I'm a god of medicine

Chapter 421 Man, Can't Be So Fast
On Monday morning, the first operation was performed on the patient of Director Liu Jian of the Interventional Department.

Small nodular liver cancer after interventional surgery.

The liver is divided into left and right lobes by the falciform ligament in the middle. The right lobe is large and thick, and the left lobe is small and thin. If the cancerous focus is located in the left lobe, the operation is relatively simple. Just perform a total resection of the left lobe of the liver. .

Without the left lobe, the human liver function can fully compensate for the right lobe alone.

But if it grows on the right lobe of the liver, it will not be so simple. The portal of the liver is on the right lobe of the liver. If the right lobe of the liver is directly cut off, it is equivalent to cutting off the blood supply to the liver, and the left lobe of the liver will also be cut off. cannot survive.

Only local excision is possible.

If the cancer focus on the right lobe of the liver is located on the outer edge of the liver, then the operation is not too difficult, just make a wedge-shaped incision, remove the cancer focus and suture it.

Naturally, the patient's cancerous foci could not grow on the outer edge of the liver, otherwise, neither Qin Gewei nor Ma Zongtai would have declined Liu Jian politely.

In fact, the location of the tumor growth in this patient is really annoying, which is basically a contraindication for surgery.

Porta hepatis!
No wonder Qin Gewei and Director Ma were unwilling to take over, starting from the hilum of the liver to remove the cancer, it would be like somersaulting among the Song kiln and Ru porcelain in the same place, if you are not careful, you will make a big mistake.It is not impossible to enter the knife from other directions, but the distance is long and the position is deep. If one fails to hold it, it will also hurt the liver portal.

In the past, Gao Yong would never touch this kind of surgery. It is not easy to be a doctor, so don't try to be brave. Getting a lawsuit is a trivial matter, and being stabbed by the patient's family with a knife is a sad reminder.

But today is different. Gao Yong on the operating table is full of information.

"Where do you enter?" Opening his stomach, Gao Yong assisted Lian Xiangdong to adjust the hook, and asked Yang Xi on the other side by the way.

Yang Xi was in a daze.

Inserting the knife from the hepatic hilus is a necessary choice. Although it is difficult, it will cause less trauma to the patient's liver and is conducive to the patient's postoperative recovery.

There is only one reason for Yang Xi to be in a daze.

Do you want to use a surgery skill card?
A level 4 surgery skill card is only 5 yuan, which is very cheap. Now Yang Xi, who is worth millions, will not notice it at all, but the problem is that I have a strong feeling that even if I don’t use the skill card, I can’t use it. Can win this operation.

Taking a deep breath, Yang Xi made a decision.

"The way through the liver door, let's do it slowly."

There is no need to pursue the speed of peeling six grapes in 10 minutes. It is enough to peel four grapes steadily in 10 minutes. Anyway, there is no live broadcast. At worst, the second operation will be delayed until noon.

Liver cancer, known as the king of cancer, has a high degree of malignancy, probably second only to pancreatic cancer, and ranks second with female ovarian cancer.Simple tumor resection plus lymph node dissection is not ideal for the treatment of liver cancer. The theory of sub-tumor lesions was once popular in clinical practice, which means that there are still invisible tiny tumors around visible cancer lesions. Cancer foci, and the high recurrence rate in situ after liver cancer surgery may be related to this.

As a result, the operation methods for liver cancer once expanded.

However, the results of clinical studies have shown that expanding the scope of resection does not significantly improve the survival rate of patients.

Therefore, in recent years, the operation methods for liver cancer have shown a trend of shrinking.

Although the prognosis of surgical resection is not ideal, it is better to be resected than not to be resected, just because most types of liver cancer are not sensitive to chemotherapy drugs and radiation, and sorafenib or lenvatinib for the treatment of liver cancer Targeted drugs are not only expensive, but also have the defect that the target is easily closed after being attacked, which makes the occurrence of drug resistance relatively high.

It's far away, so I hurried back to the operating table.

In 10 minutes, with the cooperation of Gao Yong, Yang Xi sorted out the anatomical structure outside the hepatic portal, and loosened the round ligament and falciform ligament of the liver, approached between the left and right liver lobes, cut open the liver, and exposed the cancer focus...

In the first assistant position, Gao Yong couldn't help shouting: "Then someone, help me wipe off my sweat!"

If you are nervous, you tend to sweat easily. Although the evildoer opposite is as steady as a dog, Gao Yong is still worried.

There were also some thin beads of sweat on Yang Xi's forehead.

Well, this is the most critical step. The speed of peeling four grains in 10 minutes is still fast. Let’s slow down to the level of peeling two grains in 10 minutes. Is there any problem?
Outsiders can't see any clues, including Yizhu Gao Yong, they will only think that the operation is too difficult, Yang Xi is very cautious, that's all.

It took a full half an hour for Yang Xi to completely remove the cancer focus.

The next steps are much simpler.

It took another 10 minutes to suture the hole dug out of the liver, and the surrounding lymph nodes were cleaned in the next quarter of an hour. Finally, the battlefield was cleaned and the abdomen was shut down to step down.

10:30, exactly two hours.

After finishing an interventional operation, Liu Jian hurried over, and couldn't help being startled as soon as he entered the door.

"Didn't finish it?"

No one cares.

Liu Jian scratched his head and smiled.

If you can't do it, you won't stay on stage for so long before you get off.

"I heard that you are fast, but I didn't expect you to be so fast, alas..." Liu Jian smiled sternly, grabbed Yang Xi's shoulders, and said, "Man, you can't be so fast!"

The operating room is like a racing track, and anyone who is there is likely to be an old driver.

For example, itinerant nurse Wen Yanyan.

Before Yang Xi could respond, Wen Yanyan opened her mouth first: "Dr. Yang can come several times a day, and it will be soon as soon as possible. Director Liu is not capable of this, is he?"

Although the Interventional Department has a separate DSA room, some cases need to be carried out in a hybrid operating room in a large operating room in conjunction with surgery. Therefore, Liu Jian is familiar with the nurses in the operating room.

Liu Jian was prepared for Wen Yanyan's seemingly incomprehensible retort, he laughed and responded: "Our interventional department can also be regarded as a surgical doctor. For a surgeon, the most important thing is the skill at hand. Yanyan, are you right?"

Wen Yanyan responded with a smile: "Your Director Liu just lost his mouth."

Yin Wei finished filling out the anesthesia record, stood up at this moment, and said: "Isn't it, Lao Liu's mouth is more useful than his hands."

This is the case in the operating room, as long as the operation is done cleanly, the atmosphere will be happy and harmonious, and all kinds of jokes can be made, but if the operation is not done smoothly, then everyone will keep silent.

The patient in this operation has to be sent to the PACU over the bed, and then pick up the patient in the next operation. There must be at least 10 minutes in between, plus the anesthesia time, enough for the operator to return to the lounge to smoke a cigarette Drink some water and restore your strength.

As soon as he lit the cigarette, Yang Xi suddenly exclaimed: "Where is my key? Why is the key to my locker missing?"

(End of this chapter)