Knight Story: Learning medicine can’t save the world!

Chapter 122 Total gastrectomy completed!!

“S-shaped pull hook.”

Lin Yu stretched out his hand.

After Shizuka Jukawa let go, Lin Yu used the hook to pull the left lobe of the liver to the right, and at the same time, pull the stomach to the left.

After fixation, Lin Yu separated the liver and stomach ligaments along the lower edge of the liver and cut them off.

When finished, the periarterial lymph nodes in the abdominal cavity are removed.

“Surgical scissors.”

Saying that, Lin Yu cut the upper peritoneum.

The lower end of the esophagus is freed.

“S-shaped pull hook.”

“Second-order medical technique, you can pull the esophagus to the left and expose the esophageal tear.”

The Second Order Hall Red Pill immediately ran up.

“The esophageal fissure is too big….4hao line.”

Lin Yu said.

Normally, the hiatal hole is just enough to allow the esophagus to pass through.

When the esophageal hiatus is too large, because the pressure in the abdominal cavity is greater than in the chest cavity, the pressure difference draws a small part of the stomach into the chest cavity, forming an esophageal fissurment.

Once a hiatal fork occurs, the organs entering the chest cavity will affect the heart, lungs, affect circulation, breathing and other functions, and even cause complications such as heavy bleeding and reflux esophageal stenosis.

Therefore, once the esophageal hiatus is found to be too large during the operation, it is necessary to suture “Hongo is quite miserable…”

Nikjido Hongmaru shook his head, “The people who write novels are quite miserable. ”

Lin Yudao.

Suturing is Lin Yu’s specialty, and soon, after suturing, Lin Yu fixed the esophagus in the diaphragm hiatus.

“The next step is to cut off the spray door, which is also the last step before the removal.”

Lin Yu reminded.

As long as the spray door is cut off, almost the entire stomach has been completely detached from the body, and then only some adhesion tissue needs to be processed to complete the total gastrectomy.

Because the lower part of the esophagus does not have a serous membrane, it is all muscular, and it is easy to tear when sutured.

This is also one of the difficulties of total gastrectomy.

“A hao line.”

The lower esophagus is suitable for suture with a 1hao thread.

The esophageal muscular layer and mucosa are fixed after successive seam sutures, and the esophagus is cut off 0.5 cm distal to the front, completely separating the gastric tube from the esophagus.

When the fresh onlookers jumped out of their esophagus, everyone present breathed a sigh of relief.

This is a big step, and then there is the final step: the removal of the entire stomach!

After Lin Yu calmed down for a while, he took a deep breath and concentrated again.

This step is not complicated, but it is very risky.

At this point, many blood vessels around the stomach have been revealed.

Once the tumor of the stomach body is accidentally cut, the cancer cells are likely to flow into the body with the blood, directly causing the patient’s death!

Of course, Lin Yu would not make such a low-level mistake.

He discreetly turned the lower end of his stomach upwards to see the link between the posterior wall and the pancreas.

“Can be separated.”

Lin Yu said.

Hideki Takano nodded, manipulating the scalpel,… Separate the fibrous tissue between the back wall of the stomach and the pancreas little by little.

After the separation, Lin Yu once again separated and ligated the gastric and splenic ligaments connecting the spleen and the short gastric blood vessels and cut off the distal end.

After this cut-off, the stomach body is completely separated from the human body.

A smile appeared on Lin Yu’s face, and he carefully held his stomach, removed the mucous membrane of the stomach tissue, and placed it on the sterile table next to him.

“Excise the tail of the body of the pancreas, remove the lymph nodes, blood vessels.”

Lin Yu said.

The tail of the pancreatic body must be removed because of tumor implantation.

And to clean lymph nodes, blood vessels, because gastric cancer mostly occurs in the small curved side, in order to cure, it is necessary to clean all blood vessels, lymph and adipose tissue except liver blood vessels and common bile duct, once there is residue, it may cause serious postoperative complications.

This is delicate work, urgent, and requires slow work.

Hideki Takano, Shizuka Jukawa, and Red Maru all looked at Lin Yu intently.

Total gastrectomy, no dangerous period, nothing to pay extra attention to.

Because, any process can be fatal, and any food may cause cancer cells to spread bloodstream, bringing irreversible consequences!

The excision of the tail of the pancreatic body is not particular, do not harm the mesangium, the membrane can be.

Takano Hideki and the others looked at Lin Yu’s series of smooth movements, and their expressions were extremely shocked.

On the operating table, any action, a simple “excision”, may include hundreds of surgeries, decades of experience.

Do not hurt the mesangium, the membrane, to say light, when the real excision will find that the scalpel is difficult to fall.

The reason why surgical experts are particularly expensive, and their salary is almost several times that of the same title, is precisely because of this.

Therefore, whether it is a chief doctor like Hideki Takano, or an instrument nurse, or an anesthesiologist, they cannot understand how this twenty-something very physical body has the professionalism, skilledness and malice that experts in their fifties and sixties do not necessarily have.

“The excision is complete.”

When these words sounded, everyone woke up like a dream, and looked at Lin Yu stunned.

“Start vascular cleaning.”

Lin Yu also didn’t notice the expressions of the others.

Cleaning blood vessels, lymphatic vessels, etc. is relatively clean, and each doctor has his own habits and has different cleaning sequences.

As long as the cleaning can be completed, it is a good idea.

“Wipe your sweat.”

Lin Yu’s voice fell, and as soon as the beautiful little nurse was about to raise her hand, Shizuka Juchuan took the lead and gently wiped Lin Yu’s forehead.

“Cleaning complete.”

This sentence after a long time made everyone present breathe a sigh of relief.

“Total gastrectomy completed.”

Lin Yu did not relax.

The completion of the resection does not mean that the surgery is complete.

After the removal of the stomach, it is necessary to carry out digestive tube reconstruction, only in this way can the patient maintain the functions of jokes, absorption, etc. in the future.

Lin Yu chose the esophagus in triassic gastric surrogate, and the duodenal interstitial triassic triassal jejunal method.

He took a section of jejunum about forty centimeters proximal to preserve the blood supply within the mesangium.

Next, all the upper jejunum mouth is sutured with the esophagus, the lower mouth is sutured with the duodenum, and the middle intestine is folded into three segments, each holding about ten centimeters.

“1 Hao line.”

Lin Yudao.

Three folded jejunum must be sutured to fix it, forming three jejunal sacs, which can replace the lost stomach cavity and use food emptying to delay nutrient absorption and weight maintenance.

Because it is three segments, the front and back two segments are the same as the original jejunum, both are circher peristalsis, and the middle intestinal segment forms a natural reverse peristalsis due to the change of position, so that the food stays longer, which can improve digestion and absorption rate.