Under all the above circumstances, ordinary doctors will be intimidated. As long as the cervical scraping is suspected to be cancer, ordinary doctors will not take the risk and will cut it out completely. They are most afraid that if the removal is not clean, the recurrence will be more serious.
A highly skilled doctor will bravely fight for his patients, provided he has the ability.
When Zuo Liang asked this question, he was actually considering whether to directly remove the cervix. Total cervix removal also preserves the uterus for the patient, but seals the cervix so that children cannot be born in the future. If the patient is older, there should be no need to preserve the cervix.
, it’s no problem to cut off the cervix.
The less trouble, the better.
However, Du Haiwei approved the surgical plan provided by Geng before the operation.
The plan Geng Yongzhe submitted was cone cutting rather than full cutting.
"Teacher Zuo, Yingying and I have discussed cutting within this range." As he spoke, Geng Yongzhe took out the notebook he had prepared and showed the surgical anatomy diagram he had drawn to the surgical teacher.
Zuo Liang had actually seen this picture before. Now he checked it carefully with his eyes and asked: "How did you determine the range?"
"The size of this tumor is about 1.9 centimeters, which is just the critical value. Therefore, the range of incision should be expanded. It is necessary to ensure that the distance between the negative margin and the tumor is 3 millimeters."
Numbers sound great, but they are difficult to implement. Let’s go back to the key issue of the margin. Three millimeters itself is a margin. To ensure this standard margin of three millimeters, the doctor’s naked eye must first be able to accurately determine the size of the tumor.
The actual edge line, secondly, it is best to cut to a value of three millimeters when cutting, so as not to cut too much or too much.
Thinking about it this way, it seems that it is not as refreshing and easy as doing it all.
Don't think like this. If you cut it right and get it right with one cut, it will save a lot of effort and time. A full cut may involve a lot of bleeding, which is very troublesome. So the biggest difference between the two is whether the doctor chooses to use his brain or his hands.
Zuo Liang felt that he had no choice. With his relatively little clinical experience, he was not sure whether he could perform the cut very accurately.
A tumor of 1.9 cm is not considered small. Doctors with some qualifications know that such a tumor is like a cavity. It may be just a black spot on the surface. In fact, it may be rotten to the root after opening the black spot. This is because the electric knife cannot cut
When it is deep enough, it can only be eliminated, and a traditional cold knife is used to cut. The cold knife needs to cut in a circular motion to the depth to completely dig out the tumor. This knife method is too difficult.
Zuo Liang frowned, not knowing how to express himself. The classmate Geng who answered him failed to answer the key points and helped him fulfill the above requirements.
I don’t blame the students. The difficulty lies in the fact that the surgeon has to do it himself. Others can’t replace the surgeon’s hands and certainly won’t be able to help.
"Teacher Zuo, why don't you let Mr. Geng take a cotton swab and draw an incision area around the tumor for you?" Xie Wanying, who was watching, saw this and took the initiative to suggest.
Zuo Liang looked at her deeply: This classmate Xie could guess what he was thinking just by hearing him ask a question.
Unlike Geng, she has worked with many teachers on the operating table and has a good understanding of how to observe and understand the surgeon's thoughts.
Du Haiwei stood aside and said nothing, seemingly not objecting to the two interns' suggestions.
The superior's opinion did not change. Zuo Liang turned to classmate Geng and said, "Okay, you can draw it."
The teacher stepped aside and Geng Yongzhe sat on the bench, dipped a cotton swab in gentian violet and carefully marked the incision site along the perimeter of the tumor in the exposed surgical field.
