I run a clinic in the United States

Chapter 82 LECS surgery and “left and right fighting”

In addition, what Murphy's mother was worried about was that the private clinics she went to in Los Angeles usually did not perform surgery.

In other words, just look at some minor ailments, and immediately refer to the affiliated hospital or a higher-level hospital when there is a serious illness.

This Iris Clinic, okay?
Zhou Qiao seemed to see her worry, so he smiled and said to her: "Our operation is performed in the operating room of the community hospital."

Because the conditions of the operating room of Iris Clinic are really not up to par, mainly due to the supporting facilities.

Once a serious accident occurs during major surgery, community hospitals will naturally have more complete supporting rescue facilities, and rescue operations will be carried out against the clock, like putting out fires.

So usually, major surgeries are performed in community hospitals or higher-level hospitals.

But if the clinic becomes big and extremely wealthy, like the Mayo Clinic, its hardware and software are among the best in the world, almost as good as any major hospital.That's another matter.

Therefore, whether doctors in private clinics in the United States can perform surgeries and what kind of surgeries they perform are mainly determined by the quality of the clinic doctors, rather than legal issues.

Although Murphy's mother was worried, she had no say.

After making preoperative preparations, Zhou Qiao led a group of people to the operating room of the community hospital.The anesthesiologist remains the senior Nancy team.

Nancy is a bit busy this afternoon, she has to support three surgeries successively.

Change shoes, change clothes, brush hands, disinfect, enter the operating room...

Anesthesia is ready, Time out...

It was still Ava as the itinerant nurse, Elena as the equipment nurse, Zhou Qiao as the surgeon, and Murphy as the surgical assistant!
Murphy stared intently at Zhou Qiao's operations.

This time, Zhou Qiao chose the "dual mirror combined with lower gastric tumor resection minimally invasive surgery" combined with gastroscopy and laparoscopy, that is, LECS surgery.

Because the tumor is very small.

LECS surgery is a combination of laparoscopic gastrectomy and endoscopic submucosal dissection. It can accurately observe the tumor location and determine the precise resection line, so as to reduce the margin as much as possible while resecting the gastric tumor.

The original indication for LECS (classic LECS) was gastric submucosal tumors (SMT) without ulceration.

Later, the indications of LECS were expanded to include gastric SMT with ulcer and gastric cancer without lymph node metastasis.

However, a major drawback of classic LECS is the risk of gastric contents contaminating the peritoneal cavity and intraperitoneal dissemination of tumor cells.

To expand the indications of LECS to include gastric epithelial neoplasia, some modified LECS have been developed, such as reverse LECS, non-exposed endoscopic gastric wall reversal (NEWS), clean non-exposed technique (CLEAN-NET), and closed-LECS , these modified LECS are currently used to treat patients with gastric epithelial tumors.

To put it simply, the advantage of gastroscopy lies in precise positioning. It can enter the inside of the stomach, precisely locate the specific location of the tumor, and resect the tumor from the inside of the stomach. big.

Laparoscopy can very conveniently perform a series of operations such as resection, suturing, and hemostasis. However, its disadvantage is that it can only be operated on the outside of the stomach and cannot detect the precise location of internal tumors.

Therefore, the combination of the two is to maximize the advantages and avoid the disadvantages. Combining the advantages of both sides, the inside and outside of the stomach work together, and the inside and outside echo, which can not only improve the accuracy of the operation, but also greatly shorten the operation time and increase the safety of the operation.

Murphy has naturally never done this kind of surgery, but Zhou Qiao is a master!It’s just 15 medical points, two high-quality interactions with Elena!

Although it is not easy to accumulate medical mysteries, and it is very difficult to "make a fortune", "small fortune" is really easy to get.So Zhou Qiao didn't cherish it that much.

As long as the little baby is still here and Zhou Qiao's health is still good, he can have a master-level medical skill every day!
It’s so tiring to study and practice, but the skills are instantly acquired, including theory and practical practice, it’s so simple and crude!
Zhou Qiao chose reverse LECS.

And with the assistance of Murphy and Elena, he also played a particularly handsome "left and right fight"!
Anyone who has watched Jin Yong's martial arts knows that the old naughty boy's left-right fighting is so good that even Huang Rong can't learn it. Only simple-minded people like Guo Jing and Xiao Longnu can master it.

At this moment, Zhou Qiao just moved his left and right hands differently!
He manipulated the gastroscope with his left hand to accurately locate the gastric neuroendocrine tumor, and used the gastroscope to incise the submucosa circularly from the inside of the stomach along the edge of the tumor.

The right hand controls the laparoscope and performs other actions.

Under the guidance of the gastroscope, the laparoscope is like having eyes, peeling off the seromuscular layer from the outside, and "tunneling" from the inside and outside of the stomach at the same time with the left and right hands.

As soon as this stunt was performed, it was absolutely stunning!
Immediately, Murphy, whose face was like an iceberg, trembled slightly. The agitation in his heart was indescribable, as if the world had opened another window for her!

"There is still such an operation? So it can be done like this! How dexterous Dr. Zhou's hands must be!"

Murphy's heart was like a stormy sea, and her admiration was like a torrent of water, but her expression was still dull.Only the flashes of light in the green eyes from time to time can reveal such a trace of emotion!
The difference between reverse LECS and classical LECS is that after stripping the seromuscular layer, the classic LECS turns the tumor to the abdominal cavity, while the reverse LECS turns the tumor inward to the gastric cavity.

Zhou Qiao was smooth and smooth, operating with ease, while explaining in detail.

In order for Murphy to hear better, he even asked Ava to turn off the stereo.

For the first time, there was no music during the operation.

Originally, Ava wanted to listen to "Sunshine Rainbow Little White Horse"!

It is said that the melody of this Chinese song is very cheerful and magical. Anyway, those who don’t understand it are the ones who are superior!For Elena and Ava, almost all Chinese songs are superior!

Just like the Chinese songs played in some bars they went to in high school, they were called foreign.

It's a pity that Zhou Qiao didn't know them at that time. If she followed them, she would know what they were playing. Good bar dance, why don't you play "Family with Children" for me?
After the submucosal layer is incised endoscopically to determine the resection line, the stomach wall around the tumor is suspended with sutures like a crown.

Each suture is pulled out of the abdominal cavity using the Endo Close device and secured at skin level with clamps.

Full-thickness resection is performed endoscopically and laparoscopically. During this period, traction sutures are used to turn the tumor into the gastric cavity to prevent contamination of gastric juice and contact between the tumor and the abdominal wall.

The tumor was removed into the gastric cavity and the specimen was taken out orally.

The edges of the incision line are then temporarily closed with manual sutures, and the incision line is then closed using a laparoscopic suturing device.

The operation went very smoothly. The tumor about 2.5cm*2.5cm was completely removed, and the stomach wall was successfully sutured.

Now that there is a surgical assistant, there is no need for Zhou Qiao to do the finishing work such as suturing, and just throw it to Murphy!

Murphy was also very happy, firstly, it was a rare opportunity to practice, and secondly, this was for her grandpa to sew!
Therefore, Murphy did it very carefully!

She thought to herself, if there is a chance, she should ask Zhou Qiao about the skill of "fighting left and right"!Of course, she didn't know that this was called "left and right fighting", only that it was quite rare!
　Throw a monthly pass, thank you!

　　
　
(End of this chapter)