Chapter 121 Shocked everyone, quickly write it down in the small book!!

I saw Lin Yu pick up the uncharged electric knife head, carefully spread the transverse colon Ximo left and right, and then put it upside down, separate the gastrointestinal ligaments in turn, and perform gastric omentectomy.

When all this was over, Shizuka Kumagawa coughed lightly.

“What’s wrong?”

Lin Yu seemed to have guessed something.

“Why not choose a blunt separation with a charged electric bunk?”

Shizuka Kumagawa asked.

Hideki Takano was also a little curious.

“Sharp separation has minimal tissue damage, why blunt separation?”

Lin Yu explained.

“The uncharged cutter head is not sharp, and using it for separation saves time, in addition, it can ensure that the separation plane is advanced in parallel to avoid tearing the mesangium due to uneven force.”

“Many doctors choose a sharp scalpel to separate, which is naturally prone to problems.”

Hideki Takano and Shizuka Jukawa looked at each other, and both saw the shock in each other’s eyes.

“Stunned… What are you doing stunned? Second-order doctor, write it down in a book! ”

Hideki Takano said.

The second-order hall red pill immediately took out a small book that said “Handsome B Second-Order Doctor’s Special Experience Book” and wrote it with a brush.

Several people present were excited.

That’s the benefit of having a specialist for surgery.

In textbooks, you can only learn that uncharged electric blades are blunt, not sharp, mixed cut and pure cut respectively have some points, disadvantages.

However, with an expert, he can let you know when to do something, when to be high-frequency, and when to turn up the output power.

This is called, practice makes true knowledge!

“Next is pyloric vascular ligation.”

Lin Yu cut the peritoneum at the lower edge of the duodenum to expose the pancreas.

In the field of view, it is clearly visible that there is an upward bulge on the surface of the pancreas, and the tip of the bulge is the root of the omentum vessel.

This is a marker used to determine arteries and veins, and some experienced doctors often use this to distinguish them.

Walking up the bulge are arteries and downwards are veins.

At the top of the bulge, the right omentum vein and the right colonic vein merged into a trunk, and Lin Yu carefully ligated with line seven.

“Scalpels, scissors.”

Hearing the utensils, Erjido Hongmaru asked curiously.

“This time it’s for sharp separation?”

Lin Yu nodded.

“The separation is the subpyloric lymph nodes, and careful cutting is required here, otherwise it is difficult to isolate successfully.”

Lin Yu slowed down his movements, increased his strength slightly, and pulled the tissue to the sides, making it tense.

Then use a scalpel to cut perpendicular along the tissue gap and at short distances.

In some places with small rental gaps, Lin Yu replaced surgical scissors, with the tip of the scissor deep into the tissue space, open the scissor handle, separate the tissue, and then cut it.

Takano Hideki and the others widened their eyes.

Whether it is separating or cutting, Lin Yu’s movements are textbook level.

It’s art!

“In the future, can I often come as a second assistant?”

Shizuka Jukawa swallowed her saliva and said.

Orochimaru didn’t blink his eyes.

“I want to come too, I’ll be a Sansuke!”

Lin Yu did not notice the conversation between the two, and after completing the separation, he found the lower edge of the second denum, stretched the duodenal wall to the right, and ligated the right omentum artery at the root.

“Groove! Can it still be like this? ”

Takano Hideki finally understood why Lin Yu separated the duodenum instead of cutting it directly.

By doing so, the dense subpyloric veins are directly avoided, reducing the risk of surgery!

“The next step is to cut the duodenum.”

Without waiting for Lin Yu to speak, the Second Order Hall Red Pill immediately handed over the non-invasive intestinal forceps.

Lin Yu smiled, it seemed that the second-order medical technique had already kept up with the beat.

Lin Yu moved his stiff neck and reinvested in the operation.

About 2.5 cm from the anterior pyloric vein, Lin Yu clamped the duodenum with a noninvasive intestine.

“Kocher pliers.”

Kocher forceps are toothed vascular forceps for their purpose as the name suggests.

After Lin Yu took it, he clamped the Kochers forceps to the proximal duodenum.

Then, easily between the two forceps, the duodenum was cut off.

Lin Yu was just about to stretch out his hand, and the Second Order Hall Red Pill Oh immediately handed over the hemostatic forceps with a smile on his face.

“You want that, right? Hehe~”

Lin Yu’s face froze: “Yes…”

Taking the hemostats, Lin Yu began to separate the fibrous tissue between the posterior wall of the duodenum and the head of the pancreas.

“Lin Yu, how are you now?”

Hideki Takano couldn’t help but ask.

It is time to choose which GI reconstruction procedure to use, and if it is a jejunal gastric replacement, then the duodenal stump should be closed.

If the jejunum and duodenum anastomosis are placed between the rows, the duodenal end needs to be preserved for later anastomosis.

The choice made will directly affect the patient’s digestion and quality of life.

The eyes of everyone, including Hideki Takano, were focused on Lin Yu’s body.

Retention means esophageal jejunostomy, and no retention means gastric replacement of a tristacked empty cyst.

Either way, there is no way to say what advantages and disadvantages there are, you can only choose the more suitable.

Lin Yu didn’t have much hesitation and spoke.

“Close the severed end and perform triassic cyst gastric surrogate.”

“Why?”

“Esophageal jejunostomy requires a measurable suture.”

“Including intermittent mattress sutures, etc., and once the mesangial space is not completely closed, it is very easy to occur internally, no matter which point, it is detrimental to the patient.”

“In contrast, triassic jejunal gastric surrogation is more suitable for patients.”

After speaking, Lin Yu closed the severed end of the duodenum, which also needs special attention, the free stump of the duodenum cannot be larger than one centimeter, otherwise blood supply will be affected.

Moreover, it is necessary to be very careful when closing, and once leakage occurs, only duodenostomy can be performed.

To put it in layman’s terms, it is excision.

After doing this step, Lin Yu began to reveal the stomach fundus and esophagus.

Everyone was quiet, not daring to disturb Lin Yu.

I saw Lin Yu’s right hand holding up the left lobe of the liver and cutting off the left delta ligament.

On the other side, Hideki Takano immediately cut off the ligaments with blood vessels and ligated!



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