At the end of the preoperative case analysis, the field of vision changed, and the surgery broadcast began 10 minutes later.
"Was the surgery done by Boss Zheng?" Lei Yinghua asked.
"Yes."
"What tactic are you going to use?"
"..." Peng Jia was stunned.
Tactics … I don't know. It had been less than three hours since they received the news, and the Imperial Capital was so busy that they had no time to deal with him.
Lei Yinghua didn't say anything and just shook her head slightly.
It seemed that this was the problem with Xinglin Garden. The surgeon did not even know what surgical method to use.
This was definitely not what a professional medical website should look like.
But was the surgery an emergency surgery?
It was impossible. If it was really an emergency surgery, the powerpoint would not be so beautiful that he could not find any mistakes.
It was better to watch the surgery. Based on the surgeon's habits, it was very likely that he would use the surgical method.
As she was thinking, Lei Yinghua noticed that something was wrong with the scene.
This is... an endoscope? ESD technology?!
It really was ESD technology!
ESD technique was also known as endoscopic mucosal dissection. It was a minimally invasive technique in which the diseased mucosa was completely removed from the submucosa under the endoscope.
It was first used in clinical practice in Japan at the end of the 1990s. The main purpose of this surgical method was to diagnose and treat early-stage digestive tract tumors. It had the advantage of removing a certain area of superficial lesions at one time.
However, the technical requirements were high and the difficulty was high.
Lei Yinghua repeatedly summarized her experience and finally determined that ESD technology was the best treatment for MW syndrome.
However, there were also problems — there were so many polyps in the patient's colorectum, and some of them were very large. During the stripping process, a careless mistake could cause intestinal perforation.
Lei Yinghua had also seen the patient's radiographic films during the preoperative case discussion.
There were at least dozens of large polyps.
Do I have to remove all these polyps at once? It should be done in two or three times.
If he were to perform the surgery himself, he would choose this method.
The patient's injury was minimal, so there was not much risk. As for being slower, that was not a big deal.
However, if it was a live broadcast of the surgery, it would not be good to do half of it and leave half of it.
In the visual field, the surgeon looked directly at the screen of the colonoscope. The colonoscope had already been inserted and was being operated.
Lei Yinghua held her breath and watched carefully.
The first polyp was 6 cm from the rectum to the anus. The diameter was about one centimeter, and the surface was not smooth.
An experienced doctor could tell at a glance that there was a high probability that this polyp was in the precancerous stage. In other words, it had not turned into a malignant tumor, but if it was not removed, there would be a fundamental change in a few months.
The spray tube sprayed out a dye, which seemed to be a 0.5% methylene blue solution. Lei Yinghua didn't like to use methylene blue. She usually used 0.4% indigo carmine.
However, this was decided based on personal preferences. No one was right or wrong.
The methylene blue was sprayed evenly. The surgeon's assistant was especially good. Lei Yinghua was a little envious.
It looked like a small operation, but as a surgeon, this was the first difficulty.
The purpose of spraying the dye was to clearly display the size and extent of the lesion.
Uneven spraying would increase the difficulty of the surgery imperceptibly.
The surgeon's team was very strong, and the assistant's operation was almost perfect. Lei Yinghua was able to form her own judgment from the first small detail.
Before the sprayed methylene blue could completely fall, the surgeon began to inject it submucosal.
Without repeating it a few times, the surgeon injected once, and the part of the polyp to be separated bulged so that there was enough field of vision to separate the submucosal layer and the muscularis propria.
There were hemostatic ingredients in the injection, which could ensure that some small capillaries would not rupture and would not bleed too much.
After the submucosal injection was completed, the electrocoagulation mark was made. The endoscopic scalpel began to cut 5mm away from the edge of the lesion.
This was too fast. What was the use of the surgeon's hand speed? Lei Yinghua was a little disdainful.
It was just for the sake of the surgery being done quickly. This was just sensationalism.
Endoscopic surgery was initially performed by doctors in the endoscopy room and gastroenterology department.
Because they were not surgeons, the process of exploration was very long.
After all, they could not come into contact with the anatomy of the intestine, and there were some subtle details that were difficult to deal with.
And surgeons were still used to operating to solve problems at the beginning, including now.
However, under the general trend of minimally invasive surgery, surgeons gradually began to perform ESD surgery.
Lei Yinghua was one of them, and he was one of the best. He had a deep understanding of ESD surgery and even had his own unique views.
The surgeon was a young challenger, but it was useless to do the surgery quickly.
Endoscopic surgery was most afraid of bleeding. Once there was a blood vessel rupture and bleeding, it would take an extremely long time to deal with it.
The patient's damage was also extremely huge.
This was something that young people did not understand. Lei Yinghua watched calmly.
Sure enough, according to Chief Lei's idea, the speed of the surgery suddenly slowed down after the incision. Not only did it slow down, but his technique was also a little clumsy.
Lei Yinghua smiled. The surgeon was still inexperienced and did not do as much as she did.
The mucosal layer of the colorectum was relatively thin. The electrocoagulation power could not be particularly high to avoid damaging the muscular layer. The surgeon's choice was correct. His electrocoagulation power was just right. Lei Yinghua was not surprised.
If he could not grasp this little detail, would he dare to do a live broadcast of the surgery? That would be a joke.
After the submucosal was lifted to an ideal position, the endoscopic scalpel was used to cut the mucosal at the outer edge of the marked point.
Lei Yinghua held her breath. Successfully cutting the surrounding mucosal was the key to the success of ESD treatment.
The endoscopic scalpel smoothly cut the mucosal around the polyp. Through the pre-incision, it entered the submucosal layer and then made a circular incision along the outside of the methylene blue mark.
The technique was very skilled, not like a newbie who had just explored ESD surgery.
This sense of familiarity was completely different from his previous judgment of the surgeon. What was going on? Could it be that there were more ineffective operations in order to show off his skills?
Yes, it was possible. Young people always had the heart to show off.
However, looking at the surgical process, Lei Yingjie even had an illusion that the surgeon had performed at least a thousand or eight hundred ESD surgeries to have this kind of skilled feeling.
Had anyone in the country performed so many ESD surgeries?
No. Lei Yingjie did not need to recall this to be sure. Because after thinking about it, he could not do it himself.
After the incision, the separator was sent in.
Blunt dissection. This was the most important node.
Many endoscopic doctors and gastroenterologists could not do this well, while general surgeons were much better.
After all, surgeons had cut and dissociated the intestine many times. Surgeons were very familiar with the intestine.
The speed of the separator was not fast, but it was not slow either. Layer by layer, like a butcher dissecting an ox. The anatomical structure of each layer was very clear. Some small blood vessels were avoided, and the bleeding was stopped at any time with electric cauterization and electrocoagulation.
After 1/22 ″, a polyp was cut off.
This speed … Lei Yinghua nodded slightly. The surgeon dared to do a live broadcast of the surgery, so he still had the skill.
The entire process of the outermost rectal polyp using endoscopy was like a textbook.
Although there was no textbook for ESD surgery until now, in Lei Yinghua's imagination, the operation she had just seen was perfect. If she had to find fault, she could only say that the later speed was a little slow and there were some ineffective operations.
Young people, in order to show off their skills, they had those operations out of thin air. At his age, he could not do it.
"Chief Lei, what do you think of Boss Zheng's surgery?" Peng Jia asked nervously.
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