The next day, Liu Maqiao came to the office of the Hepatobiliary Department 1 early and discussed the surgery with Hua Bucheng and Hu Yidao.
"I went through it again last night. There are better plans in several places. You can follow me through it."
Liu Miqiao started drawing on the 4A paper with a pen, while Fan Jianqiang and another deputy chief physician watched. In fact, they had little to do with the explanation. Retracting hooks was their main responsibility. What they learned was not the methods and steps of today's surgery.
They haven't reached this point yet and have only learned basic skills.
They looked at it very seriously.
This is a groundbreaking operation, a subversive operation. The liver is cut into pieces, and those with cancer metastasis are cut out cleanly. What is left are just scattered liver fragments. Then, the fragments are put back together again.
In the end, it was barely a liver—one-fifth of a liver.
One-fifth of the liver is still a problem. Past knowledge tells us that only one-third of the liver can compensate. Now only one-fifth is left, can it compensate?
No one asked this question because they all knew that Liu Miqiao could not possibly not know it. This is common sense.
Of course, this problem is not impossible to solve. Now that there is an artificial liver, you can use the artificial liver as a transition, and then remove the artificial liver after the liver becomes larger and regenerates.
Perhaps Liu Miqiao thought this way.
Liu Muqiao only talked about the surgical process and precautions, but didn't mention anything else.
"Have I made it clear?" Liu Maqiao asked everyone.
"Understanding" means that you understand it. "Understanding" does not mean that you can do it. No one said anything.
Liu Muqiao doesn't force everyone to understand. He just reminds them what to do during the operation.
"Get ready to go on stage."
The patient has been pushed away by the operating room nurse.
The first assistant is Hu Yidao. He is younger than Hua Bucheng and has greater potential. Liu Maqiao likes to make him his main assistant recently.
Hu Yidao knew that today's burden was heavy, and whether he could cooperate with Liu Miqiao well was crucial to the success of today's operation, so he hurried to the operating room.
Fan Jianqiang and Deputy Chief Doctor Lin have no reason to lag behind.
Only Liu Muqiao and Hua Bucheng can fall one step behind.
There is still a lot of work to be done before the operation.
Positioning the patient, disinfecting, and laying out sterile drapes are all done by the first or second assistant. They may also have to perform catheterization in the operating room, which is Fan Jianqiang's responsibility.
Of course, female patients can also be guided by nurses.
In front of medical staff, gender is not important and is often ignored.
"Liu Miqiao, the patient has one-fifth of his liver left. Are you planning to transition to an artificial liver?" Hua Bucheng couldn't help but ask.
Liu Muqiao shook his head and said: "It's not necessary. The cancer has almost occupied the entire liver, and it has already been able to compensate."
Hua Bucheng was slightly startled, "Are you sure?"
He was not sure whether Liu Muqiao was correct and had no experience in this area. In the past, patients with this kind of disease were mobilized to go home and spend their days at home. Any treatment was meaningless.
"It should be like this."
Liu Muqiao didn't say for sure, that is to say, in his mind, it was not important. The most important thing was to remove the cancer cells through surgery.
Ten minutes later, Liu Muchiao and Hua Bucheng appeared in the operating room, and Hu Yidao and the others also began to wash their hands.
After washing his hands, and with the help of the nurse, he put on the surgical gown. Liu Maqiao did not stand in the surgeon's seat.
Hu Yidao was startled. In this posture, should I do the surgery for a while?
That's right, Liu Muqiao put his hand on the sterile towel and said to Hu Yidao: "You are the surgeon."
Hu Yidao stood at position C and said, "Okay, I'll do the abdominal dissection."
Liu Muqiao said seriously: "Until you can't do it anymore, hand over the surgeon to me."
Hu Yidao was so excited that he almost kowtowed in thanks.
He was following Liu Muqiao in surgery, so it would be great if he could get help from Hua Bucheng. Today, Liu Muqiao actually asked him to perform such a difficult surgery.
Be sure to perform well.
Hu Yidao's surgical skills are quite good. When he was at his old employer Huacheng Hospital, he earned the nickname "Hu Yidao". It was indeed not easy.
Hu Yidao changed his job to Antai Hospital, and his nickname was greatly reduced. Who dared to call him "Yidao" in Antai Hospital?
Except for Liu Muqiao, everyone else is a rookie.
Hu Yidao is quite good at hepatobiliary surgery. Among dozens of chief doctors, he quickly stood out and was on par with Hua Bucheng.
He made a "7"-shaped incision very cleanly and used 7 knives. This is already amazing. There is a huge liver under the 7-shaped incision, which most people would not dare to do.
After clearing the surgical field, some ligaments were cut, and finally the portal venous system was cleared.
These processes were quite satisfactory, and Liu Muqiao did not raise any questions. This does not mean that Hu Yidao did it perfectly, but it did not bother him. For high-level experts, Liu Muqiao adopted an inclusive attitude, and it would be fine if the operation was not perfect.
"Keep going." When it was time to cut out the liver, Hu Yidao hesitated, and Liu Maqiao tapped the hemostatic forceps with scissors.
Hu Yidao began to remove the main tumor tissue.
This big tumor is the size of a goose egg.
It took him 30 minutes to cut it off.
Liu Miqiao looked at the tumor and made an incision to carefully observe the color and texture of the tumor.
This is a habit of Liu Muqiao.
Through observation, he can roughly determine the type of tumor.
Low differentiation.
The answer given in Liu Muqiao's mind.
Very bad.
The lower the degree of differentiation of the tumor, the higher the degree of malignancy, the easier it is to metastasize, and the higher the chance of recurrence.
However, Liu Muqiao's expression didn't change much, which was expected. He then said: "You continue."
Hu Yidao never thought that the mission of the surgeon had not yet been completed.
In the first two and a half hours, Hu Yidao's operation was smooth and the operation was excellent. Liu Maqiao did not put forward any opinions. Now, he encountered a challenge.
According to the preoperative plan, the tumor in the left lobe of the liver should be removed. For the small left lobe of the liver, 3 liver segments need to be cut off, and 4 pieces of liver tissue are retained.
The treatment of blood vessels is the key point.
Hu Yidao's original intention was to return the chief surgeon to Liu Miqiao, but Liu Miqiao asked him to continue, of course he was happy.
It is not often that you have the opportunity to challenge yourself. Today is a rare opportunity. The surgery is difficult and there are experts around to protect you. There will not be many opportunities like this in your life.
Hu Yidao took a deep breath and then exhaled a long breath to calm down.
Here we go.
He slowed down his movements and made them smaller, separating different liver segments step by step. He replaced the ultrasonic scalpel with an ordinary blade. Although there was more bleeding, the damage was less.
It took 15 minutes to remove the first left lobe liver segment.
Liu Muqiao nodded and said: "Yes, well done. Continue."
With the experience of resection of the first liver segment, Hu Yidao became more courageous. This time, it only took him 10 minutes to remove another small liver segment.
Above, on the MRI film, there is a 0.8 cm nodule.
This chapter has been completed!