan was impeccable in terms of strength control and choice of cutting position when removing internal organs, he was simply exceptionally talented.
Then, Wu Yuan entered the next stage, which was to ligate the blood vessels of the gastric wall in sequence along the greater curvature of the stomach.
Be aware that there are many blood vessels in the stomach. If ligation is not performed, excessive blood loss is likely to occur during the resection, causing serious consequences.
Left gastroepiploic arteriovenous, right gastroepiploic arteriovenous...
Next, Wu Yuan ligated the right gastric artery at the lesser curvature of the stomach.
Liu Xuening was in the position of first assistant and had the best vision. Wu Yuan's series of operations caught her in a daze.
Wow, this is too neat.
Liu Xuening is also a surgeon, she couldn't imagine that she could do what Wu Yuan did.
Not only that, of course Liu Xuening has also seen other old surgeons perform operations, but in my impression, it seems that they can't reach Wu Yuan's level.
Moreover, the operation process of most of the stomach is actually very cumbersome. It seems that Wu Yuan has not only done a few operations, but countless operations to be so proficient.
Wu Yuan is still so young, which hospital will give him so many opportunities?
Difficulty Is this the level of surgeons at Dongcheng Hospital?
No, he is not a doctor of Doctor Dongcheng, but a doctor of the Affiliated Hospital of Yanda University.
Why is Wu Yuan's surgery level so high?
At this moment, Liu Xuening understood why Zhu Yulong dared to recommend Wu Yuan.
Not to mention anything else, if Wu Yuan's level is placed in the Third City Hospital, he will be the core force among surgeons.
At this time, Wu Yuan has already completed the ligation of the blood vessels, so that the most important step can be carried out, which is the resection of the pathological tissue in the stomach.
Wu Yuan did not act immediately, but observed first.
Because this kind of subtotal gastrectomy is not just a resection, but also anastomosis of the remaining part with the jejunum and duodenum stump.
In other words, a surgeon who performs this type of operation is equivalent to a tailor, and needs to be "designed".
If the anastomosis is not good, it will not only have serious sequelae, but also cause various complications.
Liu Xuening didn't dare to breathe a sigh of relief, watching Wu Yuan thinking there.
After a while, Wu Yuan seemed to have finalized his plan: "Scalpel, the smallest one."
After hearing this, the equipment nurse gave Wu Yuan a No. 3 scalpel with a No. 11 blade in it.
This is the smallest type of scalpel, and it is specially used for cutting blood vessels, nerves, gastrointestinal tract and heart tissue.
But ordinary surgeons can't use such a small scalpel, it's too thin, too small, and too difficult to use.
But for Wu Yuan, it was just right. After all, his finger dexterity was different from ordinary people, and it belonged to superhuman ability.
Of course, there is a smaller scalpel, the one with the 12-gauge blade, but that's only used in facial plastic surgery, and that's for microscopic plastic surgery.
At this moment, Wu Yuan started to move the knife.
Not only Liu Xuening, but even everyone in the observation room dared not speak out.
Because Wu Yuan's movements were too delicate, everyone stared straight at him, some of them opened their mouths wide enough to fit an ostrich egg into it.
Wu Yuan cut off a small piece of diseased tissue and put it in a tray.
Liu Xuening took a look and couldn't help but be surprised.
That's completely diseased tissue, with no disease-free tissue attached.
Liu Xuening looked at the remaining stomach tissue near the patient's incision again, and there was no residue in that area!
In other words, Wu Yuan's range of excision was very precise.
This is amazing, how did Wu Yuan do it?
Although Liu Xuening was close, she couldn't see clearly.
In the observation room, someone asked: "His movements are so fast, are you sure he didn't make a mistake?"
Liu Qiaojun shook his head: "No, it's very detailed, it's amazing! Very detailed!"
Wu Yuan continued to remove other gastric pathological tissues~IndoMTL.com~Liu Qiaojun was already fascinated.
He was also an excellent surgeon before, so he knew how difficult Wu Yuan's moves were.
I didn't expect such a young doctor to have very good skills. Thinking about it, this is really a bit contrary.
I don't know how Wu Yuan practiced it.
In the blink of an eye, Wu Yuan had cut off three pieces of diseased tissue.
Wu Yuan tried his best to control the scope of resection to the minimum, and tried to only resect the diseased tissue without involving the healthy stomach tissue.
Liu Xuening's eyes could hardly catch up with Wu Yuan's movements.
Suddenly, Wu Yuan's movements stopped.
Liu Xuening found it strange, it was a bit abrupt.
Liu Xuening: "What's wrong?"