Doctor of Healing

Seeing Ji Xiang standing directly on the assistant's seat after laying out the list, Director Liu didn't say much, and stood on the operator's seat to start the operation.

The patient was under general anesthesia, and Director Liu made a 1.5cm incision under the costal margin of the posterior axillary line to the retroperitoneal cavity.

To stop bleeding from the incision, he stretched his fingers along the incision to push open the peritoneum, inserted a balloon, and injected about 800 mL of air.

"Technology has improved really fast. When I was just learning surgery, I removed all my kidneys and opened the knife directly. I stretched my hand in and pinched the kidney pedicle and clamped it directly. The operation was simple." Director Liu injected air into his hands Put in the sterile field and start small talk.

We have to wait here for a while, Ji Xiang knows.

"Tell me, how many waists have you got in your life?" The itinerant nurse said contemptuously, "Aren't you afraid that you won't have a waist in your next life?"

"Healing diseases and saving lives, can that be called a kidney?" Director Liu said, "Telling you about technological progress, you don't even understand."

"As if you understood."

Several people were chatting indifferently, and Ji Xiang was carefully observing the difference between the equipment in the operating room and the system operating room.

There is a big difference. The system operating room should be the upper limit of this era, whether it is hardware or software.

After staying for 5 minutes, Director Liu shut up and started the operation again. He could switch between the two states freely.

Director Liu enlarged the retroperitoneal space, deflated the air bag and exited the balloon, and placed the cannula at an appropriate location according to the tumor location.

After the surgery was done, Director Liu gradually became serious.

He is gradually adjusting his state like a hero who is about to compete in martial arts and face the enemy of his life.

Director Liu fixed the posterior axillary cannula with No. 7 wire, and then inflated CO2 gas to maintain the pressure at 12-14mmHg.

The space was observed under the laparoscope, and the renal artery and renal vein were freed from the renal fat capsule along the surface of the psoas major muscle.Then free the fat around the kidney and try to get as close to the renal tumor site as possible.

After doing this, everything is no different from previous operations.

But when Director Liu continued to wander, he immediately discovered the difference.

The closer to the tumor, the more convenient it is to mobilize the tissue. Because of the embolism, the tumor and the surrounding tissue within 1cm have already undergone ischemic necrosis, and after the end of the initial edema period, there will be delamination with the surrounding blood supply tissue. .

It was so!

Director Liu confirmed his guess.

Although laparoscopic surgery cannot touch the changes in kidney tissue with hands, Director Liu has performed similar operations for many years, and local changes can be felt with long forceps.

He cut off the renal pedicle artery with a clamp to control the blood supply to the renal pedicle.

After the clamp is secure, about 100 ml of ice-cold saline is injected through the aspirator, and the temperature is lowered locally to protect the kidneys.

It is gradually separated near the tumor, and the tissue around the tumor is the same as the puff pastry, so it becomes easier to dissociate.

In the past, during the countdown period, the operation was very intense, and I was afraid that the operation would not be completed smoothly due to the delay.

After all, the renal artery is clamped and closed. Once the tumor cannot be removed and the blood supply is opened again during the countdown, at least 10 minutes will be wasted for the next closure just to stop the bleeding.

In that case, the simple operation would be complicated, and the difficulty would rise sharply.

However, tumor resection after interventional surgery is completely different, and the difficulty of surgery plummets.

Soon, Director Liu realized another benefit.

During the countdown time, it is enough to dissociate and cut along the necrotic site, because the place where the embolized tumor artery has no blood supply is the place where the tumor artery supplies blood.

This is so special!

The more Director Liu works, the happier he is.

"Specimen bag." Director Liu said in a low voice.

"Director Liu, did you cut it off?" The anesthesiologist still reported the time every minute to remind the operator.He didn't expect it to be so fast!

"Yes." Director Liu nodded happily.

The anesthetist had just completed the anesthesia record and hadn't had time to look at the screen.

Looking up and distinguishing carefully, the anesthesiologist's mask moved a little.

"Director Liu, why do I feel that it is different from the previous surgery?" the anesthesiologist asked doubtfully.

"Didn't I say that the patient first embolized the tumor's blood vessel, and the tumor tissue and surrounding tissue were necrotic to a certain extent." Director Liu put the tumor and adipose tissue into the specimen bag and pulled it out.

"The necrotic tissue and the surrounding normal kidney tissue are really layered and well-defined." Director Liu couldn't help but praise.

"2 zeros absorbable thread."

"I'll go, Director Liu, you really study new techniques!" The anesthesiologist said in surprise.

Doctors at Director Liu's age seldom come into contact with new things, and their backgrounds are thick enough, so why bother to make things difficult for themselves.

Besides, is mature technology also responsible for patients? Most of the old directors and professors think so.

According to the description in the medical records, the patient had undergone an interventional operation a few days ago. The anesthetist was surprised. He didn't know the significance of doing so.

But from the perspective of the operation process, the significance of doing so is simply too great, and the difficulty of the operation has plummeted.

The equipment nurse handed over 2 0 absorbable sutures with needles to Director Liu.

The figure "8" was sutured, and Director Liu carefully added two more stitches.

After loosening the vascular clamp and restoring the blood supply to the renal pedicle, Director Liu and Ji Xiang observed whether there was active bleeding on the wound.

There was no active bleeding, the wound was covered with hemostatic gauze, and a silicone drainage tube was placed around the kidney.

The operation was over before the itinerant nurse and the equipment nurse had finished counting the equipment.

"It's over! Call it a day!" Master Liu said in a high-spirited manner.

Chapter 157 The late stage of social cow disease

"Director Liu, this is too awesome!" the anesthesiologist praised.

Director Liu smiled triumphantly, and glanced at Ji Xiang out of the corner of his eye.

He knew that the operation would be faster if Ji Xiang were to do it. This kid is really talented, he can do it right away, and his level is extremely high, he is more mature and slippery than an old guy like himself who has been doing surgery all his life.

Regardless of whether he has other backgrounds, this alone is enough to make people admire.

The patient was sent back, the operating room was disinfected, and the next patient was picked up.

The three partial nephrectomy operations were all completed at one o'clock in the afternoon, and Director Liu was in a good mood.

"knock off!"

After finishing the operation, Director Liu felt refreshed.

Since I started to learn to perform partial nephrectomy with laparoscopy, no operation has ever been performed more smoothly than today.

Director Liu even had an illusion that his surgical skills had improved by leaps and bounds, and he had reached the top level in China.

But he knew that the illusion was always just an illusion.

Today's operation is highly completed and performed smoothly, because the interventional embolization was performed first.

Did not expect, really did not expect.

One more operation before operation will have a substantial impact on partial resection.

Changed clothes and went to see the patient. Director Liu was very satisfied. He told the patient to stay on the brakes for 3 days. He also told Mr. Wu to be optimistic about the patient and call himself if there is any problem. Then he took Ji Xiang away.

"Xiaoji, let's go to Yuanliao City today. I've only met the doctor there a few times, but it's very interesting."

"Interesting?" Ji Xiang wondered.

In his opinion, doctors can only be described as professional and unprofessional, what the hell is fun.

"More than ten years ago, I just came back from studying endoscopy in the imperial capital. That winter, I came to the door alone with a few pheasants."

"Tell me, who is this person who gives gifts and pheasants?"

Ji Xiang guessed that it should be the doctor who invited Director Liu to perform the operation today, but if preconceived ideas are excluded, according to Director Liu's description, it must be the poor patient's family members who came to the door with a pheasant in order to express their gratitude.

The gift is light and the affection is heavy, the money may not be accepted, but the pheasant must be accepted.

"It's the patient's family." Ji Xiang said.

"Hahaha, I thought so too, but after talking for a while, I found out that he was the doctor who went to 912 to study after I left, the one from Yuanliao City." Director Liu had a strange expression when he mentioned this person.

He seemed to want to laugh, but there was a bit of seriousness and incomprehension in his smile.

"Director, although Yuanliao City is not big, if a surgeon visits, he should take two bottles of Moutai." Ji Xiang laughed.

"Yeah, I'm also surprised." Director Liu said, "The first time we met, the doctor said some weird things to me. At that time, I thought he was crazy, so I ignored him."

"Is it an interventional operation?" Ji Xiang was startled, and followed Director Liu's train of thought to find out the answer.

More than ten years ago, Director Liu was talking about more than ten years ago!

At that time, there were not many people with such a vision, let alone more than ten years ago, there were not many people who could accept it in front of them.

"Yeah." Director Liu nodded, "At that time, I didn't even know what interventional surgery was. I only knew that the circulatory department used this thing to place stents. You said, such a lunatic came here with a pheasant, so I didn't care what he was doing. .”

"Supposedly, I can understand that people who study together say that they are brothers when they brag. Besides, asking me to do surgery is also considered a kind of income, you are right."

"Yes." Although Ji Xiang has never been in contact with it, this kind of thing is not difficult to understand.

"However, I don't know if this person has lost his mind. After two years of silence, he came to me again."

'"Oh?"

"The second time I came to the door, this person is old." Director Liu said, "Hair is thin, and it's almost lost in his 30s. This time, he didn't carry a pheasant and told me about the flying knife."

"Guess how much he told me."

"..." Ji Xiang heard the situation at that time from Director Liu's tone.

This is a very strange feeling, just the joking tone fully outlines the situation at that time.

"500! He said he would give me 500 yuan for an operation." Director Liu still couldn't stop laughing when he recalled, "Why should I send him a few hundred yuan to send a beggar?"

Although Director Liu was scolding, Ji Xiang didn't hear any malice.

"He told me for half an hour that all the rich people in Yuanliao City went to Fengtian or came to our provincial capital for medical treatment and surgery, and the rest of the family were old, weak, sick and disabled, and they were not well-off. Please forgive me. "

"Forgive me!"

"Hahaha, Director, look at you." Ji Xiang smiled.

"To tell you the truth, I have never seen a person with such a low EQ." Director Liu said calmly while driving, "You say cure the disease and save the patient, and I admit it, but doctors are not made of iron, and they need to rest. I will rest once a week A little more than a day, and I still have to go to his place to help the poor, isn't this a joke?"

"At that time, I admitted two more patients in the Second Affiliated Hospital, okay? I don't do surgery there."

"What happened later, Director?" Ji Xiang asked.

"I kicked people away, I really hate people." Director Liu said, "He will come to bother me once a year in the future, I think his EQ is really negative."

"It seems so."

"Either tell me something, or say that he has developed a world-leading new surgery. At that time, my feeling was... do you know about anorectal surgery?"

"Uh..." Ji Xiang had a bad feeling.

"He has eyes but no pearls." Director Liu shook his head, "This guy is so bragging that he doesn't write drafts. Although the metaphor is not appropriate, every time I see his face, it looks like a doctor in the anorectal department changing a patient's medicine. He has eyes but no eyes. Eyes but no eyes!"

"Hahaha." Ji Xiang laughed when he understood Director Liu's meaning.

"You said, Yuanliao City is a small prefecture-level city that doesn't shit. The average salary is so low that people can't believe it. He told me that he is world-leading. I think this person's social cattle is already late. The law is saved."

"Interventional surgery?" Ji Xiang asked.

"That's right." Director Liu didn't shy away from saying it, and nodded, "I had forgotten about it, but I couldn't stop him from rambling on. So after you mentioned it after the rescue last time, I thought of it."

"!!!" Ji Xiang felt his hair explode.

"I searched for a long time, and finally got his phone number through the teacher in the imperial capital. I made a phone call and asked, but he was very enthusiastic, saying that there will be a patient undergoing surgery tomorrow."

"Let's go and have a look!" Ji Xiang regained his energy all of a sudden.

"Don't hold out too much hope. I was mainly curious. I was so passionate at the time. Now that I think about it, if he could achieve something, he would have made great achievements. Besides, if he wants to do something, it's not that simple."

Ji Xiang nodded, indeed.

Not to mention anything else, there are tens of millions of DSA machines, which is difficult for Yuanliao City to afford.

Chapter 158

Director Liu drove to Yuanliao City.