Back to 1999: From operating surgeons to becoming a top doctor

The patient was lying on the operating table in a supine position. As the third bag of red blood cells was transfused, the blood pressure increased significantly.

Because the spleen is located in the left upper abdomen, it is very difficult to perform traditional surgery. Therefore, Xiao Chenguang chose the four-hole method for safety reasons.

The observation hole was established 1 cm to the left of the navel, and the puncture needle was inserted at 30 degrees to avoid blood vessels and mucosa.

"Wenxia, ​​connect the gas cylinder."

"Okay."

As soon as the voice fell, the half-human-high blue carbon dioxide gas cylinder made a buzzing sound.

The patient's lower abdomen began to bulge slightly. Xiao Chenguang glanced at the blood oxygen saturation on the monitor and maintained above 90%.

It means that there is no problem with the establishment of the puncture card.

"Gao Yang, you come to establish the operation hole and the auxiliary hole."

In laparoscopic surgery, the establishment of the observation hole needs to be close to the abdominal wall. The puncture is the most difficult and the most likely to go wrong.

The last time Lao Wang rescued a pulmonary embolism, it was most likely that the card was established and the blood vessels were accidentally injured.

When the carbon dioxide gas was continuously pumped in, the intra-abdominal pressure was too high, and the gas entered the blood circulation, which caused the blood pressure and oxygen saturation to drop.

"Okay."

Lin Gaoyang took the puncture needle, but the last rescue was still vivid in his mind, which made him hesitate to insert the needle.

"Don't worry, I'll watch, it's okay."

The pneumoperitoneum is now fully established, the peritoneum is pushed open, and the puncture is simpler than the observation hole, so Xiao Chenguang asked Lin Gaoyang to do it.

Then, under Xiao Chenguang's guidance, the operation hole and auxiliary hole were established in the patient's left axillary line, the left midclavicular line rib margin and the left side under the xiphoid process.

The instrument entered, and as the screen lit up, the abdominal cavity structure was clearly visible.

"The patient's spleen is too large, this is already considered a giant spleen."

There was a cry of surprise in the operating room.

The spleen of a normal adult is 10 long, 6 wide, and 3 thick, and weighs only 100-200 grams.

But the spleen on the screen is deformed and enlarged, and even almost fills the entire screen.

Visually measuring its weight, it is estimated to be seven or eight times that of a normal spleen.

"Boss, can this still be cut?"

As the camera hand, Lin Gaoyang not only checked the patient's spleen when exploring the abdominal cavity, but also just looked at the liver.

As the culprit of this emergency.

The condition of the liver is also not optimistic. The hardened and atrophied part accounts for 90% of the whole liver, and irregular wrinkles have appeared on the surface of the liver, which is likely to induce liver cancer.

If this is not done carefully, the patient may lie on the stage and cannot get up.

"At least she can say goodbye to her family soberly."

The situation in the abdominal cavity is worse than Xiao Chenguang imagined.

Generally, at this stage of exploration, most doctors will go down the stage to talk to the family members and then give up the operation.

Because 80 to 90 percent of patients have lost the meaning of surgery and are likely to die.

But Xiao Chenguang didn't think so at the moment.

"Electrocautery, prepare to free the spleen."

Seeing that Xiao Chenguang was going to continue, Li Wenxia immediately took the high-frequency electrosurgical device.

Crackling...

The electrosurgical knife started, making a buzzing sound.

Xiao Chenguang stepped on the pedal, controlled the electrosurgical knife, and began to operate in the abdominal cavity.

"Negative pressure suction."

"Understood."

When the electrosurgical knife freed the spleen and stomach ligament from the upper part of the greater curvature of the stomach, a puff of smoke rose from the screen.

Lin Gaoyang held the mirror with one hand and inserted the negative pressure suction device from the auxiliary hole with the other hand and started it.

The smoke dissipated and the spleen hilum was exposed.

Then Xiao Chenguang began to separate the splenic artery, ligated it, and freed the lower pole of the spleen, the retroperitoneum, and the upper pole of the spleen in turn.

Fully free the spleen.

The whole process was very fast. Lin Gaoyang, holding the camera, could hardly keep up with Xiao Chenguang's speed.

"4-0 line, change to long forceps, deal with the splenic pedicle blood vessels."

This step is the key and difficulty of freeing the spleen.

If you are not careful, the blood vessels will be torn, which will cause heavy bleeding again.

At this time, Xiao Chenguang missed the vascular linear cutting stapler commonly used in later generations, which can clamp and cut all blood vessels with one shot.

Save time and effort.

But now, Xiao Chenguang can only ligate and cut one blood vessel at a time.

Everyone in the operating room did not dare to disturb Xiao Chenguang at this moment.

Everyone looked at the screen at the same time. In the whole picture, only the needle holder and separating forceps controlled by Xiao Chenguang were operated in a limited space.

The hand muscles moved slightly, and the instrument on the screen rotated with it, wrapping the black silk thread around the blood vessel, and then pulling it tightly to ligate and cut the blood vessel.

Over and over again, in a cycle.

"Put on a condom and use the net to retrieve the spleen."

After an unknown amount of time, when Xiao Chenguang's words rang out in the operating room, everyone breathed a sigh of relief.

At this point, Xiao Chenguang had completely freed the spleen pedicle and pierced the left upper abdomen.The puncture hole was enlarged to 20cm.

"Director Xiao, I'll give it to you."

Li Wenxia handed the plastic recycling bag that had been prepared long ago to Xiao Chenguang.

He manipulated the clamps on both sides, held them tightly and stretched them open, and then a spleen larger than a fist was put into the bag and taken out.

With a heavy dark red spleen placed in the treatment bowl, the operation came to an end.

Although the remaining gastric vascular resection was also difficult, it was much simpler than this operation.

Like the coronary vein of the gastric branch, the esophageal branch, the left inferior phrenic vein, and the left gastric artery and vein located in the pancreas.

Xiao Chenguang treated all the parts that caused the blood vessels to swell.

At least for him, after this operation, the patient will not have upper gastrointestinal bleeding in his lifetime.

As for liver problems, Xiao Chenguang could only sigh helplessly.

Many hepatitis patients will not have serious liver cirrhosis problems as long as they pay attention to diet and treatment.

Naturally, there will be no problems like the ones faced by the patients in this operation.

In the final analysis, the lack of publicity and the lack of attention accounted for a large part of the reasons.

The operation went smoothly and the patient was successfully weaned from the ventilator and extubated.

The moment he woke up, he seemed like a different person.

He was gentle and spoke softly, without any of the tantrums he had just thrown.

This surprised Lin Gaoyang, who had been guarding the patient table.

"Brother Liu, Wenxia, ​​thank you for tonight."

The operation was successfully completed, and Xiao Chenguang expressed his gratitude in the operating room.

After all, he was pulled in late at night to perform the operation, and he was not attending the class. He was able to come entirely for Xiao Chenguang's sake. This favor must be remembered.

"It's okay. I was going to stay up all night to write the score, but I didn't expect that you could complete such a big operation in two or three hours. It's really amazing."

Liu Tie couldn't help but sigh.

Xiao Chenguang is really a man who does great things quietly. Laparoscopic splenectomy is something I have never heard of, not to mention in Yingcheng, even when I was studying laparoscopy in the provincial capital.

Xiao Chenguang did the operation secretly at night. If he could write a paper and publish academic research, it would make a group of people excited.

No, I have to talk to Xiao Chenguang next time. If there is such an operation in the future, I will record it in advance.

Even if he doesn't have time to do it, I can help. After all, he is the main surgeon in the same operation, but anesthesia can also take a place. When the article and technology are published, I can also benefit from it.

"Xiao Xiao, it's okay, we will go back. At this time, maybe we can watch a game. What if we win."

Hearing Liu Tie's words before leaving, the muscles at the corners of Xiao Chenguang's mouth twitched.

He really wanted to tell Liu Tie that for his own health, it is better not to have expectations for this sport.

Otherwise, it is easy to have high blood pressure.

Afterwards, with the family members grateful, the patient was safely pushed back to the ward for 24-hour monitoring and observation of vital signs.

After explaining the precautions to Lin Gaoyang, Xiao Chenguang returned to the small intensive care unit.