Why did he have to write down the surgical record based on what he saw? The laparoscope in your hands is swinging like a pendulum, what can I see?
"Perform the surgery well. Doctor Xia, remove the abscess and pus, about 900ml, "Zheng Ren said.
"Oh, oh." Xia Hua quickly memorized it.
"The next step is to loosen the adhesion, and then it's time to open the lower pulmonary ligament," Zheng Ren continued.
Uh … You've already reached this stage?
Xia Hua stared hard at the screen, trying to find any trace of the inferior 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 visual image, so he could not be sure if he was cutting the inferior pulmonary ligament.
Zheng Ren loosened the pulmonary ligament and opened the mediastinal pleura.
The forceps were as flexible as fingers, and the esophagus was soon exposed to the field of vision.
"Slow down and let Dr. Xia take a look. Otherwise, we won't be able to write the surgery record," Zheng Ren said.
"Just make it up. It's the same process anyway." Su Yun said.
"Here, Doctor Xia, you see? There's a rupture in the esophagus. It's about 2cm long. The surrounding tissue is fragile and cannot be sutured at the first stage, "Zheng Ren said.
Xia Hua took a closer look. When Su Yun pulled back the lens, he saw that there was a hole about five centimeters away from the cardia. The surrounding area was pale white, and there was even a small amount of pus coating.
The suturing of the esophagus was extremely difficult to begin with because the elasticity of the esophageal wall was relatively weak. Forcefully suturing the esophagus would result in high tension and poor local blood supply, which would easily lead to necrosis after the surgery.
Xia Hua was still trying to figure out what kind of drainage should be left at the rupture to draw out the thick fluid and exudate to prevent further infection in the thoracic cavity and mediastinum.
A second-stage surgery was Xia Hua's first judgment.
However, the timing of the second-stage surgery was not good. Moreover, the second-stage surgery of the esophagus was different from that of the gastrointestinal tract.
If there were similar problems in the intestines, it would be very easy to solve. A fistula would do. It was just that there was an abnormal bowel passage. The patient was not used to it and needed some time to get used to it.
However, if the esophagus were to wait for the second stage of surgery, the patient would have to be maintained through nasal feeding or intravenous high nutrition.
How to ensure nutrition?
"Doctor Xia, please assist Su Yun with the rest of the work," Zheng Ren said.
Xia Hua began to worry. At this moment, Zheng Ren's voice reached his ears. He was stunned for a moment before answering casually.
"Uh … what about you?"
"Hey, did you listen to the analysis?" Su Yun was really unhappy this time. If Zheng Ren had not gotten off the stage and touched his arm, the hemostatic forceps that were left behind during the opening of the stage would have smashed into him.
"Are you really going to do a second-stage surgery that you have no confidence in?" Su Yun said disdainfully, "Lower membrane anti-reflux stent. The patient can eat seven days after the surgery. The stent will be retracted according to the situation 14-28 days after the surgery."
Xia Hua listened quietly. He felt that something must have gone wrong somewhere. Either there was a problem with his understanding, or there was a problem with his cognition.
In short …
The problem was with him, not with Boss Zheng.
Xia Hua knew what the term 'membrane anti-reflux stent' meant, but he had never seen one before.
He should have brought a bag to prevent the gastric juice from flowing back, causing the membrane stent wall to leak.
However, could the stent be recovered 14 to 28 days after the surgery? Could the food path grow?
"What happened after that?" Xia Hua asked.
"We'll see what happens next. It'll be great if the esophagus can grow back. The surgery was successful, and the patient was discharged. If it doesn't grow back, although it's unlikely … How's the strength of your endoscopy room? "Su Yun asked.
"…" Xia Hua had no idea what the new surgical method was.
"They probably haven't come into contact with it before." Zheng Ren called Gao Shaojie over to help and explained, "After the surgery, nutrition has to keep up. A 2cm esophageal wound should be easy to grow back. If it doesn't work, the edge won't be so fragile. We can use esophageal laparoscopic suture to solve the problem. "
Xia Hua was still confused.
"We'll talk about it when the time comes. If it doesn't work, ask the patient to go to the Imperial Capital to find me. Otherwise, I'll come back again. The probability of this happening isn't high. It should grow back. Don't worry, "Zheng Ren said.
"Boss Zheng, this stent is too advanced," Gao Shaojie said as he measured the membrane anti-reflux stent.
"Yes, it's specially made to prevent gastric juice from reflux. It's not usually used, so it's not surprising that you haven't seen it before. "Zheng Ren smiled.
Because the patient's condition was different from Xia Hua's father's, the guide wire went straight in.
"We're stepping on the line. Close the door," Zheng Ren said.
Gao Shaojie noticed that Feng Xuhui did not go out. Instead, he stayed in the operating theater wearing a lead apron.
This young man had a bright future! Gao Shaojie thought to himself that he had to stay in the operating theater even if he had to hold the line. He refused to leave Boss Zheng behind.
He regretted it for the ten thousandth time. If he could do it all over again, he could not leave his son, who was about to take the college entrance examination, and Boss Zheng to the Imperial Capital.
This was fate!
Gao Shaojie thought about it as he quickly prepared the stent.
He only stepped on the line once, and the membrane anti-reflux stent was in place. Boss Zheng did not even compare it and directly opened the stent.
"The position is just right. Perfect!" Su Yun stood in the surgeon's position and touched the esophagus with a pair of forceps.
The membrane anti-reflux stent had completely blocked the damaged part of the esophagus. There was no gap. A few centimeters up and down, and the overall position was just as he said — perfect!
Gao Shaojie was stunned.
The lower esophageal stent looked simple, but in fact, there was still a saying. The position of the upper and lower esophagus, the strength of the stent opening, and various other details definitely affected the quality of life of the patient after the surgery.
The position under Boss Zheng's stent was just right. Based on Gao Shaojie's many years of clinical and surgical experience, that was the most ideal position.
Surgery could actually be done this way! It seemed like he had not used his brain, but Gao Shaojie knew that this was the reflection of countless surgical experience.
It looked easy, but in fact, Boss Zheng had honed it countless times.
Gao Shaojie sighed in his heart.
The preoperative diagnosis was clear, the assessment was accurate, and the intraoperative actions were clean and agile. The surgery combined with the interventional surgery had turned a patient who originally needed a second-stage surgery into a case with a high probability of being completed in the first stage.
Awesome!
Gao Shaojie sighed in his heart.
With Boss Zheng beating it with hemostatic forceps every day, Old Liu was already ridiculously strong. Gao Shaojie continued to regret in his heart.
"Old Gao, I'll be off then." After Zheng Ren finished removing the stent, he turned around and left the stage.
"Oh," Gao Shaojie quickly responded.
The lower esophageal stent itself was not a major surgery. There were not many things to do after the surgery, so Gao Shaojie was busy wrapping things up.
"Doctor Xia, the surgery process is roughly like this. After the surgery, strengthen nutrition and fast for seven days, "Zheng Ren reminded him worriedly.
"Yes, yes." Xia Hua gradually understood the entire surgery process.
Aside from the sarcastic and effeminate assistant's dazzling yet dizzying maneuvers, the surgery could be said to have been performed perfectly!
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