The system takes me for surgery

Patients with gallbladder cancer face many difficulties in reoperation. The trauma of the previous operation and abdominal adhesions caused by postoperative inflammation have brought great difficulties to the reoperation.

Due to the trauma of the previous operation and the pathological characteristics of the tumor itself, gallbladder cancer has a high probability of invasion of surrounding organs and tissues, peritoneal metastasis, and lymph node metastasis. Early neural invasion and lymph node metastasis.

So Liang Yi and the four of them were extra cautious when assessing. This complexity far surpassed all surgeries in previous competitions.

There are two types of surgery that can be used. The first is simple gallbladder removal, which is far from enough for this "advanced patient". The second is more difficult and requires additional gallbladder removal of adjacent organs. Radical resection of cancer, such as simultaneous resection of the transverse colon, pancreas and duodenum, etc.

In reality, when doing clinical considerations, if right hepatectomy and pancreatoduodenectomy are performed at the same time, due to the extensive scope of the operation and the great trauma, the chance of long-term survival of the patient after the operation is less, and the patient died after the operation. Rates are high, so decisions should be made on the basis of patient conditions only after due consideration.

Xiao Yongheng frowned and thought for a long time. Liang Yi was not in a hurry to act, and carefully evaluated. He did not regard the "competition props" in front of him as a simulator but as a real clinical patient, and made the most reasonable operation plan for him.

At this time, the audience was quiet instead, because this has touched the blind spot of most people's knowledge. When encountering small difficult topics, everyone will discuss them enthusiastically, but when faced with such a big problem, everyone suddenly has no topic to talk about, because they can't think of a topic. The solution is too complex.

After reading it, Jiang Wenfeng laughed at himself: "This topic is a bit against the sky. If I had just advanced, I might be standing there now."

The patient had right intrahepatic metastasis and hilar bile duct invasion, so extrahepatic bile duct resection is also an important part of this operation.

Xiao Yongheng, Wang Chenlun, and Shan Linfei thought that there was a problem with the bile ducts in the right liver and hilar area, and Liang Yi also believed that the hilar bile duct could be preserved.

Wang Chenlun took the lead. He cut the anterior peritoneum of the hepatoduodenal ligament at the upper edge of the duodenum, and separated the proper hepatic artery according to the position of the hepatic artery pulse.

His movements were sharp, and the rhythm quickly opened up. The beginning was full of gunpowder, and the audience woke up from the silent state just now.

Xiao Yongheng also took action, his operation speed was faster than Wang Chenlun, and there was a tendency to overtake Wang Chenlun in about 10 minutes of the start.
Wang Chenlun had just finished treating the hepatic artery, and Xiao Yongheng had already begun to separate the tissue on the right side connected to the duodenum.

The movement is gentle and precise, reaching the front of the portal vein. Within 5 minutes, the portal vein trunk is separated, and the hepatic artery and portal vein are lifted with a thin silicone rubber tube for traction.

After Liang Yi finalized his plan, he followed closely behind the two of them.

After half an hour of the game,

Liang Yi also caught up with almost 20 seconds behind the two of them.

The rhythm is very tight, and the audience watching from below is more nervous than the players.

He carefully separated the lower end of the common bile duct, cut it between two blood vessel clamps, and sutured the lower end closed with fine silk thread, then hemostasised the bleeding, and left the upper end of the blood vessel clamp as a handle, pulling it upwards, cutting and suturing the right side of the portal vein Lymphatic and adipose tissue at the border, and postduodenal lymph nodes removed. Since the hepatic artery and portal vein have been mobilized and retracted, there is no concern of injury.

Chen Mingde smiled and said to Duan Lulu: "Liang Yi has the style of a general, not a feminine surgeon."

"Teacher, what do you mean?" Duan Lulu asked.

"That is, his surgical style is not static and gentle, but judging the situation and being able to combine strength and softness. It is not easy to do this under such a tense state."

"It feels like a martial arts novel." Duan Lulu saw that her mentor was smiling, and knew that he liked Liang Yi from the bottom of her heart. To be honest, it really made people jealous!

"Haha, almost, this game is wonderful."

At this time, Liang Yi jumped to the No.2 position with lightning speed.

Wang Chenlun froze as soon as he raised his head, thinking that he was being blindsided, but Liang Yi's video showed a larger size than him, so he took a look, and it was indeed in front of him.

This guy, wasn't he still behind just now, he caught up so quickly, did he miss any steps?

At this time, Xiao Yongheng also noticed that the person in the video on the screen that seemed to be sticking closely behind him was no longer Wang Chenlun. He saw that it was Liang Yi. The movements of his hands slowed down a bit, and after watching Liang Yi's operation, It's not particularly fast, how could it surpass Wang Chenlun?

Shan Linfei fell to the No.4 position, and she also felt it, but remembering Liang Yi said to walk at her own pace and not be disturbed by others, she restrained the urge to look at the screen, lowered her head, and concentrated on the operation.

Wang Chenlun began to feel the pressure, and looked up at the screen from time to time. Although Liang Yi was not moving fast, he was able to take a small step ahead of him in the short time lag when he looked up at the screen. He was a little anxious to clear the lymph nodes around the common hepatic artery.

His hands began to tremble a little, he tried his best to restrain his movements, and slowly separated the artery from its surrounding tissues along the front of the proper hepatic artery.

After resisting the urge to look up at the screen a few times, Shan Linfei has begun to adapt a bit, and can control her own rhythm. She carefully identifies the right hepatic artery and the left hepatic artery, the branch of the proper hepatic artery, and the The right hepatic artery branch is cut at the left edge of the bile duct, and the lower end of the common bile duct is lifted up as a traction to separate the bile duct from the front of the portal vein.

Unexpectedly, Wang Chenlun's ability to resist pressure is quite strong. Although his hands are shaking a little, the overall rhythm is not chaotic. It's just that the state of chasing makes him a little out of control, and his hand feeling is gradually declining, Liang Yi analyzed.

He has already separated the transverse groove of the hepatic hilum. After finding the entry point, he will separate the transverse part of the left hepatic duct due to tumor blockage and expansion, and cut off the left hepatic duct about 1.0cm away from the edge of the tumor. Line traction is used as a mark, and then at the proximal end, traction to the right is used, turned over, and separated to the right part of the hepatic hilum.

Xiao Yongheng felt that Liang Yi was following him like a ghost, and he also felt the pressure, but his self-control was very strong.

He lowered his head, and his neck became a little stiff. At that time, he used all his strength to suppress the urge to raise his head, because he instinctively wanted to raise his head to watch the live broadcast on the screen, but his reason told him that watching would only waste time, and the two were caught in a huge game.

He chose to cut the branch from the sagittal part of the portal vein to the left inner lobe of the liver and its accompanying bile duct and blood vessels on the right side of the falciform ligament.