The patient's liver showed signs of nodular cirrhosis, and the overall atrophy was very obvious.
Zheng Ren reached out and a latex tube fell into his hand.
He used the latex tube to pass through the lesser omentum and wrap it around the hepatoduodenal ligament to block the blood flow into the liver.
Then, he lifted the right liver and placed a towel under the right diaphragm, exposing the right liver.
"Can you touch it?" Su Yun asked.
"Yes, the boundary is still clear," Zheng Ren said.
After saying that, he left the liver and Su Yun reached out.
He gently touched the right liver. With a little force, he could feel a relatively large tumor inside the liver.
After Su Yun finished touching it, Professor Yang touched his body.
The feeling … was harder than the liver cancer tumor in his impression. It was not just a little harder.
Could it be that the tumor tissue had changed so much after the necrosis? Professor Yang was a little puzzled.
Normally speaking, the texture of the tumor tissue was harder than the surrounding ordinary tissue, but it definitely should not be this hard.
He used the endotherm knife to cut the liver capsule about 2 cm away from the tumor. On both sides of the cutting edge, he used a No. 7 silk needle to suture it.
This step was prepared for the assistant. He lifted the liver tissue and exposed the field of vision, relying on the No. 7 silk thread to lift it.
Su Yun and Professor Yang each pulled a thread to expose the liver.
Zheng Ren looked at the operating area. He reached out and gently patted the ultrasonic knife in his hand.
He began to use the ultrasonic knife's head forceps to perform blunt dissection.
Clap clap. The slow coagulation sound continued to ring out.
Small blood vessels would make a popping sound when they were slowly coagulated with a low power. Larger blood vessels would make a popping sound when they were quickly coagulated with a higher power.
The speed of the surgery was not fast, but it was not slow either.
In the background music of good luck, the popping sound kept ringing out. In Professor Yang's opinion, Zheng Ren's hands seemed to have a strange rhythm.
Small blood vessels and bile ducts were closed and cut with the ultrasonic knife. When it came to blood vessels above 4-5mm, Zheng Ren did not use the high power of the ultrasonic knife. Instead, he chose to use a titanium clip to clamp and cut them.
"Boss Zheng, the ultrasonic knife can cut a blood vessel up to 6mm," Professor Yang reminded.
"There are reports that when blood vessels with a diameter of more than 4mm are cut with an ultrasonic knife, there is a 3-5% chance of bleeding after the surgery," Zheng Ren said as he performed the surgery. As Zheng Ren performed the surgery, he said, "Although the pressure inside is quite great after the surgery and even if the bleeding can be stopped, there is no need."
Professor Yang thought for a moment. He had never seen a similar report.
However, Boss Zheng's surgery was really clean. The liver had been split open, and there was not much blood in the surgical field. He had been holding the suction device in his hand, and the hissing sound indicated that it was ready to go.
However, there was only a few milliliters of blood in the tube of the aspirator. There was almost no bleeding during the whole process of splitting the liver.
As the second assistant, Su Yun held a piece of gauze in his hand with hemostatic forceps. Occasionally, he would dip it in blood to expose a clear surgical field for the surgeon.
On the pure white gauze, there were specks of red blood, like plum blossoms in the twelfth month.
The amount of blood loss was unbelievable.
A black, hard tumor appeared in the surgical field.
"It looks a little different from a normal liver tumor," Su Yun whispered after seeing it.
"There's a huge difference. You'll know when you're free later," Zheng Ren said.
"Boss Zheng, is it because the blood supply artery was embolized?" Professor Yang asked.
"That's part of the reason, but more importantly, it's because the tumor tissue is necrotic, which is very different from normal tissue. The surgery is more accurate and simple, "Zheng Ren said as he looked at the operating area.
This was a live broadcast of the surgery. Zheng Ren learned from the previous surgery and Xie Yiren's flirtatious eyes. He did not raise his head at all. His field of vision was always locked on the liver tumor in the operating area.
He began to free the tumor.
Zheng Ren used the ultrasonic knife and titanium clip to land on the upper half of the tumor. The free tissue was about 0.7 cm away from the tumor tissue.
Soon, Professor Yang discovered something different.
Just as Zheng Ren had said, the surgery seemed to be much simpler than he had expected, and there was less bleeding.
Usually, the Department of Hepatobiliary and Pancreatic Surgery also used an ultrasonic knife. Even a high-value consumable like a welding gun like a subhelium knife would occasionally be used when the bleeding was not stopped.
The surgery was the same.
However, under Boss Zheng's hands, it seemed to have suddenly become extremely simple.
The forceps at the head of the ultrasonic knife continued to perform blunt dissection. The sound of tapping was continuous, and the surgery was carried out very smoothly.
Bleeding?
Professor Yang glanced at the aspirator in his hand and the gauze in Su Yun's hand.
It would be nonsense to say that there was no bleeding.
But the bleeding was speckled … How was the surgery record supposed to be written? Bleeding 3ml?
MD！ If it was written like this, would it be considered a false medical record?
"Chief Zhou, the boss is about to cut off the blood supply from the phrenic artery," Su Yun suddenly said.
Ever since Zhou Chunyong went on the operating table, he had not said a word and observed carefully.
This was the first time he had seen the anatomical structure of liver cancer after interventional embolization.
Was it a branch of the phrenic artery?
Zhou Chunyong still remembered that when he performed the interventional embolization surgery, he did not find this artery on the radiographic films before the surgery.
He did not see the process of Boss Zheng's superselection and embolization either.
But … Where was it?
The sound of tapping rang out, and Zheng Ren continued to swim down. Zhou Chunyong was a little confused. He asked in a low voice, "Doctor Su, where is it?"
"It was cut by the ultrasonic knife just now," Su Yun said. "Didn't you see it?"
"Oh, oh, that's it," Zhou Chunyong said embarrassedly, pretending that he had seen it.
He felt ashamed.
He was not a surgeon. The anatomical structure was only learned from images and books.
If he really opened the abdomen and saw the actual situation with his own eyes, he would be dumbfounded.
What the hell can you see?! Other than the fact that there was no bleeding and the surgery was done cleanly, there was nothing good about it.
However, Zhou Chunyong knew that the surgery was done cleanly. This was good!
Before the surgery, Professor Yang of the 912 Department of Hepatobiliary and Pancreatic Surgery had said that blood should be prepared. Now, it seemed that there was no need at all.
"Chief Zhou, even if I were to perform an ordinary liver splitting surgery, the bleeding should be about 100ml by now," Zheng Ren said. "The less bleeding is because the tumor's blood supply has been embolized."
Hearing Zheng Ren's reminder, an indescribable emotion rose in Zhou Chunyong's heart.
He had been working for almost twenty years. This was the first time he had seen it with his own eyes, and he had to have Boss Zheng tell him what the effect was.
This … Sigh.
When Professor Yang heard Zheng Ren's words, he felt even more upset.
If he were to perform an ordinary liver splitting surgery without a liver interventional embolization surgery before the surgery, the bleeding would be at least 500ml by now.
Yes, this was all an extraordinary performance.
As a precaution, blood transfusions had already begun.
However, according to Boss Zheng, if he did it, the bleeding would only be 100ml now?
It should be impossible. He could not take bragging on the operating table seriously, Professor Yang comforted himself.
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