Start with an emergency physician

"If he heard this, he would probably wake up in shock.……"Haiyang joked.

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

"The operation begins."Zhou Yuan said after looking at the time.

The scalpel fell.

Zhou Yuan chose the most common opening method, which is the midline incision in the upper abdomen.

"So accurate!" Jiang Xiaoqi was a little surprised.

Generally speaking, in open surgery, the surgeon will choose to make a horizontal incision of the anterior sheath of the rectus abdominis one centimeter above the navel to determine the position and width of the linea alba, so as to confirm the open abdominal incision.

Those who dare to operate directly are extremely confident in their surgical skills.

Zhou Yuan explained while operating:"The position of each person's organs is slightly different. Before the operation, I learned about the position of the patient's organs. Moreover, my hands are relatively steady and my sense of direction is good, so I can perform an open abdomen with one cut."

He Jianyi:"Haiyang, have you learned it?"

Haiyang nodded excitedly:"I have learned it, but I don't know how to do it!"

A few minutes later, the abdominal cavity was opened and the stomach was exposed.

It can be seen that there is a large tumor in the stomach body, surrounded by a large amount of colon, which is yellow and has many small blood vessels.

At this point, Zhou Yuan's face became serious.

After opening the abdomen, the organs in the abdominal cavity must be explored to confirm the metastasis of cancer cells. This step requires strict adherence to the principle of tumor-free operation, that is, not touching the tumor.

Once the tumor is scratched, the cancer cells are likely to spread through the blood. At that time, the patient may be beyond help.

He Jianyi, Jiang Xiaoqi and others also held their breath. At this time, no one dared to speak to disturb Zhou Yuan.

""Curved forceps." Zhou Yuan said.

The exploration process followed the principle of starting from far to near.

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

Then the liver, from the diaphragmatic surface, the visceral surface, to the liver hilum, spleen hilum and then to the pancreatic tail.

"The tail of the pancreas needs to be removed."The tumor has implanted here.

As soon as Zhou Yuan finished speaking, Haiyang immediately took note.

""Oval forceps." Zhou Yuan said.

Total gastrectomy is a major operation in the gastroenterology department, and only the director dares to perform it. In the emergency department, even if they can remove half of the stomach, they are considered to have superb skills.

Therefore, except for He Jianyi and Jiang Xiaoqi who understood what Zhou Yuan was going to do next, everyone else was confused. They didn't know what to hand over until Zhou Yuan called for the instruments.

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

Next, he began to check the infiltration range and mobility of the tumor.

"Adhesions occurred in the pancreas and transverse colon mesentery, and some lymph nodes were metastatic."

Haiyang immediately noted it down.

After completing the first full exploration, Zhou Yuan went from left to right, up and down, and from front to back. After confirming the final resection range, Zhou Yuan put down the oval forceps.

Haiyang stared at the patient's stomach and said,"I have never seen such a beautiful stomach. Whether it is the shape or the curvature, it is perfect. I really want to know how beautiful it was before gastric cancer!"

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 gastrectomy, I will remove the tumor and give it to you?" Zhou Yuan said.

Haiyang was stunned and shook his head frantically.

"Teacher, please block the blood circulation of the gastric artery and vein."

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

He Jian nodded and took action quickly:"Blocked."

Zhou Yuan nodded,"Director Jiang, please help me"

"Are you going to... suture the left and right gastric arteries and veins?" Jiang Xiaoqi was a little surprised.

This speed is too fast...

Zhou Yuan did not speak. After Jiang Xiaoqi took the oval forceps and adjusted the stomach position, he immediately picked up the needle holder and sutured the right gastroepiploic artery and vein with No. 4 thread.

"S-shaped retractor."

Zhou Yuan held the retractor and carefully pulled the liver upwards, while asking Jiang Xiaoqi to pull the stomach downwards, exposing the hepatogastric ligament.

"Tissue scissors"

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

Haiyang immediately ran over happily.

Damn, major surgery is good. Before, I could only count the gauze with the little nurse, but now I am the third assistant and can actually observe the liver up close!

He Jianyi pouted on the side.

Is this still my disciple!

Isn't it just a liver? Why are you so excited?!

""You are useless!" He Jianyi cursed with a smile.

At the same time, he was also happy that he could find a vascular clamp when Zhou Yuan was the surgeon.

Zhou Yuan moved quickly. After fixing the liver and stomach, he quickly found the bloodless part of the liver and stomach ligament, cut it with tissue scissors, separated the right gastric artery and vein, and cut and ligated it neatly.

In the same way, Zhou Yuan sutured and ligated several arteries and veins on the left side.

"Next is the omental bursa resection."Zhou Yuan said.

The reason why he shouted out was, on the one hand, to tell the instrument nurse and Haiyang what instruments he might use, so that they could prepare them in advance.

On the other hand, it was also a teaching method.

In any case, there were only a few people who could master the master-level total gastrectomy, not to mention in Yanjing International Hospital, even in the whole country. Being able to observe it up close was beneficial to everyone present.

""Okay!" Haiyang realized Zhou Yuan's intention and was touched.

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