Resection of benign liver tumors is not difficult. Compared with malignant tumors, this kind of surgery is like one in the sky and the other in the earth. And benign tumors look down on normal cells.
It is self-contained and wrapped in a layer of clothing on the outside. To put it simply, a hole is made with a fist in the normal tissue of the liver, and then a plastic film is placed, and benign tumors are spread out inside the plastic film.
The operation is very simple. First, the surrounding blood vessels are ligated, and then the skin is peeled off bit by bit until it is clean. Then the wound is stopped bleeding, the abdomen is closed, and it's over.
Of course, speaking of it, everything is very simple. But that's not the case when it comes to doing it.
A doctor, the most ordinary doctor, has five years of undergraduate studies, three years of rotation, one year of retractors, and one year of simple surgery without consumables such as appendix and hernia.
If the doctor is skilled enough and can also be a good person, then at this time, the teaching doctor will start to let go a little and let the doctor perform peripheral liver surgery, which is a simple gallstone and gallbladder removal surgery. Note that these are all laparotomy surgeries.
Once you are familiar with your skills, you can start doing laparoscopy. Continue the above round and do another round. First, you learn to make a hole, then learn to use laparoscopy to do the appendix, and then do the gallbladder.
Some people here may ask, if laparotomy can cause serious damage and laparoscopy is advanced, why should we learn to do laparotomy? In fact, the reason is very simple. Take the appendix for example. Not all appendicitis can be treated laparoscopically, but all appendicitis can be treated open. That’s the reason.
Doctors who cannot perform laparoscopy are not qualified to perform laparoscopy. Waiting for this general surgery doctor to become bald and old.
When the green young man turned into a greasy uncle, and when the director was about to enter the countdown to retirement, he slowly started to come into contact with the liver.
Zhang Fan had a system, but he didn't. He wanted to have liver surgery at a young age, so he just had to endure it. There was no such thing as a matter of life and death.
Sometimes, if you think about it, doctors want to reach the top of the world in their profession.
In fact, it is just like cultivating immortals. If you want to get ahead in this industry, the excellence of your background (school), the reputation of your teacher (mentor), your own talent and hard work, and the size of your gang (hospital) are all indispensable. .
Zhang Fan is really lucky. Not only did he have the system, he came to a small place after graduation, had the opportunity to practice, and met a good leader and teacher. He was really lucky.
Benign tumors of the liver can actually be treated in municipal hospitals, let alone provincial hospitals. However, Zhang Fan has to pay for the surgery himself.
When Zhang Fan entered the operating room, the patient was lying on the operating bed quietly with his upper body naked and a urinary catheter inserted underneath. Zhang Fan has never seen anyone, whether rich or ordinary, lying on the operating bed who is not afraid.
The patient had not yet been anesthetized. When he saw Zhang Fan entering the operating room, the patient forced a smile on his face and did not speak. He was about to speak when the anesthesiologist administered the drug and the patient was instantly numb. Sticking out tongue and rolling eyes.
After the patient was arranged by the anesthetist, disinfected and surgical drapes were laid out, Zhang Fan washed his hands. After entering the operating room, the nurse quickly put Zhang Fan into surgical gown with a smile.
As the nurse tied the clothes behind Zhang Fan, Zhang Fan stood beside the instrument nurse's operating cart and put on gloves. And my mind is full of various examinations of the patient.
Imaging examination results, such as CT, MRI, and PET, indicate that the liver tumor is benign, and even laboratory tumor markers indicate that the patient's tumor is benign. However, the results of these examinations can only be used as a reference and cannot be used as a diagnosis.
What is the gold standard for tumor diagnosis? It is to cut it out and do pathology. Before there was pathology, the patient's diagnosis was always a question mark, that is, an uncertain diagnosis.
Therefore, during surgery, it is necessary to leave operating space for the condition to worsen according to the standards of disgusting tumors. In surgery, there is a very classic saying: God is not willing to correct a wrong incision.
When the knife is cut, there is no way out, no way for the doctor to regret it. Therefore, when a doctor lifts the knife, he must have a clear mind. This brain is created after years of experience from easy to difficult, and practice from childhood to adulthood.
The patient is ready. The surgical position is head-high and feet-down. Intravenous catheters have been implanted in both arms. Antibiotics are input on one side and energy is input on the other side. These two channels are actually used to prepare for any symptoms that may occur during the operation. Reserved in case of unexpected need for blood transfusion.
As for the incision, Zhang Fan chose a subcostal incision. Many doctors prefer a midline incision, which is an incision from the xiphoid process to the navel. There are many benefits, because the incision is in the middle, and the surgical plan can be adjusted at any time according to the condition. There are many shortcomings, the biggest one being excessive damage.
Surgery for benign liver tumors was too simple for Zhang Fan. Most of the famous instruments in the operating room were matte, and the only thing that could reflect light was the blade of the scalpel.
When the cold light from the tip of the knife reflected, Zhang Fan started. The skin was like tofu, and Zhang Fan gently drew a big arc.
Separate the muscles, cut open the peritoneum, and bend the forceps with a sound! Click! With a clicking sound, Zhang Fan opened a big hole in his abdomen, and his liver was exposed in front of the doctors.
The liver, the liver with benign tumors, is very strange. A normal liver is like an irregularly shaped piece of blood tofu, flat and tender.
The wine business owner's liver is different. His liver with benign tumors has a completely different painting style. It looks like the liver has grown muscles, like a piece of meat dug out of a Belgian ox.
Although it is not as uncomfortable as a malignant tumor, it is not as cute as a normal liver.
A normal liver is like a little shota, giving people a feeling of affection or closeness.
And a liver with benign tumors is like Dwayne Johnson. As he looked at it, he wished he could take a needle to release the energy from his body.
"It looks like it's benign." Zhang Fan looked at the raised fleshy bumps on the surface of the liver and said to the two directors who performed the surgery. Without waiting for their reply, Zhang Fan began to insert his hands into the patient's body to see. It's probing.
This is a necessary step in tumor surgery. Regardless of whether it is benign or malignant, the surgeon must use his own hands to make a definite diagnosis of the organs surrounding the patient's liver.
This action was like shuffling the cards with both hands after a game of mahjong. Zhang Fan touched the organs around the liver with both hands and found nothing abnormal.
Then, he said to the circulating nurse: "Electrosurgical knife!"
"Electric knife?"
The circulating nurse looked at Zhang Fan uncertainly, and then at the two directors of hepatobiliary surgery. The girl accompanied the doctors at the Hepatobiliary Surgery Department during many surgeries on benign tumors. None of them used electrosurgery and they were all separated with bare hands.
Before Zhang Fan figured it out, he would have done this kind of surgery with his bare hands. But since Zhang Fan figured it out, it can be said that there are no tricks anymore. How to do it with little damage, how to do it, how to do it fast, how to do it. .
"Give it to Zhang Yuan!" The director of the fifth department of hepatobiliary and biliary tract was impatient and looked at the nurse who was a little hesitant, so he said anxiously.
"Haha, it's okay, give it to me." Zhang Fan smiled. The little nurse was helpless and handed the electric knife to Zhang Fan.
Then, only a faint smoke was seen rising, the electric knife was flying in Zhang Fan's hand, and not a trace of blood could be seen in the liver tumor.
"Beautiful!" the director of the Department of Hepatobiliary Surgery couldn't help but say.
A smooth road to medicine
A smooth road to medicine
