When it comes to the liver, this is the key point, because the patient’s clinical symptoms are basically related to the liver.
From the beginning, it was written in the medical record that this patient had liver cirrhosis. Most late-stage liver cirrhosis is caused by shrinkage of the liver. On the contrary, this patient had a rare liver enlargement, which did not seem to be in the early stage.
The reason is that Budd-Chiari syndrome causes congestion and swelling of the liver parenchyma. Doctors have basis to suspect that the cirrhosis of the liver may be caused by Budd-Chiari syndrome, which is different from most cases.
Hepatic vein and upper inferior vena cava obstruction are the main causes of Budd-Chiari syndrome.
By observing the contour and outer surface of the liver through laparoscopy, combined with preoperative CT and other examination results, it can be temporarily determined that there is no tumor inside the liver.
No doctor is relieved.
Because the preoperative examination has shown that the patient's main lesion is not in the liver but in the inferior vena cava. This surgical image is equivalent to confirming that there is cancer in the patient's body.
The real-time atmosphere of the operating room was conveyed to the exchange meeting site.
The lively noise disappeared, and low air pressure filled the air.
Every surgeon can't wait to be slapped in the face after opening the abdominal cavity. As long as it's not cancer, everything will be fine, but now he has to adjust his mentality and continue.
Jiang Mingzhu grabbed the collar of her clothes and exhaled to adjust her breathing. She was about to sweat. At this moment, she admired her junior sister Xie Wanying who was in the operating room. You know, it is unimaginable for a medical student to be so calm.
She clearly knew that she was doing a live broadcast, but Xie Wanying's hands were always as steady as Mount Tai in the picture. Even if there were some bad results, she would never be able to control herself and her hands would be shaking.
The previous surgery is about to enter the deep water area, and all conditions of the inferior vena cava must be understood. At this time, an important anatomical structure is touched called the porta hepatis. The porta hepatis, like the splenic porta and renal pedicle, belongs to various blood vessels, nerves, lymphatic vessels and other important tissues that enter and exit the liver.
As an important part of the liver, only specialists understand the importance of the porta hepatis in hepatobiliary surgery. If you are not careful, it will cause severe bleeding. Among them, the hepatic vein has a very thin wall and little surrounding connective tissue, resulting in hepatobiliary surgery.
Hepatic vein injury is common.
Before reaching important anatomical parts, the separation forceps are used to separate the peritoneum around the liver. Improper and unstable operation may tear the inferior vena cava, left hepatic vein or left inferior phrenic vein. Such results often lead to the formation of air embolism in addition to major bleeding.
.
Air embolism is air embolism. Speaking of the dangers of air embolism, people who have had a diaphragm injection know that if air in the infusion tube is injected into the human blood vessel, people will die. In this operation, because the inferior vena cava is connected
Right atrium, if the air reaches the right atrium, the patient will die faster.
The breath that everyone held was watching the delicate and delicate movements of the separation pliers.
This is the difference between a team of celebrity doctors and ordinary doctors.
Look at the previous surgery for liver tumors, which also involved separation of the hepatic hilus. But what they did was not as good-looking as this one.
What's the reason?
Even an amateur photographer can feel it and fix the live broadcast directly on the laparoscopic monitor. Because the field of view of laparoscopic surgery given by the mirror holder is already very good, the amateur photographer will mess with it.
Changing the focal length of the lens is not as clever as an experienced surgeon.
"The light source of this mirror arm is very slippery."