Surgical artist

Chapter 408 Excellent in all directions without dead ends
He looked at Zhao Peiru: "Dean Zhao, shall we start?"

Zhao Peiru said directly: "Start."

As soon as he said this, everyone's expressions became serious.

Whether it is successful or not depends on the last step!

All the students and disciples know that this is the research direction that Mr. Zou Bin cares most about in recent years.

They all know how hard Mr. Zou has worked in this area and how much they hope to succeed.

"As long as this operation is successful, Teacher Zou's wish for these years will be fulfilled."

"He no longer has to work hard day and night, and no longer has to sigh and sigh at the medical records of elderly patients every day."

Several students and disciples silently prayed for the success of the operation in the observation room.

On the operating table, academician Zou Bin behaved relatively calmly.

He has had many successes in his life.But in fact, the number of failures is too many to count.

Every success is accumulated on the basis of countless failures and trial and error, which also created his strong mind.

He knows that success is not easy, and he also understands the importance of calm and calm response.

In the face of surgery and patients, there should be no hesitation in the slightest. We must strengthen our beliefs and do our best to make no mistakes.

In another transparent observation room, there are Xiaomeng, Xiaomu, Ma Lin and others who were lucky enough to come in to observe.

They were able to come in because of Zhao Peiru's personal relationship. If it weren't for Zhao Peiru and the fact that this is the headquarters of Jiangxin Hospital, with their seniority and status, it would be impossible to get their turn.

"The opportunity to observe the top team should be cherished."

Everyone's eyes widened, reluctant to blink.

Standing on the operating table is the top pancreas team in the country!
Zhao Peiru's move is also to let his team members take a good look and learn how other top teams operate and cooperate.Let your team have a growth goal.

……

The operation begins.

Zhao Peiru was familiar with the way, took the right side, and made an incision into the abdominal cavity through the rectus abdominis muscle.

This is the most suitable approach for this patient that he found after more than a dozen attempts in the virtual operating room of the golden preview.

After the approach, the duodenum is freed, and a [-]-centimeter long longitudinal incision is made at the lower part of the common bile duct. The end of the bile duct is obstructed, and then a [-]-centimeter incision is made longitudinally in the ampulla of the intestinal wall, and the intestinal wall is retracted to expose Out of the tumor.

Zhao Peiru is very familiar with the situation in the patient's body.

He had performed hundreds of surgeries on this body in the virtual operating room before, and Zhao Peiru could perform this surgery on any structure in the body even with his eyes closed.

Therefore, every step can be extremely precise.

After this set of operations, Academician Zou Bin next to him was stunned.

It's not that Zhao Peiru's operations are so special, these operating procedures are written in the detailed plan they agreed on.

But Academician Zou Bin had a vague feeling that something was wrong.

For surgery, after the incision and approach, the first step is not to immerse yourself in the operation.

Instead, it is necessary to check first to find out whether there is organ metastasis, whether there is mass tumor infection, whether there is obstruction, and whether there is enlarged lymph node.

The steps of detection are like when playing a game, you must first open your field of vision, put on real and fake eyes, and light up the fog.

Only with a clear vision can we do a good job in the following operations.

But Zhao Peiru was very fast when he was doing the probing steps, as if he had his own "real eye", where his hand touched, he found the thing that should be touched very appropriately.

Obviously it looks like direct blind sex, but it can free the duodenum and the lower part of the common bile duct very well.

Academician Zou Bin frowned: "When did Dean Zhao understand the patient's body structure in such detail?"

"Could it be...through familiarity with anatomy, coupled with preoperative film reading?"

Film reading is very particular about skills and empirical methods.

A good doctor can have a good understanding of the patient's body structure and the affected part of the lesion when reading the film, and can even build a 3D model of the patient's body in his own mind.

Could it be that this Dean Zhao Peiru has this kind of ability?
In his mind, he has already constructed a 3D stereogram of the patient's body?That's why it's so easy to do?
"Fu Cheng, get out of the way, and I will help."

Zou Bin intends to test what he thinks.

When Academician Zou Bin spoke, Fu Cheng was startled: "Are you physically strong enough?"

The original plan was that Fu Cheng was in charge of the first third and the last third of the operation, and only when the core part was in the middle would academician Zou Bin come on stage to assist Zhao Peiru.

And now that the operation has just started, academician Zou Bin is going to take over?

Academician Zou Bin nodded: "Don't worry, I can handle the assistant's workload."

Only then did Fu Cheng back down.

Sure enough, as soon as Academician Zou Bin got started, the rhythm of Zhao Peiru's operation became a little faster.

With the assistance of Academician Zou Bin, a top surgeon who is a living fossil in the world, Zhao Peiru is even more comfortable.

If we say that the previous director Fu Cheng could only use [-]% of his proficiency trained in the virtual operating room with the golden preview card.

If it were Academician Zou Bin, he would be able to perform [-]% of his performance.

As soon as the pace of the operation was accelerated, the progress was picked up immediately.

This change is obvious, not only Fu Cheng noticed it, but everyone in the observation room also noticed it at once.

"Sure enough, Academician Zou Bin's technical level is higher."

"Even if it's just working as an assistant, the efficiency and progress of the operation can be improved so quickly."

If you don't compare, you don't know. This comparison reveals the technical proficiency of Academician Zou Bin more and more.

"No, it's not just academician Zou Bin who's helping."

"The most powerful one is Dean Zhao Peiru."

"Have you noticed that no matter whether it is Director Fu Cheng or Academician Zou Bin, no matter who goes up to cooperate, Director Zhao can catch it steadily and follow the rhythm of the other party. What does this mean?"

What does this mean?
Everyone's heart froze.

This shows that Zhao Peiru's level is at least on par with Academician Zou Bin.

Although many people know that Zhao Peiru's level is not low, they think it is about the same as Director Fu Cheng, or just a little bit better.

Now it seems that he is on par with Academician Zou Bin!

Especially the elders of the Fourth Hospital, such as Xiao Meng, Xiao Mu, and Ma Lin, were even more excited, proud, and pleasantly surprised.

Academician Zou Bin on the operating table was even more shocked.

Others can't see it, but he is the person involved, and they can feel that Zhao Peiru is still accommodating himself.

"If it weren't for me, his operation efficiency would be even faster."

"His understanding of the patient's situation is beyond imagination!"

Sure enough, his mastery of the patient's body structure is already very high!
This shows that Zhao Peiru has a very strong ability to read films before surgery!

In addition, there is also the ability to operate hard, which is also extremely superb.

Academician Zou Bin could feel that Zhao Peiru still didn't do his best, but took the initiative to reduce the operating frequency to cooperate with his assistant.

"Am I still underestimating him?"

Academician Zou Bin couldn't figure out where Zhao Peiru's ceiling was.

The high-level academicians he knew could not escape the erosion of time, and their physical and energy would inevitably decline.

And those middle-aged doctors in their 40s and [-]s who are physically fit and energetic often don't have enough experience and skills to reach the level that old academicians can cope with on the operating table.

This Zhao Peiru has both the rich experience of the old academicians and the stamina and physical strength of the middle-aged doctor, showing excellent practical ability, which is really rare.

The process on the operating table continues to advance.

After exposing the tumor, Zhao Peiru used a thin needle to penetrate the tumor body and pulled out a silk thread for traction.

With the assistance of the biliary tract probe operated by Academician Zou Bin, the duodenum was lifted upwards, and the duodenal mucosa, submucosal muscular layer, and lower part of the common bile duct were removed with an electric knife along the edge 0.5 cm away from the tumor. and the end of the pancreatic duct.

At this time, academician Zou Bin suddenly said: "Dean Zhao, is a five millimeter margin enough?"

They agreed in the protocol before that the cut here is 1 cm to 1.5 cm, which is based on comprehensive consideration of tumor size, anatomical space, and prevention of residual lesions.

But how did he know that Zhao Peiru has already verified countless times in the virtual operating room space, and has conducted a large number of tests on the margin of tumor resection.

This 0.5 cm resection is enough to remove the tumor, and at the same time, there is no residual lesion, and as much normal tissue as possible is preserved for the patient.

This patient is an elderly patient. Preserving more normal tissues for him can improve his postoperative recovery and save him a lot of pain.

Zhao Peiru said, "Five millimeters is enough. Director Fu Cheng, these edge sections should be biopsied."

Fu Cheng took the slice carefully and handed it to the young student who had been waiting beside him. The young student immediately went to the laboratory next door.

Academician Zou Bin hesitated for a moment, but did not stop Zhao Peiru.

A [-] mm cut-off edge, although a little risky, is not too much of a problem.It will not be too late to make a decision after seeing the results of the marginal biopsy.

If there is a problem at that time, it can also be reworked to expand the range of edge removal.

Afterwards, Academician Zou Bin concentrated his energies on the first assistant's own work.

Electrocoagulation to stop bleeding.

The electrocoagulation hemostasis knife in his hand can always follow Zhao Peiru's place where the knife is cut, and keep pace with it, keeping the amount of bleeding to a minimum. This not only saves the patient from suffering, but also fully exposes the surgical field, providing the surgeon with an excellent surgical environment. .

Afterwards, the two cooperated to incise the pancreaticobiliary mucosa, resect the mucosa, and suture the pancreaticoenteric mucosa and biliary tract mucosa.

In this step, the walls of the common bile duct and duodenum are completely mucosalized, the inner walls of the common bile duct and pancreatic duct, and the walls of the pancreatic duct and duodenum are completely mucosalized.

So far, the work of dissociation and excision has been completed.

Next, is the reconstruction of the digestive tract and important pipelines.

In everyone's minds, the positive infinity symbol, the shape of 8 horizontally appeared.

This matching shape is unique, but extremely effective.Through various verifications, the team members have proved that this anastomosis method has many advantages, and it is also the most important step that can greatly reduce the risk of our surgery.

"and many more."

Academician Zou Bin suddenly said, "The results of the pathological examination of the slices have not yet come out."

Once the digestive tract reconstruction work has started, it will be a bit troublesome to rework.

That would have to be "opened up" again, which is undoubtedly another serious trauma for the elderly patients who are already frail and impatient.

It was also Zhao Peiru's operation that was too fast and efficient.If it is replaced by other people to perform this operation, the step of digestive tract reconstruction will not be reached at all, and the results of pathological examination will be available.

At this time, the young student came quickly from the laboratory next to him, held up the inspection report that had just been printed out, and brought the temperature of the printer, and said, "All the results of the slices are negative!"

After saying this, everyone breathed a sigh of relief!

This shows that the positive part has been completely removed, and all of them have been removed from the patient's body.

The rest of the body is all negative!

There was joy on everyone's face.

As a doctor, what I like to hear most is the sentence that the margins of the slices are negative, which means that they don't need to expand the resection.

As for Academician Zou Bin, he looked at Zhao Peiru a few more times in surprise.

Although Zhao Peiru's move was small, it was only a deviation of five millimeters when he cut the knife, but it helped the patient a lot, allowing his body to recover faster after the operation. For the former patients, it is tantamount to sending charcoal in the snow.It is not an exaggeration to say that it can make it live for a few more years.

Subsequently, the ∞-shaped digestive tract reconstruction work was carried out.

Its operation is not very difficult, and compared with the conventional anastomosis method, it does not increase the additional difficulty of operation.

Under the operation of two top doctors, Zhao Peiru and Academician Zou Bin, all reconstructions were completed soon.

In the last step, Fu Cheng, as the second assistant, placed a silicone tube support with a similar diameter in the pancreatic duct of the patient, fixed it with absorbable thread, and placed a T tube in the common bile duct for drainage.Subsequently, the incised anterior wall of the duodenum was sutured horizontally and intermittently with No. 1 silk suture.

After no omissions were checked, the abdomen was closed and sutured layer by layer.

The whole set of surgical procedures was done in full accordance with the treatment plan.

During the operation, there was neither a little accident nor rework.

Everyone felt that the operation went a little unexpectedly smoothly.

It went so well!

They reminisced about the process of this operation. Every step of the operation by the chief surgeon, Zhao Peiru, was all effective operation, and there was no waste operation.

This also led to the fact that the surgery, which was expected to take at least four hours, was completed in just three hours.

"This Dean Zhao's surgeon level... feels so high!"

"It seems to be no worse than when Mr. Zou was the main surgeon."

The team members brought by Academician Zou Bin also changed their gaze towards Zhao Peiru.

Your thinking is flexible, your brain is bright, and the theoretical part is strong, so forget it.

But the practical part of your surgery is also ridiculously strong. Compared with Mr. Zou, a top technical expert, it is on par, and your physical strength and endurance are even better!
This is simply excellent in all aspects, with no dead ends and no shortcomings!

After finishing the final stitching work, Fu Cheng also let out a long sigh of relief.

There was also a relaxed smile on his face.

This operation is [-]%, and a piece of Teacher Zou's heart disease can finally be removed.

(End of this chapter)