Dave stood on the right side of the patient, and the deputy director of the Second Aid stood below him. The first assistant, Director Shen, stood on the left side of the patient, and the third assistant, Director Guo, stood under Director Shen.
Director Ran, the anesthesiologist, stood at the head of the patient. Behind him was the anesthesia machine, the most expensive machine in the entire operating room.
The equipment nurse stood above Dave, and Tao Le stood opposite her.
Yang Ruixue and Chen Ke, who were waiting outside, looked eagerly here, but they couldn't see anything at all.
There were seven people surrounding the operating table. It was so packed that it was strange to see anything.
The operation begins. Just as Dave told Tao Le before, he wanted Tao Le to take a good look at his current level, so he did the whole process himself. Director Shen and Deputy Director Jin just cooperated with him in pulling hooks, handing things, and cleaning.
But the more this happens, the more you can see Dave’s level.
He made an oblique incision under the right costal margin, parallel to the pancreas. This is different from the commonly done right upper quadrant transrectus abdominis incision.
The incision is made through the rectus abdominis in the right upper abdomen, and the incision is usually extended to 3 to 4 centimeters below the navel. The woman now has an A-shaped obese body shape, and the surgical field is not fully exposed using this method.
Another type of upper abdominal transverse incision, although the surgical field is fully exposed, causes too much muscle damage, and is also not suitable for this older woman.
Director Shen, Deputy Director Jin and Mr. Guo all understood the reason why Dave chose this incision, and they nodded secretly in their hearts.
The abdomen was opened, and the second and third assistants assisted in retracting the hook to fully expose the surgical field.
First, a general exploration is performed to understand the nature of the lesion and see if there are any problems that may affect the operation.
Dave carefully explored the pelvic, liver and abdominal lymph nodes in order from far to near. Finally, he personally touched the extrahepatic bile duct and pancreatic head with his fingers to carefully feel whether there were any enlarged lymph nodes around them.
Tao Le wanted to observe the operation carefully and did not want to pay attention to Goldfinger's prompts.
But this operation was really complicated. Just seeing this place filled her mind with a lot of questions.
For example, why such a curved incision was made, and what exactly Dave wanted to find out while he was working so hard to explore there.
In addition, the golden finger reminder appeared repeatedly, and later it was hung in front of her eyes, blocking her sight:
"After testing, pancreaticoduodenectomy is supported under the current conditions. Is simulation guidance practice required? Yes/No."
Tao Le sighed, without further arguing, he directly chose "Yes" and entered the system space.
Probably dissatisfied with her for taking her time to come in after so many reminders, the man with the mask showed his venomous tongue again today.
But compared to these, the operation itself brought her greater frustration.
It's really too complicated and too difficult.
The mask man completed the teaching operation in only two and a half hours.
When it was her turn, the first operation took eight hours, and the simulated patient died on the operating table.
Tao Le once felt that she simply couldn't hold on. This surgery is not something she can handle now, and it would be difficult for her to learn it.
"Haha, it turns out you are nothing more than that." The masked man sneered: "You don't have the heart of a doctor and you have entered the wrong profession. Why don't you change your profession now!"
These words, full of contempt, aroused the unyielding energy deep in her heart.
The heart of a doctor. In her two lives, she cultivated this heart, with unswerving determination and no regrets.
She didn't say anything, she just put aside all distracting thoughts and concentrated on doing it.
Once, twice, three times. One hundred times, two hundred times
Surgery takes less and less time, and there are fewer intraoperative errors and fewer postoperative complications.
Five hundred times, six hundred times.
Tao Le has forgotten everything. He only thinks about the patient and the operation, and just wants to do his best to prolong his survival time.
"Three hours, fifteen minutes and thirty-three seconds. Rating: Excellent."
Tao Le stood back on the operating table, and Dave was still exploring carefully and carefully.
This time, Tao Le not only knew what he was doing, but was also able to judge everything he sensed based on his movements.
There was no way, she was too familiar with every part of this patient's body.
Dave stopped. Tao Le knew that he had understood that the lesion had not metastasized far away and could proceed to the next step: separation before resection.
The separation process was done meticulously and gracefully under Dave's gentle movements.
His fingers were long and slender, and his movements were gentle but extremely agile. Director Shen and others who were watching were ecstatic and beautiful, and even Tao Le nodded secretly.
It was precisely because she had been honed in the golden finger space for so long that she could see the subtle and rare things in Dave's movements.
Separating the portal vein and superior mesenteric vein is the main difficulty in the isolation stage.
Of the hundreds of surgeries performed before Tao Le, at least 20 made mistakes at this step, which directly led to massive bleeding.
Dave was very careful in what he did. He used blunt-tipped forceps to gently separate the lower edge of the pancreas along the surface of the vein. His movements were light and steady. The forceps were guided by his arms and were precise, naturally minimizing risks.
Seeing this, Tao Le was also a little impressed with him.
She reached Dave's current level only after hundreds of surgeries in the golden finger space; only after hundreds more surgeries did she achieve sublimation.
And how did Dave develop such surgical skills? In addition to talent, he must have also put in a lot of hard work.
Thinking of this, when she looked at Dave, her eyes became more appreciative.
After completing the separation before resection, it was concluded that pancreaticoduodenectomy was feasible, which was just the beginning of the operation.
Tao Le looked at the time. It only took nearly an hour to separate. Dave really worked slowly and carefully.
Among the people present, she was the only one who felt that the operation was slow.
If Director Shen takes the stage, he will be more cautious and slower.
In his eyes, Professor Dave's separation movement was light but hesitant and decisive. It showed the other party's calmness and confidence, and was proof of his strength.
Next comes the excision process.
The patient has intermediate stage adenocarcinoma of the pancreatic head. According to standard pancreaticoduodenectomy, the distal stomach, lower common bile duct, gallbladder, pancreatic head, neck and uncinate process, and about 10 cm of proximal jejunum need to be removed. .
For patients over 50 years old, only the distal one-third of the stomach needs to be removed; for patients under 50 years old, one-half often needs to be removed.
The distal gastric resection, gallbladder, pancreatic head, neck and jejunum resection were all relatively smooth. At most, it was due to lack of cooperation, which slowed down the speed and increased communication. It was not a big problem.
But when cutting off the uncinate process, an accident occurred.
