Write a surgical record when you see something? The endoscope in your old man's hand is shaking like a big pendulum, what can you see!
"Do a good job. Dr. Xia, remove the pus and pus, about 900ml." Zheng Ren said.
"Oh, oh." Xia Hua quickly wrote it down carefully.
"The adhesions are released next, and then it's time to open the inferior pulmonary ligament." Zheng Ren continued.
Uh...have you made it this far
Xia Hua looked hard at the screen, trying to find the shadow of the lower pulmonary ligament.
The position of the operation in front of him looked very similar, but the camera was too close, and there was no overall intuitive image. He could not be sure whether the lower pulmonary ligament was being cut.
Zheng Ren released the inferior pulmonary ligament and opened the mediastinal pleura.
The separating forceps are as flexible as fingers and quickly expose the esophagus to view.
"Move slowly and let Dr. Xia take a look. Otherwise, we won't be able to write down the operation records." Zheng Ren said.
"You can make it up as you like, it's the same process anyway." Su Yundao said.
"Here, Doctor Xia, you see, there is a breach in the esophagus, about 2cm long. The surrounding tissue is relatively fragile and cannot be sutured in the first stage," Zheng Ren said.
Xia Hua looked carefully, and when Su Yun pulled the camera away, he saw a break in the esophagus about 5cm away from the cardia. The surrounding area was pale with a small amount of pus.
Suturing the esophagus is extremely difficult because the elasticity of the esophageal wall is relatively weak, so the suturing is difficult, the tension is high, and the local blood supply is not good enough, so necrosis is easy to occur after the operation.
Xia Hua is still trying to figure out what kind of drainage strip should be left in the breach to draw out the thick juice and exudate and avoid further infection in the chest and mediastinum.
A second-stage surgery was required, which was Xia Hua's first decision.
But the timing of the second-stage surgery is difficult to choose, and the second-stage surgery of the esophagus is different from that of the gastrointestinal tract.
If you have similar problems in your intestines, it can be easily solved by just making an ostomy. It is an abnormal defecation path that the patient is not used to and it will take some time to get used to it.
However, if the esophagus is waiting for the second-stage surgery, the patient will need to take liquid food through nasogastric feeding or intravenous high nutrition to maintain it.
How to ensure nutrition
"Doctor Xia, come and assist Su Yun with the rest of the work." Zheng Ren said.
Xia Hua began to feel worried. At this time, Zheng Ren's voice reached his ears. He was startled for a moment and answered casually.
"Uh... what about you?"
"Hey, have you listened to the condition analysis?" Su Yun was really unhappy this time. If Zheng Ren hadn't stepped down and touched his arm, the hemostatic forceps left behind when the stage started would have been smashed over.
"Are you really going to do an uncertain second-stage surgery?" Su Yun said scornfully, "The covered anti-reflux stent will be used. The patient can eat for 7 days after the operation. The stent will be recovered 14-28 days after the operation according to the situation."
Xia Hua listened quietly, feeling that something must have gone wrong somewhere. Either there is a problem with my understanding, or there is a problem with my cognition.
Anyway…
The problem lies with him, not with Boss Zheng.
Xia Hua could understand the meaning of the coated anti-reflux stent, but he had never seen it before.
You should wear a bag to prevent gastric juice from refluxing, causing the wall of the stent to be eroded and leaked.
But after the stent is removed, it can be recovered 14-28 days after the operation? Can the esophagus grow
"What happens after that?" Xia Hua asked.
"It depends on the situation later. It would be great if the esophagus can grow back. The operation is successful and the patient is discharged. If not, although it is unlikely... How is the power of your endoscopy room?" Su Yun asked.
"..." Xia Hua didn't understand what the new technique was at all.
"They probably haven't had any contact with them." Zheng Ren called Gao Shaojie to help, and then explained: "You have to keep up with post-operative nutrition, and a 2cm esophageal tear should be easy to grow. If it doesn't work, the edges won't be so brittle by then. The problem can be solved using esophagoscope suturing technology.”
Xia Hua was still confused.
"Let's talk about it then. If it doesn't work, let the patient go to the imperial capital to find me, or I will come back again. The chance of this happening is not high, it should be able to grow, don't worry." Zheng Rendao.
"Boss Zheng, this stent is too advanced." Gao Shaojie said while comparing the coated anti-reflux stent.
"Well, it's specially made to prevent gastric juice reflux. It's basically not used at ordinary times. It's not surprising if you haven't seen it before." Zheng Ren smiled.
Because the patient's condition was different from that of Xia Hua's father, the guide wire was inserted directly.
"It's time to step on the line, close the door." Zheng Ren said.
Gao Shaojie noticed that Feng Xuhui did not go out, but stayed in the operating room wearing a lead suit.
This guy has a real future! Gao Shaojie thought to himself that he had to stay in the operating room despite the line and refused to leave Boss Zheng.
He regretted it for the ten thousandth time, but if he had to do it over again, he would never leave his son who was about to take the college entrance examination and Boss Zheng to go to the imperial capital.
This is life!
Gao Shaojie thought about it while quickly preparing to remove the bracket.
After only stepping on the line once, the coated anti-reflux stent was in place. Boss Zheng opened the stent directly without any hesitation.
"The position is just right, perfect!" Su Yun stood at the surgeon's position and touched the esophagus with forceps.
The covered anti-reflux stent has completely blocked the damaged part of the esophagus, with no omissions left, just a few centimeters up and down, and the overall position selection is just like what he said - perfect!
Gao Shaojie was stunned.
The lower esophageal stent may seem simple, but it actually has its merits. The upper and lower positions, the strength of the stent opening, and various details determine the patient's quality of life after surgery.
The position under Boss Zheng's stent is just right. Judging from Gao Shaojie's many years of rich clinical and surgical experience, that is the most ideal position.
Surgery can actually do this! It looked like he had no brains, but Gao Shaojie knew that this was the reflection of countless surgical experiences.
It looks relaxed, but actually Boss Zheng has practiced it countless times.
Gao Shaojie sighed in his heart.
The preoperative diagnosis is clear, the assessment is accurate, the intraoperative movements are clean and quick, and the surgical operation is combined with interventional surgery, turning a patient who originally needed a second-stage operation into a case that can be completed with a high probability of being completed in one stage.
Awesome!
Gao Shaojie sighed in his heart.
With Boss Zheng beating him with hemostatic pliers every day, Lao Liu must have become extremely strong, and Gao Shaojie continued to feel regretful in his heart.
"Lao Gao, I'll get off then." Zheng Ren finished taking off the stand, turned around and stepped off the stage.
"Oh." Gao Shaojie responded quickly.
The lower esophageal stent itself is not a major operation. There is not much to do after the operation, and Gao Shaojie is busy finishing the work.
“Dr.
"Yeah." Xia Hua gradually understood the entire operation process.
Except for the gorgeous but dizzying operation of the sarcastic and sissy assistant next to me, the surgery was perfect!