Surgical artist

Chapter 440 The Mystery of Double Mirror Surgery

Zhan Tong, director of the Department of Gastroenterology at Jiangxin Hospital, after answering the phone, suddenly walked towards the elevator in a hurry.

When he was about to leave, he greeted several people and came to the elevator together.

With a "ding", the elevator door opened.

A rescue lathe was pushed out of the elevator urgently.

Among the people who followed the lathe were not only the director of the emergency department, but also the vice president Pan Mingde.

The patient on the lathe bed is Pan Mingde's father-in-law.

After a while.

Urgently determine the treatment plan: laparoscopic surgery, resection of the right colon.

Soon, the operating room will be ready.

After preoperative preparations such as streptomycin, metronidazole, and 50% magnesium sulfate, the patient was intubated and given general intravenous anesthesia.

Afterwards, Zhan Tong led the surgical team into the operating room.

This time, the director of the department, Zhan Tong, is in charge of the operation, and her assistant Xiao Huang, who is also very capable of supporting the environment, is in charge of the mirror.

After thinking for a while, Zhan Tong said, "Call Dr. Su Youliang in."

Since this young man is intended to be supported by Dean Zhao Peiru, she might as well be a favor so that this young doctor can learn something.

Start the rescue operation.

Zhan Tong's laparoscopy is very good. Sheath tube was inserted, laparoscopic observation port was established, and the main operation port was selected at the midpoint of the line connecting the navel and xiphoid process.

Then look into the mirror.

"Ok?"

Zhan Tong was staring at the electronic display of the laparoscope, suddenly, his expression paused, and his brows were tightly frowned: "No, go back to the position just now."

Her assistant, Xiao Huang, slowly moved the laparoscope lens back.

"Stop here."

Zhan Tong frowned tightly: "This is... multiple adenoma?"

The face of Xiao Huang next to him became serious in an instant: "It does look like multiple adenomas."

The temperature in the entire operating room suddenly dropped by two degrees.

When they perform laparoscopic colon surgery, what they are most afraid of is encountering such multiple tumors.

The omission rate of such tumors is high.

Because laparoscopy is more like a "two-dimensional" exploration perspective, this disadvantage is not obvious when facing a single tumor, but once this multiple tumors are involved, the "two-dimensional" perspective has limitations in exploration , will be infinitely magnified.

"This has to be converted to laparotomy."

"With laparoscopic surgery alone, the cut will not be clean."

Everyone nodded solemnly.

Assistant Xiao Huang also said: "Relying on a laparoscope alone has a limited field of vision. In the face of this kind of multiple pancreatic tumors, if one lesion is missed, the operation will be for nothing. We can't take risks. To be on the safe side, we can only Switch to laparotomy."

Zhan Tong sighed helplessly, and said, "It's not up to us to switch to laparotomy."

She called Xiao Zhang, another young doctor who had been waiting beside her all the time: "Xiao Zhang, go and explain clearly to Dean Pan and the family members."

"Converting to laparotomy will not only cost more, but also cause more trauma and risk. Let them think carefully."

Not everyone is willing to switch to laparotomy.

Zhan Tong said again: "Ask Dean Pan, should we switch to laparotomy here, or transfer to another hospital? Do double-lens surgery?"

It is said that other hospitals have a kind of double-lens surgery, using laparoscopy and colonoscopy at the same time, which can broaden the field of vision and accurately locate.Even in the face of multiple pancreatic tumors, minimally invasive methods can be used to detect all of them clearly, and the operation can be completed using only minimally invasive techniques.

However, this technique has not been mastered by the Gastroenterology Department of Jiangxin Hospital.

"Also, invite Wei Xiaobin, the director of the Department of Hepatobiliary and Pancreatic Surgery. If you want to convert the laparotomy, you have to rely on him to do the second half of the anastomosis."

Xiao Zhang hurried out.

In the operating room, the operation came to a standstill.

……

outside the operating room.

Xiao Zhang told Pan Mingde about the situation.

The faces of the family members behind Pan Mingde turned pale.

Laparoscopic surgery is still a minimally invasive surgery, and it is easier for them to accept in their hearts. Moreover, because of the small trauma, the hospital stay is short, and they can be discharged in about four days, and gradually return to normal life.

But once the laparotomy is transferred, it will be troublesome. Once the laparotomy is performed, who knows what unexpected things will happen?And once the operation is performed, there will be no recuperation time for several months, and there will be no recovery at all, which is especially difficult for the elderly.

"Old Pan, why don't you transfer my dad to the First Affiliated Hospital of the University of Medical Sciences?" Pan Mingde's wife came over and asked in a low voice.

At this moment, a voice sounded from the side.

"Dean Pan?"

Zhao Peiru passed by here, saw Pan Mingde, and greeted him with a smile.

Pan Mingde's expression was a bit ugly at the moment, but he managed to squeeze out a smile and said hello, "Dean Zhao."

"What's the matter?"

Zhao Peiru looked around and understood: "Is someone sick at home?"

Pan Mingde nodded.

Zhao Peiru: "Xiao Zhang from the gastroenterology department, what's going on inside?"

After Xiao Zhang explained the situation, Zhao Peiru immediately made a decision and said: "President Pan, the patients are lying on the operating table, and they have already been anesthetized and perforated into the abdomen, so don't bother to transfer them, it's not good for the patients. "

He stepped up and was about to walk inside: "Let me do this operation. I will use the double mirror technique."

After Pan Mingde was taken aback for a moment, he was overjoyed immediately!
If someone else said this, he probably didn't believe it. When did their Jiangxin Hospital master the dual mirror technology?But when these words came from Zhao Peiru's mouth, the credibility was too high!

"Okay, thanks for your hard work!" Pan Mingde only had time to say a word before Zhao Peiru entered the operating room.

"Old Pan, was that just now?"

Both the wife and the mother-in-law looked over without knowing why.

Pan Mingde smiled and said, "We can rest assured that he will perform the operation. Mom, the one just now is our vice president, Zhao Peiru."

Zhao Peiru?
The wife and mother-in-law looked at each other and understood immediately.

When Pan Mingde returned home, he often talked about the rapid development of Jiangxin Hospital. Among them, there was always one name, Zhao Peiru.

"Is he the famous doctor who can match the national academician level?"

Pan Mingde nodded and said, "Yes. He doesn't know how many operations are more complicated and difficult than this one. We can rest assured that Dad will take over this operation."

"You guys wait here, I'll go in and have a look."

When Pan Mingde entered the operating room, he saw Zhao Peiru inside the glass door, wearing a surgical gown with the help of the itinerant nurse.

Inside, Zhan Tong and the others saw Zhao Peiru come in, and their hearts skipped a beat!
Dean Zhao wants to take over the operation himself?

A while later, Wei Xiaobin was also notified and rushed over, but now that Zhao Peiru had taken over, he was no longer needed.

Zhao Peiru said: "Director Zhan, does the operating room have a full set of colonoscopy equipment?"

This is the operating room of the gastroenterology department, with a glance...

Relatively crude.

Compared with their "luxury" operating room for hepatobiliary and pancreatic surgery, which requires huge investment and various project funds, this is just an ordinary "city-level" operating room.

Compared with the equipment and decoration level of his medical research headquarters in the West Campus, it is much worse.

Fortunately, the equipment required for this operation is not expensive. Laparoscopy and colonoscopy are relatively cheap and common.

Zhan Tong nodded quickly: "There is Dean Zhao."

She also trembled in her heart. Could it be that Dean Zhao is going to have double-lens surgery?
Zhao Peiru: "A few of you, which one is the best?"

Zhan Tong subconsciously looked at his assistant Xiao Huang, who also gently raised his hand.

"You come to be my assistant. You can operate laparoscopy and colonoscopy proficiently, right? During the operation, you and I need to exchange positions many times. Is it okay?"

Xiao Huang glanced quickly at Zhan Tong, director of the ophthalmology department, and then at Dean Pan Mingde in the small observation room behind.In the end, he nodded deeply: "No problem!"

He took a deep breath and knew this was a big opportunity.

If the performance is not good, it must be over.But if you perform well, maybe this is your chance.

After Zhan Tong gave him an encouraging look, he stepped back and gave Zhao Peiru the position of chief surgeon.

After getting off the operating table, Zhan Tong thought for a while, and said to the young doctor Su Youliang next to him: "Go and call all the other doctors in the department."

"Dean Zhao is going to do the dual-lens technology, which is only available in large hospitals. Let all the doctors in the department come to observe and learn."

Su Youliang's heart moved. They invested so much in the three courtyards, but they failed to introduce this dual-mirror technology.Now at Jiangxin Hospital, I have the opportunity to learn.

He hurried to call someone.

After a while, the observation room was full of gastroenterologists.

Everyone whispered in low voices, why did Dean Zhao suddenly want to teach the dual-mirror technique.

"Director Zhan."

A group of directors of the gastroenterology department stood behind Zhan Tong and said in a low voice, "Dean Zhao still knows the double mirror technique of our gastroenterology department?"

Zhan Tong glared at several people: "Double-mirror technology is difficult for us, but for Dean Zhao, can it be called difficult? He can even do organ cluster transplantation, and even Academician Peng Shu's intestinal anastomosis He can improve it. There is also the previous colon reverse peristalsis technology, which was also brought out by Director Zhao."

Everyone thought it was true. In the field of colon, Dean Zhao has already come up with the technology of reverse peristalsis, and if he comes up with a dual-lens technology, what's the matter?
Besides, in the Department of Hepatobiliary and Pancreatic Surgery, Zhao Peiru probably has mastered both types of endoscopes, right?Now it's just applied to the colon area.

Thinking about it this way, it makes sense.

"Look at it later, and study hard. If anyone can master this double-lens technology first, I will promote him and lead a surgical team independently, specializing in this double-lens colectomy."

Everyone breathed hot immediately!
I can't wait to stare wide-eyed without blinking!

……

On the operating table, Zhao Peiru said to Xiao Huang: "Enter the colonoscopy."

Xiao Huang took a deep breath and stepped into the mirror step by step. The colonoscope was easy to enter, and the colonoscope reached the target area in about 3 minutes while inflating it.

"With my laparoscopy, after determining the location and upper and lower margins of multiple tumors, they were marked with sutures one by one."

While Zhao Peiru instructs Xiao Huang to operate the colonoscope, he is also doing his own thing.

Holding a hand assistant in his left hand, he used an ultrasonic knife to do mobilization work, mobilized from the splenic flexure of the colon, and cut the outer peritoneum of the descending colon.

At the same time, protect the ureter, ligate the intestine with a cotton band at a distance of 5 cm from the suture mark tumor, dissect the mesentery at the root of the colon, and ligate it with a thread.

"These two mirrors are matched together, and the vision is really good."

"Using two viewing angles for the same location target, even the operation will become more confident."

"Dual mirrors do have a benefit in terms of vision."

The people in the gastroenterology department who were watching, looked at the images displayed on the two monitors, and couldn't help affirming it.

In their daily work, they perform laparoscopic surgery almost every day, and the feeling is completely different when they only face one image and face two images.

It's like a person uses two eyes to locate a pen in front of him, and he can touch it very accurately.

But if you close one eye, you may mistake the real distance between the pen and yourself.

On the operating table, Zhao Peiru cut off the left branch of the middle colic artery and the left colic artery using the high cut method.A sample of the colon is then removed through a minimally invasive incision using a hand aid.

"This is... an excision and suture operation outside the body?"

Everyone was startled suddenly.

So, is this the meaning of dual mirror operation?

The part that is easy to see directly with double mirrors is dissociated, separated, and excised in the body.And the most core part, which is difficult to see directly with the double mirror, is cut off, and it is taken out of the body directly, and the resection and anastomosis are performed outside the body.

One is inside the body and the other is outside the body, but the essential requirements are the same, that is, to be performed under direct vision.

Many people showed contemplative expressions.

Zhao Peiru used this operation to teach everyone that the operation should be performed with sufficient and good vision, preferably under direct vision.

In this way, the lesion can be resected to the maximum extent, and the possibility of omission is eliminated.The second is to make the operator more confident in the operation and make the operation more convenient and simple.

After the resection was completed, Zhao Peiru continued to perform colon-to-end anastomosis in vitro, and sutured the mesenteric hiatus.After the examination, the specimen was shortened and returned to the abdominal cavity.

"Xiao Huang, check the operation area to see if there is active bleeding or bleeding."

"Spray biological protein glue."

"A rubber drainage tube was placed in the left abdominal cavity."

Following the instructions, the operation came to an end.

The total time for one operation was only 110 minutes, which also included Zhan Tong's operation and the waiting part of the operation.

If Zhao Peiru were to be in charge of the operation from start to finish, it would take about 80 minutes to complete it.

"Double-mirror technology... so awesome!"

Everyone was shocked when they saw how long the operation took.This is much faster than a single laparoscope!
"In fact, it's easy to understand. There are many things to consider when performing a single laparoscopy. The surgeon is hesitant and hesitant. At the same time, many auxiliary techniques are needed to assist in positioning, which is a waste of time."

"And this pair of mirrors not only improves the operation efficiency, but also improves the positioning accuracy, greatly reducing the probability of omissions, which can make the operation faster and better."

Everyone in the observation room was amazed and admired.

Zhan Tong, director of the department, said: "When only laparoscopy is used, we often need to inject melanin at the base of the lesion to mark the location, but often encounter the problem of inconspicuous coloring, wide coloring range, and timeliness."

"With the dual-lens technology, all these operations can be omitted, so the efficiency of the operation is actually improved."

"In addition, when Xiao Huang's colonoscopy was withdrawn just now, did you hear the special order from Director Zhao?"

(End of this chapter)