When doctors have a simulated operating room

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Provincial Hospital, Gastrointestinal Surgery.

Department Director Shen Wei saw Zhang Yi’s video of radical treatment of cardiac cancer in a medical forum.

I was dumbfounded just looking at it!

"Where is this boss?! Why is he so powerful!"

But if you take a closer look, it seems like you have seen this person’s operating techniques somewhere before? !

Where is it?

"By the way! The last time I saw such awesome operations and suturing was on the day of Professor Xu Changxu's surgery!"

"It's Zhang Yi! This big guy is Zhang Yi!"

For a time, the director of gastrointestinal surgery quietly became a little fan of Zhang Yi~

Jingle Bell!

Suddenly, the gastrointestinal surgery phone rang.

Shen Wei picked up the answer: "Hello, gastrointestinal surgeon."

"Consultation? Okay, I'll be right over."

The hepatobiliary surgery department downstairs asked for a consultation and said that a female patient in her thirties had arrived and a joint consultation was needed.

In the consultation room.

Family members, all doctors from the hepatobiliary surgery department, oncology surgery department, gastrointestinal surgery department, radiology department, urology department, anesthesiology department, and pathology department gathered together.

It was for a patient named Jiang Weiwei.

"The patient is a female. Her lower abdomen bulged and gradually increased four months ago. At first, she thought she was pregnant so she didn't pay much attention.

Later, he was examined at the local county hospital and found that it was suspected to be a tumor, so he went to the provincial hospital for a review. "

"This is the abdominal CT report of this patient that just came out this morning. Please take a look."

The oncology surgeon turned on the projection, and a very clear gray CT image immediately appeared on the wall.

It doesn't matter if you don't watch.

This sight shocked everyone present!

"What is this? Is it a tumor? Why is it so big!"

"Yes, it's a tumor, and it's a giant tumor with a diameter of 23 centimeters!"

Hearing this, the doctors in the office took a silent breath.

“The patient’s tumor almost occupies most of the pelvic and abdominal cavity and compresses the digestive tract, squeezing the entire stomach into the diaphragm. He cannot eat much and feels tired even after walking for only a few minutes.

There is also weight. Six months ago, I weighed 120 kilograms. As my belly became bigger, I also lost weight in the past four months. Now I only weigh 103 kilograms.

And this CTA, look at the blood vessels on her tumor. The diameter of the tumor blood vessel wall is almost two centimeters.

I guessed that the tumor must be connected to the mesentery, great blood vessels, ureters, and important organs throughout the abdominal cavity. "

"The surgery is very difficult, and we need to discuss the surgical plan with everyone. After deciding on a surgical plan, we can try virtual surgery first to see if it can be successful."

After the oncology surgeon finished speaking, the pathologist suggested:

"Let's do a puncture biopsy first to see if the tumor is malignant? If it is malignant, then a tumor as big as hers must have invaded her liver, gallbladder, pancreas, spleen and stomach."

If it is malignant and has invaded multiple organs, then the operation is of little significance.

The oncology surgeon nodded: "I just finished it this morning and the specimen has been sent to the laboratory."

Generally, the waiting time for a needle biopsy is relatively long, about four to five days.

The results will be available within a few hours.

Of course, the prices of the two are definitely different.

"I have seen a case from a foreign hospital before. The tumor adhered to several organs in the peritoneum and the entire peritoneal wall. It was very difficult to dissociate. The entire tumor was like a stone and was completely stuck inside. I had to find it if I wanted to dissociate it. There is no place to cut the knife.

When their doctor opened the abdomen, they found that the intestines and urinary tube were squeezed out of shape, and a large pile of feces and excrement accumulated in the bend of the intestine.

I see that this tumor is similar to the one in that case. It is estimated that the entire pelvic and abdominal cavity is adherent. This kind of surgery is too difficult.

Moreover, the diameter of the blood vessels on the tumor blood vessel wall is also two centimeters, which shows that the blood vessels in the tumor are very tense. Once they rupture and bleed, there is no place to stop the bleeding.

Therefore, I suggest that we directly open the abdomen to check the situation and do the best we can. If it cannot be done, the patient should be transferred to Imperial or Modu Hospital immediately. "

The urologist suggested.

The hepatobiliary surgeon shook his head: "We are a provincial hospital. If we can't perform this operation, isn't it a loss of reputation?"

As soon as the hepatobiliary surgeon said this, everyone in the other departments nodded.

"Yes, I remember there was a 15-centimeter tumor the year before last. Shouldn't we also remove it? This 23-centimeter tumor is very difficult, but if we all work together and dissociate it bit by bit, it shouldn't be a big problem. " said the anesthesiologist.

this kind of surgery

It is similar to radical resection of gastric cancer.

It is not difficult to say.

But it is definitely not simple to say.

It is very troublesome, and the trouble is to free it.

Separate the adhesions of organs bit by bit.

And it is very challenging for the doctor's eyesight and anatomical knowledge.

You must know which oblique abdominal muscle is cut and which connecting ligament is cut.

Otherwise, if you cut a large blood vessel, it will be a life.

An hour later.

After the discussion, the doctors decided to open the abdomen and free it directly.

They chose to believe in themselves~~

After a series of examinations, fortunately, the tumor is not malignant.

As long as the large tumor is removed, the patient can resume his normal life.

In the operating room of the provincial hospital.

The doctors swore and were full of confidence.

The patients and their families also believed in the doctors of the provincial hospital.

After all, it is the provincial hospital, and they are all big guys.

The chief surgeon is the deputy director of the Department of Oncology, Yu Shen.

The rest of them helped to free the tumor. Of course, they were all chief physicians of gastrointestinal surgery and urology.

The operation was very difficult, so those who came were all experienced.

The young doctor could only stay in the monitoring room next to him.

Tracheal intubation, general anesthesia, skin preparation, disinfection, and drape.

Midline incision in the abdomen.

Because the tumor was very large, in order to fully expose the surgical field.

Yu Shen enlarged the incision to fifteen centimeters.

As the electric knife went down little by little, the epidermis, fat, and muscle were pulled apart.

But what everyone didn't expect was.

Fifteen centimeters of incision can't see anything? !

Looking at the deep red tumor in front of him, the tumor seemed to be about to burst out as soon as the skin was opened with a spreader!

Completely blocked the incision!

"No, I can't see the boundary clearly. Expand the incision again."

The fifteen centimeters incision was enlarged to twenty centimeters!

Look again.

Now I can see the boundary a little more clearly.

But due to the need for the operation, Yu Shen enlarged the incision by another five centimeters.

Then, he used a spreader to spread the skin on both sides.

Now, the situation of the entire abdominal cavity was completely exposed to everyone.

But for a while, the entire operating room was quiet...

Why was it quiet?

Because people were stupid!

Yu Shen believed that he had never seen such a tumor in his more than 20 years of medical practice!

It almost fits the entire stomach, intestines, bladder and various other blood vessels and fascia!

It's like someone glued it in with glue!

How can this be cut? !

In the operating room, it was terribly quiet.

No doctor could take on this tricky job.

It's troublesome and complicated, and the difficulty is very high.

It's not known whether there are arteries and large blood vessels in the organs and blood vessels where the tumor adheres.

If there are, it will be even more troublesome!

Yu Shen looked at the doctors nearby:

"Um...this operation..."

Next to him, the urologist hesitated for a while and said:

"How about...sending the patient to Rong Province Cancer Hospital after closing the abdomen? Professor Wang Pingqi of the Cancer Hospital is an expert in oncology. The case I mentioned before was performed by Professor Wang Pingqi."

The doctors were silent.

Really send the patient to Rong Province?

Why don't you trust yourself and try to move it?

Suddenly, Shen Wei, the director of gastrointestinal surgery, who was standing in the second assistant position, suddenly said:

"I have a way to avoid sending the patient to Rong Province. We can do it ourselves!"

Everyone looked at him: "What method?"

Shen Wei: "Ask Zhang Yi to help!"