An incision was made next to the right side of the rectus abdominis, the abdominal wall was incised, and blunt dissection was performed.
Zheng Ren was extremely proficient at doing this. He only used electricity to burn three unavoidable capillaries. There was almost no bleeding, and then he began to use blunt dissection, protect the peritoneum, and open the abdominal cavity of the experimental subject.
After entering the abdominal cavity, Zheng Ren was stunned.
Once the peritoneum was opened, no lacunae could be seen at all. The huge liver and space occupied completely blocked the surgical field.
The huge space occupied by the second porta hepatis, from the film, it seems that it shouldn’t be so big. However, Zheng Ren was not surprised or hesitant. He started along the mouth and then used an automatic hook to open the muscles and expose the surgical field.
It took nearly ten minutes for Zheng Ren to open the abdominal cavity and expose the surgical field.
The left liver occupied a huge space near the second porta hepatis, accompanied by intracystic necrosis. The right liver had obvious hyperplasia and edema, and the entire liver could no longer see its original shape.
Right liver edema brings great difficulties to autologous liver transplantation.
The surgery is difficult...
But no matter how difficult it was, it had to be done. Zheng Ren gritted his teeth and started the operation alone.
And not only was it a one-person operation, the surgical approach was also wrong.
Zheng Ren soon discovered that although this operation was for hepatic hydatid disease, it would require a right nephrectomy or segmental right kidney resection first.
Because of the infiltration and spread of hydatid, the liver and kidneys have been connected and fixed in one place.
After all, he is not a urology doctor. Although Zheng Ren is good at watching movies, he is not omnipotent.
Zheng Ren now feels that he is not afraid of loneliness or anything else when he performs surgery alone. The hardest part is to move the experimental subject alone and change its position.
Damn big pig hooves, not smart at all, Zheng Ren thought to himself.
There was no other way but to change the patient's position by myself. Then Zheng Ren ordered an intermediate skill book, and his heart ached again.
Although intermediate skills are not usually used, a book is required for surgical training. This is too luxurious.
But there is no way, who makes Big Pig Hotter have to start from scratch
The subject was placed in the left lateral decubitus position with the right side upward, and the right kidney was exposed through the traditional 11th intercostal incision.
Separate the kidneys, separate and control the renal blood vessels, and be careful not to cause massive bleeding. Although he was an experimental subject, Zheng Ren still went all out.
The intermediate skills in the Department of Urology are still a little rough, but Zheng Ren has a good foundation and the level of surgical skills in the General Surgery Department is high. All kinds of blunt separation and clamping are handy.
The improved skills are mainly about understanding the anatomy.
Zheng Ren didn't look at the skill tree. It is estimated that the skill tree of the Department of Urology is also growing like crazy now.
But he has no interest in urology. He just clicks on some skills in passing because he needs surgery.
The operation was a bit rough, but Zheng Ren didn't have much time to polish it. After resection of the renal segment, no active bleeding was detected, and the subject was immediately repositioned after flushing the renal pelvis and renal calyces.
If a urological surgeon performs a segmental nephrectomy, he will definitely be very cautious. But who is Zheng Ren? He is a man who stands on top of the world in interventional surgery.
At Haicheng City No. 1 Hospital, when Da Pig Hoof was first assisting, Zheng Ren performed interventional embolization on a patient with vascular rupture and bleeding about one month after segmental nephrectomy.
Therefore, Zheng Ren underwent segmental nephrectomy without any psychological burden at all.
If that doesn't work, just intervene in embolization. I'm very familiar with it. Moreover, bleeding after segmental nephrectomy cannot be completely avoided.
After all, the kidney is so fragile. This is determined by the nature of the organ itself and has nothing to do with the skill of the surgeon.
Following the original incision step by step, suddenly, a blood vessel at the second porta hepatis was ruptured, and blood spurted out all over Zheng Ren's head and face.
Experimental subject, death.
The blood vessels are so brittle... Zheng Ren felt helpless. After practicing the local anesthesia surgery in Nanchuan Town, and breaking through the shackles between life and death, his general surgery skills had reached more than 98,000 points. He had reached the peak of the master level and was about to break through. , become a master.
I didn’t expect that this would happen when the blood vessels were freed!
If it were a real surgery outside, the patient would probably die at this moment, and I would be frightened half to death.
Zheng Ren shivered, sighed, thanked Big Pig Hoof, and then started the operation again.
The experimental subject was immediately replaced with a complete one, and this time Zheng Ren knew the order of the operation.
After the renal segment resection, the laparotomy was performed again. The bleeding site at the second porta hepatis was removed last time, but this time we were more careful.
Hepatic hydatid is indeed worthy of being called insect cancer and is extremely corrosive. The second porta hepatis and surrounding ligaments and layers of connective tissue are very fragile and thin. Looking at the normal tissue structure, blood was sprayed all over the head accidentally.
Experimental subject, death.
Experimental subject, death.
Experimental subject, death...
Zheng Ren's heart grew colder the more he did it. His level of general surgery was not bad. He had even undergone extreme surgeries for earthquake relief. It could be said that he was very strong.
But this level is still not enough.
At this time, Zheng Ren had completely forgotten the benefits that system tasks had brought to him, and he couldn't even care about his heartache.
I worked hard and tried my best to win this operation.
The so-called benefit, the huge benefit, is nothing compared to a human life.
Finally, during the 19th surgical training, Zheng Ren successfully peeled off the blood vessels and ligaments at the second porta hepatis.
A warm current reverberated throughout my body, this feeling was so familiar.
Zheng Ren had a similar experience. He knew that his general surgical skills had become master-level without even realizing it.
Normally, Zheng Ren would definitely be ecstatic.
Coming from a general surgery background, it is a big deal that this major can be promoted to a master level, surpassing the level of a department director in a large tertiary hospital.
However, in the system operating room, the operation has just begun.
The liver is freed, the gallbladder is removed, the perihepatic ligament and the second porta hepatis are separated, and the suprahepatic-inferior vena cava is freed. The diaphragm is separated and opened, severed above the stenosis of the thoracic and vena cava, the first porta hepatis is freed, and the liver is completely removed. See the invasion and narrowing of the thoracoabdominal transitional segment of the inferior vena cava...
Zheng Ren did not undergo end-to-side anastomosis of portal vein to artificial vascular diversion by vascular surgery. This section is bypassed directly. Even if the completion degree of the operation given by the system is not high enough, it doesn't matter.
He really didn't have time to complete this extremely long operation.
because,
Next,
Going to have a liver transplant.
Autologous liver transplant!
Zheng Ren had only heard of autologous liver transplantation, but had never seen it.
Autologous liver transplantation was first performed by Professor Pichlmayr of the Hannover Organ Transplantation Center in Germany in 1988. The liver was completely removed and removed from the body, and then the lesions were resected and then replanted in situ. Later, Hannoun and Sauva made improvements without cutting off the first porta hepatis, which was called semi-isolated autologous liver transplantation.
The technology of autologous liver transplantation is derived from the technology of allogeneic liver transplantation but is higher than that of allogeneic liver transplantation. It is called the last barrier of liver surgery!
As a doctor with a background in general surgery, Zheng Ren knew this. The last barrier, Zheng Ren has been "coveting" for this.
Now you have to do it yourself. Only when you get started will you realize how difficult it is.