1528 Fake medical record
The patient’s liver showed signs of gnarled cirrhosis, and the overall atrophy was very obvious.
Zheng Ren reached out, and a latex tube fell into his hand.
He used a latex tube through the omentum to wrap around the hepatoduodenostomy ligament in preparation for hepatic blood flow obstruction.
Then, he lifted the right liver and placed an abdominal towel under the right diaphragm to expose the right liver.
“Can you touch it?” Su Yun asked.
“Yes, the boundary is still clear.” Zheng Ren said.
With that, he moved his hand away from the liver, and Su Yun extended her hand.
He touched the right liver lightly and used a little force, and he could feel a relatively large lump inside the liver.
After Su Yun was done, professor yang touched his hands and body.
To the touch … It was harder than the liver cancer lump in his memory, and it was not just a little harder.
Could it be interventional embolism? the changes after the tumor tissue necrosis were so great? Professor yang was confused.
Normally, the texture of tumor tissue was harder than the normal tissue around it, but it should not be so hard.
He used an electric scalpel to cut the Glisson of the liver at a spot about 2 cm away from the tumor, and on both sides of the cut, he used a large needle with 7 – 0 surgical silk thread to suture it.
This step of the operation was prepared for the assistant. The liver tissue was pulled and the surgical field was exposed, and the seven – Thread method was used.
Su Yun and professor yang each pulled a thread and exposed the liver.
Zheng Ren looked at the operating area, reached out, and gently patted the ultrasonic knife in his hand.
He began to use the forceps on the head of the ultrasonic knife to perform blunt separation.
“Pa, pa!” Man ning’s voice rang out continuously.
When small blood vessels were slowly coagulated with a small amount of energy, popping sounds would be heard. If a larger blood vessel was coagulated at a faster rate with a higher power output, it would make popping sounds.
The surgery was not carried out quickly, but it was not slow either.
In the background music of “good luck,” the sound of “pa pa pa” was constantly heard. In professor Yang’s eyes, Zheng Ren’s hands seemed to have a strange rhythm.
The small blood vessels and bile duct were closed and cut with an ultrasonic knife. When he encountered a bone with a diameter of more than 4 5mm, Zheng Ren did not use the high – Power of the ultrasonic knife. Instead, he chose to use titanium clips to perform clamping and severing.
“Boss Zheng, an ultrasonic knife can cut a blood vessel up to 6mm in diameter.” Professor yang reminded.
“It has been reported that the probability of bleeding after cutting a blood vessel with a diameter of more than 4mm with an ultrasonic knife is 3.5%.” Zheng Ren said as he performed the surgery,””Even though the pressure inside is quite high after the surgery, and the bleeding can be stopped, it’s not necessary.”
Professor yang thought about it and realized that he had never seen such a report.
However, boss Zheng’s surgery was really clean. The liver had been split open, and there was not much blood in the operating field. He had been holding the aspirator in his hand, and the hissing sound indicated that the aspirator was ready to be used.
However, there was only a few millimeters of blood in the tube of the aspirator. There was almost no blood loss during the entire process of removing the liver.
As the second assistant, Su Yun used hemostatic forceps to hold a piece of gauze and occasionally dipped it in blood to expose the surgical field clearly for the surgeon.
The White gauze was dotted with red blood, like the plum blossoms in the twelfth lunar month.
The amount of blood loss was unbelievable.
A black, hard tumor tissue appeared in the operating field.
“It looks a little different from a normal liver tumor.” Su Yun said in a low voice after seeing it.
“There’s a big difference. You’ll know when you’re free. ” Zheng Ren said.
“Boss Zheng, is it because of embolism in the blood – supply artery?” Professor yang asked.
“That’s one of the reasons, but it’s mostly because of the necrosis of the tumor tissue, which is very different from normal tissue. The surgery will be more accurate and simple. ” Zheng Ren said as he looked at the operating area.
This was the live broadcast of the surgery. Zheng Ren had learned from the experience of Xie Yiren’s flirtatious gaze in the previous surgery. He did not raise his head at all, and his vision was fixed on the liver tumor in the operating area.
The tumor started to separate.
Zheng Ren used an ultrasonic knife and titanium clips to touch the upper half of the tumor, and the free tissue was about 0.7 cm away from the tumor tissue.
Soon, professor yang noticed the difference.
Just as Zheng Ren had said, the surgery seemed to be much easier than he had expected, and there was less bleeding.
The Department of Hepatobiliary and Pancreatic Surgery usually used an ultrasonic knife for surgery. Even the sub – helium knife, which was a high – value consumable like a welding gun, was occasionally used when the bleeding did not stop.
The surgery was the same surgery.
But in boss Zheng’s hands, it suddenly seemed to become extremely simple.
The forceps on the head of the ultrasonic knife kept separating the head of the ultrasonic knife. The sound of slapping continued, and the surgery went smoothly.
Bleeding?
Professor yang looked at the aspirator in his hand and the gauze in Su Yun’s hand.
It would be nonsense to say no.
But the bleeding was like stars … How was he supposed to write it down in the surgery record? 3ml of blood loss?
MD! If he wrote this, it wouldn’t be considered a false medical record, right?
“Director Zhou, the boss is about to cut off the supply blood vessel from the diaphragm artery.” Su Yun suddenly said.
Ever since Zhou chunyong stepped onto the operating table, he had not said a word and had been observing carefully.
This was his first time seeing the anatomical structure of liver cancer after interventional embolism.
A diaphragm artery branch?
Zhou chunyong still remembered that he had not found this artery on the preoperative scan when he was performing the interventional embolism surgery.
He did not see boss Zheng’s super selection and embolism process.
But … Where was he?
“Pa, PA.” The sound rang out, and Zheng Ren continued to drift downward. Zhou chunyong was a little confused and asked softly,””Doctor su, where are you?”
“The ultrasonic knife cut it off just now.” “You didn’t see it?” Su Yun asked.
“Oh, oh, that’s it.” Zhou chunyong said embarrassedly, pretending that he had seen it.
He felt ashamed.
He was not in the field of surgery, and he had only learned the anatomical structures from medical imaging and books.
If he were to really open it up and see the actual situation with his own eyes, he would be dumbfounded.
What can you see! Other than the fact that there was no bleeding and the surgery was clean, there was nothing good about it.
However, Zhou chunyong knew that it was good if the surgery was done cleanly!
Before the surgery, professor yang had said that he needed to prepare blood for the patient who had to pay 912 points for Hepatobiliary and Pancreatic Surgery. Now, it seemed that there was no need.
“Department Director Zhou, even if it’s me who performed an ordinary liver stroke surgery, the bleeding by now should be around 100ml.” “There’s less bleeding because the supporting blood vessels of the tumor were embolized,”Zheng Ren said.
An indescribable feeling rose in Zhou chunyong’s heart when he heard Zheng Ren’s hint.
He had been working for almost twenty years, and this was the first time he had seen it with his own eyes. He even had to ask boss Zheng to tell him what the effect was.
This … Sigh.
When professor yang heard Zheng Ren’s words, he felt even more upset.
If he were to perform a normal liver slashing surgery without combined with hepatic embolism before the surgery, he would have lost at least 500 ml of blood by now.
Well, this was an extraordinary performance.
Just in case, they had already started the blood transfusion.
But according to boss Zheng, he had only lost 100ml of blood if he had done it?
‘That shouldn’t be possible. I can’t take it seriously when I brag on the operating table,’ professor yang comforted himself.