Circuit surgery is different from conventional flying knife surgery. For flying knife surgery, if the expert has a better personality, he will also explain it to the local doctor on the operating table. If the doctor is more arrogant, he will not say a word, and even the local doctor will not even let him tie a knot, and he will do it himself. We take care of the whole process, and the local doctor is also a human-shaped retractor.
There was nothing he could do about it. After all, he had spent half his life on his reputation to make money, not to promote technology.
However, it is necessary to explain the circuit surgery in detail, and even find a way to make it clear to the doctors involved in the operation. Just like watching a movie, there must be no mosaic. Although many big guys can do it without coding, what exactly is this thing? Whether it is natural or man-made, mosaics still won’t work.
Therefore, at the beginning of the operation, Zhang Fan had to explain that Zhang Fan was a little uncomfortable with this kind of surgery.
Because Zhang Fan was known as a surgical mute at Chasu Hospital, he had surgery and could barely speak.
This makes sense, but everyone doesn't follow it strictly. There is a rule in the surgical rules and regulations that clearly stipulates that you should try not to talk during the surgery, because talking will cause droplets, and if there are droplets, there is a possibility of infection. sex.
A man and a woman are arguing face to face. In fact, it is not unreasonable to describe them as kissing from a molecular level.
If you need to speak in the operating room, you must speak quietly, but in reality, doctors and nurses drive very fast.
Back then, at Chasu Hospital, a patient went to the Discipline Inspection Commission to file a complaint against the hospital because the surgeon was chatting with a nurse after he was discharged. Because at that time, while the patient was half anesthetized and half awake, he heard this sentence, "You must have never seen such a big person." .”
The nurse didn't know whether it was true or false, so she immediately retorted, "Yes, I haven't seen it before. Anyway, yours is smaller than his."
This is true. You can imagine how fast this car is.
"Zhang Yuan, the preparations for the operation are complete." The anesthesiologist said to Zhang Fan gently. The anesthesiologist was brought by Old Man Wu and had worked with Zhang Fan before.
As soon as Zhang Fan heard this, he stood up, nodded to the camera, and then nodded to Old Man Wu.
He knew that his old man was staring at the screen right now. He was probably more nervous than he was. And the uncle, at such an old age, still went into the operating room to help Zhang Fan stand up regardless of the trouble.
Zhang Fan couldn't say thank you, he could only feel grateful from the bottom of his heart.
"Conventional midline incision cannot be saved. Make it as large as possible. Although the damage will be a little bigger, it is more cost-effective than the secondary extension after an accident."
Zhang Fan took the scalpel and used the back of the scalpel to make a simulated incision on the patient's stomach as he demonstrated. This method is used in many surgeries, but other doctors do not demonstrate but preview.
Before many doctors perform skin incision, they will perform a drill with the handle or back of the knife. Make white marks on the skin.
The gallbladder is hidden at the edge of the liver. How to describe this thing? In fact, it is like a lady wearing a dress. When the wind blows, the hem of the dress flutters violently. It flickers and disappears, which can make many fat men excitedly say, White, black, Mickey Mouse!
The gallbladder is actually the same, appearing and disappearing. When most people enter the hospital, the doctor will ask the patient to lie down with his legs together and retract them. Then the doctor's hands will be clasped on the edge of the ribs, and he will ask the patient to inhale while breathing. Ask the patient to exhale and touch the palms up and down deeply and shallowly with the breathing.
This is just like the wind. With this operation, you can feel whether it is white or black.
Before entering the abdomen, there is nothing special. It is a routine operation. Not to mention Zhang Fan, at Shanhua Hospital, any general surgeon can make it clear to you.
When it entered the abdominal cavity and held up the liver, the cancerous gallbladder appeared.
A normal gallbladder is like a crystal clear purple grape hidden under the grapevine in the morning, stained with dew. As the body squirms, the crystal clear bile flows slowly inside the grapes. Under the illumination of the fluorescent lamp, it really feels like sucking with all your heart.
To be honest, the organs of the body are quite beautiful when normal. They are definitely cuter than the organs on the surface of the body. The pink intestines, the fresh liver with a sense of nobility, the white and smooth bladder, and even the The lungs are like pink and white jade.
But this patient’s gallbladder is not so cute. To choose a word to describe it, it is like a male toad meeting a female toad. The scarred bumps all over his body become bigger and more bloated as they become filled with blood. , the yellowish viscous viscous liquid occasionally secreted can make you vomit out the half-boiled fried eggs you ate in the morning.
The originally water-drop-shaped purple gallbladder now looked like a toad huddled together, and because of the enlargement, the gallbladder had a slightly unpleasant smell.
"It's late! It's late when we open the door. It's not easy for Zhang Yuan to get through this one."
In the observation room, many doctors came and whispered. Everyone originally thought that Shanhua would find a patient with early-stage cancer for the first round surgery, but they didn't expect that the patient would be in the late stage.
In fact, the director of general surgery at Shanhua had talked with Zhang Fan at the beginning, and he meant that for the first surgery, it was best to choose patients in the early stages, as the surgery would be less difficult.
But Zhang Fan refused. Sometimes, the doctor's profession is very strange.
Gu Shao
Some doctors have a good reputation. Hua Tuo is no match for him in this world, but they also follow the saying that Zhuge is always cautious! Whether this habit is good or not is hard to say in the medical field.
This kind of caution will greatly reduce medical accidents, but the disadvantages are also obvious. Such doctors will hardly take risks in treatment.
Mr. Wu is famous for how many things he has done, such as the Asian Liver Atlas and the Asian liver surgery. In fact, these are not as good as the risk he took to perform a huge tumor resection on a young child. The old man's surgery is currently the youngest patient in the world and the largest cancer tumor.
From an academic perspective, this resection is not as important as the above, and it also feels like a violation of the law to perform surgery regardless of surgical contraindications. But, can we say that the old man was wrong?
Therefore, the medical profession really cannot simply define a doctor by being good or bad.
Zhang Fan is not as sentimental as Old Man Wu, and has not yet reached that level of cultivation, but Zhang Fan is confident in his surgical skills.
Since he was so insistent, the director of general surgery at Shanhua also wanted to see the level of this future leader.
Therefore, the first surgery was on a very serious patient.
"You must want to destroy the surrounding blood vessels and nerves involved here. This is the difficulty. Please pay attention."
Zhang Fan said softly, but the sound made the eyes of a group of doctors in the observation room almost bulge.
The difficulty of this kind of surgery is not to remove the gallbladder. The difficulty of removing the gallbladder is actually not much different from that of removing gallstones. The real difficulty is to clean the nerves and blood vessels around the gallbladder.
Many cancer surgeries are very difficult. The difficulty is not the removal of the disease focus. Removing a disease focus is actually the same as removing a piece of rotten flesh. It is not difficult.
The difficulty is dissection. In many cancer surgeries, the scope of dissection extends to seven, eight or even ten lymph nodes above and below the surrounding area. How do you put this thing? To put it simply, for example, if you perform surgery on the belly button, some operations require lymphatic dissection under the armpit.
With such a big distance, it can be said that if one of them is accidentally missed, the result will be wasted. And the scale of damage along the way is unimaginable.
It is equivalent to destroying a person's defense organization.
Surgery for gallbladder cancer is even more troublesome. Look at the pancreas, liver, and colon next to it. These are all things that are not easy to mess with.
"Gauze wrap!"
The director of the nursing department quickly handed Zhang Fan a piece of gauze soaked in saline.
Zhang Fan began to wrap the gallbladder. The moist white gauze was gently wrapped and knotted around the gallbladder. The gallbladder, which was instantly disgusting, was wrapped in the gauze.
Zhang Fan started cleaning.
Blood vessels, terminal vessel resection, descending nerve resection, lymphadenectomy.
Lymph like sesame seeds hangs near the hepatic portal vein, hanging on the thigh of the elder brother like a arrogant little brother, constantly shouting, don't come here, come here, my elder brother is not easy to mess with.
There are layers of sesame seed-like lymph lying around the thick hepatic portal vein, and as the hepatic portal vein fluctuates, the lymph also rises and falls.
The knife was replaced with a new sharp knife. Scalpels are very particular. For example, a scalpel for skin incision will usually be replaced with a new one after entering the abdominal cavity. It is not a waste for the doctor, because at this time, the blade must be kept sharp.
Zhang Fan held the handle of the knife and began to clean. Swish, swish, swish, swipe, swish, swish, the blade of the blade along the portal system, just like peeling a carrot. I don’t know whether Zhang Fan was nervous or not. Zhao Jingjin and Shanhua’s director of general surgery, even I didn't dare to breathe loudly.
At this time, if you are not careful and the blade penetrates just a millimeter or two millimeters, the cleaning will turn into a big gush of blood.
Outside the operating room, a group of people kept shaking their heads as they watched, "This can't be done. This request is too difficult. It can't be done! The blade of his knife is along the outer membrane of the blood vessel. This..."
Just when everyone thought this guy was here to show off his skills, Zhang Fan started to speak, "The blade of the blade is close to the outer membrane. You must feel the resistance of the outer membrane to the blade. Along this layer of resistance, the blade is slightly tilted ten degrees. , don’t be careless about the strength of adduction and downward movement, you must always feel the resistance of the outer membrane.”
"Here I go, if you can still talk after doing this kind of thing, is this still a human being?" A senior deputy director said fiercely. Old Man Lu smiled slightly outside the operation and said: "This is an improvement of Qiu style knife technique. You see, Zhang Fan's knife tip is not slanted outward. He does not use the force of pushing down, but relies on joint tearing. of!"
Zhang Fan explained to the director of Shanhua bit by bit the difficulties of the operation and how he performed the operation. It could be said that he broke it into pieces and explained it to the director of Shanhua.
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