After Fang Le's operation had been going on for a period of time, Xiao Conglin's operation had reached the final stage.
Compared with semi-isolated liver resection and liver transplantation, there are not so many doctors around the operating table. After all, it was an operation at that time. Eight or nine doctors gathered around the operating table to perform the operation, which made the operation seem complicated. Space is very tight.
Since liver transplantation is a two-stage operation, it does not require as many manpower to operate a single operation in the early stage. It will only become more stressful in the later stage.
"Dr. Fang's surgery seems to be a little different."
After watching for a while, as the abdominal cavity and chest cavity were opened, Fang Le began to remove the liver, and Chu Jianlin suddenly discovered something abnormal.
"Unless Director Chu said anything, I didn't even notice that Dr. Fang seemed to be avoiding the inferior vena cava. Does this mean he doesn't intend to remove it?"
Niu Baohua also discovered something abnormal.
Living donor liver transplantation has not been developed for a long time so far. The world's first living donor liver transplantation was performed in 1988, but the patient died of hemodialysis 12 days after the operation.
The following year, country r completed their country's first living donor liver transplant. The patient took more than 200 days after the operation, less than a year.
Another year, that is, in 1990, after completing four cases of living donor liver transplantation, Country R summarized its experience and adopted microsurgical vascular reconstruction technology as a routine method for hepatic artery reconstruction. This initiative completely changed the field of living donor liver transplantation. Transplant prognosis.
Later, Xiangjiang, Taiwan, and Country H also completed the first living donor liver transplant operations in their regions.
Up to now, living donor liver transplantation has only been developed for six years, and several countries around China, including country R, country H, and some Western countries, have completed their first living donor liver transplantation.
It is precisely for this reason that the country's expectations and desires for the first living donor liver transplant are really quite persistent.
Since ancient times, China has been a world power. Although it has experienced a period of downturn, most Chinese people are still very proud at heart.
It is really a shame that we have not been able to master the technologies that other countries and small border countries have mastered.
Living donor liver transplantation has not been developed for a long time, and so far, there are not many surgical procedures developed.
Generally speaking, there are two main methods of liver transplantation, one is orthotopic liver transplantation and the other is auxiliary liver transplantation.
Orthotopic liver transplantation involves removing all of the patient's liver and then transplanting part of the viable liver.
In auxiliary liver transplantation, the diseased part is removed, part of the patient's liver is retained, and a new liver is transplanted into the patient's splenic fossa.
Both methods have their own advantages.
Regarding the previous cases of living donor liver transplantation, most of them were orthotopic liver transplantation, and not many auxiliary liver transplantations were performed.
In the past six years, liver transplant surgery has not been fully developed. The mortality rate is still high, there are many complications, and the surgical risks are high. There are few doctors who can perform this kind of surgery, and there are also few patients who can afford this kind of surgery.
Over the past six years, the number of living donor liver transplant operations accumulated in the world has been countless.
Xiao Haoping and Xiao Conglin had not experienced liver transplant surgery before, so they did not know much about it, but Chu Jianlin and Niu Baohua had both seen liver transplant surgery.
Although they had only watched once or twice, they still knew and understood the basic operations.
In the past, living donor liver transplants performed in many countries involved directly resecting the inferior vena cava, but Fangle seems to want to preserve the inferior vena cava.
"Did Dr. Fang also invent a new surgical technique?"
Meng Qingfei was a little unbelievable.
Neither Chu Jianlin nor Niu Baohua said a word.
This is not a minor operation, but a ceiling for extrahepatic surgery. It can be called the most difficult liver transplant operation among extrahepatic surgeries.
This kind of surgery, even if it is done honestly and according to the original operation, the success rate is hard to say, but Fang Le seems to have invented a new surgery now, which is different from the liver transplant surgeries performed in other countries.
Jiangzhou Provincial People's Hospital.
In the large demonstration classroom on the other side, Guan Liangshan and others were waiting for the surgery video and news. Following the model of Xijing Hospital, Jiangzhou Provincial People's Hospital also followed suit this time.
"To be precise, there is a fundamental difference between the living donor liver transplant performed by Fang Le this time and the traditional liver transplant."
Before the video was sent, someone asked Professor Guan to say a few words, and Guan Liangshan just said a few words.
"Conventional liver transplant?"
Some people were subconsciously stunned when they heard this word coming out of Guan Liangshan's mouth.
What kind of thing can be called tradition is that only when there is innovation and change on the original basis can the previous thing be called tradition.
Living donor liver transplantation has only been around for six years. Has it become a tradition in Guanliang Pass?
Even with the previous solid liver transplants, the changes in liver transplant surgeries so far have not been too great.
"Previously, living donor liver transplants performed in Country R, Country H, or in Xiangjiang all involved direct resection of the inferior vena cava, but this time Dr. Fang wanted to preserve the inferior vena cava."
Guan Liangshan continued.
"Without resection of the inferior vena cava?"
Some people couldn't help but ask: "Professor Guan, what are the benefits and risks of not removing the inferior vena cava?"
"During the preoperative discussion, Fang Le specifically told me that this method of not resecting the inferior vena cava mainly has the benefit of preventing the recurrence of primary diseases after liver transplantation. For example, patients with hepatitis B, liver cancer and other primary diseases,
This surgery can reduce the chance of recurrence of the primary disease."
Guan Liangshan said: "Of course, this method has not been tried yet, and it is hard to say what the specific postoperative conditions will be. But after all, it is the first operation. Whether it is the previous traditional transplant method or this new attempt, it is the first time.
, we all try with an attitude of being responsible for the patients.”
Many doctors in the demonstration classroom knew that the patient had liver cancer. If this new surgical procedure can really reduce the probability of recurrence of the primary disease, it is indeed worth trying.
Surgery is only one type of treatment. The purpose is to cure diseases, save patients' lives, and prolong patients' lives. It is not just surgery for the sake of surgery.
Liver transplant surgery is inherently risky. If the patient's liver cancer recurs after surgery, the operation will be of little significance.
Although at present, many patients and their families who undergo this kind of surgery are willing to gamble their lives. If they don't do it, they will die, but if they do, they may live. Most people are willing to take the gamble as long as they have the conditions.
.
But as a doctor, you need to consider more issues.
If this operation is not the first one, it is actually a bit risky for Fang Le to try this. But this operation is the first operation. In the eyes of others, the reason why Fang Le can do this operation is because Fang Le
I have experience in hemi-isolated liver resection, but not in liver transplantation.
As far as liver transplant surgery is concerned, whether it is the previous surgery or the new surgery Fang Le tried himself, it is the first time and has the same risks. The difference is that there is only a reference for the former one.
But this kind of reference may not be of much significance in today's surgery.
It is normal for doctors who are trying liver transplantation for the first time to make some changes in their understanding and knowledge, and to make some changes based on the specific conditions of the patient.
What is difficult for everyone to accept is that this is the first case of innovative surgery.
A young man in his early twenties had previously invented a new tendon suturing method, then performed the country's first semi-isolated liver resection, and now performed the first liver transplant, and there was a breakthrough.
Just like the liver transplant surgery performed after Country R, microsurgical vascular reconstruction technology was used as a routine method for hepatic artery reconstruction. This breakthrough is quite remarkable.
Now Fang Le has made a new attempt based on the previous operation. If the operation is successful, the significance of this first living donor liver transplant will be different.
"Professor Guan, Dr. Fang didn't say what kind of surgery this is?"
someone asked.
"Fang Le said that without resection of the inferior vena cava, it would be like putting a liver on the vena cava, so it is called piggyback liver transplantation."
Guan Liangshan explained: "The difference between this surgery and previous liver transplants is..."
Before the operation, Fang Le communicated with Guan Liangshan. Now Guan Liangshan just told Fang Le's analysis. Before the video came over, everyone listened with interest. In fact, most people couldn't understand it.