Due to time constraints, there was no opportunity for students to ask questions and discuss in the ward. The attending doctor made a patrol and, like the second general surgeon, did not discuss anything and rushed to the operating room to perform the operation. At this point, surgeons are much harder than internists.
Already.
Half an hour of ward rounds by a follower was like a quick glance at a medical student like Xie Wanying who came to study in this department on her first day. She couldn’t recognize the faces of many patients and had no idea what was going on. The teacher could only give her tasks when assigned.
After the afternoon, there was no need to worry at all. After this comparison, it seemed that it was a good thing that she was left out in the ward in the second year of general foreign language.
When I went to the operating room, Xie Wanying became very familiar with the operating room environment. But this time, she was undergoing hepatobiliary surgery, not general surgery. Remember Sister Jiang’s words, wherever you go to study with the teacher, you must concentrate and not be distracted, and don’t think about your ex.
. She did not meet Teacher Tan or the others. She stood directly in the operating room of the Hepatobiliary Surgery Department to observe.
The surgery this morning was a laparoscopy on a patient with primary liver cancer.
All surgical departments tend to perform minimally invasive surgeries. Laparoscopy for liver cancer has been promoted a lot, but the threshold for doing it is much higher than laparoscopic surgery for gastrointestinal tract. For an operation like today, the seniors held a meeting to discuss it that night.
long time.
Specifically, Xie Wanying did not participate in the group meeting that night and did not know the content. She could only stand in the operating room and observe.
The chief surgeon is Brother Tao, I heard about it before.
The first assistant is Dr. He.
The mirror holder is not Dr. Qiu. Dr. Qiu has gone to help in another surgery. It is another resident doctor named Gong Xiangbin. He is one year older than Dr. Qiu. He is shorter and fatter than Dr. Qiu. He is not as handsome, gentle and stable as Dr. Qiu.
of a doctor.
Song Xuelin, who was called to have a try, put on a surgical gown and stood behind the first assistant and the intermediate surgeon as if on standby. It was not clear what operations he would be asked to perform at that time.
She has graduated, but she is not, she is just an intern. So it is reasonable for the teacher to ask her to just watch. Xie Wanying watched attentively. She has been working as a mirror holder at Teacher Tan's place for a long time, and this is her first time as she has more experience as a mirror holder.
When looking at laparoscopy for liver surgery in the Department of Hepatobiliary Surgery, one must first carefully observe Dr. Gong’s operation.
Dr. Gong's hands seemed to be motionless, and he had to look like a magnifying glass to detect the tiny amplitude. Unlike the gastrointestinal tract, the liver is a substantial organ that is fixed in one area. Surgery around the liver is basically done in
Operating in this area requires considerable stability and delicacy. The gastrointestinal tract is a hollow organ, and it has many twists and turns, requiring more dexterity.
The hand holding the mirror had already paid attention to caution, not to mention the first assistant and the surgeon. As Dr. He said, they were like deminers, digging in little by little without daring to make any big moves.
After all, the liver is filled with very, very rich blood vessels. When removing a tumor, you need to cut the liver. As long as the position of the cut is slightly deviated, it is easy to hit various blood vessels in the liver, and blood will bubble up all over the liver wound.
.
If there is a large area of parenchymal hemorrhage, during laparotomy surgery, the surgeon will rush to directly press the liver wound with his hands to stop the bleeding. During laparoscopic surgery, the doctor's hands cannot enter, so he can only use hemostatic gauze to apply pressure. If pressure is applied,
If the bleeding point cannot be found, the only option is open surgery. It can be seen that difficulty in stopping bleeding is a major flaw of laparoscopy in liver surgery, which seriously restricts laparoscopic surgery. The liver tumor cannot be large and the location of the cancer cannot be involved.
to the portal vein, and has higher requirements for the patient's liver function level.
