"The portal vein divides the liver into upper and lower segments. The left and right portal veins send out upper and lower branches into the center of each segment respectively. According to this division method, each segment is an independent unit, and resection of any segment will not affect the others."
After Tanabe Yuro left, Fang Le continued to talk to Xiao Conlin: "Director Xiao is an expert in this field, and I don't need to say more. In order to ensure the survival of the liver during splitting, the resection must be along these segments.
Peripheral vascularization is performed, that is, the resection line is parallel to the hepatic veins, so that the centrally located portal vein, bile duct, and hepatic artery are preserved."
As he spoke, Fang Le operated: "Actually, splitting the liver is similar to our normal liver resection, except that the part removed during liver resection does not need to be used anymore. We only need to consider the remaining parts. But splitting the liver
Consider availability when leaving.”
Xiao Conglin nodded.
In terms of extrahepatic surgery, Xiao Conglin is indeed considered a top expert. Except for liver transplantation, Xiao Conglin has done all other liver surgeries.
During routine liver resection, the resection is also based on the structure of the liver, but as Fang Le said, the cut part does not need to be considered anymore, only the residual part can be considered.
For a liver surgeon of Xiao Conglin's level, what he lacks is actually training and some practical operations on some difficult problems.
While listening to Fang Le's explanation and watching Fang Le's operation, Xiao Conglin instantly realized that she was actually the one who gained the most from this operation.
Originally I just wanted to take a dip, but ended up getting to the very bottom. This is a pleasure that you can only know if you experience it.
Sure enough, this is how my family is treated.
"Lao Xiao, this piece of shit."
Showing the classroom, Han Shengxue looked at the picture on the display screen and cursed with a smile.
"Director Xiao is really enviable this time."
Zhang Ruihua nodded, wishing he could take Xiao Conlin's current position.
Before the operation, everyone thought that Xiao Conglin was just a handyman. Unexpectedly, now Xiao Conglin was indeed the only chief physician who could be by Fang Le's side. Everyone else, such as Chu Jianlin and others,
When you have tasks that you are responsible for, you don’t dare to be distracted at all.
"The patient has a liver tumor. The resection must be clean and reconstruction should be considered later."
Tanabe Youlang stood on the side and gave Chu Jianlin guidance, giving pointers in key places.
It turns out that Ariro Tanabe just wanted to be able to watch the operation up close, but this was actually his real purpose.
But what Fang Le said just now made Tanabe Yuro feel a lot more attentive.
"Phew, wipe the sweat!"
Fang Le took a breath and spoke to the circulating nurse beside him. The circulating nurse hurriedly stepped forward and gently wiped the sweat off Fang Le's forehead.
After all, it is a delicate job and the operation is not short.
"The left liver lobe is separated."
Showing the classroom, Zhang Ruihua said softly: "Dr. Fang's separation is faster than I thought."
"Not only is it fast, it's simply skillful."
Meng Qingfei from behind interrupted.
Han Shengxue is an emergency doctor. His surgical skills are limited to laparotomy and thoracotomy. He doesn't know much about the liver, so he doesn't know how to do it. Fortunately, there are two people around him, Zhang Ruihua and Meng Qingfei, who are doing popular science.
"Trimming the donor liver."
Fang Le split the left liver lobe and removed it, and a nurse nearby hurriedly brought a container.
In this regard, Ariro Tanabe is experienced in trimming the bile ducts and portal veins to facilitate anastomosis during the transplantation process.
As the left liver lobe separated, the right liver was gradually separated.
After Xiao Conglin processed the donor, the donor was transported out of the operating room.
The main surgeons who performed this surgery were actually teams from two hospitals, Union Medical College and Shanghai Hospital. In terms of operating techniques, Chu Jianlin and Niu Baohua were both skilled, but they had not overcome some difficulties and had no relevant experience.
Now Tanabe Yuro and Fang Le are personally providing guidance, and the operation is proceeding in an orderly manner.
"If it's a little off, you have to be careful when cutting it off, and consider recreating it later during the transplant."
Fang Le walked to Chu Jianlin who was undergoing surgery, looked at him for a while, and reminded him in a low voice.
"yes."
Chu Jianlin responded hurriedly and asked: "Doctor Fang, is this here?"
"right."
Fang Ledao: "Although this operation is slightly more difficult when removing the liver, it will be much more convenient for us during transplantation. During liver transplantation, both removal of the diseased liver and transplantation of the donor liver must be considered. When the patient's condition is stable,
In this case, we still need to consider the convenience of liver transplantation as much as possible.”
"According to Dr. Fang's perspective, it will indeed be easier when the time comes."
Tanabe Yuro nodded, he learned again.
Chu Jianlin's operation just now was actually guided by Tanabe Yuro, but Chu Jianlin was still more willing to trust Fang Le than Tanabe Yuro.
At present, Fang Le does not perform many surgeries, but the prognosis of patients is very good.
"Intubate the distal liver and start vena cava bypass..."
Fang Le would give guidance at critical moments from time to time.
In this kind of large-scale surgery, intraoperative cooperation is very important. The tacit cooperation of the team is sometimes more important than an excellent surgeon.
Of course, this excellence is only slightly outstanding. If the level gap is too large, it can still make up for some shortcomings.
As the book of war says: It’s not about the number of soldiers, it’s about the general’s deployment!
Among the several surgeries that have been performed, Fang Le performed most of them for the first time. Cooperation and tacit understanding did not exist at all, and the entire scene was controlled by the surgeon.
In the demonstration classroom, a large group of experts could not see the specific details of the operation, but seeing so many doctors busy in the operating room, as experts in extrahepatic surgery, many of them were making up their own minds.
"Dr. Fang's field control ability is too strong."
"Yes, it seems that I have predicted it. Just like just now, if Dr. Fang hadn't spoken out in time, something might have gone wrong."
A group of people were talking, and Fang Le suddenly turned around, and Fang Le's face wearing a mask appeared on the screen. Many people couldn't help but exclaimed in their hearts: "You are so young."
"The profession of doctor really depends on talent."
Meng Qingfei was talking to Zhao Deqiang beside him: "How many years have we been in this field?"
"hehe."
Zhao Deqiang smiled and did not answer. Talking about this kind of topic, isn't that asking for abuse?
Anyway, Zhao Deqiang is not a liver surgeon, so he just watches the fun.
For Yanjing Hospital and Union Medical College Hospital, it is really a foolish dream for the emergency department to expand its territory to other areas such as extrahepatic or extracardiac surgery.
A talented young doctor like Fang Le is really rare to see in a century.
"Hook, up!"
Fang Le reminded, while Chu Jianlin carefully took out the diseased liver. The child's diseased liver was slowly taken out from the abdominal cavity.
"Such a small liver."
Chu Jianlin couldn't help but comment.
After all, he is a five-year-old child and his liver is not that big.
The red liver was held in the palm of Chu Jianlin's hand and placed on the tray beside him.
"How is the liver donation going?"
Fang Le turned around and asked.
"Doctor Fang!"
Xiao Conglin hurriedly sent the donor liver, and Fang Le began the transplant himself.
"Pay attention to the matching."
"3-0 slide line."
"puff!"
Fang Le was dealing with the children here. Suddenly, on the other side, the doctors who were operating seemed to have been collectively cast down.
Niu Baohua was removing the diseased liver when suddenly a column of blood sprayed directly onto Chu Jianlin's face. The mask and microscope were covered with blood stains.
This unexpected situation instantly made a group of doctors beside the operating table turn pale, and no one knew what to do.
"Intraoperative arterial bleeding?"
In the display classroom, many people couldn't help but stand up when they saw the column of blood that suddenly spurted out, eager to get in through the display screen.
Han Shengxue, who was joking with Zhang Ruihua, couldn't help but change his expression.
There was bleeding from the meridians during the operation, and it was sprayed in a column style, which could cost one's life.
Moreover, this is a liver transplant surgery, which can be called the top surgery of extrahepatic ceiling, but this situation occurs at this time.
"Why is there sudden bleeding?"
"Did you miss anything during the previous inspection?"
"You can't say that. Any situation may happen during the operation. This time it will be difficult to handle."
"Don't even move."
There was a situation over there, and Fang Le also noticed it immediately.
"Professor Tanabe."
With that said, Fang Le called out to Ariro Tanabe, handed the work in his hand to Ariro Tanabe, and then walked over there. At this moment, the calmest person in the entire operating room was Fang Le.
(Old readers all know that Qianjin is not a doctor. This kind of plot is very slow to write. Please forgive me!)