Start as an Emergency Physician

"If he hears this, he will probably wake up in fright," the ocean joked.

Zhou Yuan ignored Haiyang's words, stretched out his fingers, and began to confirm the location of the abdomen.

"The operation began. Glancing at the time, Zhou Yuan said.

The scalpel fell.

Zhou Yuan chose the most common method of opening, that is, the median incision of the upper abdomen.

"Accurate!" Jiang Xiaoqi was a little surprised.

Generally speaking, in laparotomy, the chief surgeon will choose to make a transverse incision of the anterior sheath of the rectus abdominis by one centimeter on the umbilicus to determine the position and width of the abdominal line, so as to confirm the laparotomy.

Those who dare to operate directly like this belong to the extreme confidence in their own surgical level.

Zhou Yuan explained while performing the surgery: "Everyone's organ position has some differences, I have learned about the patient's organ position before the operation, and my hand is relatively stable, the sense of direction is good, I can do a knife to open the abdomen." "

He Jianyi: "Ocean, have you learned?".

Ocean nodded excitedly: "I learned, but I won't!".

After a few minutes, the abdominal cavity opened and the stomach was exposed.

It can be seen that there is a large tumor in the stomach body, surrounded by a large number of colons, yellow in color, and many small blood vessels are distributed.

At this point, Zhou Yuan's face also became grim.

After the laparotomy, the abdominal cavity is examined to confirm the metastasis of cancer cells. This step requires adherence to the strict principle of tumor-free operation, i.e., not touching the tumor.

Once the tumor is punctured, there is a high chance that the cancer cells will spread through the bloodstream, and the patient may not be able to save it.

He Jianyi, Jiang Xiaoqi and the others also held their breath, and none of them dared to disturb Zhou Yuan at this time.

"Bent tweezers. Zhou Yuandao.

The probing process follows the principle of distance and proximity.

Zhou Yuan carefully examined the rectal fossa of the bladder and found no tumor.

Then there is the liver, from the diaphragm and viscera to the hepatic hilum and spleen hilum to the tail of the pancreatic body.

"The tail of the body of the pancreas needs to be removed. "Tumor cultivation is happening here.

Zhou Yuan's voice fell, and Haiyang immediately wrote it down.

"Forceps oval. Zhou Yuandao.

Total gastrectomy is a major operation in the gastroenterology department, and only the director dares to operate it, not to mention the total gastrectomy in the emergency department, and it is considered skilled to remove half of the stomach.

Therefore, except for He Jianyi and Jiang Xiaoqi who understood what Zhou Yuan was going to do next, everyone else was stunned, and they needed Zhou Yuan to shout the utensils before they knew what to deliver.

After Haiyang handed over the oval forceps, Zhou Yuan took the oval forceps, lifted the stomach, and then covered it with gauze to seal it.

Next, the extent of the tumor's invasion and mobility are examined.

"Adhesions occurred in the pancreas and transverse mesocolon, and partial metastases occurred in the lymph nodes. "

The ocean immediately took note of it.

After completing the first general investigation, Zhou Yuan went from left to right, up and down, and back to back, and after confirming the final excision range, Zhou Yuan put down the forceps oval.

Ocean stared at the patient's stomach and said, "I have never seen such a beautiful stomach, both in shape and curvature, it is perfect, I really want to know how beautiful it is when I don't have stomach cancer!"

The corners of Zhou Yuan's mouth twitched.

Beauty....

From a medical point of view, Yang Wei's stomach is indeed basically the same as the stomach in the textbook.

"After the stomach was removed, I cut the tumor by the way and gave it to you?" Zhou Yuan said.

The ocean was stunned and shook his head frantically.

"Teacher, please block the perigastric artery and venous blood circulation. "

Zhou Yuan picked up the oval forceps again and pulled the stomach forward and upward, exposing several major blood vessels.

He Jian nodded and made a quick move: "It's blocked." "

Zhou Yuan nodded, "Director Jiang, please take a hand." "

"You're going to... Stitch the left and right arteries and veins of the stomach?" Jiang Xiaoqi was a little surprised.

That's too fast...

Zhou Yuan didn't speak, and after Jiang Xiaoqi took over the forceps oval and adjusted the posture of the stomach, he immediately picked up the needle forceps and used the fourth wire to suture the right artery and vein of the gastric omentum.

S-shaped retractor. "

Zhou Yuan held the retractor hook in his hand and carefully pulled the liver upward, while letting Jiang Xiaoqi pull the stomach downward, exposing the liver-stomach ligament.

"Tissue scissors. "

"Senior Brother Ocean, help keep the liver in place. "

The ocean immediately ran over with joy.

Damn, major surgery is good, I used to be able to count gauze with the little nurse next to me, but now I am a third assistant, and I can still observe the liver up close!

He Jianyi pouted on the side.

Is this still your own disciple!

Isn't it just a liver, excited like this?!

"It's not promising!" He Jian scolded with a smile.

At the same time, I was also happy that I was able to touch a vascular clamp when Zhou Yuan was the main knife.

Zhou Yuan's movements were very fast, and after fixing the position of the liver and stomach, he quickly found the vascularity of the liver and stomach ligament, cut it with tissue scissors, separated the right artery and vein of the stomach, and cut and ligated it neatly.

In the same way, Zhou Yuan sewed up several arteries and veins on the left side.

"Next is the removal of the omentum sac. Zhou Yuandao.

On the one hand, he shouted out to tell the instrument nurse and the ocean what equipment he might use, so that they could prepare it in advance.

On the other hand, it can be regarded as teaching.

In any case, there are few mastered mastered total gastrectomy in Yenching International Hospital, even in the whole country. Being able to see it up close once is beneficial for everyone present.

"Okay!" Haiyang realized Zhou Yuan's intentions, and his heart was a little moved.

——

The seventh watch is over, and the eighth watch begins, asking for flowers and evaluation votes to support!