The road to the rise of great doctors

Chapter 81 Laparoscopic Surgery

Taking a marker, Li Jing marked the places where puncture and incision would be made.In this way, it can also serve to inform the assistant about the scope of disinfection and draping.

Then, Li Jing opened the door and went outside the operating room, brushed and disinfected his hands, and prepared to go on stage.

Liu Dong took the sterilization bowl and sterilized it carefully. These operations had been performed countless times during his rotational internship in the Department of Urology, so it was a very easy task for him.

After disinfection, spread the towel according to the marked place, "inverted triangle".After placing the middle order, place the large order.At this time, the instrument nurse in the operating room was also ready to continue and took the stage.

While disinfecting and draping, Liu Dong looked at the three marked small incisions and suddenly remembered that he had seen a popular question on the forum, "My girlfriend has a surgical scar on her belly button and on both sides of her belly. May I ask what kind of surgery this was?"

There are more than 5 followers and hundreds of responses.Several representative responses are as follows:

"We were stabbed by Poseidon's Trident during the War of the Gods. At that time, all three of our family participated in the holy war, and we all suffered varying degrees of injuries while protecting each other."

"Today's young people, I don't quite understand. Your relationship with your girlfriend has developed to the point where you can see the incisions on your stomach, but you still can't ask the other party what kind of surgery he had? I don't understand this. What kind of relationship?"

"My brother also has a surgical incision on his lower abdomen. He is 18 years old now. Yes, just as you guessed, he had an abortion when he was 7 years old. Okay, are you satisfied?"

"Well, maybe the questioner thinks that a woman's belly does not have the gastrointestinal appendix, gallbladder, spleen, kidneys and other organs, so she only has a uterus, and the uterus has no other diseases besides giving birth to a child."

"It's like when you go to a drugstore to buy medicine and the clerk asks you what medicine you want, you tell her you want to buy 'capsules'."

Thinking of this, Liu Dong couldn't help but smile to himself.

Just like today's surgery, there are three incisions, and there are three scars after the operation. These are just the incisions commonly used in laparoscopic surgery.

For retroperitoneal surgery, the three incisions are on the waist and abdomen.If the surgery is done through the abdominal cavity, there will usually be one incision in the navel and two others on the abdomen.

So, the standard answer to this question is, "What kind of surgery have you had? Laparoscopic surgery!" Haha.

After being prepared and disinfecting their hands with disinfectant again, Li Jing and Liu Dong put on surgical gowns.An excellent laparoscopic surgery, even if the operation is difficult and the steps are complicated, is composed of countless basic laparoscopic operating techniques.

Doctors like Li Jing, with the support of a large amount of theoretical knowledge of anatomy and surgery, and at the same time doing every step of the action well and in place, can carry out the entire operation smoothly, giving the doctors who are observing the operation a smooth operation. A beautiful enjoyment.It is precisely because of his relatively sufficient understanding of this matter and the guidance of a good teacher that he can catch up quickly after a period of practice when he focused on scientific research in the early stage and did not have sufficient clinical participation.The charm inherited by teaching hospitals like the Medical College Affiliated Hospital.

Liu Dong now has proficient laparoscopic operation skills, but what he lacks is anatomy and understanding of surgery. As long as he watches it a few times and understands it well, he will master the surgical skills faster.At that time, the only thing that will restrict him is his professional title and qualifications.

On the stage, Li Jing, Liu Dong and the equipment nurse.

In the audience, Director Zhao Jun and doctors of all sizes in the department were watching, and they had turned on the video recording program early.This was also done with Li Jing’s consent.Record teaching videos for later viewing, learning and comparison.

In the era of laparoscopy, video recording can be more clear than that of open surgery, which is also a great tool for technological innovation and technology promotion.This is also the reason for the rapid growth of young doctors.

This operation used the retroperitoneal approach that is often used by domestic doctors, sometimes also called the retroperitoneal approach.The advantage is that it has little interference with intra-abdominal organs, does not contaminate the abdominal cavity, avoids interference of intra-abdominal organs on the operating field of vision, postoperative intestinal complications, and potential risks of intra-abdominal dissemination of tumors.The disadvantage is that the operating space is not as wide as the trans-abdominal space, and the anatomical landmarks are not as obvious as the trans-abdominal one.

I saw Li Jing making several incisions with ease and placing the puncture cannula inside.The gas is connected to expand the space in the posterior abdominal cavity to facilitate operation.

Then, he took the laparoscope first, went in and took a look, and found that there was no bleeding or other problems.Then, he handed it over to Liu Dong, intending to give this student some advice.The reason why he brought Liu Dong out instead of other people in the department was that Liu Dong was relatively free, and Liu Dong's diligence allowed him to see himself in Liu Dong at that time. , is also full of longing for clinical operations.
"In laparoscopic surgery, the assistant who holds the mirror is very important. The mirror is equivalent to the surgeon's eyes and the photographer who shoots the movie. Whether the operation goes smoothly and whether it can bring beautiful enjoyment to the viewers depends to a large extent. It depends on the operation of the mirror hand and the performance of the magician!"

Li Jing glanced at Liu Dong, and then said, "You are the mirror holder now. You must grasp the direction of the laparoscope. When adjusting the direction of the optical fiber, you must ensure that the mirror body is always in the upright position. The surgical field of view should be placed on the monitor screen. In the center of the screen, the most important thing is the operating instruments in the surgeon's right hand. For example, when performing separation operations, the ultrasonic scalpel and scissors should be placed at the focus point, and when suturing, the suture needle should be placed in the center of the screen."

While Li Jing was talking and doing, Liu Dong showed unusual proficiency, which made Li Jing a little surprised, but he did not show it, but continued, "We must master the distance of the laparoscope and try to avoid close shots within the observation range. If When a close-up view occurs, the focus of the laparoscope and the built-in light cannot be concentrated in the operating area. The distance of the mirror body must also be adjusted according to the surgeon's operation. For example, when the surgeon changes instruments, the laparoscope should be moved back to the inside of the sheath to facilitate the surgeon's insertion. After installing a new instrument, you can locate the position of the instrument as soon as possible. Invisible places are dangerous and easy to be damaged. You must make sure that the instrument is in sight or you need to know what the instrument is doing."

“A good telescope operator must also be familiar with the surgical process. He must not only pay attention to the surgeon’s ongoing operations, but also predict the next operation, so that the direction of the laparoscope can be adjusted in a timely manner to ensure smooth operation. It’s going on.”

Although Liu Dong already has the ability to operate, he still benefited a lot from hearing the summary of these theories.

He nodded and said loudly, "I understand, thank you, Teacher Li!"

(End of this chapter)