In addition, what worries Murphy's mother is that the private clinics she goes to in Los Angeles usually do not perform surgeries.
In other words, we only look at some minor problems, and if there is a serious illness, we will immediately transfer it to an affiliated hospital or a higher-level hospital.
Is this Iris Clinic okay?
Zhou Qiao seemed to see her worry, so he smiled and said to her: "Our operation is performed in the operating room of the community hospital."
Because the conditions of the operating room of Iris Clinic are really not up to par, mainly due to the supporting facilities.
Once a serious accident occurs during major surgery, community hospitals will naturally have more complete supporting rescue facilities, and rescue operations will be carried out against the clock, like putting out fires.
So usually, major surgeries are performed in community hospitals or higher-level hospitals.
But if the clinic becomes big and extremely wealthy, like the Mayo Clinic, its hardware and software are among the best in the world, almost as good as any major hospital. That's another matter.
Therefore, whether doctors in private clinics in the United States can perform surgeries and what kind of surgeries they perform are mainly determined by the quality of the clinic doctors, rather than legal issues.
Although Murphy's mother was worried, she had no say.
After making preoperative preparations, Zhou Qiao led a group of people to the operating room of the community hospital. The anesthesiologist is still the senior Nancy team.
Nancy is a little busy this afternoon. She has to support three surgeries.
Change shoes, change clothes, brush hands, disinfect, enter the operating room...
Anesthesia preparation is complete, time out...
Ava is still the circulating nurse, Elena is the instrument nurse, Zhou Qiao is the surgeon, and Murphy is the surgical assistant!
Murphy stared intently at Zhou Qiao's operations.
This time, the surgery chosen by Zhou Qiao was the "double-scope combined lower gastric tumor resection minimally invasive surgery" using gastroscopy combined with laparoscopy, which is also known as LECS surgery.
Because the tumor is very small.
LECS surgery is a surgery that combines laparoscopic gastrectomy with endoscopic submucosal dissection. It can accurately observe the location of the tumor and determine the precise resection line, thereby minimizing the resection margin while removing the gastric tumor.
The original indication for LECS (classic LECS) was gastric submucosal tumors (SMT) without ulceration.
Later, the indications of LECS were expanded to include gastric SMT with ulcer and gastric cancer without lymph node metastasis.
However, a major drawback of classic LECS is the risk of contamination of the peritoneal cavity with gastric contents and intraperitoneal dissemination of tumor cells.
In order to expand the indications of LECS to include gastric epithelial neoplasia, some modified LECS have been developed, such as reverse LECS, non-exposure endoscopic gastric wall version (NEWS), clean non-exposure technique (CLEAN-NET), and closed-LECS , these modified LECS are currently used to treat patients with gastric epithelial tumors.
Simply put, the advantage of gastroscopy is precise positioning. It can enter the inside of the stomach, accurately locate the specific location of the tumor, and remove the tumor from the inside of the stomach. However, when the wound is large after full-thickness resection under gastroscopy, it is more difficult to suture the wound. big.
Laparoscopy can very conveniently perform a series of operations such as resection, suturing, and hemostasis. However, its disadvantage is that it can only be operated on the outside of the stomach and cannot detect the precise location of internal tumors.
Therefore, the combination of the two is to maximize the strengths and avoid the weaknesses, combine the advantages of both sides, cooperate inside and outside the stomach, and echo inside and outside, which can not only improve the accuracy of the operation, but also greatly shorten the operation time and increase the safety of the operation.
Murphy has naturally never done this kind of surgery, but Zhou Qiao is a master! It’s just 15 medical points, two high-quality interactions with Elena!
Although it is difficult to accumulate medical knowledge and "make a big fortune" is very difficult, "small fortune" is really easy to come by. So Zhou Qiao didn't cherish it that much.
As long as the little baby is still here and Zhou Qiao's health is still good, he can have a master-level medical skill every day!
It’s so tiring to study and practice, but the skills are instantly acquired, including theory and practical practice, it’s so simple and crude!
Zhou Qiao chose reverse LECS.
And with the help of Murphy and Elena, he also played a particularly cool "left and right fight"!
Anyone who has watched Jin Yong's martial arts knows that the old naughty boy's left-right fighting is so good that even Huang Rong can't learn it. Only simple-minded people like Guo Jing and Xiao Longnu can master it.
At this moment, Zhou Qiao just moved his left and right hands differently!
He controlled the gastroscope with his left hand, accurately located the location of the gastric neuroendocrine tumor, and used the gastroscope to make a circular incision into the submucosal layer from the inside of the stomach along the edge of the tumor.
The right hand controls the laparoscope and performs other actions.
Under the guidance of the gastroscope, the laparoscope is like having eyes, peeling off the seromuscular layer from the outside, and "tunneling" from the inside and outside of the stomach with both hands.
As soon as this stunt was performed, it was absolutely stunning!
Murphy, who had an iceberg-like facial expression, immediately shook her body, and the excitement in her heart was indescribable, as if the world had opened another window for her!
"Is there such an operation? It turns out that it can be done like this! How dexterous Dr. Zhou's hands must be!"
Murphy's heart was like a stormy sea, and her admiration was like a torrential river, but her expression was still dull. Only the light that flashes in the blue eyes from time to time can reveal such a trace of emotion!
The difference between reverse LECS and classic LECS is that classic LECS turns the tumor toward the abdominal cavity after peeling off the seromuscular layer, while reverse LECS turns the tumor inward into the gastric cavity.
Zhou Qiao explained in detail while operating smoothly and effortlessly.
In order for Murphy to hear clearly, he even asked Ava to turn off the stereo.
For the first time, there was no music during the surgery.
Originally, Ava wanted to listen to "Sunshine Rainbow Little White Horse"!
It is said that the melody of this Chinese song is very cheerful and magical. Anyway, those who don’t understand it are the ones who are superior! For Elena and Ava, almost all Chinese songs are superior!
Just like the Chinese songs played in some bars they went to in high school, they were called foreign.
It's a pity that Zhou Qiao didn't know them at that time. If he had followed them, he would have known what they were playing. It's a good bar dance. Can you play "Family with Children" for me?
After the submucosal layer is incised endoscopically to determine the resection line, the stomach wall around the tumor is suspended with sutures like a crown.
Each suture is pulled out of the abdominal cavity using the Endo Close device and secured at skin level with clamps.
Full-thickness resection was performed endoscopically and laparoscopically, during which the tumor was turned into the gastric cavity with traction sutures to prevent gastric juice contamination and contact between the tumor and the abdominal wall.
The tumor was resected into the gastric cavity and the specimen was taken out orally.
The edges of the incision line are then temporarily closed with manual suturing, and the incision line is closed using a laparoscopic suturing device.
The operation went very smoothly. The tumor, which was about 2.5cm*2.5cm, was completely removed and the stomach wall was sutured smoothly.
Now that there is a surgical assistant, Zhou Qiao doesn't need to do the finishing work such as suturing himself, just leave it to Murphy!
Murphy was also very happy. Firstly, it was a rare opportunity to gain experience. Secondly, this was stitching for her grandpa!
Therefore, Murphy did it very carefully!
She secretly thought that if she had the chance, she would ask Zhou Qiao for some advice on the "left and right fighting" technique! Of course, she didn't know that this was called "fighting between left and right". She only knew that it was quite rare!
