When doctors have a simulated operating room

The doctor said that the operation was a complete failure.

One hundred percent? ?

Yes!

Qian Zhenggang asked Zhang Yi to perform the operation just for this one hundred percent certainty.

After finding out that his mother had a malignant uterine fibroid, considering the age and size of the fibroid, Qian Zhenggang only thought of Zhang Yi!

Only Zhang Yi would say that he was one hundred percent sure when performing this kind of operation!

So...

Zhang Yi seemed very anxious when he heard Qian Zhenggang's tone.

Come to think of it, who wouldn't be anxious if his mother was sick and had a tumor?

Zhang Yi turned around and gave him a reassuring look:

"Dean Qian, since you are here, I will definitely try my best. I dare not say that I am 100% sure now, but... I can still try my best with a 99% chance."

Hearing this, Qian Zhenggang's face showed a look of relief.

Ah~

The 99% you said... that is the 100% in my eyes!

"Okay! Thank you Zhang Yi! Thank you! Don't worry, I won't let you make this trip in vain."

Zhang Yi said politely:

"Dean Qian, let's not talk about this for now, the operation is important."

Then Zhang Yi looked at the other people in the office and said:

"As for the surgical plan, my suggestion is to perform it under colposcopy, without making a surgical opening in the abdominal cavity.

Because this patient is already 70 years old, surgery is not conducive to recovery, and colposcopy is the most suitable for her."

After Zhang Yi said this, several gynecologists looked at each other and asked hesitantly:

"But...but the tumor is too big, Whether it is the position or the surgical field, the colposcopy is not as clear as direct surgery.

We are considering this question, whether colposcopy is more suitable or abdominal surgery is more suitable.

If you choose to have surgery, once the abdomen is opened, the surgical field of the entire lower abdomen will be very clear, and it can also avoid the possibility of accidentally injuring blood vessels during surgery and carefully release the pressure of the ureter.

Even the doctor's operating space will be very spacious.

But if it is a colposcopy, the surgical field and operating space are not so wide, and you look at this position. "

The gynecologist said while switching the stereoscopic 3D image on the projection wall.

"Here, the largest fibroid squeezes the posterior fornix without a single gap, let alone the uterine opening?

If it is a colposcopy operation, the lens may not be able to determine the exact location of the fibroid as soon as it is inserted.

Zhang Yi, did you not do a colposcopy? This is the patient's colposcopy picture, you can take a look.

You can't even see the uterine opening when you go in, it's all bulging fibroids. "

As he said, he changed another photo.

The photo shows a female colposcopy.

The normal result should be that after the dilator is used to dilate the vagina, the doctor can see the normal rosy cervix inside as soon as the vagina is opened.

Because the cervix is ​​facing the vagina.

But this is not the case in the image in front of me.

Not only is it not the case, but I don’t know where the cervix is ​​crooked.

The normal cervix is ​​very easy to recognize, it is a bit like the shape of an asshole.

It is the chrysanthemum style.

If it is a cervix that has given birth, it is a chrysanthemum style with the word "一".

Dean Qian’s mother must have a cervix with the word "一" chrysanthemum style.

But there is no such thing in the picture. Instead, the enlarged fibroids have blocked the entire front end of the vagina.

The entire front end is even a little congested.

In such a crowded situation, how can it be operated? ? !

Even if it can be operated, the operating space is too small!

It is not as direct as operating on the abdomen!

Although direct surgery would be more dangerous for the old lady, and the recovery would be slower in the later stage.

But!

If the colposcopy is not performed properly, wouldn’t the old lady die on the spot? ?

Who will take this responsibility? ?

Hey!

In short, both surgical methods have advantages and disadvantages.

Now it depends on which one is better and safer.

Looking at the picture on the projection wall, Zhang Yi said:

"As for colposcopy, colposcopy is safe, less traumatic and faster in the later stage.

As for the problem you mentioned that the operating space is too small and crowded, this... is not a problem, I can solve it."

—

Hiss!

Hiss!

Hiss!

It's you, Zhang Yi!

The most critical and tangled problem that other doctors think is...

is not a problem in Zhang Yi's mouth! !

Hey!

The same doctor

A doctor from a hospital, no wonder he was chosen by the president of Union Hospital...

This is the difference!

"Ahem... Well, since you said so, Zhang Yi? Why not..."

"Okay! Then Zhang Yi, when do you think the surgery is appropriate? I have already arranged the preoperative preparations last night."

Qian Zhenggang said impatiently.

"All the preoperative preparations have been done?!" Zhang Yi was a little surprised.

"Yes, I had already arranged it when you agreed to come, and I knew that you, Zhang Yi, could do it!"

"Okay, since that's the case, let's not waste time and prepare for the surgery."

"Okay!"

Seeing Qian Zhenggang's obedience to Zhang Yi, everyone was moved.

Hey!

Zhang Yi is really different after he came back from Union Hospital.

Soon, the operating room was ready.

Zhang Yi was the surgeon, and President Qian and the doctors from the gynecology and oncology departments assisted him.

The news that Zhang Yi came back for surgery spread throughout the hospital.

In the operating room, besides the directors who were assistants, there were also many doctors who came to watch the operation.

Zhang Yi also knew these people.

Some had pursued him, some admired him, and some were interns he had led.

"Doctor Zhang~"

"Long time no see, Doctor Zhang!"

"It's time to watch your operation again, Doctor Zhang."

As soon as these people came in, they took the initiative to greet Zhang Yi.

Zhang Yi nodded to them one by one.

"Why are there so many people coming in? No, no! All go out, only the assistants!"

Qian Zheng had just changed his clothes and came in when he saw this scene.

The entire operating room was crowded with more than ten or twenty people.

This is an operating room, how can so many people work? ?

"Ah? Dean Qian, can't we just come in and take a look?"

"That's right, Dean Qian, can we watch Zhang Yi's surgery?"

"No! Do you think this is a simple surgery? What if something goes wrong?

Get out now! Go outside and watch! Don't let me say it a second time!"

"Oh..."

"Oh..."

Seeing that Qian Zhenggang seemed to be about to get angry, everyone quickly slipped away.

To avoid being affected and angered.

The operating room was now empty.

On the operating table, the old lady was given general anesthesia and respiratory induced anesthesia.

Because she was Dean Qian's mother, the doctors who were assisting were actually a little nervous.

Especially Qian Zhenggang himself!

This was the first time in his life that the person lying on the operating table was not someone else, but his own family!

This feeling...

It was so wonderful...

——

"The time is 9:21 am, the patient's vital signs are normal, and the blood oxygen is normal."

"Okay, the operation begins!"

Just when Qian Zhenggang was stunned for a while, Zhang Yi had already started.

Colposcopy requires the patient to lie flat with legs raised and placed on the foot pad at the bottom of the operating table.

The surgical site must be completely exposed.

Disinfection first.

Before entering the operating room, the skin preparation has been done.

So at this moment, Zhang Yi and Qian Zhenggang are holding iodine cotton balls to apply a large area of ​​the patient's entire perineum, lower abdomen, and the position of the anus behind.

The lower abdomen, perineum, inner thighs on both sides, and anus, all need to be taken.

"Vaginal dilator."

After disinfection, the surgical channel is opened.

First use the vaginal dilator to open it, and then use the titanium alloy dilator used in abdominal surgery to dilate it again.

This way the surgical field can be slightly larger.

Seeing his mother being "tortured" like this, Qian Zhenggang felt a little uncomfortable.

But it can only be like this.

Compared with open abdominal surgery and colposcopy surgery, the trauma is too great.

Later, chemotherapy drugs must be taken, and the wound must be ensured to recover as soon as possible.

A 70-year-old old lady...

Qian Zhenggang was afraid that his mother would not be able to hold on.

So Zhang Yi's colposcopy surgery was the best choice for his mother at the moment.

"Open it, hold it, I've disinfected it."

After opening the vagina, disinfect the operating channel inside with iodine, including the uterine fundus.

"Give me the vaginal mirror."

Zhang Yi showed that he took the vaginal mirror and inserted the lens into the pelvic cavity through the gap opened by the expander.

On the display screen, everyone saw the scene inside.

The old lady was fat. In addition to the large proportion of fat in her abdomen, the 17-centimeter uterine fibroids were the largest.

The lens went up and then turned around. When it bypassed the bladder, it got stuck and could not be moved.

"See, it's too crowded. I suggested that we should do the surgery directly before. The surgical field environment is too bad."

Seeing this scene, several other directors frowned and looked at Qian Zhenggang.

It seemed that they wanted to give Qian Zhenggang a suggestion to change the surgical method.

.

Qian Zhenggang said nothing.

He also knew that in such a crowded situation, it might not be possible to find blood vessels to ligate even if he went in with the electrocoagulation knife, not to mention that the entire uterus would have to be peeled off after ligation.

But...

Suddenly, Zhang Yi said without raising his head:

"It's okay, give me the electrocoagulation knife."

Everyone looked at Zhang Yi.

This kid...

is really confident!

"Okay...!"

Qian Zhenggang believes in Zhang Yi!

"Here you go!"

As he said that, he handed the electrocoagulation knife to Zhang Yi.

When Zhang Yi was exploring the way with the electrocoagulation knife, he stretched his hand in and said:

"Stretch it a little more, as long as the largest fibroid is removed, the surgical field will be much wider."

So, Qian Zhenggang and others pushed again to expand Zhang Yi's operating range as much as possible.

Following the direction indicated by the colposcope, Zhang Yi inserted the electrocoagulation knife into the pelvic cavity.

"Inflate."

"Okay."

During abdominal surgery, carbon dioxide gas is injected into the abdominal or pelvic cavity to prop up the entire peritoneum and abdominal skin, which can also expand the surgical field and operating space.

Soon, the old lady's belly became bigger.

However, it was not abnormally large, but the internal inflation caused the abdomen to be forcibly expanded.

Although the operation port was narrow and tight.

But it was enough for Zhang Yi.

Under the camera, Zhang Yi first began to swim from the ligaments and fascia around the uterus and its appendages.

Peel off the tissues associated with the uterus bit by bit.

Then use sutures to ligate the blood vessels.

The uterine artery and the bladder artery are actually branches of the common iliac artery.

From the common iliac artery, there are internal iliac arteries, external iliac arteries, superior gluteal arteries, inferior gluteal arteries, as well as superior bladder arteries, uterine arteries, etc.

Therefore, before starting to peel off the uterus, or before freeing the largest fibroids, the common iliac artery must be clamped first.

The superior vesical artery is in the upper part of the uterine artery.

Zhang Yi ligated the blood vessel just three centimeters above the superior vesical artery.

It is necessary to ensure that the blood flow to the uterus is cut off, and other organs are also supplied with blood during the operation.

The length of the channel for girls is generally about 10 centimeters.

Therefore, the operating instruments used in this operation are at least 20 centimeters long.

"The blood vessels have been ligated. I will first free the largest fibroids, take them out, and then completely remove the uterus and ovarian appendages."

"Okay!"

Seeing Zhang Yi's skillful and precise technique, the big leaders nodded one after another.

Zhang Yi performed the operation, just watch it.

Why are you talking so much~

The main blood vessels supplying blood to the entire uterus were ligated, and Zhang Yi was much bolder in freeing.

No longer afraid of bleeding.

Of course, the action still needs to be fast, after all, the patient is a 70-year-old old lady.

The total amount of bleeding will be controlled after ligation, but a small amount of bleeding will definitely still occur.

In addition, the ligation time should not be too long.

Therefore, Zhang Yi's actions were still very quick.

The tumor was very large, even larger than the uterus.

Zhang Yi showed blunt separation along the curved edge of the fibroid.

As soon as the knife was cut, blood gushed out.

Qian Zhenggang's heart tightened when he saw this scene!

Although he was prepared for bleeding.

But he still felt distressed when he saw the blood gushing out.

The person lying on the bed was his elderly mother.

If he hadn't been too busy with work and neglected her health, the fibroid would have been detected and removed at the smallest time.

Alas!

Now it has turned out like this...

He, as a son, is guilty!

"Try to see if the suction device can be inserted in to flush it." Zhang Yi suddenly said.

"Oh, okay!"

The bleeding now is the blood that was already in the uterus before the blood vessels were clamped.

So there will definitely be bleeding, but it can be controlled.

Sizzle~

After flushing and suction, the freeing continues.

Most fibroids are derived from the proliferation of uterine smooth muscle cells, and a small number of fibroids also contain fibrous tissue.

Generally, fibroids are round, or large, small, or oval.

The larger the fibroid, the easier it is to squeeze and cause the inside of the uterine cavity to deform.

If the fibroids of women with fertility needs are too large and cause stenosis in the uterine cavity, it will also cause infertility (too narrow to prevent sperm from passing through, and after conception, it cannot implant and form an embryo).

Qian Zhenggang's mother has been completely deformed.

Still unable to have children, Zhang Yi does not need to consider anything else when he is freeing.

Wow!

Just like cutting pork in the vegetable market, the fibroid was cut out smoothly.

The blood is still flowing.

But the blood pressure has not dropped much

As long as the blood pressure doesn't drop, the person will be stable.

"Give me the tissue forceps, size 7, and come over with the sterile tray!"

Zhang Yi said as he clamped the oversized fibroid.

Qian Zhenggang quickly held the tray and placed it under the perineum and waited.