On the second day, in the operating room, Zhang Fan was the chief surgeon, Zhao Quanping was the first assistant, Zhao Jun was the second assistant, and Li Jingjin, a professor of hepatobiliary neoplasms of Di Da, was at the operating room platform. He didn't have much confidence in the eradication of this kind of tumor. Although he was an invited consulting expert, he was not too optimistic about Zhang Fan's ability to do it, but he didn't say anything, let's do it first! Lao Chang also came. Although they are both experts and professors of the same system, he has a bad relationship with Li Jingjin. They are both experts of the same level, and they are from the same region. One point, so it is true that colleagues are enemies.
The two of them didn't feel embarrassed, they stood on both sides of the operating table. Although they didn't communicate much, neither of them was optimistic about Zhang Fan's ability to complete the operation. It's true that such a young doctor can perform such a large operation and such a high-end operation. Kind of kidding.
They are all here for consultation, as long as they don't have surgery, they don't have any responsibility. Anyway, they are not afraid of big troubles just to watch the excitement. The city hospital must insist on doing it, and Lao Li doesn't insist on it either!
At the beginning of the operation, Zhang Fan chose the conventional incision. This kind of operation would rather have a larger opening than a small one. With small incisions, it seems that the damage is small, but in fact, the field of vision is not clear, and the damage to the internal organs is greater. The sharp knife scratched the skin, and the fat layer cracked the skin. The electric knife stopped the bleeding, and the smoke was faint!
Entering the abdomen, Zhang Fan began to detect the size and scope of the tumor, to find out whether the tumor tissue had really invaded the hepatic hilum and large blood vessels. The tumor was really not small, occupying a large space in the middle lobe of the liver. Standing on both sides, Li Jingjin and Lao Chang also saw the size of the tumor, and shook their heads at the same time, it was too big. It may have violated the large blood vessels! One mistake, liver failure can't run away!
Zhang Fan touched lightly with his hand, and the tumor tissue grew rapidly and overbearingly, and the damage to the body and tissues was particularly severe when the gnashing of teeth and claws were opened. The surface was only a thin film, which would rupture if not careful. This patient's tumor has already invaded the large blood vessels, and if it moves a little bit, it may rupture and bleed heavily.
Zhang Fan slowly separated the hepatorenal ligament and severed the triangular ligament. This operation is much more difficult than general liver surgery, too much movement will lead to ulceration and massive bleeding, so every movement should be careful and careful! "Gauze wrapped." Zhang Fan said simply. Zhao Jun immediately wrapped the liver with gauze and supported the liver with his hands. The last ligament, the coronary ligament, was separated and severed. The ligaments that fix the liver are all loose, and the assistant has to bend down to support the liver to ensure that the liver cannot move.
Zhao Jun bowed down. He is now the chief physician, working as an assistant for a resident, doing hospital work. But he has no complaints at all. This is the team, this is the doctor, and this is the characteristic of technical positions. Only technical heroes.
The surgical round knife gently slides through the liver capsule, and slowly enters the liver tissue with a large curved hemostatic forceps at the front edge of the liver to separate, and the forceps enter a little bit. It is very critical at this time, it must be accurate, and you must be very familiar with the anatomy, otherwise a blood vessel will be missed, and it will be difficult to stop the bleeding in this case.
The vena cava and short hepatic veins are ligated one by one to stop bleeding. The liver has a double blood supply system, which is particularly complicated. However, the veins and arteries leading to other lobes of the liver cannot also be ligated, otherwise the other lobes of the liver will die due to ischemia. After confirming that the ligation of the blood vessels was successful, Zhang Fan gently released the hemostat, and the left and right livers, which were already grayish white, returned to blood color, which indicated that the blood vessels in the left and right liver lobes were unobstructed.
The position of the middle lobe of the liver is too dangerous, the portal of the liver is close to the inferior vena cava, and the three veins of the liver pass through the middle lobe of the liver. There is too much bleeding from the wound at this position, the blood supply is rich, the tissue is complicated, and the number has increased exponentially. Difficulty of surgery.
Which artery or vein needs to be ligated, and which artery or vein leads to other liver lobes must be distinguished. After cutting the liver, it is really impossible to distinguish them without decades of experience in liver surgery. Surgery is so difficult, without a teacher, it is really too difficult. This is also the reason why middle lobe tumor surgery is difficult to do. Without the support of a large number of disease sources, it is impossible to mature. A good teacher is indispensable for a large number of disease sources.
Zhang Fan ligated, stopped the bleeding, let go of the hemostatic forceps, and the left and right liver lobes returned to color. Both Li Jingjin and Lao Chang thought it was incredible. They were already proficient at such a young age. Both of them were experts. Looking at Zhang Fan's technique I knew that this young man was very powerful.
Time passed little by little, and four hours had passed, and the preparations for removing the tumor were the last step. After covering the liver wound with a hot saline bag, the liver cancer tissue began to be removed. Liver cancer grows too fast, the cancer cells outside are not yet mature, and the liver cancer tissue inside is necrotic due to lack of nutrition. The normal nutrition of the human body cannot satisfy the growth of cancer cells, erosion, infiltration, planting, and there are too many ways for cancer cells to spread Yes, it's really scary.
Five centimeters of cancerous tissue was completely removed. Compress the wound tissue to bleed, and then inject chemotherapy drugs from the omental vein to kill cancer cells that have entered the blood. Finally, the greater omentum was freed to cover the edge of the liver, ligated and fixed.
The operation was considered a success, because the tissues surrounding the liver cancer were treated very cleanly. When the liver cancer was resected and placed in a tissue tray, Lao Li exclaimed in amazement: "Precise liver resection! It's amazing! I've learned a lesson!"
When Lao Chang saw that Zhang Fan had completely resected the cancer tissue, there was no major bleeding, and the patient's vital signs were particularly stable, he quietly left the operating room. He was ashamed of the consultation fee and the air ticket! He made up his mind that he would never come to Cha Su Market again! It's too nonsense, just jumping out of a small doctor can do this kind of operation, it's really too nonsense!
Lao Chang left, no one cared, the expert team outside the operation was still on standby, watching Lao Chang leave in a dingy state, as if ignoring it, the retribution came too fast!
The operation continued. After Zhang Fan left the drainage tube, the equipment nurse counted the gauze, and after the equipment was completed, he began to close the abdomen. After more than six hours, the operation was over, and Zhang Fan began to give verbal doctor's orders, "Fast for three days after the operation, supplement plasma and albumin, and inhale oxygen at a low flow rate."
After listening to Zhang Fan's doctor's order, the general surgeon said, "Got it!" The patient was sent to the ICU by the anesthetist and the itinerant nurse, and a group of nurses from the operating room hurried forward to help the three surgeons take off their surgical gowns.
Are you tired? Not tired is a fake, more than six hours, fixed posture, not tired is the robot. Zhang Fan, who had just taken off his surgical gown and gloves, was held by Professor Li of Di University, "Director Zhang, amazing! Precise liver resection, the technique is too precise, too powerful!"
It's really not easy for a provincial surgeon to call him a director.
"You are being polite! Please give me more advice!" Zhang Fan was very polite, he respected others ten feet.
It's not time to rest yet, in the lounge of the operating room. The supporting expert team and Zhang Fan and Lao Li began to discuss postoperative care and special care for special diseases. A strict and scientific nursing plan must be formulated, otherwise the operation was successful, and the patient died of infection as a result!
Ouyang personally presided over it, and the directors of each department discussed together. The plan was quickly approved and sent to the Nursing Department, under the charge of the head nurse.
When Ouyang, several surgical directors, Zhang Fan, and Professor Di Dali were left, Professor Li said with emotion: "Dean Ouyang, you are really amazing. Your liver and gallbladder tumors have come ahead of us. Congratulations. "
"The development of regional hospitals is not easy, and we need Professor Li's support in the future!" Ouyang blushed! Although Lao Chang left, the operation is now a success! Ouyang thought of Chang Chang's dingy figure, and felt very happy. If it wasn't for the wrong occasion, she really wanted to laugh three times!
"President Ouyang, I have a suggestion, I don't know if I should say it or not!" Lao Li looked at the happy Ouyang and said.
Who Ouyang is, Lao Li knew as soon as she opened his mouth, what Lao Li wanted to say, immediately said: "There is nothing you can't say, you are a professor and expert in a higher-level hospital, if you have any suggestions for our lower-level hospitals, please don't hesitate to let me know It is really difficult for us to train a mature doctor. The remote area cannot retain talents, and it is really difficult~! I have protested at the municipal committee meeting several times. The siphon phenomenon in the superior hospital puts too much pressure on us. "
What Lao Li wants to say, I can't say it! Ouyang's meaning is very clear, and he can give any suggestions and opinions. If he wants to make a noise, he will be sorry. Ouyang even moved out the municipal party committee!
"Hehe, yes, yes, it is really not easy for frontier hospitals to develop. In fact, we are the same. The siphon phenomenon in big cities puts more pressure on us. Many doctors who graduated with Ph.D.s went directly to the south. I have no other intentions , I just want to ask Director Zhang to go to our hospital for a few operations and give us lessons. His precise liver resection is too good, I can say this, Director Zhang is the first in the frontier for precise liver resection!"
"You're too polite, how could he be so young? Dr. Zhang is still a resident doctor. It would be a joke to give lectures in provincial hospitals. We are not self-preserving. How about Professor Li? You can bring your patients to our hospital, and we will 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 support hospital, even if we help The hospital can't do it, we can also form a department to help, how about it, as long as there are suitable patients, our hospital will definitely cooperate fully, what equipment do you need, if you say, the city hospital doesn't have it, I will apply now!" Ouyang even beat and dismissed They rejected Professor Li's proposal.
"Are you kidding! You want to poach someone from me!" Ouyang looked at Lao Li proudly, Professor Li shook his head with a wry smile, and turned to look at Zhang Fan.
"It's a pity!" A voice came out of his heart.
"Doctor Zhang is still a resident doctor?" He was not reconciled.
"Well, yes, Professor Li. It hasn't been long since I got my practicing certificate."
"Dean Ouyang's suggestion is very good. But I have an opinion. I can't make decisions about the hospital-level support, but I can still make decisions about the interaction between departments. The operation can be done in Chasu City, but the assistant They must all be members of our department. We develop together, what do you think, Dean Ouyang." Old Li's plan failed, so he immediately turned around and prepared to train his own doctors.
He was also worried that the doctors in his own department would go to the mainland for further studies, but he was very relieved when he came to Chasu City!