The patient is a 65-year-old man who came to a hospital for treatment due to upper abdominal discomfort.
Gastroscopy revealed a red and depressed lesion in the gastric antrum. Pathological biopsy showed that it was high-grade intraepithelial neoplasia and local canceration.
Just the day before yesterday, the Department of Gastroenterology invited the Oncology Department, Radiation Oncology Department, and Gastrointestinal Surgery Department for a discussion, and they agreed that the patient met the characteristics of early cancer and was suitable for ESD surgery.
However, one difficulty with this operation is that the lesion is a bit large.
The oval-shaped lesion, about 7 cm by 4 cm, with unclear boundaries gave all the doctors in the first hospital a headache.
They have never done such a large area of endoscopic submucosal dissection.
Director Xiao gritted his teeth and stamped his feet, ready to go into battle personally and meet the challenge.
But the family members seemed to hear the drumming in their hearts.
The patient's son immediately said that he did not need to work for the doctor of the first hospital, and he would hire a famous doctor to do the flying knife.
Before he could successfully contact him, Ai Yuan appeared.
His arrival was just in time, which perfectly solved the confusion between doctors and patients, so today's teaching surgery was born.
Tracheal intubation, general anesthesia. The anesthesiologist made a signal and the operation began.
Ai Yuan skillfully operated the endoscope.
The endoscope has a handle with various mechanism buttons on it, which is a bit like a stick-shaped game handle.
Doctors generally hold the mirror shaft with their right hand and control the "steering wheel" that rotates up, down, left and right with their left hand. The two hands cooperate with each other to complete various operations far inside the stomach.
As soon as Ai Yuan moved his hand, the spectators in the classroom held their breath and watched intently.
This is not only because of the opponent's reputation, but also because of the current teaching method, which makes it impossible for them to slip away.
Thanks to Tomio Company, the demonstration classroom in the first hospital was renovated last week and turned into a holographic teaching method.
Every observer is immersed in the operation, standing on the side of the operating table and observing the operation up close.
In addition to not being able to interact with you, this teaching mode is many times more powerful than before.
Every action, every word spoken by the surgeon, and every incident handled are intuitively presented to the observers.
Director Xiao could tell at a glance that Ai Yuan's mirror-holding gesture was very different from his own.
Like many endoscopists, he likes to hold the handle with his ring finger and little finger, and use his middle finger to press the gas injection button and suction button, but Ai Yuan is not like this.
He used his thumb, middle finger and ring finger to hold the handle of the endoscope and control it in his palm - the ring finger could touch any button up, down, left or right at any time.
His index finger is placed on the suction button and his middle finger is placed on the air injection button to ensure that there will be no delay when operating at the same time.
Director Xiao nodded frequently. No wonder I always feel like I am overqualified when performing ESD. It turns out that my gestures are wrong.
As expected, he is indeed an outstanding doctor from Haishi No. 1 Hospital. Just one endoscopic operation technique has benefited me a lot.
Tao Le had just performed more than 300 ESD surgeries of the same type in the Golden Finger Space. Looking at Ai Yuan's operation now, his experience was deeper than that of Director Xiao.
The reason why she was able to achieve excellence after only making more than 300 units was naturally because she had become extremely familiar with the operation of the endoscope during the previous endoscope retrieval battle, so it would naturally be much easier now.
The operation of the endoscope is not just about the dexterity of the fingers, but also requires adapting to local conditions. By adjusting the gas in the lumen to control the movement of the endoscope, and using forceps to expose the field of view, more precise treatment can be achieved.
For example, if you want to drive an extended container truck, you just need to be able to turn the steering wheel and step on the accelerator and brake.
If you want to drive a car quickly and steadily, and even turn with great flexibility, you must go through long-term and extensive training.
Ai Yuan has performed nearly 200 ESD surgeries, and they are of various types - far higher than Director Xiao.
But if it were just for the patient in front of him, Tao Le's experience could surpass him countless miles.
The operation was carried out in an orderly manner. Mark the lesion and perform submucosal injection to make the lesion convex. Use a needle incision knife to mark a circle around the lesion.
Thirty minutes have passed since we reached this point.
Next, it’s time to cut and peel.
Ai Yuan was about to take action when he heard Tao Le say: "Doctor Ai, please wait a moment."
Ai Yuan attached great importance to Tao Le's opinions. He came to Yunshi No. 1 Hospital originally for her, but he stopped immediately after hearing this.
"Doctor Tao, if you have any opinions, feel free to ask."
"I'll do acupuncture to stop the bleeding first, and then you can do the incision and peeling." She said as she took out the prepared disposable filiform needle.
Ai Yuan's pupils shrank instantly.
He had seen acupuncture and other things during the operation last night, but he didn't know why at the time.
But now he knows that its purpose is to stop bleeding.
Intraoperative acupuncture to stop bleeding? Simply unheard of, could this work? Ai Yuan's mind was filled with questions.
Not only him, but also everyone watching the holographic demonstration in the classroom.
Among them, Director Xiao had heard some rumors, but the others knew nothing about it, so they didn't believe it at all.
This little Tao didn't take this opportunity to learn from Dr. Ai, but instead made arrogant remarks.
If acupuncture can stop bleeding, we have already collectively organized and studied it. Who cares whether it is a method of traditional Chinese medicine or Western medicine?
What is useful is a good method, and doctors have always been pragmatic.
Tao Le didn't know, let alone what they were thinking.
She shot out the needle like the wind and quickly inserted it into several acupuncture points around the stomach, and then signaled Ai Yuan to continue.
The latter did not hesitate, used a needle incision knife to make the opening, and then used an IT knife to perform incision and peeling.
With such a large wound peeling off, bleeding is inevitable.
Intraoperative bleeding is the difficulty in ESD surgery.
A commonly used method in clinical practice is to use hot biopsy forceps to coagulate blood. However, bleeding often recurs, and after repeated coagulation, eschar will appear, causing the wound surface to harden, greatly increasing the difficulty of complete peeling.
But something magical happened. Wherever the IT knife passed, not a drop of blood seeped out.
Until the entire lesion was completely peeled off, exposing the huge underlying muscularis propria, the surgical field was still clean without even a drop of blood.
Seeing this scene, the spectators outside the classroom fell into collective silence, and then became excited.
Even in a holographic vision environment, there were still many people who couldn't restrain themselves and cheered.
Xiao Tao's hand is so handsome!
It's just a simple insertion of a few needles, and not a drop of blood will flow out. What kind of magical technology is this?
The older director and attending physician were just as impressed and amazed at most, but the young people in Corey had lively ideas and had already thought of studying under a teacher.
Young doctors in the new era have never thought about having any unique skills. When they see new technologies, they always want to share and learn.
We don’t understand the complicated acupuncture, so we just want to learn how to stop bleeding with acupuncture.
If you can learn this, why should you be afraid of ESD surgery in the future? It doesn’t matter how big the wound is!
Moreover, gastroenterology department needs to stop bleeding, but it is not limited to ESD surgery.
At this moment, when everyone looked at Tao Le, their feelings were completely different from before.
My child will resume classes next Monday and will have to go to school for nucleic acid testing this morning. The second shift at noon may be slightly delayed. Well, actually the second update in the past few days was later, so please bear with me.
Thanks to Yingying Yingxiang for the 100 starting point coins! Thank you all for your monthly votes, subscriptions, recommendation votes and comments! In the near future, Xiaohai will speed up the pace of the plot and optimize everyone's reading experience. Please continue to support this book!
(End of chapter)
