The patient's liver showed symptoms of nodular cirrhosis, and the overall atrophy was obvious.
Zheng Ren stretched out his hand, and a latex tube fell into his hand.
He used a latex tube to pass through the small omentum and wrap around the hepatoduodenal ligament to prepare for blocking the blood flow to the liver.
Then lift the right liver and place an abdominal towel under the right diaphragm to expose the right liver.
"Can you touch it?" Su Yun asked.
"Yes, the boundary is quite clear." Zheng Ren said.
After saying that, he took his hand away from his liver, and Su Yun stretched out his hand.
By gently touching the right liver with a little force, you can feel a relatively large mass inside the liver.
After Su Yun finished touching, Professor Yang touched his hands.
The touch... is harder than the liver cancer tumor in my impression, not even a little bit harder.
Could it be said that due to interventional embolization, the tumor tissue has changed so much after necrosis? Professor Yang was a little confused.
Normally, the texture of tumor tissue is harder than the surrounding normal tissue, but it should never be this hard.
Use electrosurgery to make an incision on the liver capsule about 2cm away from the tumor, and use No. 7 silk needles to interlock and suture on both sides of the incision.
This operation is prepared for the assistant. It lifts the liver tissue and exposes the field of vision. It relies on the No. 7 lifting thread.
Su Yun and Professor Yang each pulled a thread to expose the liver.
Zheng Ren looked at the surgical area, stretched out his hand, and the ultrasonic scalpel gently patted his hand.
He began to perform blunt dissection with the forceps on the head of the ultrasound scalpel.
Bang bang, the sound of slow condensation kept ringing.
For small blood vessels, slow coagulation with low power will produce a popping sound. For larger blood vessels, a more powerful rapid coagulation device will be used, which will make a snapping sound.
The operation was not fast, but it could not be said to be slow.
In the background music of good luck, the sound of popping continued to sound. To Professor Yang, Zheng Ren's hands seemed to have a strange rhythm.
Small blood vessels and bile ducts are closed and cut with an ultrasonic scalpel. When it comes to tumors larger than 4-5mm, Zheng Ren does not use the high power of the ultrasonic scalpel, but chooses to use titanium clips to clamp and cut them off.
"Boss Zheng, the ultrasonic scalpel can cut blood vessels up to 6mm." Professor Yang reminded.
"There are reports that if blood vessels with a diameter of more than 4mm are cut with an ultrasonic scalpel, there is a 3-5% chance of rupture and bleeding after the operation." Zheng Ren said while performing the operation: "Although the pressure is relatively high after the operation, Even bleeding can be stopped, but it’s not necessary.”
Professor Yang thought for a moment and found that he had never seen similar reports.
But Boss Zheng’s surgery was so clean. The liver had been split open and there wasn’t much blood in the surgical field. I have been holding the suction device in my hand, and the hissing sound indicates that the suction device is ready to go.
However, there was only a few tenths of a milliliter of blood in the tube of the suction device, and there was almost no bleeding during the whole process of liver splitting.
As the second assistant, Su Yun holds a piece of gauze with hemostatic forceps in his hand, and occasionally dips it in blood to expose the surgeon's clear surgical field.
On the white gauze, there were dots of red blood stains, like plum blossoms in the twelfth lunar month.
The amount of bleeding was unbelievable.
A black, hard tumor tissue appeared in the surgical field.
"It looks a bit different from normal liver tumors." Su Yun whispered after seeing it.
"The difference is huge. You will know it when you drift away for a while." Zheng Ren said.
"Boss Zheng, is it because the blood supply artery is embolized?" Professor Yang asked.
"There are reasons for this, but the main reason is that the tumor tissue is necrotic and is very different from normal tissue. The surgery is more accurate and simpler." Zheng Ren said while looking at the surgical area.
This is a live broadcast of the surgery. Zheng Ren learned from the experience and lessons learned from the previous surgery and Xie Yi's flirting. He did not raise his head at all, and his field of vision was always focused on the liver tumor in the surgical area.
Start dissociating the tumor.
Zheng Ren used an ultrasonic scalpel and titanium clips to place on the upper half of the tumor. The free tissue was about 0.7cm away from the tumor tissue.
Soon, Professor Yang discovered something different.
Just like Zheng Ren said, the operation seemed to be much simpler than he expected, and there was less bleeding.
Normally, hepatobiliary surgery also uses ultrasonic scalpel. Even helium knives, a high-value consumable like a welding gun, are occasionally used when the bleeding doesn't stop.
Surgery, it's the same surgery.
But under Boss Zheng's hands, it seemed that everything suddenly became extremely simple.
The forceps on the head of the ultrasonic scalpel were constantly performing blunt separation, and the popping sound was constant, and the operation was going smoothly.
Bleeding
Professor Yang glanced at the suction device in his hand and the gauze in Su Yun's hand.
To say no is nonsense.
But there are bits and pieces of bleeding... How should I write the surgical record? Bleeding 3ml
MD! If you write it like this, it won't be considered a false medical record.
"Director Zhou, what the boss is about to cut off is the feeding blood vessel from the phrenic artery." Su Yun said suddenly.
Since Zhou Chunyong went to the operating table, he has said nothing and observed carefully.
This was the first time he saw with his own eyes the anatomy of liver cancer after interventional embolization.
Is the phrenic artery branching
Zhou Chunyong still remembers that when he was undergoing interventional embolization surgery, he could not find this artery on the preoperative film.
Boss Zheng himself did not witness the super selection and embolization process.
But... where is it
Bang bang, the sound sounded, and Zheng Ren continued to swim downstream. Zhou Chunyong looked a little confused and asked in a low voice: "Doctor Su, where is he?"
"That's what was cut off by the ultrasound knife just now." Su Yun said, "Didn't you see it?"
"Oh, that's it." Zhou Chunyong said nonchalantly, pretending to have seen it.
He felt ashamed.
I am not a surgeon. I only learned the anatomy from images and books.
If he really had to disembowel it and see the actual situation with his own eyes, he would be dumbfounded.
You can see the thread! Apart from the fact that there was no bleeding and the operation was clean, there was nothing good that could come of it.
But Zhou Chunyong knows that if the operation is clean, it is good!
Before the operation, Professor Yang from 912 Hepatobiliary Surgery said he needed to prepare blood, but now it seems that it is completely unnecessary.
"Director Zhou, for ordinary liver splitting surgery, even if I perform it, the bleeding should be about 100ml by now." Zheng Ren said: "The bleeding is small because the feeding blood vessels of the tumor are embolized."
After hearing Zheng Ren's prompt, Zhou Chunyong felt an indescribable emotion in his heart.
I have been doing my job for twenty years. This is the first time I have seen it with my own eyes, and I have to ask Boss Zheng to tell me what the effect is.
This...sigh.
Professor Yang felt even worse when he heard Zheng Ren's words.
There is no common liver splitting surgery combined with liver interventional embolization surgery before the operation. If it were done by myself, the bleeding would have to be at least 500ml at the current level.
Well, these are all extraordinary performances.
As a precaution, blood transfusions were started at this time.
But according to Boss Zheng, if he did it, the bleeding would only be 100ml
It shouldn't be possible. He was bragging on the operating table and couldn't be taken seriously. Professor Yang comforted himself in his heart.