The next day, in the operating room, Zhang Fan was the surgeon, Zhao Quanping was the first assistant, Zhao Jun was the second assistant, and Li Jingjin, Professor of Hepatobiliary Oncology at Di Da, was at the operating room platform. He didn't have much confidence in the eradication of this kind of tumor. Even though he was the consultant expert invited, he wasn't very optimistic that Zhang Fan could do it, but he didn't say it, let's do it first and see! Lao Chang is also here. Although they are both experts and professors in the same system, he does not have a good relationship with Li Jingjin. They are both experts of the same level, and they are from the same region. There are only so many hospitals that perform acupuncture. If you have more, he will have less. One point, so it is absolutely correct to say that peers are enemies.
The two of them didn't feel embarrassed. They stood on both sides of the operating table. Although there was little communication, neither of them was optimistic that Zhang Fan could complete the operation. For such a young doctor to perform such a major operation and such a high-end operation, it was really hard for them to do so. A bit tongue in cheek.
They are all here for consultation. As long as they don't have surgery, they have no responsibility. They are just watching the excitement anyway and are not afraid of trouble. The city hospital insists on doing it, and Lao Li doesn't insist on it either!
At the beginning of the operation, Zhang Fan chose a conventional incision. This kind of surgery would rather make the opening larger than smaller. A small incision may seem like a small injury, but in fact the vision is unclear and the damage to the internal organs is greater. The sharp knife cuts through the skin, and the fat layer breaks apart the skin. The electric knife stops the bleeding, and the smoke is faint!
Entering the abdomen, Zhang Fan began to explore the size and scope of the tumor to understand whether the tumor tissue had truly invaded the porta hepatis and major blood vessels. The tumor was really not small. It occupied a large space in the middle lobe of the liver. Li Jingjin and Lao Chang stood on both sides and saw the size of the tumor. They shook their heads at the same time. It was too big. It may have violated the major blood vessels! One mistake and liver failure can't escape!
Zhang Fan gently touched it with his hand, and found that the tumor tissue grew rapidly and overbearingly, causing great damage to the body and tissues. There was only a thin film on the surface, and it would burst if not careful. This patient's tumor has invaded the large blood vessels. If the tumor moves a little more, it may burst and cause massive bleeding.
Zhang Fan slowly separated the liver and kidney ligaments and cut off the deltoid ligament. This operation is much more difficult than ordinary liver operations. Excessive movements can lead to ulceration and massive bleeding, so be careful with every move! "Gauze wrapping." Zhang Fan said simply. Zhao Jun immediately wrapped the liver with gauze and held it with both hands. The last ligament, the coronary ligament, was separated. The ligaments that fix the liver are free, and the assistant has to bend down to hold the liver to ensure that it cannot move.
Zhao Jun bent down, he was already a chief physician, working as an assistant for a resident, doing the work of a resident. But he has no complaints at all. This is the team, this is the doctor, this is the characteristic of technical positions, and only technical heroes are heroes.
The surgical round knife gently slides across the liver capsule, and a large curved hemostat is used to slowly enter the liver tissue at the front edge of the liver to separate and clamp it bit by bit. This is very critical. It must be accurate and very familiar with the anatomy. Otherwise, if a blood vessel is missed, it will be difficult to stop the bleeding.
The vena cava and short hepatic veins are ligated one by one to stop bleeding. The liver has double blood supply systems, which is particularly complicated. However, the veins and arteries leading to other liver lobes cannot also be ligated, otherwise the other liver lobes will become ischemic and necrotic after the operation. After confirming that the blood vessel was successfully ligated, Zhang Fan gently released the hemostatic forceps. The blood color of the left and right livers, which were already a bit gray, returned to normal, which showed that the vascular tissues of the left and right liver lobes were unobstructed.
The location of the middle liver lobe is too dangerous. The porta hepatis is close to the inferior vena cava, and the three veins of the liver pass through the middle liver lobe. There is too much bleeding at this location. The blood supply is rich and the tissue is complex, which has doubled. Difficulty of surgery.
Which artery or vein needs to be ligated, and which artery or vein leads to other liver lobes, must be distinguished. When the liver is cut open, it is really impossible to distinguish them without decades of liver surgery skills. Surgery is so difficult. Without a teacher to guide you, it would be too difficult. This is why surgery for tumors in the middle lobe of the liver is difficult. Without a large amount of source support, it is impossible to mature. Good teachers are indispensable for many diseases.
Zhang Fan performed the ligation and stopped the bleeding, then released the hemostatic forceps. The color of the left and right liver lobes returned to normal. Both Li Jingjin and Lao Chang found it incredible that they had become so skilled at such a young age. Both of them were experts. When they saw Zhang Fan's technique I just knew that this young man was very powerful.
Time passed little by little, and four hours had passed. The last step of preparations to remove the tumor was to use a hot saline bag to cover the liver wound, and then begin to remove the liver cancer tissue. Liver cancer grows too fast. The cancer cells outside are not yet mature. The liver cancer tissue inside has become necrotic due to lack of nutrition. The normal nutrition of the human body cannot satisfy the growth of cancer cells. There are too many ways for cancer cells to spread due to erosion, infiltration, and planting. Yes, it's really terrifying.
Five centimeters of cancerous tissue was completely removed. The wound tissue is compressed to bleed, and then chemotherapy drugs are injected from the omental vein to kill the cancer cells that enter the blood. Finally, the greater omentum was freed, covered with the liver edge, ligated, and fixed.
The operation was considered a success, because the tissue around the liver cancer was treated very cleanly. When the liver cancer was removed and placed in the tissue tray, Lao Li exclaimed: "Precise liver resection! Amazing! I have learned a lesson!"
When Lao Chang saw that Zhang Fan had completely removed the cancer tissue, there was no major bleeding, and the patient's vital signs were extremely stable, he quietly left the operating room. He was already ashamed of the consultation fees and air tickets! He made up his mind that he would never come to Cha Su Market again! It’s so ridiculous that a little doctor can perform this kind of surgery at random. It’s really ridiculous!
No one cares about Lao Chang's departure. The expert team outside the operation is still on standby. Watching the dejected Lao Chang leave, it's like ignoring him. Retribution comes too quickly!
The operation continued. After Zhang Fan placed the drainage tube, the instrument nurse counted the gauze and instruments and began to close the abdomen. After more than six hours, the operation was over, and Zhang Fan began to give verbal medical instructions, "Fast for three days after the operation, replenish plasma and albumin, and inhale low-flow oxygen."
After listening to Zhang Fan's instructions, the attending general surgeon said, "Roger that!" The patient was sent to the ICU by the anesthesiologist and circulating nurse. A group of nurses from the operating room hurriedly stepped forward to help the three surgeons take off their surgical gowns.
Are you tired? If you are not tired, you are lying. For more than six hours, you have to stand in a fixed position. If you are not tired, you are a robot. As soon as Zhang Fan took off his surgical gown and gloves, his hand was held by Professor Li from Di University, "Director Zhang, this is amazing! Precision liver resection, the technique is so precise, so awesome!"
It is really not easy to get a provincial surgeon to be called director.
"You're so polite! Please give me more advice!" Zhang Fan was very polite. He respected others as much as three feet.
It's not time to rest yet, in the lounge of the operating room. The support expert team and Zhang Fan and Lao Li began to discuss postoperative care. Special care for special diseases must formulate a strict and scientific care plan. Otherwise, if the operation is successful, the patient will become infected and die!
Ouyang personally presided over it, and the directors of each department discussed it together. The plan was quickly approved and distributed to the nursing department, with the chief nurse in charge.
When Ouyang, several surgical directors, Zhang Fan and Professor Li were left, Professor Li said with emotion: "Dean Ouyang, you are really amazing. You have hepatobiliary tumors that are ahead of us. It is gratifying to congratulate you. "
"The development of regional hospitals is not easy. Professor Li will need more support in the future!" Ouyang's face was red! Although Laochang is gone, the operation is now successful! Ouyang thought of Lao Chang's gloomy figure and felt very happy. If it weren't for the wrong occasion, she would really want to laugh three times!
"Dean Ouyang, I have a suggestion, I don't know whether to say it or not!" Old Li looked at the happy Ouyang and said.
She knew who Ouyang was when he opened his mouth and what he wanted to say. She immediately said: "There is nothing that cannot be said. You are a professor and expert in a higher-level hospital. If you have any suggestions for our lower-level hospitals, please feel free to give them." It is really difficult for us to train a mature doctor. It is really difficult to retain talents in remote areas~! I have protested at the municipal party committee meetings several times. The siphon phenomenon in higher-level hospitals puts too much pressure on us. "
What Lao Li wants to say cannot be said! Ouyang's meaning is very clear, and he can make suggestions and comments. I'm sorry if he wants to poach people. Ouyang even moved out of the municipal committee!
"Haha, yes, yes, it is really not easy for frontier hospitals to develop. In fact, it is the same for us. The siphon phenomenon in big cities puts more pressure on us. Many doctors who graduated with doctorates went directly to the south. I have no other meaning. , I just want to ask Director Zhang to go to our hospital to perform a few surgeries and give us lessons. His precision liver resection is so amazing, I can say this, Director Zhang is the best in precision liver resection!"
"You're too polite. How can you say that? He's too young to praise him! Dr. Zhang is still a resident doctor. Going to a provincial hospital to give lectures will make people laugh. We are not self-respecting. So, Professor Li, with this kind of specialness You can bring your patients to our hospital, and we can make progress together. Regional hospitals are too difficult, lacking doctors, and even less typical patients. Provincial hospitals have many patients and high-quality doctors. We can form a supporting hospital, even if we provide assistance If the hospital doesn't work, we can also form a department to help. How about it? As long as there are suitable patients, our hospital will definitely cooperate with us. What equipment is needed? If you tell us that the city hospital doesn't have it, I will apply now!" Ouyang refused. vetoed Professor Li's proposal.
"Are you kidding! You want to poach someone from me!" Ouyang looked at Old Li proudly. Professor Li shook his head with a wry smile and turned to look at Zhang Fan.
"What a pity!" A voice came out in his heart.
"Doctor Zhang or the resident doctor?" He was unwilling to accept it.
"Well, yes, Professor Li. It wasn't long before I obtained my practicing certificate."
"Dean Ouyang suggested this, which I think is very good. But I have an opinion. I can't make the decision on hospital-level assistance, but I can still make the decision on the interaction between departments. The surgery can be done in Chasu City, but the assistant They must all be members of our department. Let's develop together, what do you think, Director Ouyang." Lao Li's plan failed, and he immediately turned around and prepared to train his own doctors.
Even if the doctors in his department were allowed to go to the Mainland for further studies, he would be worried that Roubaozi would never come back, but when he came to Chasu City, he felt relieved!
