life is sweet

Chapter 201 [201] Choice of surgical plan
Su Qingchun's face turned red all of a sudden.

Fortunately, the anesthetist didn't say anything, otherwise Su Qingchun would have died of embarrassment.

After the embarrassment, Su Qingchun couldn't help being puzzled: According to the actual situation of this patient, there is no need for laparotomy at all!

Laparoscopy is her best choice.

Of course, he could no longer ask the anesthetist this question foolishly. Just as he was full of doubts, the door of the operating room opened.

It turned out that it was Cai Junmei who came.

So he hurriedly asked Cai Junmei: "Director Cai, why is this operation not a hysteroscopic operation? Just now I saw that the anesthetist performed spinal anesthesia."

"Oh, it's spinal anesthesia. This patient is undergoing laparotomy."

Cai Junmei replied lightly.

After finishing speaking, she looked at Su Qingchun still looking puzzled, and continued to explain, "This operation plan is based on the actual situation of the patient and finally chooses to open the abdomen."

Because the patient with spinal anesthesia is actually awake, Su Qingchun approached Cai Junmei and asked in a low voice: "I have seen the condition of this patient before, and he can undergo hysteroscopic surgery. Did you choose to have an open laparotomy in the end? It would be very traumatic."

"And I see that the patient is not married yet, and the possibility of adhesion after laparotomy is much higher."

Su Qingchun's words seemed to be questioning Cai Junmei, his speech was always so direct and simple.

"Laparotomy is indeed not as good as hysteroscopy, I know for sure."

Immediately after Su Qingchun finished speaking, he felt that his words were not euphemistic just now, so he quickly explained: "I'm sorry, Director Cai, I didn't question your meaning, but I just think that this patient doesn't seem to need an open laparotomy."

"The surgical plan is the final choice of the patient and his family, and it is laparotomy," Cai Junmei said affirmatively, "You don't have to worry about it."

"Oh."

After Cai Junmei finished speaking, she glanced at Su Qingchun, and then added, "This patient's situation is also quite special. The reason for choosing open surgery is that the cost will be lower, and the operation itself will be cleaner."

Generally, when the cost issue is involved clinically, it is indeed very difficult and sensitive for doctors.

"The cost of hysteroscopy is a bit higher, but this operation is not big, so it's not much different, right?" Su Qingchun said, "Since she has decided to have the operation, this little money is really nothing compared to the possible risks. It needs to be so serious."

"Hey, the cost of the operation is not the same. Sometimes patients with a difference of hundreds of dollars will be suspicious. We deliberately do it for the sake of making more money. Don't worry about this matter anymore. The final choice of operation method still depends on the patient. We are definitely not going to force it.”

After Cai Junmei finished speaking, she continued to add, "And this patient's fibroid is 6 cm, and it is still in the submucosal muscle. It is better to open the laparotomy."

"The submucosal muscle is 6 centimeters and can be used for hysteroscopy. I have done several hysteroscopes for such a large one before, and they are all fine. I had a patient who was nearly 7 centimeters before and I had a hysteroscopy." Su Qingchun insisted road.

"Even if you can't do hysteroscopy, you can still do combined uterine and abdominal surgery."

"What you said varies from person to person, and it also depends on the actual situation." Cai Junmei seemed to disagree with Su Qingchun's opinion, and she didn't seem to want to entangle Su Qingchun about this matter.

He only said: "This is a matter and we will not discuss it anymore. The family members of the operation plan have already signed."

"Oh...then there's nothing the patient can do if he persists. I just think it's a pity to have an open surgery for such a young patient." Su Qingchun replied helplessly.

Although Cai Junmei explained that this was what the family meant, Su Qingchun seemed a bit unacceptable.

He understands that doctors must follow the opinions and ideas of family members and patients when choosing a surgical plan, but as a doctor, he still can't accept laparotomy for such an operation.

After all, many factors need to be considered comprehensively for an operation. Of course, he also knows that traditional laparotomy has the advantages of easy operation, skilled doctors, high success rate, and reasonable cost.

However, there are more disadvantages. For example, laparotomy means more bleeding during the operation, greater trauma, and longer surgical scars on the stomach. Generally speaking, laparotomy does a lot of damage to the patient.

Although the cost of hysteroscopic surgery is higher than that of laparotomy, the advantages are obvious: less bleeding, less trauma, faster recovery after surgery, and only 3 small holes are left on the stomach.

Moreover, if the patient has undergone caesarean section, appendicitis or other laparotomy, and the belly has been disfigured, it is even more necessary to choose hysteroscopy.

The girl Su Qingchun underwent this operation is not very old, and she has no experience of laparotomy, but once laparotomy is performed, the risk of postoperative uterine adhesions is much greater than that of hysteroscopic surgery, which is especially important for those who have not given birth. Especially important for girls.

For the cost of surgery, the potential risks of laparotomy are more important. In addition, the patient's fibroids are not very large, so it can be completed under hysteroscopy.

Therefore, Su Qingchunli really felt that it was a pity to perform laparotomy in this way. If the patient belonged to him, he would try his best to persuade the family and the patient to adopt laparoscopic surgery.

But doctors are like this sometimes, just like Director Cai said, very helpless, you really think about patients, but patients often doubt your original intention.

In any case, in order to avoid some unnecessary disputes, doctors generally respect the decisions of patients and their families.

The patient at this time was actually fully awake. She seemed to hear the doctor whispering aside, and said with some concern: "Doctor, what's the matter? Is there a problem?"

Cai Junmei looked at a patient, immediately gave Su Qingchun a look, walked to the operating table, and said, "Oh, it's okay, we're just discussing some surgical matters."

"Oh, I thought there was something wrong with my surgery."

"Don't worry, we haven't started yet, it's okay, don't worry." Cai Junmei reassured.

"Then when can the operation be started?"

Cai Junmei glanced at the clock and replied: "It will be soon, you should take a rest first."

After comforting the patient, she walked back and said to Su Qingchun, "Don't mention this matter again."

"Ah."

Since Cai Junmei said it was the patient's choice, Su Qingchun felt that there was nothing he could do about it, so he didn't mention it again.

After the operation started, Su Qingchun cooperated with Cai Junmei to perform the operation.

After the laparotomy, Su Qingchun found that the patient's fibroids were much more than he expected. He suddenly felt that if he performed this operation by himself, it might be a bit difficult to perform hysteroscopy, but the combination of hysteroscopy and laparoscopy should be no problem.

He felt a little regretful when he thought that the patient was not married yet.

I thought: It is really not worthwhile to have a laparotomy for such a fibroid.

But no matter how Su Qingchun felt that 1 was not worth it, there was nothing he could do to regret it.

Doctors are often so helpless. There are obviously some better medical methods, but you tell the patient that the patient will always consider the doctor's starting point from another angle, which will also make the doctor choose some more conservative treatment methods in surgery. .

This is very helpless and realistic, and Su Qingchun has nothing to do with such a problem.

Although this operation is different from what Su Qingchun expected, it can be done laparoscopically.

However, laparotomy is simpler and more proficient in operation for the surgeon, and the field of view is wide, so the operation will be relatively clean. Like this operation, if a laparoscopic operation is performed, it will test a doctor's skills. .

However, Su Qingchun believed that Director Cai would not be troubled by this. Judging from the current operation, Su Qingchun guessed that if there were no accidents in this operation, Cai Junmei should have completed myomectomy soon.

　At present, there are generally two methods for uterine fibroid removal: one is laparotomy and the other is laparoscopy, and laparoscopy has two endoscopic surgical methods: laparoscopy and hysteroscopy.Some patients believe that hysteroscopy can directly enter the uterine cavity, which is less invasive and more "advanced" than laparoscopy. Among these types of operations, laparotomy is the most traumatic and the price is the cheapest.

　　
　
(End of this chapter)