Start with the emergency physician

“If this sentence were for him, he would probably wake up in fright…” joked Haiyang.

Zhou Yuan ignored Haiyang’s words, stretched out his finger, and began to confirm the part of the open abdomen.

“The operation begins.” Glancing at the time, Zhou Yuan said.

The scalpel falls.

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

“Accurate!” Jiang Xiaoqi was a little surprised.

Generally, in open surgery, the main surgeon will choose to cut the anterior sheath of the rectus abdominis one centimeter horizontally on the umbilicus to determine the position and width of the abdominal white line, thereby confirming the open incision.

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

Zhou Yuan explained while opening the operation: “Everyone’s organ position has some differences, I have learned the position of the patient’s organs before the operation, and my hands are relatively stable, I have a good sense of direction, and I can open the abdomen with one knife.” ”

He Jianyi: “Ocean, have you learned?” ”

Ocean nodded excitedly: “Learned, but not!” ”

After a few minutes, the abdominal cavity opens and the stomach is exposed.

It can be seen that the stomach body has a large tumor, surrounded by a large number of colons, yellow, distributed with many small blood vessels.

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

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

Once the tumor is cut, then the cancer cells are likely to spread through the blood, and I am afraid that the patient will be difficult to save at that time.

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

“Bending tweezers.” Zhou Yuandao.

The exploration 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 diaphragmatic surface, the visceral surface, to the hepatic hilus, the spleen hilus to the tail of the pancreas.

“The tail of the pancreatic body needs to be removed.” Tumor implants occur here.

Zhou Yuan’s words fell, and the ocean immediately wrote it down.

“Oval forceps.” Zhou Yuandao.

Total gastrectomy is a major operation on the gastroenterology side, only the director dares to operate, the emergency department side is not to mention total gastrectomy, can remove half of the stomach is considered sophisticated.

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

After the ocean passed the oval tongs, Zhou Yuan took the oval tongs, lifted his stomach, and then covered it with gauze.

Next, the examination of the extent of invasion and mobility of the tumor is started.

“Adhesions occur in the pancreas and transverse mesangium, and lymph nodes appear partially metastasized.”

The ocean immediately wrote it down.

After completing the first overall exploration, Zhou Yuan went from left to right, up and down, from front to back, and after confirming the final excision range, Zhou Yuan lowered the oval forceps.

Ocean stared at the patient’s stomach and said: “I have never seen such a good-looking stomach, whether it is in shape or curvature, it is perfect, I really want to know how good it looks when I don’t have stomach cancer!” ”

The corner of Zhou Yuan’s mouth twitched.

Beauty….

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

“After the gastrectomy, I cut the tumor by the way and gave it to you?” Zhou Yuan said.

Ocean was stunned and shook his head frantically.

“Teacher, trouble to block the circulation of gastric periphery and venous blood.”

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

He Jian nodded and quickly struck: “Blocked.” ”

Zhou Yuan nodded, “Director Jiang, trouble to help.” ”

“Are you going to… Suture the left and right arteries and veins of the stomach? Jiang Xiaoqi was a little surprised.

That’s too fast….

Zhou Yuan did not speak, and after Jiang Xiaoqi took the oval forceps and adjusted the posture of the stomach, he immediately picked up the needle forceps and used the fourth line to suture the right arteriovenous of the gastric omentum.

“S-shaped pull hook.”

Zhou Yuan held the pull hook and carefully pulled the liver upward, while allowing Jiang Xiaoqi to pull the stomach downward, exposing the liver-stomach ligaments.

“Tissue scissors.”

“Senior Brother Haiyang, help maintain the position of the liver.”

The ocean immediately ran over with joy.

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

He Jianyi pouted on the side.

Is this still his own disciple!

Isn’t it just to mention a liver, excited to be like this?!

“Nothing!” He Jianyi scolded with a smile.

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

Zhou Yuan’s action was very fast, after fixing the position of the liver and stomach, he quickly found the vascular place of the liver and stomach ligament, cut it with tissue scissors, separated the right arteriovenous of the stomach, and cut and ligated it neatly.

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

“Next is the removal of the omentum sac.” Zhou Yuandao.

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

On the other hand, it is also teaching.

In any case, master-level total gastrectomy, let alone in Yanjing International Hospital, even in the whole country, there are few masters. Being able to see it up close is beneficial for everyone present.

“Okay!” Haiyang felt Zhou Yuan’s intentions and was a little moved in his heart.

——

The seventh more ends, the eighth more begins, ask for flowers and evaluation votes to support!