Start From Emergency Doctor

Chapter 56

The resection of the gastroementum is relatively easy, but it is a test of strength, especially when it is separated, if one is not careful, the separation will fail and cause rupture of blood vessels or tissues.

After easily separating the greater omentum from the transverse colon, Zhou Yuan began to separate the transverse mesocolon.

Here is special attention, the transverse mesocolon is easy to break.

“Electric knife, blunt separation.” Zhou Yuan said.

Blunt separation?

Everyone, including Jiang Xiaoqi, frowned.

However, because Zhou Yuan was focusing on the separation, no one said any doubts in their hearts.

I saw Zhou Yuan picking up the uncharged electrosurgical head, and carefully cutting the transverse mesocolon horizontally, and then putting down the electrosurgical knife, separating the gastrointestinal ligaments in turn, and performing gastroemental resection.

After all this was over, Jiang Xiaoqi coughed gently.

“What’s the matter?” Zhou Yuan guessed.

“Why did you choose to use an uncharged electric knife head for blunt separation?” Jiang Xiaoqi asked.

He Jianyi is also a little curious: “Sharp separation has the least damage to tissues, why choose blunt separation?”

Zhou Yuan explained: “The uncharged electrosurgical head is not sharp. Using it for separation can save time. In addition, it can ensure that the separation plane advances in parallel to avoid tearing the mesangium due to uneven force. Many doctors choose to use it. A sharp scalpel is used for separation, which is naturally prone to problems.”

He Jianyi and Jiang Xiaoqi looked at each other, both of them could see the shock in their eyes.

“Frozen…what are you doing in a daze, Ocean, write it down with a notebook!” He Jianyi shouted.

Ocean hurriedly took out a small book with “Special Experience Book for Junior Zhou Yuan’s Surgery” and started to write.

The few people present were extremely excited.

This is the benefit of following a specialist for surgery.

In textbooks, you can only learn that the uncharged electric knife head is blunt and not sharp. What are the advantages and disadvantages of mixed and pure cutting.

However, following an expert, he can let you know when to do what, when to high frequency, and when to increase the output power.

“Next is pyloric ligation.”

Zhou Yuan incised the peritoneum at the lower edge of the duodenum to expose the pancreas.(Read more @ wuxiax.com)

In the operation field, it is clear that there is an upward bulge on the surface of the pancreas, and the top of the bulge is the root of the right omentum vessel.

This is used to judge the signs of arteries and veins, and some experienced doctors often use this to distinguish. The arteries are walking up along the bulge, and the veins are walking down.

At the top of the protrusion, the right omental vein and the right colon vein merged into a trunk, and Zhou Yuan carefully ligated it with the 7th thread.

“Scalpel, scissors.”

Hearing the appliance, the ocean asked curiously, “A sharp separation this time?”

Zhou Yuan nodded: “The subpyloric lymph node is separated. It needs to be carefully cut, otherwise it will be difficult to separate successfully.”

Zhou Yuan slowed down his movements, increased his strength a little, pulled the tissue to both sides to make it tense, and then used a scalpel to make a vertical and short cut along the tissue gap.

In some places where the tissue gap is very small, Zhou Yuan replaced it with surgical scissors. He used the scissors tip to penetrate into the tissue gap, opened the scissor handle to separate the tissue, and then cut it apart.

He Jianyi’s eyes widened.

Whether it’s separating or cutting, Zhou Yuan’s movements are textbook-level, and they are simply art!

“Can I be the second assistant often in the future?” Jiang Xiaoqi swallowed and said.

Sun Meng’s big eyes refused to blink: “I want to come too, I’ll be a fourth assistant.”

Zhou Yuan did not notice the conversation between the two of them. After completing the separation, he found the lower edge of the duodenum, stretched the duodenal wall to the right, and ligated the right omental artery at the root.

“Fuck… it can still be like this!”

The ocean finally understood why Zhou Yuan had to separate the duodenum instead of cutting it off.

In doing so, the dense subpyloric veins are directly avoided and the risk of surgery is reduced!

“The next step is to cut the duodenum.” Zhou Yuan said.

Before Zhou Yuan could speak, Haiyang immediately handed the non-invasive bowel forceps up.

Zhou Yuan smiled, it seems that the ocean has caught up with the rhythm.

Zhou Yuan moved his stiff neck and went back to the operation.

At a distance of about centimeters from the pre-pyloric vein, Zhou Yuan clamped the duodenum with an atraumatic intestine.

“Kocher pliers.”

Kocher forceps are toothed vascular forceps, which are used just as the name suggests.

Zhou Yuan took it and clamped Kocher to the proximal end of the duodenum.

Then, the duodenum was cut easily between the two forceps.

Zhou Yuan was about to stretch out his hand, Haiyang immediately handed out the hemostatic forceps with a smile on his face: “You want this, right? Hey…”

Zhou Yuan’s face froze, “Yes.”

After receiving the hemostatic forceps, Zhou Yuan began to separate the fibrous tissue between the posterior wall of the duodenum and the head of the pancreas.

“Zhou Yuan, how do you choose now?” He Jianyi couldn’t help asking.

It is time to choose which gastrointestinal reconstruction technique to use. If the jejunum replaces the stomach, then the duodenal stump must be sealed. If the jejunum and duodenal anastomosis are inserted between rows, the stump of the duodenum needs to be retained for later anastomosis.

The choice made will directly affect the patient’s digestion and quality of life.

Everyone, including He Jianyi, focused their eyes on Zhou Yuan.

———

The eighth watch is sent, and the ninth watch is started!

Brothers, we are very close to the number one on the monthly ticket list. Whether this book can land in the first place on the Feilu monthly ticket list is up to everyone, ask for a monthly ticket! Ask for a monthly pass! Ask for a monthly pass! .