He inserted the ultrasound endoscope to show the location of the cyst. He chose a suitable puncture point and used the color blood flow chart to show the nearby blood vessel structure.
The shape was very ideal. This position and this image were exactly what Professor Yang had imagined. There was almost no deviation.
He knew that his level was constantly growing. Every time he came into contact with and learned a new surgical method, there would be such an exciting process. This feeling was also Professor Yang's favorite.
Growth and joy were really intoxicating.
The puncture needle was retracted into the outer sheath and inserted into the endoscopic ultrasound tube. Then, Professor Yang sent the puncture needle into the stomach and carefully extended the tip of the needle. He did not want to poke a hole in the stomach wall before the surgery was performed.
Although the hole was a little shocking and the stomach wall was very easy to recover, Professor Yang still carefully paid attention to every step of the operation.
Then, he identified the position of the needle tip on the ultrasound image and pierced the needle into the cyst cavity under the guidance of the ultrasound image.
When he felt a clear sense of emptiness, it meant that the puncture needle had already entered the cyst. Professor Yang's heart calmed down. This was because the cyst wall did not cause trouble for him. If the puncture was difficult, he would have to connect the puncture needle to the high-frequency electrotomy and pass on the pure electrotomy current. If that was the case, it would be very troublesome.
His luck was good today. Professor Yang had the idea that the puncture of the cyst wall would not go smoothly during the preoperative evaluation.
Everything went smoothly. He almost hummed a lively song.
The 19G puncture needle successfully punctured the cyst wall and inserted a 0.035-inch guide wire. After using a 4mm and 6mm diameter expander to expand the puncture hole, a 24mm double-lumen metal stent was successfully placed under the guide wire.
The surgery was basically over. Professor Yang carefully used the ultrasound probe to observe the pancreatic pseudocyst. He found that it was beginning to shrink, which meant that the fluid accumulated in the cyst was being drained into the stomach and then into the intestine.
It was very smooth! The corners of Professor Yang's mouth curled up slightly under the mask.
The patient in this surgery was almost the largest pancreatic pseudocyst he had ever seen or performed. If it was laparoscopic surgery, it would be very difficult to ensure that there would be no complications.
However, there were not many complications in endoscopic ultrasound-guided pancreatic pseudocyst drainage. It was just internal drainage. What complications could there be? Professor Yang believed that the biggest risk lay in the steps of the puncture. God knew if there would be bleeding from the puncture even though there were no blood vessels in the ultrasound.
If that was the case, it would be f * cked.
People who were in the medical field were all very cautious. Professor Yang could be considered a more moderate person.
When he first started working, pancreatic pseudocyst was a serious disease. The surgical grade was very high, and the postoperative risk was very high. After laparoscopy was developed, the surgical procedure and postoperative complications would be reduced correspondingly.
But now, surgery was like 'playing'. Professor Yang was a doctor who had personally experienced these stages, so his feelings were extremely deep.
"Professor Yang, is the surgery over?" the anesthesiologist asked with a smile.
"Yes, it's about time." Professor Yang was not in a hurry. He observed for a few more minutes and confirmed that the pancreatic pseudocyst had shrunk. He smiled and said, "It's done."
"Professor Yang, can we do this for pseudocysts in the future?" the anesthesiologist asked.
"How could this be?!" After Professor Yang finished the surgery, his mood was also high. He said casually, "The pseudocyst is tightly attached to the gastrointestinal tract wall, and there are no large blood vessels blocking it. It would be more ideal if the digestive tract bulged due to the pressure of the cyst and the mucosa had an obvious change in color. This was a necessary condition now. If he wanted to use minimally invasive surgery in any situation, he had to be at Boss Zheng's level. Me? Not in my next life. "
"You're too modest," the anesthesiologist said with a smile.
"It's important to know one's limits," Professor Yang said very seriously. "This is not modesty. This is the truth. Boss Zheng is so awesome. I don't want to think about it. "
"Heh." The anesthesiologist did not know what he was thinking and chuckled.
"Don't doubt me. Let's talk about this surgery. Whether the stent is blocked or not after the surgery depends on interventional radiography. I'm lucky and the patient screening is very good. If it's really carried out in large quantities, I'll definitely have to trouble Boss Zheng sooner or later, "Professor Yang said.
Professor Yang had carefully analyzed the indications for endoscopic ultrasound-guided pancreatic pseudocyst drainage and how to treat it after the accident. When he was in Japan, he had also consulted his tutor.
The reason why the surgery could go smoothly and looked simple and easy was actually because of a reason.
No success could be obtained inexplicably. Professor Yang firmly believed this. Seeing that the cyst was shrinking, he began to pull back the guide wire.
As he pulled the guide wire, he said kindly, "Don't tell anyone else about what you said just now, Boss Zheng …"
At this point, Professor Yang was stunned.
The guide wire … could not be pulled! Normally speaking, at this time, he should be holding the guide wire in his hand and smoothly taking it out.
He could not pull it. What the hell was this!
Where was it stuck? It could not be. The guide wire was thin and smooth. How could it be stuck?
What kind of complication was this? What kind of accident was this? Professor Yang was stunned.
He had made sufficient preparations, but he did not expect an accident to happen when the surgery was already "over".
Professor Yang panicked.
He immediately used the ultrasound to take a look, but the ultrasound had its own advantages and disadvantages. At this time, it was useless.
"Professor Yang, what are you planning to do?" the anesthesiologist asked curiously.
"…" Professor Yang felt like crying.
He really could not show off at all. He had just shown off a little and something happened immediately.
The most important thing was that he did not even show off. It was just that the anesthesiologist praised him a little, and he even spoke to him earnestly.
The anesthesiologist realized that something had happened. He stopped what he was doing and did not push the medicine for the patient. If the patient woke up and something happened to the surgery, he would not be able to explain it.
He looked into Professor Yang's eyes and waited for him to explain the situation.
"I … I think the guide wire is stuck."
The anesthesiologist laughed.
"Professor Yang, don't joke with me," the anesthesiologist said. "The guide wire is not something else. I would believe it if you said that the stent is stuck. The guide wire is stuck? How is that possible? "
Professor Yang cursed in his heart. F * ck, I don't believe it either.
He tried again, but he still could not pull the guide wire.
"It's really stuck. I'm not joking." Professor Yang calmed himself down and immediately said, "Is there anyone in the hybrid operating theater?"
"There's an orthopedic surgery. The remaining operating table is empty. Please wait a moment, I'll go take a look." After the anesthesiologist finished speaking, he quickly ran out.
Professor Yang stood on the operating table, wanting to cry but having no tears.
He was also dumbfounded as to what had happened. Was he not careful enough? Was there some kind of operational error? Was it …
None of them!
At this moment, he had no idea what had happened.
..
..
Note: Quoted from the Journal of the British Gastroenterology Society, Gastrointestinal Endoscopy, September 27, 2015.
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