Doctor of Healing

After writing it down, Ji Xiang came to the system space.

"Teacher, the cyst is very big." Ji Xiang and the system NPC said after reporting.

"It's not a cyst, or it's not an ordinary cyst." The system NPC said, "It should be huge hydronephrosis."

"Teacher, do you have water in your kidneys?"

"Yes." The NPC of the system nodded, "Generally, when hydronephrosis is discovered, the kidneys will be preserved more or less. They may not function, but they can be seen on the image."

"But huge hydronephrosis..."

"Teacher, why is the name of this disease so strange?" Ji Xiang asked.

"It's very huge, there's nothing to describe it." The system NPC said, "Dr. Stirling first proposed the concept of huge hydronephrosis in 1939.

That is to say, if the amount of water in the collecting system exceeds 1 000 ml, the radiological manifestations are that the water reaches or exceeds the midline of the abdomen, occupies half of the abdominal cavity, or the long diameter of the water exceeds 5 vertebral lengths. "

"However, clinically, 1000ml of water is not considered huge. I have seen patients with more than 5000ml."

"This must be at least 5000ml."

"Yes, but the patient didn't feel uncomfortable, and he didn't come to the doctor until complications occurred. It is very rare. The venous thrombosis of the lower extremities is caused by the compression of the inferior vena cava by huge hydronephrosis, which leads to obstruction of the return and reduces the blood flow rate."

"It's relatively rare. It's normal if your director hasn't seen it."

"The principle is the same as hydronephrosis. The etiology includes ureteropelvic junction stenosis, vesicoureteral reflux, megaureter, and posterior urethral valves. 80% of patients are caused by ureteropelvic junction stenosis."

"As for the treatment..." After speaking, the system NPC paused.

"Stenosis release surgery?"

"General hydronephrosis can do this, but the kidney on the side of huge hydronephrosis has no function. If you keep it, the loss outweighs the gain. It needs to be surgically removed."

Ji Xiang nodded.

"Don't underestimate this operation." The system NPC said, "The operation of huge hydronephrosis is quite difficult. Although the concept was proposed in 1939, laparoscopic surgery has been carried out in the last century, and laparoscopy can be used to treat huge hydronephrosis. , was not reported until 1991."

"Why, teacher."

"Because of the relatively long time, the dorsal membrane and peritoneum of the kidney fuse, and the local anatomical tissue changes, making it difficult to complete the operation with laparoscopy."

"If it was an open surgery, it would be a little easier."

"Doctor Xiaoji."

"Yes." Ji Xiang replied immediately.

He was a little distressed, wondering if the system NPC wanted to experience empathy by himself.

"Let's train the operation directly. You can watch me perform one operation, and then try a few times by yourself." The system NPC said, "You will understand why the operation is difficult after you have done it yourself."

"Don't you need to empathize?" Ji Xiang asked.

"The patient didn't feel anything before the discovery of the venous thrombosis, so there is nothing to try." The system NPC said, "If the operation fails, you can try it."

Ji Xiang clicked his tongue, not daring to raise any further objections.

Chapter 233

The anesthetist in the operating room of the system begins to anesthetize the simulator.

The NPC of the system stood in front of the film reader with his hands behind his back, reading the film as if he were meeting someone.

The only step omitted here is to check the patient's information. Ji Xiang has done a lot of operations in the operating room of the system, and he has known this for a long time.It is an important point to distinguish between the inside and outside of the system operating room.

When performing surgery in reality, one must oppose the verification of information to avoid cutting the wrong organs, just like Director Liu has obsessive-compulsive disorder.

Brush hands, spread sheets, perform surgery.

After the general anesthesia is completed, the simulator adopts the lateral position, adjusts the angle of the operating table, the middle position is raised, and the diseased side kidney faces upward.

After the disinfection of the operation area was completed, Ji Xiang stood in the position of the assistant.

The system NPC makes three incisions on the waist of the simulated human. The first incision is 2cm above the ilium, the second incision is located at the lower edge of the ribs, and the third incision is on the side of the back and psoas muscles. The three incisions are about 1cm each , into the laparoscope.

Create pneumoperitoneum.

As soon as he entered the abdominal cavity, Jixiang discovered the difficulty of the operation.

The dorsal membrane of the kidney and the peritoneum are seriously adhered, and the laparoscopic surgery has limited vision and almost no operative field!

If Ji Xiang does this operation by himself, even if all his urology operations are above LV7, it will be quite difficult.

"Here, here is the difficulty." The system NPC clicked on the glued spot with pliers.

"I see, teacher. The adhesion is stronger than expected. No wonder laparoscopic surgery was successfully reported in 1991."

"The adhesion in the reported operation was not severe, but it just provided a way of thinking." The system NPC said while starting blunt separation.

Although it is a laparoscopic surgery, the operator controls the laparoscopic forceps and separates them by hand are two completely different concepts, but the system NPC's technique is extremely delicate.

Looking at the fusion of the back membrane of the kidney and the peritoneum, there is no gap at all, but his pliers can always find the gap accurately.

Clamping, electrocautery, blunt dissection, no matter how difficult it is, no matter how limited the field of vision, his operation is still orderly and clean step by step.

After more than 20 minutes, the almost impossible task was completed under the hands of the system NPC in front of Ji Xiang.

The system NPC finds the renal artery and vein on the dorsal side of the kidney, and uses special locks and forceps to ligate the renal artery and vein under the laparoscope.

The hardest step is the blunt dissection, after which the surgery is quick.

After ligating the blood vessels, the NPC of the system cuts and separates the tissues around the kidney drastically. The fascia and ligaments connecting the kidney can be removed, and the kidney is completely freed, and the ureter of the kidney is cut off at the lowest end.

A 4cm incision was made on the abdominal wall, and the kidney was taken out.

Rinse, suture, and the operation is over.

Seeing that the whole operation was calm and without any difficulty, Ji Xiang weighed his own level and felt that it should be extremely difficult for him to perform.

He reckoned that all surgical operations of the system NPC should be level LV9, maybe even reaching the pinnacle.

"You do it next." The system NPC took off his gloves.

"it is good."

Send out the simulator of the first operation and pick up the second simulator.

The previous steps were exactly the same. After Ji Xiang separated the adipose tissue, he saw the peritoneum and the back membrane of the kidney that were stuck together.

Although his surgical skills were not as good as those of the system NPCs, they were still extremely high. He patiently separated them little by little, but there was still a mistake in the middle.

During a separation, Ji Xiang's strength was a little stronger, the adhesion was torn, and a small capillary began to bleed.

The field of surgery suddenly blurred.

"Here, you need to use your skills—to be discerning." The system NPC took the long hemostatic forceps and began to stop the bleeding, and explained the technical details to Ji Xiang.

Perceptiveness - When using this skill, the resolution of the naked eye is improved, and the resolution and refresh rate are improved.

It is the active skill reward given by the system after Wu Jixiang made more than 100 records in the competition.

Ji Xiang always thought that it was needed for interventional surgery, but the super-selected grade 4 branch artery, which is more difficult for interventional surgery, was useless, so it has been left idle.

If it wasn't for the reminder from the system NPC, Ji Xiang would have forgotten that this skill still exists.

I didn't expect such "high-end" skills to be used in non-interventional surgery.

"Here, pay attention to the screen." The system NPC reminded.

Ji Xiang concentrated on watching the laparoscope screen, and the system NPC started blunt separation with two long hemostatic forceps.

This time the system NPC did it very slowly, explaining it while doing it.

"Here, you first use your skills throughout."

"Teacher, I need surgery points..." Ji Xiang said distressedly.

Surgical points are needed in surgical training, which is a big project that "burns money". Even if Ji Xiang has little savings now, he cannot afford it.

"Nonsense, you don't need surgery points, why don't you keep laying eggs?" the system NPC scolded.

As if the strengthened and strengthened version of [Superior Doctor's Gaze] fell on him, Ji Xiang stopped talking back, and immediately used the active skill - discerning the details.

The skill was activated, and the movement of the system NPC on the screen changed from smooth to stagnant.

Dismantling frame by frame, Ji Xiang was fascinated instantly.

It was so!

In just a moment, Ji Xiang understood the meaning of the system NPC.

In one frame, Ji Xiang clearly saw the capillaries buried in the connective tissue.

At the same time, the pliers in the hands of the system NPC just happened to land on the capillary, and the electric cauterization immediately stopped the bleeding before tearing the blood vessel.

Take precautions before they happen, and do everything first. This is the difference between system NPCs and performing surgery yourself!

Although Ji Xiang was a little overwhelmed by the consumption of surgery points, he had no time to feel distressed and concentrated on watching the system NPC's surgery.

Every system NPC can find the blood vessel in an instant and stop the bleeding in advance.

This skill is really easy to use when blunt separation, completely beyond Ji Xiang's previous "stereotype" prejudice.

Did you know clearly that the surgery was a few levels behind, and the more Ji Xiang did it, the happier he was, and the improvement of his technical level must make people feel happy.

The operation was completed smoothly again.

After the operation, Jixiang sent the simulator away without rushing to start the next operation.

The skill time has come, but the sentiment is like a tidal wave.

The system NPC did not urge him, he seemed to understand what Ji Xiang was thinking at this time, and just waited quietly and patiently.

After a long time, Jixiang began to ask technical details.

His savvy is very high. Although Ji Xiang has added all the free points to the lucky value, his basic attributes are high, and he always sees the problem to the point.

The system NPC answered every question of Ji Xiang, and after a long time of thinking, Ji Xiang started the next operation training.

After a few operations, the system NPC said, "Go back first, come back later. Skills"

Ji Xiang still had a lot to say, but he respected the system NPC's opinion and left the system operating room.

Chapter 234

Back in reality, Jixiang sat quietly in front of the computer to experience the surgical training just now.

Because the active skill was used in this operation - discerning the details, so the feeling is completely different.

Jixiang seems to have forgotten the operation points that are consumed by distress. He disassembles the operation frame by frame, and the operation method of "predicting" the blood vessels in advance and avoiding bleeding makes Jixiang happy.

Surgical skills have not improved, but Jixiang knows that after dozens of surgical trainings, he should be able to truly predict where the blood vessels are without skills.

Just like the system NPCs do.

Although the skill points have not increased, Jixiang can feel that he has really gained something, and it is quite huge.

"You, get up."

Kicked Jixiang's chair leg with one foot.

Ji Xiang turned his head and saw a middle-aged doctor beckoning him to give way.

He is about 1.7 meters tall, has a round face, wears glasses, and is strikingly bald with only a strand of hair on top of his head.

That lock of hair was coiled on his forehead like a treasure, maintaining the last dignity of a middle-aged man.

"Teacher, sit down." Ji Xiang was not unhappy with the bald man's behavior, and said politely after standing up.

"I don't have any vision at all. I don't know how to give up my seat. Why are young people doing this?" the bald man muttered after sitting down.

Director Liu saw that Ji Xiang didn't seem angry, so he came over and patted Ji Xiang to comfort him, but didn't say anything else.

"Old Lu, why are you so angry?" Director Liu said.

"It's just hydronephrosis, why do you still need a consultation." The bald director Lu said disdainfully, "Look at what's going on here, and let me tell you, Lao Liu, don't plan to do this operation yourself, you can't do it. "

Director Liu smiled.

"It's called huge hydronephrosis. I haven't heard of it." The bald director Lu said contemptuously, "The diagnostic entry was just established in 1997. I saw the film, and the kidney function is absent. The contralateral kidney is fine. It can be cut off directly. .but!"

As he spoke, the long hair on his forehead fluttered.

Ji Xiang's eyes lit up, this guy is awesome!