Titanium clip suturing is the most common and simplest endoscopic suturing technique.
For the patient in front of me, the wound caused by the denture insertion was only 1.5 centimeters wide and the wound was not large. This method of closure was very suitable for him.
The reason why Mr. Shao was willing to let Tao Le do it was naturally because he had confidence in Tao Le.
Her hands are very stable, so she can do a good job whether it is acupuncture or suturing. It is not difficult to operate titanium clips to close the wound under endoscopy.
Just install the titanium clip into the titanium clip releaser, and then send it into the stomach wound along the cannula to close it.
The titanium clip remains in the body after closure is complete. It is small in size and well compatible with the body. After the wound heals in about ten days and a half, it will be discharged from the body on its own, and there is no need to take it out again.
Mr. Shao had already thought about it. Even if Tao Le was not familiar with the operation, there would definitely be no problems if he was watching and giving personal guidance.
For outstanding young people, opportunities for practice must be created at all times to increase their clinical experience.
Mr. Shao's face was filled with the holy light of being a teacher, and his eyes looking at Tao Le became softer.
So when Tao Le rejected the titanium clip release and asked the instrument nurse for a flexible needle holder through the endoscopic channel and absorbable barbed sutures, both Mr. Shao, Mr. Zhang and Mr. Xu Shou were very surprised.
"Xiao Tao, are you going to do EHS?" Mr. Shao asked hesitantly.
The operating room of their gastrointestinal endoscopy department does have such needles and threads, but no one has ever used them since they were purchased.
Because EHS surgery, that is, endoscopic manual suturing, is currently the latest and most difficult technique for endoscopic suturing in the world.
Compared with the traditional titanium clip suture method, the benefits of this technique are obvious. The suture is tight and will not crack due to excessive slippage of the gastric mucosa itself, which can avoid postoperative bleeding to the greatest extent.
It is not only suitable for small wounds on the patient in front of you, but also for large trauma operations such as gastric mucosal dissection.
The only disadvantage is that the requirements for surgeons are extremely high.
Performing continuous linear suturing under endoscopy is not as simple as suturing directly with a hand-held needle. Untrained people cannot even sew a single stitch.
Even an experienced endoscopist can perform eight or nine stitches in an hour.
As a leading international new technology, it has been promoted and applied on a small scale in Beijing and Haishi, but in third-tier cities like Yunshi, it has just been put on the agenda.
To be precise, learning and mastering EHS technology is the main focus of the Department of Gastroenterology in the first hospital next year.
Therefore, Mr. Shao's shock is completely understandable - even if Xiaotao is a disciple of Zhou Guoshou, he is still a Chinese medicine practitioner. How can he master such cutting-edge Western medicine suture technology?
"Yes." Tao Le nodded and said, "The patient is old and has coagulation disorders. Once the titanium clip falls off halfway, it will cause gastric bleeding or even perforation, which is too dangerous."
“With EHS, you don’t have to worry about these problems at all.”
"Well, we all know the benefits of EHS." Mr. Shao asked: "It's just that this operation is very difficult, so don't force it!"
A faint smile appeared on Tao Le's face.
It is true that the operation of EHS is really difficult, but that was all in the past.
There used to be endless patients, there used to be masks and sharp tongues, there used to be concentration, there used to be no one and no one.
The instrument nurse had found what she was looking for.
Tao Le took it and used the needle holder to clamp the suture near the end of the needle so that the suture could swing freely when entering the stomach through the cannula.
Just such an action made Mr. Shao's eyes light up.
He has watched the operation videos and explanations of EHS. Although he has not done it himself, he has a good vision.
This little Tao, ah no, it’s Doctor Tao. He really understands, not just pretending to understand.
Once Tao Le got into working mode, he immediately forgot everything around him.
She didn't notice that the head nurse received another call, from Dean Lin himself.
"Ms. Lorene's surgery hasn't started yet?" he asked.
"It's already started - fifteen minutes." The head nurse replied truthfully.
Three minutes for anesthesia, two minutes for acupuncture to stimulate the gastric antrum, three minutes for endoscopic extraction, and six minutes for finding sutures and unpacking. It took less than a minute for Tao Le to get started.
"What?" Dean Lin's voice rose by one degree, which was rare in his career as a dean: "Didn't your family call you and tell you that the lady has a coagulation disorder?"
"That's true. But at that time, the patient had severe pain in his upper abdomen, and several doctors judged that a perforation might be imminent, so..."
Dean Lin understood immediately: "So I have to operate immediately, alas."
"Don't worry, Dean, we didn't perform any surgery." The head nurse explained, "Mr. Shao took it out under the endoscope."
"Oh? Xiao Shao is good!" Dean Lin praised: "He performed the gastroscopy again. Was it successful? Good, good, good!"
"Not entirely." The head nurse explained seriously: "It's Dr. Tao."
"Tao Le?" Dean Lin had just reviewed the notification sheet for this operation: "I know, Xiao Tao went to the rescue and became an anesthesiologist."
"Dr. Tao did more than just perform anesthesia. She suggested using acupuncture to stimulate the stomach and increase peristalsis to loosen foreign bodies."
"I understand." Dean Lin praised: "This plan is similar to the previous two-mirror combination, but it does not require surgery and is simple and easy to implement."
"That's right." Dean Lin changed his tone: "The foreign body has just been taken out, and the sutures haven't been started yet, right?"
"The suturing has begun." The head nurse looked forward, and Tao Le's operations were clearly displayed on the big screen:
After the needle holder enters the stomach, Tao Lezai inserts the needle from the side of the wound, withdraws the needle and passes it through the loop at the end of the suture, tightens it, and then continuously sutures in a linear manner with an interval of about 3 mm.
Tao Le did this process smoothly, and it was a pleasure for everyone present to watch.
"What!" Dean Lin's voice was raised twice higher than before.
"Wait a minute, let them wait!" he said loudly:
"The patient has an extremely rare allergy to titanium metal and cannot be sutured with conventional titanium metal clips."
"Let them spray the hemostatic agent first, and don't do anything else first. The experts from Haishi have already set out and will be here to perform EHS suturing in three hours."
"Dean, don't worry." The head nurse's heart skipped a beat when she heard that she was going to stop now.
But after hearing it, she put her mind at ease again, and her voice became more orderly.
"No titanium clips are used for suturing." She said, "Dr. Xiao Tao is doing EHS suturing."
She glanced at the big screen again. Tao Le was cutting off the remaining sutures with scissors, holding the sutures with a needle holder, taking out the needle through the cannula, and throwing it into the stainless steel tray.
"...It's done now," the head nurse added.
"Xiao Tao, she can also do EHS?" Dean Lin was extremely surprised: "And how could it be so fast?"
He seemed to have exchanged a few words with someone on the other end of the phone, and then asked: "How long is the wound, and how many stitches did Xiao Tao have to sew in total?"
"One point five centimeters, six stitches."
"This is impossible!" Dean Lin and the unknown voice said at the same time.
It’s the last day of the month, please vote! Xiaohai still owes you an extra chapter this month, maybe two chapters... It will be delivered as soon as possible in the next two days. Please ignore the past grudges and continue to support Xiaohai!
(End of chapter)
