After 100 Days Of Signing In, The First Operation Shocked The Medical Community!

Chapter 202 Partial Distal Gastric Resection Surgery

“Tuk tuk!”

There was a knock on the door and the sun could not be seen. Liu Xin could only know the time with his watch. It was six o’clock the next morning, and it was the time when the first orthopedic surgery began yesterday.

He opened the door and it was not Jiang Shisan who appeared this time, but a middle-aged doctor with a beard and a very rough appearance. It would be difficult for him to tell if he was not wearing a doctor’s white coat.

“Chen Dongfang.”

The man is straightforward and straight to the point.

“Liu Xin.”

“There will be an operation at 8 o’clock today, digestive surgery, let’s go when you are ready.”

Liu Xin didn’t expect to start a relatively large operation the next day. He originally thought it would only start with some minor operations.

“Ready.”

Chen Dongfang led Liu Xin into a consulting room and opened the door of the operating room in the same way. He pulled down the hourglass, and only had a full eight hours.

“let’s start.”

Although Liu Xin was puzzled, he was mentally prepared. After a while, the nurse pushed the anesthetized patient into the operating room.

Eight hours are very abundant. After seeing the examination, Liu Xin determined that the patient’s stubborn illness should be gastric cancer, but it is not the advanced stage. Only a portion of the stomach needs to be removed to save life.

“Surgery for partial resection of the distal stomach.”

After Liu Xin said that, he took a special look at the door. This time Chen Dongfang did not stay outside the door like Jiang Shisan, only Chu Jingyuan.

“Prepare surgical tools.”

The second assistant is very fast, and the preparations for the distal partial gastrectomy are simply divided into several types, such as distal partial gastrectomy, total gastrectomy and proximal partial gastrectomy, as seen from the gastroscopy report Does it happen? A gastric cancer tumor was born in the distal tail, connected to the duodenum. If it is not removed immediately, it will cause damage to most areas of the stomach, which is quite troublesome.

“Doctor Liu, what kind of surgery will you use to remove the stomach?”

Liu Xin has already thought about the condition of the patient’s stomach. At present, gastrectomy basically follows three surgical methods, one is Pi Luo’s type one, the other is Pi Luo’s type two and gastrojejunum ROU-EN- The Y anastomosis was performed.

From the gastroscopy, Liu Xin was basically convinced that this operation needs to be performed conservatively. The patient suffers from gastric cancer, but it is not particularly serious. The result of not completely resected, the Pirot method, is the most obvious and the cleanest.

“Pi Luo’s style.”

“good!”

Soon the tools are ready.

“Supine position, using epidural anesthesia.”

“Anesthesia is ready.”

In order to avoid problems in the operation, the nurses of the Yaoxianhui usually give a preliminary anesthesia before entering the operating room. This effect lasts less than 20 minutes, but it is also the most effective way to determine the formal anesthesia after the inspection.

“Push methadol vinegar statically and maintain an anesthetic injection every three hours.”

“Why not perform accurate anesthesia for eight hours?”

The anesthesiologist hurriedly asked, after all, it is very troublesome to keep the anesthetic injection for three hours, and an anesthesia injection should be performed every three hours. Moreover, if it is this kind of resection operation, once the anesthesia effect disappears, the patient is very likely to wake up.

“Surgery requires the removal of part of the sphincter, and the regurgitation of duodenal fluid is frequently observed during the three-hour period. If this is the case, the entire process needs to ensure that the duodenum is unblocked.”

The anesthesiologist still didn’t understand why, but since Liu Xin was sure he needed to do this, he could only give an initial injection of the drug for only three hours of anesthesia.

“The drug has been injected and the patient has entered anesthesia.”

“Scalpel.”

Liu Xin took the scalpel and carefully incised the skin of the patient’s abdomen. At the same time, he paid attention to the condition of the stomach. The duodenum was exposed to the public. The incision was fast and accurate, almost reaching the connection between the stomach and duodenum of the patient. Location.

“Toothed vascular clamp.”

The nurse handed the vascular forceps over and wiped the sweat from his forehead.

Although Liu Xin has done this type of surgery for the first time, he has already experienced it in the system, so he quickly used forceps to clamp the connection between the duodenum and the stomach, and directly connect the left side of the stomach. Turn it over, and you can clearly see the presence of stomach tumors under the naked eye.

“Sutures.”

The nurse offered it again.

Liu Xin’s next step is to directly suture the stump of the duodenum with needles and thread, using a closed suture method, and continuous suture is beneficial to the suture.

“Loosen the pliers.”

Second help nodded lightly and obeyed the instructions. Originally, he needed to connect the minimal wound of the duodenum for retraction, but Liu Xin directly closed the intestine with a fusiform suture method. There was no muddy and watery process in the process.

“so fast.”

Nisuke couldn’t help but admire.

“The shuttle stitching method is currently the fastest way of stitching, and it is also very convenient after removal.”

Liu Xin couldn’t help but sigh that Murongsong has an excellent understanding of the improvement of suture method. It is impossible to do this step without certain experience, but if Murongsong is present, it is estimated that he will be greatly surprised. Liu Xin’s speed It has far exceeded his imagination.

After suturing one place, Liu Xin lifted the patient’s transverse colon, which is the most important part of the Pi Luo style. At present, the distal stomach cannot be removed immediately, and the transverse colon can only be incised in a cruciform manner and exposed by flipping. The way to re-stitch.

“Toothed vascular clamp.”

Second help immediately got started, using pliers to connect the intestines with the remnant stomach.

“Intestinal forceps.”

The nurse handed it one. Liu Xin held two scalpels in one hand and the intestinal forceps in the other. He sutured the blood vessels at a place less than 0.5 cm in the seromuscular layer.

“Doctor Liu, don’t you have a gastrectomy yet?”

The second help is holding the intestines and showing awkward expression.

“hold on.”

Liu Xin sutured the transverse colon to the incision of the intact stomach, and then used a scalpel to turn over and cut most of the distal stomach one by one, and the whole process went smoothly.

“Okay, let go.”

The second assistant opened the pliers in his hands, and his hands were already shaking. After all, it took nearly an hour to maintain this position.

“One more bowel pliers.”

Nisuke put on another one, and Liu Xin motioned to him to make effective sutures on the posterior wall of his transverse colon and stomach stump, twice in a row, which confused Nisuke.

“Why do it twice?”

“One time was the duodenal stump, and the other time was the stomach stump. The first time was to prevent duodenal fluid reflux from the stomach and intestines, and the second time was the operation. Core.”

Soon, the transverse colon was sutured again, and Liu Xin sutured the last part of the intermittent seromuscular layer, and the whole operation ended perfectly.

“Suture the wound.”