Live surgery is not an ordinary surgery. It not only needs to be seen clearly by the surgeon but also by the audience. Considering that the surgeon is a team of doctors, the mirror holder can cut the lens at will and the surgeon can follow the operation even if the surgeon cannot see clearly.
The patient's condition is something that I have thought about before, but the audience is different. The surgeon does not know the situation, so I can only know it while watching on the spot.
The importance of the mirror hand is once again reflected.
This mirror holder seems to be not only smooth in movement, but also skilled in technique. He should be at a mid-to-high level.
Doctors from other hospitals immediately understood: "Yeah."
Why did Tao Zhijie let a relatively rare female doctor join his team? Isn't it because of this? Surgery does not exclude female doctors. As long as the female doctor has super technical skills and strong physical strength, no one has time to make irresponsible remarks.
The silence and admiration of this group of people confirmed that Xiao Xie had spoken with his strength, and all kinds of inexplicable suspicions naturally disappeared.
The surgical image on the curtain was positioned in the inferior vena cava, and everyone could clearly see the lesion area there.
Teacher Lu coughed softly and said, "Looking at it this way, it's a primary inferior vena cava tumor."
Jiang Mingzhu handed the thermos cup she brought to the teacher.
"No need." Teacher Lu waved his hand, probably not in the mood to drink water.
The current surgical exploration results are not ideal and nothing happens, so no one will be in a good mood.
It is not a metastatic tumor thrombus, but an extremely rare primary inferior vena cava tumor. This disease is said to be malignant in the majority, and the most common one is inferior vena cava leiomyosarcoma.
PIVCLMS inferior vena cava leiomyosarcoma is no different from metastatic cancer, and the prognosis is also very poor. Moreover, chemotherapy and other methods have little effect on it. If you want to prolong the patient's survival, you can only use surgery as much as possible.
However, apart from laparoscopy, it is difficult to complete such an operation using traditional laparotomy.
Backtracking, the origin of PIVCLMS is the smooth muscle of the IVC wall of the inferior vena cava. Therefore, the wall of the inferior vena cava is thin and the tumor cannot be peeled off. Resection can only be performed. The scope of resection needs to include the inferior vena cava, liver, kidneys, peripheral lymph, etc. invaded by the tumor.
organize.
Just looking at the scope of this disease, you can feel that the current surgery is extremely difficult to perform.
After all, the inferior vena cava is a large vein in the human body and is anatomically extremely long. If there is a tumor in the inferior vena cava, it will be divided according to specialties, and multiple surgical specialties are not allowed.
Some doctors have theorized that the inferior vena cava can be divided into four segments from bottom to top based on this disease.
The first segment goes to the level of the renal vein, the second segment goes from the opening of the deep vein to the third porta hepatis, the third segment goes from the third porta hepatis to the level of the diaphragm, and the fourth segment goes from the upper segment of the diaphragm to the right atrium. The first segment belongs to the category of urology
Now, the second paragraph may involve urology and hepatobiliary surgery. By analogy, the third paragraph is mainly about hepatobiliary surgery, and the fourth paragraph is about cardiothoracic surgery.
Returning to the current surgical case, the CT angiography results showed that, coupled with the patient's obvious Budd-Chiari syndrome, the tumor obstruction mainly occurred in the third segment of the inferior vena cava, so the hepatobiliary surgery department was responsible.
At this time, the hepatobiliary surgeon needs to further confirm during exploratory surgery whether the tumor is growing only within the vein, growing outside the vein, or both.
