Chapter 746: The intestine is soft, and so is the cecum.
In the operating room, Fatty Liang has completed anesthesia.
Liao Yiyi was lying on her left side. When she was in Annex 2, the nurse had already done a bowel cleansing, so she was ready for surgery.
Tang Fei brought a sterilized drape and then put on a surgical gown on the stage. She inserted the endoscope through the anus and gently moved it retrograde along the intestines, passing through the anal canal, rectum, descending colon, transverse colon, and ascending colon.
Finally, the camera reaches its destination - the end of the cecum, where the appendix is connected to the cecum.
Tang Fei found the inner opening of the appendix, fixed the camera at this position, stopped what she was doing, and waited for Yang Ping to come on stage.
The front is just the preparation for the surgery, and the back is the actual operation. From this point on, the camera is turned on.
Therefore, the entire surgical video is shot under the microscope inside the intestines and abdominal cavity. Apart from this, there is no other filming content.
Yang Ping washed her hands and went on stage, with Tang Fei as an assistant helping to fix the camera.
The doctors in the demonstration classroom are watching the live video on the high-definition screen.
The endoscopic ultrasonic scalpel begins to operate. It cuts a small opening around the appendiceal fossa, extends through this small opening, and begins to search for and separate the appendix and mesoappendix.
With almost no pause, the ultrasonic scalpel separated the appendix and mesentery from its surroundings. The appendix was mostly necrotic and perforated.
The ultrasonic scalpel serves as both a separation tool and a cutting tool. The two functions are used interchangeably. It is extremely skillful to use and can quickly separate the appendix artery and vein intact.
The most difficult step in endoscopic transcecal appendectomy is actually this step: separating, ligating or clamping the appendiceal artery, but for Yang Ping, it is not a big deal.
The absorbable vascular clamp clamps the appendiceal artery, and the ultrasonic knife accurately cuts it off. Finally, the appendix is resected decisively and completely along the edge of the appendiceal fossa on the inner wall of the cecum, and then taken out.
The price of absorbable blood vessel clips is a bit expensive, but it can be dissolved and disappeared in the body later, so it is worth the price.
The operation continues, and every instrument under the microscope is more flexible than the doctor's fingers. You can do whatever you want, and you can achieve what you want and do.
Just now, when the appendix was gently manipulated by the separation instrument, the appendix and surrounding adjacent organs could be seen almost 360 degrees, and the operating field of view was excellent.
The adhesions that were originally regarded as tigers pose no threat to Yang Ping. His instruments always operate in the anatomical gaps, and he is as at ease as a fish in water. Although the gaps have been eliminated by adhesions, Yang Ping can still find their location.
Appendectomy is originally very simple, but it is just an endoscopic resection through the cecum, which is very difficult. Moreover, the appendix adheres to the surrounding area, abscesses form around it, and there are adhesions in the intestinal tube, so this operation becomes extremely complicated and difficult.
No one dares to use this new surgical method to treat such a complex acute appendicitis. No matter the operating ability of the equipment, the field of vision, or the operating space, it is not allowed to do so.
The appendix was completely removed, taken out from the body and put into a specimen bag, and sent to the pathology department for pathological examination after surgery.
According to medical practice, any organ or tissue removed from the human body must be sent to the pathology department for pathological examination.
After the appendix was removed, a small incision appeared on the cecum where the appendix originally opened. Using this incision, Yang Ping's instruments entered the abdominal cavity again and began to clean up the pus.
The suction device under the endoscope sometimes sucks and sometimes flushes, starting a carpet-like suction and flushing without dead ends.
This is the most difficult step of the operation. Compared with surgical or laparoscopic appendectomy, this step of endoscopic transcecal surgery will be limited by the operating field of view and operating space, because the instruments entering through the incision on the inner wall of the cecum cannot be opened.
It is as comfortable as surgery or laparoscopic surgery, but it has certain blind spots in vision and operation.
Moreover, this blind spot is very large, which means that it is impossible to completely treat abscesses and adhesions with this method, which is why others dare not use this surgery.
Director Fang stared at the high-definition screen, not daring to blink, for fear of missing the most critical step. After all, this kind of surgery is rare. Once missed, it might be difficult to see it again in the future.
He also had many questions in his mind, such as how to deal with abscesses and intestinal adhesions. The dead corners and blind spots of instruments are objective difficulties and cannot be made up for by skillful operation.
The next operation completely exceeded Director Fang's imagination.
The suction device under the mirror is both a blunt separation tool and a flushing and suction tool. I don’t know why, but the visual field of view and operating space in the video are completely unrestricted.
The parts of the abdominal cavity that needed to be treated were gradually displayed in the field of view. Under the gentle operation of the instruments, the abscesses appeared in the field of view bit by bit, without any omission. Just like laparoscopic surgery, there were no blind spots or dead corners. What's going on?
Although it is an endoscopic resection through the cecum, the field of view and operating space are as free as laparoscopic surgery.
Has it been converted to laparoscopic surgery?
Impossible. The entire surgical live broadcast video has been continuous without any interruptions or even lags. How is it possible to change the surgical procedure?
If the surgical procedure is to be changed, the current video will inevitably need to be interrupted, and the video after the surgical procedure will be changed will only start after the interruption, and there must be a pause period in the middle.
Director Fang did not dare to think too much, fearing that he would be distracted and miss some shots, so he continued to observe.
The suction device thoroughly flushed and aspirated the abscess, and even expanded the scope to the surrounding normal areas. Director Fang saw that at the end, the entire field of vision was no longer turbid under the flushing of physiological saline, and was completely clear and clean.
When Director Fang was wondering, similar magic appeared in the treatment of intestinal adhesions. Dead corners and blind spots did not exist at all. It seemed that the entire intestinal tube was passed through the field of vision, and the adhesions were gently separated by the ultrasonic scalpel.
Director Fang didn't even see the ultrasonic scalpel using energy. It was used as a purely mechanical separation forceps throughout the process. Under the skilled separation of the ultrasonic scalpel head, all existing adhesions were easily separated.
Then there was an orderly and thorough flushing, and the entire abdominal cavity was treated cleanly.
In the end, the intestines that seemed to be disturbed were completely restored to their original positions after being processed.
Perfect! It’s hearty and refreshing to watch.
When any surgeon sees this kind of surgery, his first impression is that the postoperative effect will definitely be good.
Cleanliness is a guarantee of quality, and this sentence also applies to surgical operations.
The source of infection was the appendix, which has now been completely removed, and the surrounding abscess caused by the appendix has been treated cleanly, and the natural infection has been eliminated.
Director Fang has only recently performed endoscopic transcecal appendectomy, with only three cases and a very limited experience.
Not to mention this kind of complicated acute appendicitis, even if it is simple edema-type appendicitis, he still has to work hard for two or three hours, sometimes even longer. He is not skilled at the step of isolating the appendiceal artery. It takes a long time to successfully separate the appendix artery.
It was torn during separation and had to be transferred to surgery to save the day.
In fact, this brand-new surgical procedure has only just been launched across the country. Many first-class hospitals have just launched it and have achieved zero breakthroughs.
Regardless of whether it is the imperial capital or the magical capital, the situation is similar. They have only started to be carried out recently, and the number of surgical cases has not been accumulated.
As for appendix 2, he said that he also performs this kind of surgery, but he just found a way to do it. It is still unknown whether he has performed it or not.
The appendix has been removed, the abscess and adhesion have been treated, and the irrigation has been so thorough, the operation should be over.
The small incision in the inner wall of the cecum left by the removal of the appendix was tightly sutured and sealed.
When the equipment completes its work and exits, on the screen, even the exit of the equipment appears smooth and silky, and it quickly exits through the safe gap.
When the instrument retreats to the ascending colon, the video ends and the screen turns off.
Endoscopic transcecal resection of the appendix requires dealing with large-scale abscesses and intestinal adhesions. The operation is actually faster and easier than open surgery by oneself.
This kind of blow made Director Fang completely forget the shame of "herding sheep".
The doctors in the general surgery department were like watching a blockbuster movie, and they were still not satisfied. They each looked at their colleagues with puzzled eyes, hoping to get answers.
Because what they saw was different from what they originally imagined and conflicted with their knowledge and experience.
This kind of surgery should be done slowly and carefully, but Yang Ping's surgery was obviously very fast.
The most incomprehensible thing is how Yang Ping managed to break through the blind spots in vision and operation. He also used the hospital's endoscope system. How could there be no blind spots? It's impossible.
From a surgeon's professional perspective, it is easy to think of this objective blind spot, but it clearly does not exist in today's surgery.
Where did you get a lens that can rotate 360 degrees? I seem to have never heard of such a lens. Even if there is a lens, the equipment cannot rotate 360 degrees.
Everyone looked at Director Fang, hoping that Director could explain a few words. Director Fang knew what everyone wanted to ask, and his old face heated up slightly: "I don't know either. Let's ask Professor Yang when you have time."
"Tang Fei, please exit the camera and equipment."
Yang Ping retreated the instruments to the ascending colon, stopped the operation, handed over the remaining work to Tang Fei and Gui Peisheng, took off his surgical gown, and returned to the demonstration classroom.
"Professor Yang, how can your lens be able to see the entire abdominal cavity, and the instrument can also treat the target of the entire abdominal cavity?" Seeing Yang Ping coming to the demonstration classroom, Director Fang couldn't help but seize the opportunity to ask.
Yang Ping smiled and said: "Director Fang, the intestine is soft, and the cecum is naturally soft as well---"
"Professor---"
Halfway through Yang Ping's words, Song Zimo, who was standing at the door of the demonstration classroom, seemed to have something to ask Yang Ping.
"Let's talk when we have time." Yang Ping stood up and left.
What does it mean?
The intestine is soft, so naturally the cecum is also soft?
Is there a time when the intestines are hard, or does someone have a hard intestine?
I didn’t know that the cecum was soft? I didn’t know that the intestine was soft?
Every doctor knows that the intestines must be soft, and the cecum is also an intestinal tube, so it must be soft as well. Is there a problem?
Director Fang scratched his head, his skull hurt after the operation.
"Director, what did Professor Yang just say?" a general surgeon asked.
Director Fang said angrily: "The intestine is soft, and the cecum is naturally soft too."
The doctor who asked the question was confused as to what Director Fang meant.
Director Fang's phone vibrated. An old classmate from Appendix 2 wanted to come and see the surgery, and also wanted to learn about it. After all, it was a new technology, and it was exciting to think about using new technology to do such a complicated appendix.
"The road is very congested, and we haven't even reached the halfway point yet. Is it convenient to park in your parking lot?" the doctor in Appendix 2 said anxiously.
Director Fang sighed and said: "Don't come, turn around and go back."
The doctor in Appendix 2 was dumbfounded: "What's going on?---"
Thinking of the sad tone of my old classmate, I instantly understood: Did the person die? He didn’t even have a chance for surgery. Alas, the second doctor felt very regretful and sad. If he had talked to his family members at that time, he would have had the surgery earlier and he would have been fine.
A human life.
"Then---I'm going back. Let's get together next time when we have time." Doctor Fu Er felt uncomfortable and very uncomfortable.
Director Fang hung up the phone and sneered in his heart: I really don’t know what’s going on here. When I came back from a trip to the toilet, the operating room had already started cleaning, and you still drove to see the operation? You’ve never seen the world.
"Director, what do you mean by that sentence just now?" The general surgeon next to him thought for a long time but didn't understand.
Director Fang stared at the doctor: "You should think about it slowly. You must learn to use your brain and expand your ideas. Do you understand? Don't just ask any questions."
The doctor had no choice but to nod.
Fatty Liao's dose of anesthesia was used very accurately. Shortly after the operation, when Liao Yiyi came out of anesthesia, she saw Fatty Liang at first sight.
"After the operation is completed, there will be no scars." Fatty Liang helped her wipe away her tears.
Liao Yiyi was a little confused, but she understood Fatty Liang's words, nodded, stretched out her hand to grab Fatty Liang's hand, and felt instantly at ease.
---
Family waiting area.
Just when Liao Yiyi's parents were worried and anxious, the door to the operating room finally opened and Liao Yiyi was pushed out.
"Yiyi, what's wrong!"
The two old men rushed up immediately and held the handrail of the flat car.
"Everything went well, the operation was perfect, there was no incision, no punching, and no scars." Fatty Liang said proudly.
This made Liao Yiyi's parents extremely happy. It felt like they were surviving a disaster. Looking at Liao Yiyi who was awake, the old couple just wanted to cry.
"Xiao Liang, thank you very much this time."
Liao Yiyi's father held Fatty Liang's hand and couldn't let go for a long time.
"Yiyi, can you hear your parents talking?" Liao Yiyi's mother touched her daughter's face.
Liao Yiyi nodded, but after all, she had just completed the operation and it was very difficult to speak.
"Dr. Liang, thank you very much." Yu Yihan also thanked Liao Yiyi.
Everyone sent Liao Yiyi to the ward. Nurse Cai had arranged for Corey's suite ward and personally welcomed Liao Yiyi with the nurse.
"Dr. Liang, I heard that you are a relative. I have prepared a room in advance and you can live in this suite." Nurse Cai helped push the cart together.
Some passing patients in the corridor were also curious about who could live in this suite ward. In general surgery, this suite ward is not open to just anyone, not even if they are rich. Professor Yang must agree to it. p>
The success of the operation, the enthusiasm of the doctors and nurses, and the luxurious suite ward made Liao Yiyi's parents feel very comfortable.
