Start From Emergency Doctor

Chapter 55

“If he hears this sentence, he might wake up in fright…” Haiyang joked.

Zhou Yuan ignored the words of the ocean, stretched out his finger and began to confirm the position of the abdomen.

“The operation has begun.” Looking at the time, Zhou Yuan said.

The scalpel fell.

Zhou Yuan chose the most common opening method, which is a midline incision in the upper abdomen.

“So accurate!” Jiang Xiaoqi was a little surprised.

Generally speaking, in laparotomy, the main knife will choose to cut one centimeter of the anterior rectus abdominis sheath one centimeter on the umbilicus to determine the position and width of the white line of the abdomen to confirm the open incision.

Those who dare to perform surgery directly are extremely confident in their level of surgery.

Zhou Yuan explained while performing the operation: “Everyone has some differences in the position of the organs. Before the operation, I knew the position of the patient’s organs, and my hands were relatively stable and I had a good sense of direction.

He Jianyi: “Ocean, have you learned it?”

Ocean nodded excitedly: “I learned it, but not!”

After a few minutes, the abdominal cavity opened and the stomach was exposed.

It can be seen that there is a large tumor in the stomach body surrounded by a large number of colons, which are yellow in color and distributed with many small blood vessels.

At this point, Zhou Yuan’s face also became serious.

After opening the abdomen, the various organs in the abdominal cavity should be explored to confirm the metastasis of cancer cells. This step needs to adhere to the strict principle of tumor-free operation, that is, not touching the tumor.

Once the tumor is punctured, the cancer cells are likely to spread through the blood, and the patient may be beyond rescue by then.

He Jianyi, Jiang Xiaoqi and others also held their breath. At this time, none of them dared to disturb Zhou Yuan.

“Bent tweezers.” Zhou Yuan said.

The exploration process follows the principle of near-to-far.

Zhou Yuan carefully inspected the rectal fossa of the bladder and found no tumors.

Next is the liver, from the diaphragm and visceral surfaces, to the hepatic portal, splenic portal and then to the pancreatic body and tail.

“The body and tail of the pancreas need to be removed.” Tumor implantation took place here.

Zhou Yuan’s voice fell, and the ocean immediately took it down.

“Oval forceps.” Zhou Yuan said.(Read more @ wuxiax.com)

Total gastrectomy is a major operation in the gastroenterology department. Only the director dares to operate it. In the emergency department, let alone a total gastrectomy, it is a superb technique to remove half of the stomach.

Therefore, except for He Jianyi and Jiang Xiaoqi who knew what Zhou Yuan was going to do next, the others were all dumbfounded. They needed Zhou Yuan to call out the equipment to know what to deliver.

After Hai Hai passed the oval forceps, Zhou Yuan took the oval forceps and lifted the stomach, and then covered it with gauze to seal it.

Next, began to check the tumor’s infiltration range and mobility.

“The pancreas and the transverse mesocolon have adhesions, and some lymph nodes have metastasized.”

Ocean immediately took it down.

After completing the first full investigation, Zhou Yuan went from left to right, up and down again, and from front to back. After confirming the final resection range, Zhou Yuan put down the oval forceps.

The ocean stared at the patient’s stomach and said, “I have never seen such a beautiful stomach. Whether it is in shape or curvature, it is perfect. I really want to know how good it looks when I don’t have stomach cancer!”

Zhou Yuan’s mouth twitched.

nice……

From a medical point of view, Yang Wei’s stomach is indeed exactly the same as the stomach in the textbook.

“After the gastrectomy, I cut the tumor by the way and gave it to you?” Zhou Yuan said.

The ocean was taken aback and shook his head frantically.

“Teacher, please block the blood circulation in the arteries and veins of the stomach.”

Zhou Yuan picked up the oval forceps again and pulled the stomach forward and upward, exposing several major blood vessels.

He Jian nodded and shot quickly: “It’s blocked.”

Zhou Yuan nodded, “Director Jiang, please help me.”

“Are you going to… sew the left and right arteries and veins of the stomach?” Jiang Xiaoqi was a little surprised.

This speed is too fast…

Zhou Yuan didn’t speak. After Jiang Xiaoqi took the oval forceps and adjusted the posture of the stomach, he immediately picked up the needle-holding forceps and sews the right gastro-omental arteries and veins with the fourth thread.

“S-shaped hook.”

Zhou Yuan held the retractor and carefully pulled the liver upwards, while letting Jiang Xiaoqi pull the stomach downwards, exposing the liver and stomach ligaments.

“Tissue shears.”

“Brother Haiyang, help keep the position of the liver.”

The ocean immediately ran over with joy.

Damn, major surgery is good. Before, I could only count gauze and play with the little nurse beside me. Now I am a Sansuke, I can still observe the liver up close!

He Jianyi pouted his mouth aside.

Is this still my own disciple!

Isn’t it just to mention the liver, so excited? !

“Not promising!” He Jian scolded with a smile.

At the same time, I am also happy that I can touch a vascular forceps when Zhou Yuan is the chief surgeon.

Zhou Yuan moved quickly. After fixing the position of the liver and stomach, he quickly found the non-vascular part of the liver and stomach ligament, cut it with tissue scissors, separated the right gastric artery and vein, and cut and ligated quickly.

In the same way, Zhou Yuan sewed several arteries and veins on the left.

“Next is the removal of the omental sac.” Zhou Yuan said.

The reason why he shouted, on the one hand, was to tell the equipment nurse and Haiyang what equipment he might use, so that they could prepare it early.

On the other hand, it can be regarded as teaching.

In any case, there are few master total gastrectomy procedures in Yanjing International Hospital, even in the whole country. Being able to observe it up close once is beneficial to everyone present.

“Okay!” Haiyang felt Zhou Yuan’s intentions, and was moved in his heart.

——

The seventh step is over, and the eighth step is started. Seeking flowers and evaluation votes for support! .