Come on, Dr. Wu

Chapter 130 The Dean’s Attention

"That's Wu Xiaofu, right? He's still an intern, and he went into surgery right away!"

In the observation room, it can be said that a lot of people have gathered at this time. Not only the doctors from the general surgery department are almost here, but also some leaders of the hospital have appeared. For example, Vice President Rong, who is in charge of the surgery department, is also sitting in the observation room at this time. In the middle, looking at the big screen in front of him, his eyes were meticulous. This person also came from general surgery, and was particularly concerned about some operations in general surgery.

This living donor liver transplant is quite difficult, and since Yu Shifu performed the surgery himself, Vice President Rong would not miss it.

There are more than a dozen people standing behind. Who would have thought that this is Sunday. Some surgeries, even at the expense of weekend rest, are still necessary, such as the liver transplant in front of you. Look at those surgeries. The attending and deputy chief physicians of the general surgery department all wanted to get into the operating room and perform the surgery themselves.

Especially after seeing Wu Xiaofu, some doctors couldn't help but feel sour.

Senior doctors like them didn't have the chance to follow him, but Wu Xiaofu was lucky. As an intern, he was not sure whether he could stay in the hospital, so he followed him. It was really incredible, he was lucky.

It's no secret that Yu Shifu likes Wu Xiaofu. What happened today shows how favored Wu Xiaofu is. They know that if there are no accidents, Wu Xiaofu's stay in the hospital should be a certainty.

Thinking of this, they found it even more incredible. Wu Xiaofu was just a master's degree student, a graduate of a non-key medical school, but now he was so lucky that he could join the First Affiliated Hospital. Thinking about it, they felt envious and jealous. , how much effort they made to stay in the hospital. Compared with Wu Xiaofu, it was simply hell mode.

"Yeah, when did I undergo the liver transplant surgery? It seems to have been when I was the deputy director."

"Don't be so upset, haven't you heard? Duan Hao personally took this intern to knife flying two days ago. He was originally going to give him some gallbladder and appendix training, but Wu Xiaofu directly performed liver resection on the two following machines. I also had surgery. It was a perfect resection. I might not be able to get it, but it was done by such an intern. It’s unbelievable. This is the next Wang Buyi.

No, Wu Xiaofu is even better than Wang Buyi. It is not an exaggeration for Director Yu to let such a genius go and cultivate him in this way. "

What?
  Everyone looked at Lian Jingwei. Not to mention, few of them knew about this matter. Lian Jingwei was definitely breaking the news.

Do interns perform liver resections? Are you kidding me?

Even Jingwei had a sigh on his face at this time. He was really blind at that time. Wu Xiaofu was clearly right in front of him, so he could have taken him down directly. If he had taken down Wu Xiaofu at the beginning, now Wu Xiaofu's teacher It's not impossible for him to accept Wu Xiaofu as a doctoral student in the future. With Wu Xiaofu's talent, he will be able to enjoy the blessings from now on.

It's better now. Even if Lin Shaoyuan missed him, Duan Hao also caught him.

The most important thing is that for such a good talent, after staying in the hospital, the first stop may be the emergency department. He and Yu Shifu had previously mentioned the issue of Wu Xiaofu's admission to the hospital after staying in the hospital, but Yu Shifu prevaricated it. , isn’t it just to favor Duan Hao by prevaricating about this kind of thing?

Alas, if you are not careful, you will regret it for the rest of your life.

A liver resection can be performed at the age of twenty-five. I am afraid that within a few years, Wu Xiaofu would dare to stand on the operating table of a liver transplant.

Vice President Rong next to him also had his ears twitching at this time. He had never heard of this matter. During this period, he went to the Party School to study and only came back the day before yesterday. Otherwise, when Wu Xiaofu and the others took the first assessment , he was the one who showed up, not Vice President Liu who was in charge of personnel.

Vice President Rong was not unaware of Wu Xiaofu.

When the pre-operative seminar was held, he was also present. Yu Shifu mentioned that Wu Xiaofu was very talented and wanted to learn from him, but he was just a third assistant. Vice President Rong didn't pay attention and directly He nodded. Although he was said to be in charge of surgery, he basically delegated the actual operations to Yu Shifu. After all, he was too busy.

Now it seems that this talent is good, but it needs to be put in quotation marks.

He is just a doctor and can perform liver resection, which is much more powerful than Wang Buyi. Thinking of this, Vice President Rong was also a little excited. He regretted missing Wang Buyi at the beginning. Now that Wu Xiaofu appears again, he will definitely It was God's blessing. Thinking of this, Vice President Rong paid more attention to Wu Xiaofu.

Although he is an assistant, Vice President Rong can see many things through this operation.

On the donor side, Yu Shifu has already started the operation. The operation is simple. It is just a liver resection, and it is much easier than liver cancer resection. After all, liver cancer patients are basically in poor health. The patient's daughter is different. , both the other organs of the body and the liver function are very healthy.

This time, half of the healthy liver was cut out, and there was no need to worry about whether the lesion could be completely removed. Even the lymph nodes could be dissected as little as possible. One operation included removal and suturing, so that Shifu and Che Liming could With his strength, it can be solved in three hours at most.

Duan Hao also started here, but unlike usual, Duan Hao moved very slowly this time.

Make an incision along the positioning line drawn in advance.

The knife is cut under the right rib and an arc-shaped incision is made until it stops at the xiphoid process, which is about ten centimeters in length.

Wu Xiaofu was holding the hook beside him and didn't say much, but his mind was running rapidly. For the assistant, every step of the operation was worth thinking about.

Why should the incision be made from here? Why should we deal with it first? After the incision is made, how to peel off the fascia to expose the field of view more perfectly without affecting the later recovery as much as possible. What is the next step for the surgeon? What kind of visual environment does he want to provide?

These are all things to think about. If you really only focus on pulling the hook, then such a meaningful operation will really be a waste.

Those who waste natural resources will be beaten to death by those in the observation room.

Electrocoagulation was used to stop the incision bleeding, and the retractor was used to expand the incision.

The familiar smell of meat lingered around, making Wu Xiaofu feel soothed. To be honest, Wu Xiaofu now just couldn't be happier without any surgery. He would feel uncomfortable if he didn't smell this smell for a day.

The liver donor's vision over there has been exposed. Che Liming's retractor skills are even better than Wu Xiaofu's. Yu Shifu took the dissociation instrument from the nurse and began to dissect and dissect around the liver of the patient's daughter. , this speed is very fast, and often the field of vision can be fully exposed in a few or two operations.

This is the style of a master.

The liver was exposed. According to the preoperative discussion sheet, part of the right lobe of the patient's daughter's liver was to be harvested, which was about two-fifths of the entire liver. Currently, the world-recognized standard for living donor liver transplantation is to harvest a living donor liver. , the maximum proportion is 75%, but few doctors actually take 75%.

For most people, half is enough, and two-fifths is a safe liver level.

Fortunately, the patient's daughter is in her prime. After the liver is removed, although her liver function will decline, as long as she survives the dangerous period and the liver begins to recover on its own, it will be much better. The liver's regeneration and recovery capabilities are very strong, 100%. Seventy-five is calculated based on the maximum recovery limit. Of course, individuals have differences, and the actual recovery level must ultimately prevail.

Even if the liver cannot be restored to its original level and function, it can be restored to a moderate degree, which is basically enough. Of course, the impact will definitely be there, and it may be lifelong. You should pay attention to drinking, taking medicine, working environment, etc.

It is easy to remove the liver, but it is difficult to remove the liver blood vessels.

It is necessary to consider whether the length of the liver blood vessels meets the transplant requirements of the liver recipient. It is also necessary to ensure that the blood supply of the liver donor is normal and that it cannot affect the liver blood supply of the liver donor and cause damage to his body.

Although it had been discussed before the operation, Yu Shifu still had to be very careful during the operation.

With the support of experience and technology, Yu Shifu didn’t have much hesitation.

He took the scalpel from the instrument nurse and began to cut the liver and kidney ligaments. This was a loosening process, and the liver was now more obvious.

Then there is the dissociation of the hepatobiliary triangle area, and then the hepatic pedicle, which, like the splenic pedicle, is the richest part of the liver with blood vessels.

The portal vein and hepatic artery are all here, as well as the common bile duct, liver autonomic nerves, lymphatic vessels, etc.

Most of these blood vessels, nerves and lymphatic vessels are immobile, and the blood vessels to be cut are mainly branch arteries and veins.

But this is enough. The body's adaptability is actually very strong. When many people with poor blood vessel conditions undergo angiography, doctors can find that although their main blood vessels are narrowed, the body begins to allow these main blood vessels to maintain normal blood supply. The surrounding branch blood vessels share more blood supply work to ensure the normal blood supply to the body.

The branch blood vessels are thickened, the blood supply activity is increased, and even more work has to be undertaken.

The same is true after the donor liver is transplanted into the recipient. After the liver transplant is successful, these are enough for the patient to rebuild the liver blood supply circuit, rebuild the bile flow pipeline, etc. The most important thing we cannot underestimate is that the body's self-recovery is an adaptive work. Sometimes, you have given up on yourself, but your body has not given up on you.

It's just that many people have created their bodies to the point where they can no longer recover.

Wu Xiaofu glanced over from time to time. There was so much for him to learn from Yu Shifu's surgical operations. He seemed to have also had a liver resection, but compared with Yu Shifu, he was not even a bit worse, if nothing else. , just this free movement is enough to cause the patient to suffer less damage than he did.

An hour later, the preliminary preparations were almost over.

Yu Shifu began to resect most of the right lobe of the donor liver. Duan Hao and Wu Xiaofu were slower and were still doing dissociation work. On the one hand, Duan Hao wanted to control the rhythm, and on the other hand, because of the patient's Due to liver failure, the activity around the diseased liver, whether it is blood vessels, ligaments, etc., is greatly lost.

Some blood vessels bleed almost at the touch of a touch, so Duan Hao had to be much gentler in every movement.

In the patient's abdominal cavity, a distinct fishy odor can be smelled. This smell is comparable to that of diabetic limb resection. Even if Wu Xiaofu was prepared and wore two layers of masks, it was difficult to resist.

In other words, Wu Xiaofu is very experienced. If he were a novice who had just practiced as an intern, he might have vomited as soon as the smell hit him.

That's not just a joke. The surgical field has been opened. A little bit of contamination may lead to the failure of the operation. No one can afford this responsibility. Therefore, interns are not allowed to perform this kind of operation. It also makes sense.

The abdominal cavity was filled with light yellow and transparent liquid. Yes, it was hepatic ascites.

Seeing this ascites, Wu Xiaofu couldn't help but think of the stagnant water in ditches he saw when he was a child. Many of the patient's organs were soaked in such ascites, which was also a major reason for the patient's skin jaundice.

Seeing this situation, even Wu Xiaofu couldn't help but frown.

I have met many patients with hepatic ascites recently, but the patient's condition in front of me is particularly serious.

Wu Xiaofu took the aspirator from the equipment nurse and began to treat the ascites. The sound of the aspirator was different when suctioning such ascites. It seemed a bit laborious. Of course, it was just because the density of the ascites was a bit high. That's it, after the ascites is suctioned, it needs to be cleaned again.

After a round of flushing with physiological saline, the smell in the abdominal cavity will dissipate a little, and it will look much better visually.

To do this, the most important thing is to expose the field of vision clearly. This is something that the surgeon must ensure during the operation. The blind man touching the elephant cannot occur during the operation.

The dark black dry liver appeared in front of Wu Xiaofu and Duan Hao. It was no surprise. This is also the behavior of the liver of end-stage patients.

This kind of liver is like an old man, dying, even breathing is difficult, how can you force it to work, just barely staying alive.

Fortunately, the liver has not yet become cancerous. Otherwise, the operation will be more difficult and the recovery expectation after surgery will be much lower.

"Fine shears, curved nose pliers."

"Non-destructive forceps, electric hook."

The cooperation between Wu Xiaofu and Duan Hao is very tacit. Both Wu Xiaofu and Duan Hao are very familiar with free work. However, it is different from the liver resection surgeries Wu Xiaofu performed before. Those few liver resections were only partial liver resections. This time it is indeed It is necessary to remove the entire diseased liver. In addition to the diseased liver, there are still active parts around the liver, which should be retained as appropriate.

The more you leave, the better the recovery effect will be later.

Donor blood vessels, bile ducts, lymphatic vessels, and those that cannot be cut by the liver donor must be left behind for subsequent docking.

After all, what they are doing now is not just a simple liver resection. They also need to consider subsequent liver transplantation. They not only need to successfully transplant the liver, but also ensure the integrity of its various channels and blood supply, so that after the transplantation, it can still function. Survive successfully.

The knives and scissors are sharp, so Duan Hao can only be careful and careful. After all, if he cuts something that shouldn't be cut, it won't be possible to sew it up again. The patient's sick body can no longer withstand such surgery.

However, vascular sclerosis caused by cirrhosis of the liver causes vascular sclerosis in the blood supply vessels of the patient's liver. When dissociating, he must be even more careful.

(End of this chapter)