How much do you think you will need? "
"There's no need for a blood transfusion," Zheng Ren said confidently.
"…" Professor Yang was slightly taken aback.
Generally, a whole section of the liver might not need blood transfusion. After all, the anatomical structure was clearer.
But this time, the liver was split, and the tumor tissue was removed from the inside.
Tumor tissue! It was surrounded by abnormally proliferating blood vessels. If only the tumor was removed and the liver was preserved, it would inevitably cause a lot of bleeding during the surgery.
Therefore, many doctors in provincial and municipal hospitals were still used to removing the left or right lobes of the liver.
Performing the surgery this way was relatively simple. Of course, relatively speaking, the trauma to the patient was also greater.
Severing the liver without blood transfusion? Wasn't that nonsense? Professor Yang scoffed at this.
However, he did not say it. He was just a little pessimistic about the results of the live broadcast of the surgery.
Boss Zheng's surgery was going smoothly and he was starting to get carried away.
"Boss, the effect of the embolization is not bad," Su Yun said as he looked at the radiographic films.
"Yes, as expected," Zheng Ren replied calmly.
"What should I do?"
"Split the liver. Use an ultrasonic knife to separate and cut it off." Zheng Ren's answer was very simple and relaxed.
"Boss, can you not be so lucky the next time you perform surgery?" Su Yun glanced at the radiographic films and knew what to do. He began to complain about the background music.
Zheng Ren did not say anything. He rested his cheek on his right hand and looked at the radiographic films seriously.
The radiographic films looked very simple. A shiny silver irregular sphere could be seen at the posterior end of the right liver, with spots in the middle.
That was the imaging manifestation of liver cancer tissue necrosis caused by lipiodol deposition after the interventional surgery.
However, for such a large liver cancer, it would take at least three to five rounds of interventional embolization for the liver cancer.
Zheng Ren seized the preoperative time to perform a 64-slice CT scan with 3D-image reconstruction in his mind, pondering the surgical approach and simulating the surgery process once again.
Su Yun saw that Zheng Ren had turned into a block of wood and looked at him in disdain. He turned around and said to Lao He, "Next time, do you dare to change the background music?"
"Doctor Su, I really don't dare," Lao He said with a smile.
Su Yun was helpless. Seeing that Lao He was done with his work, he and Professor Yang positioned the patient and went to wash their hands.
He washed his hands, disinfected them, and came to the equipment table.
Xie Yiren had already put on her clothes and finished checking the equipment. She handed the curved plate and oval forceps to Su Yun, then grabbed a handful of sterile gauze and placed it in the curved plate.
"Yiren, the next time Zheng Ren has an appendectomy or something like that, if he doesn't call you, you'll fall out with him," Su Yun urged.
Xie Yiren narrowed her eyes and smiled.
Her eyes were like crescent moons, faintly flickering with bright light.
"What? An endoscopic appendix? "Lao He and Professor Yang were stunned when they heard Su Yun's words.
"Yeah." Su Yun took the oval forceps and picked up the iodophor gauze. He began to disinfect it as he said, "An intracavitary appendix, or an ectopic appendix, 12 cm above the ileocecal region. He only cared about doing this kind of surgery himself. Old He, do you think this is something a human would do? "
Professor Yang agreed with Su Yun's words.
The endoscopic appendix was known as the Bermuda of general surgeons.
He was lucky that he did not encounter this even once when he performed an appendectomy. Who would have thought that his stomach and intestines would meet in just a few days?
"How did you find it?" Professor Yang asked in surprise.
"I heard it was through a colonoscope."
"Tsk tsk."
"Boss, it's almost done. Go wash your hands," Su Yun said.
"Okay." Zheng Ren finally switched out of his wooden state and went to wash his hands.
"Brother Yang, are you nervous?" Su Yun began to spread the sterile sheet and asked.
"A little."
"Just get used to it." Su Yun smiled and said, "Is the ultrasonic knife from Johnson & Johnson?"
"Yes."
"Changfeng doesn't produce ultrasonic knives either. It's still a small company." Su Yun sighed.
During the surgery, he could not see Feng Xuhui and his two big boxes. He always felt that something was missing.
Professor Yang began to put on his clothes and smiled. "I prepared two ultrasonic knives."
"That's too wasteful," Su Yun said.
"Isn't it because I'm afraid of bleeding?" Professor Yang said, "Splitting the liver, a tumor of about 8 cm. I estimate that there will be about 1,000 ml of blood."
Professor Yang put on his clothes and stood in the first assistant's position. He began to fiddle with the ultrasonic knife, electric burn, and other equipment.
"You still say you're not nervous? These two ultrasonic knives are for places that the boss didn't notice. You can check and fill in the gaps here," Su Yun said with a smile.
Professor Yang's thoughts were exposed, but he did not say anything. He just smiled.
Wasn't it normal to prepare more things for the surgery to prevent accidents from happening?
Zheng Ren came in after washing his hands. He put on sterile gloves and surgical gown. He looked at Little Yiren and smiled.
When she came to the surgeon's position, Hu Yanhui put on the live broadcast glasses, connected the signal, and made a start gesture.
The surgery officially began.
Take the right upper abdomen and make an incision under the right costal margin. From the left side of the xiphoid process to the edge of the 12th costal margin, the skin, subcutaneous, and muscles were cut layer by layer.
Professor Yang was a little nervous and his hands were a little stiff.
However, it was just opening the abdomen. It did not affect anything. Zheng Ren did not seem to notice.
"Circulating nurse, go and get the blood," Professor Yang said while Zheng Ren was dealing with the subcutaneous capillaries.
"Okay, Professor Yang." The circulating nurse asked, "How much do you want?"
"Take 10 units of red blood cells first."
"Wait and see. There's no need," Zheng Ren did not even raise his head. He looked at the surgical field seriously and said.
The circulating nurse was at a loss.
Who should he listen to?
Normally, he should listen to the surgeon, but Professor Yang had another way of saying it.
He hated this kind of situation the most. No matter what he did, he would offend people.
"Boss Zheng, are you really confident?" Professor Yang did not expect the dispute to appear at the very beginning.
Recalling what Chief Li had said to him, he decided that he had to steadily grasp the rhythm of the surgery. Everything Boss Zheng did seemed to be too rash.
"It's okay. I'll give it a try."
"Boss Zheng, prepare some blood first. What if we need it?" Professor Yang insisted.
"Okay, take a few units and prepare them." Unexpectedly, Zheng Ren did not exercise the authority of the surgeon. Professor Yang insisted for a while before he agreed.
The circulating nurse let out a long breath. It was uncomfortable to be in a splint.
In the time it took to say a few words, the peritoneum had already been protected and they entered the abdominal cavity.
Professor Yang took a look at the operating area and immediately began to feel nervous.
How did he do it so quickly! He had to concentrate on the supporting platform. This was a live broadcast of the surgery!
After disconnecting the round ligament of the liver, Zheng Ren's hand reached in.
Then, he skillfully separated the hepatic ligament, right coronary ligament, right triangular ligament, and hepatorenal ligament. At the same time, he bluntly separated the exposed area of the liver to reach the inferior vena cava and continued to dissociate the right liver.
This was the preparatory work in the early stages. Although it was simple, Boss Zheng's technique was skilled. It was as if he had done more than a thousand cases. There were no big movements. Most of the time, his fingers were constantly moving. It looked really pleasing to the eye, Professor Yang thought to himself.
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