Chapter 1527 False Medical Records
The liver of the patient has the performance of nodular cirrhosis, and the overall atrophy is obvious.
Zheng Ren stretched out his hand, and a latex tube fell in his hand.
He used a latex tube through the lesser omentum foramen and wound the hepatoduodenal ligament in preparation for occlusion of hepatic blood flow.
The right liver was then lifted up and a drape was placed under the right diaphragm to expose the right liver.
"Can you touch it?" Su Yun asked.
"Yes, the boundary is still clear." Zheng Ren said.
After he finished speaking, he took his hand away from the liver, and Su Yun stretched out his hand.
Gently touch the right liver, with a little force, you can feel a relatively large mass inside the liver.
After Su Yun touched it, Professor Yang touched his body.
The touch... It is harder than the liver cancer lump in my impression, not even a little bit hard.
Could it be said that it is interventional embolization, the change of tumor tissue after necrosis is so great? Professor Yang was a little puzzled.
Normally, the texture of tumor tissue is harder than the surrounding ordinary tissue, but it should never be so hard.
The hepatic capsule was used as an incision margin at a distance of about 2cm from the mass by electrocautery, and the two sides of the incision margin were interlocked with a large needle of No. 7 silk thread.
This step is prepared for the assistant, pulling the liver tissue and exposing the field of vision, relying on the seventh wire to lift.
Su Yun and Professor Yang pulled a thread each to expose the liver.
Zheng Ren looked at the surgery area, stretched out his hand, and patted the ultrasonic knife lightly in his hand.
He started blunt dissection with the forceps on the head of the ultrasonic scalpel.
Papa, the slow condensate sound kept ringing.
Small blood vessels can be coagulated slowly with low power, and there will be a popping sound. Larger blood vessels will make a popping sound when they need to be coagulated with a higher power.
The operation is not fast, but it is not slow either.
In the background music of Good Luck, the sound of crackling sounded constantly. From Professor Yang's point of view, Zheng Ren's hands seemed to have a wonderful rhythm.
Small blood vessels and bile ducts are closed and cut off with an ultrasonic knife. In the case of more than 4-5mm, Zheng Ren did not use the high power of the ultrasonic knife, but chose to use a titanium clip to close and cut it.
"Boss Zheng, the ultrasonic scalpel can cut blood vessels of up to 6mm." Professor Yang reminded.
"It has been reported that when a blood vessel with a diameter of more than 4mm is cut with an ultrasonic knife, the possibility of rupture and bleeding after surgery is 3-5%." Zheng Ren said while performing surgery: "Although the pressure inside is relatively high after surgery, Even the bleeding can stop, but it's not necessary."
Professor Yang thought for a while, but he had never seen similar reports.
But Boss Zheng's operation was really clean. The liver had been split open, and there was not much blood in the surgical field. He has been holding the suction in his hand, and the hissing sound indicates that the suction is ready to go.
However, there was only a few tenths of a milliliter of blood in the tube of the aspirator, and there was almost no bleeding during the whole process of splitting the liver.
As the second assistant, Su Yun held a piece of gauze in his hand with hemostatic forceps, and occasionally dipped it in blood to expose a clear surgical field for the surgeon.
On the white gauze, there are red bloodstains, like the plum blossoms in the twelfth lunar month.
It's hard to believe that the bleeding is so little.
A black, hard tumor tissue appeared in the surgical field.
"It looks a little different from a normal liver tumor." Su Yun said in a low voice after seeing it.
"The difference is huge, you'll know it when you wander for a while." Zheng Ren said.
"Boss Zheng, is it because the blood supply artery is blocked?" Professor Yang asked.
"There are reasons for this, but it is more because the tumor tissue is necrotic, which is very different from normal tissue. The operation is more precise and simpler." Zheng Ren looked at the operation area and said.
This is a live broadcast of the operation. Zheng Ren learned from the experience and lessons of the last operation and Xie Yi people's eyebrows. He didn't look up at all, and his field of vision was always locked on the liver tumor in the operation area.
Start free tumor.
Zheng Ren used an ultrasonic knife and a titanium clip to land on the upper half of the tumor, and the free tissue was about 0.7cm away from the tumor tissue.
Soon, Professor Yang discovered something different.
As Zheng Ren said, the operation seemed to be much simpler than he expected, and the bleeding was also less.
Usually hepatobiliary surgery is performed, and the ultrasonic knife is also used. Even the sub-helium knife, a high-value consumable like a welding gun, is occasionally used when the bleeding does not stop.
Surgery is the same surgery.
But under the hands of Boss Zheng, it seems to have suddenly become extremely simple.
The forceps on the head of the ultrasonic scalpel kept doing blunt separation, the sound of slaps unceasingly, and the operation went smoothly.
Bleeding?
Professor Yang glanced at the suction device in his hand and the gauze in Su Yun's hand.
To say no, would be nonsense.
But there are bits and pieces of bleeding...how to write the operation record? Bleeding 3ml?
MD! Writing like this will not be considered a false medical record.
"Director Zhou, what the boss is about to cut off is the supplying blood vessels from the phrenic artery." Su Yun said suddenly.
Since Zhou Chunyong was on the operating table, he has not said a word and observed carefully.
This is the first time he has seen the anatomy of liver cancer after interventional embolization.
Is it a branch of the phrenic artery?
Zhou Chunyong still remembered that when the interventional embolization operation was performed at that time, the artery was not found on the preoperative film.
Boss Zheng didn't see the process of super selection and embolism himself.
But... where is it?
Papa, the sound rang out, and Zheng Ren continued to wander down. Zhou Chunyong looked a little confused, and asked in a low voice, "Doctor Su, where are you?"
"That's what the ultrasonic knife cut just now." Su Yun said, "Didn't you see it?"
"Oh, that's it." Zhou Chunyong said embarrassingly, pretending that he saw it.
He was ashamed.
I am not a surgeon myself, and I only learned the anatomical structure from images and books.
If he really opened his belly and saw the actual situation with his own eyes, he would be dumbfounded.
You can see a thread! Except that there was no bleeding and the operation was clean, there was nothing to see.
But Zhou Chunyong knew that if the operation was done cleanly, that was good!
Before the operation, Professor Yang of the 912 liver and gallbladder also said that it is necessary to prepare blood. Now, it is completely unnecessary.
"Director Zhou, even if I did an ordinary liver splitting operation, the bleeding should be around 100ml by now." Zheng Ren said, "The bleeding is less because the blood vessels that feed the tumor are embolized."
Hearing Zheng Ren's prompt, Zhou Chunyong raised an indescribable emotion in his heart.
I have been doing my job for 20 years. It is the first time I have seen it with my own eyes, and I have to tell me what the effect is from Boss Zheng.
This... ugh.
When Professor Yang heard Zheng Ren's words, his heart was even more uncomfortable.
There is no common liver splitting operation combined with liver interventional embolization before the operation. If you do it yourself, the bleeding will be at least 500ml.
Well, it's all over the top.
As a precaution, blood transfusions have been started at this time.
But what Boss Zheng said, what he does now is only 100ml of bleeding?
It should be impossible. The bragging on the operating table should not be taken seriously. Professor Yang comforted himself.