1884 Surgery combined with intervention = no need for a second stage surgery
He would write down the surgery record of whatever he saw? The mirror in your hand is shaking like a big hammer, what can you see!
“Perform the surgery well. Doctor Xia, remove the moss and pus, about 900ml. ” Zheng Ren said.
“Oh, oh.” Xia Hua quickly noted it down.
“After loosening the adhesion, it’s time to open the ligament of the lower lung.” Zheng Ren continued.
Uh … They’ve already reached this stage?
Xia Hua tried her best to look at the screen, trying to find the shadow of the lower lung ligament.
The position of the operation before his eyes looked very similar, but the camera was too close, and there was no overall visual image. He could not be sure whether he was cutting the lower lung ligament.
After Zheng rensong untied the lower lung ligament, he opened the longitudinal pleura.
The forceps were as agile as a finger, and soon, the esophagus was exposed.
“Slow down and let doctor Xia take a look. Otherwise, we can’t write it down in the surgery record.” Zheng Ren said.
“I’ll just make it up. It’s the same process anyway.” Su Yun said.
“Here, doctor Xia, do you see? there’s a tear in her esophagus, about 2 cm long. The surrounding tissue is rather brittle, and we can’t perform a primary suture. ” Zheng Ren said.
Xia Hua took a closer look, and when Su Yun pulled the camera away, he saw that there was an opening about 5 cm away from the esophagus. The surrounding area was pale white, and there was a small amount of puss.
The suturing of the esophagus was extremely difficult to begin with because the elasticity of the walls of the esophagus was relatively weak. If he were to suture it forcefully, the tension would be high, and the local blood flow would not be good enough. After the surgery, it was very easy for necrosis to occur.
Xia Hua was still thinking about what kind of drainage strip should be left at the rupture to draw out the thick juice and Oozeling to prevent further infection in the chest and diaphragm.
Xia Hua’s first judgment was that she needed to undergo a second stage of surgery.
But wasn’t it easy to choose the time for the second stage surgery? besides, second stage surgery for the esophagus and gastrointestinal tract were different.
If there was a similar problem in the colon, it was easy to solve. Fistulation would be enough. The patient was not used to the abnormal passage when defecating, and he needed some time to get used to it.
However, if the patient’s esophagus was to be operated on at the second stage, the patient would have to be fed liquid food through the nose or receive high nutrition through the veins to maintain his or her condition.
How could nutrition be guaranteed?
“Doctor Xia, come and help Su Yun with the rest of the work.” Zheng Ren said.
Xia Hua began to worry. At this moment, Zheng Ren’s voice reached his ears. He was stunned for a moment before he replied casually.
“Uh … What about you?”
“Hey, did you hear the diagnosis?” Su Yun was really unhappy this time. If Zheng Ren had not stepped off the stage and touched his arm, the hemostatic forceps that he had left behind during the opening of the surgery would have been thrown over.
“Are you really going to perform a second – Stage surgery that you’re not confident in?” Su Yun said in disdain,”the lower part of the ladened membrane anti – reflux stent. The patient can eat seven days after the surgery. The stent will be withdrawn from the patient between 14 to 28 days after the surgery according to the situation.”
Xia Hua listened quietly. He felt that there must be a problem somewhere. Either there was a problem with his own understanding, or there was a problem with his own perception.
In short …
The problem was with him, not boss Zheng.
Xia Hua could understand the meaning of a medical material such as a covered membrane to prevent regurgitating stent, but he had never seen it before.
It should be a bag to prevent gastric reflux, which would cause the membrane stent wall to corrode and leak.
However, after the stent was removed, it could be recovered 14 to 28 days after the operation? Could food path grow?
“What happened after that?” Xia Hua asked.
“We’ll see how it goes. If the esophagus can grow, it’ll be great. The surgery will be a success, and the patient will be discharged. If it doesn’t grow, although the possibility isn’t high … How’s the strength of your laparoscope room?” Su Yun asked.
Xia Hua had no idea what the new surgical method was.
“I don’t think they’ve come into contact with it.” Zheng Ren called Gao Shaojie over to help and then explained,””Postoperative nutrition needs to be kept up. A 2cm esophagus breach should be easy to grow. If it really doesn’t work, the edge won’t be so fragile by then, and we can solve the problem with our skills in using a laryngoscope. “
Xia Hua was still confused.
“We’ll talk about it when the time comes. If it doesn’t work out, ask the patient to come to the capital to find me. Otherwise, I’ll come back again. The probability of this happening is not high, so it should be able to grow. Don’t worry. ” Zheng Ren said.
“Boss Zheng, this stent is too advanced.” Gao Shaojie said as he measured the plastic surgery with a membrane to prevent reverse flow.
“Yes, it’s specially made to prevent gastric reflux. I don’t usually use it, so it’s not strange that I’ve never seen it before. ” Zheng Ren smiled.
As the patient’s condition was different from Xia Hua’s father ‘s, the guide wire was directly inserted.
“It’s time to step on the line, close the door. ” Zheng Ren said.
Gao Shaojie noticed that Feng Xuhui didn’t go out, but stayed in the operating room in lead clothes.
This young man really had a bright future! Gao Shaojie thought to himself,”even though I’m in the operating room, I still don’t want to leave boss Zheng.”
He regretted it ten thousand times, but if he could do it all over again, he couldn’t leave his son who was about to take the college entrance examination and go to the capital with boss Zheng.
This was life!
While pondering, Gao Shaojie quickly prepared the scaffold.
He only stepped on the line once and the membrane anti – reflux stent was in position. Boss Zheng opened the stent without even comparing the measurements.
“The position is just right, perfect!” Su Yun stood at the position of a sorcerer and touched the esophagus with a pair of pliers.
The covered membrane anti – reflux stent had completely blocked the damaged part of the esophagus without any gaps. It was a few centimeters above and below, and the overall position was chosen perfectly just as he had said!
Gao Shaojie was stunned.
An esophageal stent might seem simple, but there was actually a reason for it. The position of the stent, the strength of the stent opening, and other details would definitely determine the patient’s quality of life after surgery.
The position of boss Zheng’s stent was just right. With Gao Shaojie’s many years of clinical and surgical experience, it was the most ideal position.
Surgery can actually be done this way! It might seem like he had no brain, but Gao Shaojie knew that this was the embodiment of countless surgical experiences.
He looked relaxed, but in fact, boss Zheng had trained himself countless times.
Gao Shaojie sighed in his heart.
The preoperative diagnosis was clear, the assessment was accurate, the intraoperative movements were clean, and the surgery was combined with interventional surgery. A patient who originally needed a second stage surgery could be turned into a medical case that could be completed with a high probability of first stage surgery.
Awesome!
Gao Shaojie sighed in his heart.
With boss Zheng beating old Liu with hemostatic forceps every day, old Liu was already unbelievably strong. Gao Shaojie continued to regret in his heart.
“Old Gao, I’ll be going down then.” Zheng Ren turned around and got off the stage after getting off the scaffold.
“Oh.” Gao Shaojie quickly responded.
Putting down an esophageal stent was not a major surgery, and there was not much to do after the surgery. Gao Shaojie quickly finished it.
“Doctor Xia, this is the general process of the operation. After the surgery, you must strengthen your nutrition and stop drinking water for seven days. ” Zheng Ren reminded him again, feeling worried.
“Yes, yes.” Xia Hua gradually understood the entire process of the operation.
Other than the harsh, sissy – like assistant beside him and the dazzling yet dizzying operation, the surgery was done perfectly!