Medical road

It is not difficult to remove benign liver tumors.Compared with malignant tumors, this kind of surgery is like one in the sky and one underground.And benign tumors look down on normal cells.

It is self-contained, with a layer of clothing on the outermost layer.In layman's terms, use your fist to press a hole in the normal liver tissue, and then put a plastic film with a benign tumor inside.

The operation is very simple. First, the surrounding blood vessels are ligated, and then they are peeled off a little bit to clean the wound. Then the wound is stopped and the abdomen is closed.

Of course, everything is very simple.But it's not that time to do it.

A doctor, the most common doctor, five years of undergraduate, three years of rotation, one year of retraction, one year of appendix, hernia and other simple and non-consumable surgery.

If the doctor is skilled enough and can be a human being, then at this time, the instructing doctor will start to let go a little and let the doctor perform peripheral surgery of the liver, which is a simple gallstone and gallbladder removal operation.Note that this is all open surgery.

When the hands are well practiced, I will start doing laparoscopy, continue the above rounds, and do another round, first learn to make a hole, then learn to use a laparoscope to make the appendix, and then make the gallbladder.

Some people here will ask, the laparotomy is very traumatic, and the laparoscopy is advanced, why do you still learn to open the stomach?In fact, the reason is very simple.For example, the appendix, not all appendicitis can be done with laparoscopy, but all appendicitis can be done with laparotomy, that's the reason.

Doctors who cannot prescribe abdominal cavity are not qualified to do laparoscopy.Waiting for this general doctor, he bald his head and stays old.

When the young green onion turned into a greasy uncle, when the director retired almost into the countdown to retirement, he slowly began to touch the liver.

Zhang Fan has a system, but not a system. The older dog wants to have liver surgery, so let's go through it. There is no fluke for life-threatening things.

Sometimes, when you think about it, doctors want to reach the top of the world in the industry.

In fact, it’s like cultivating immortals. If you want to get ahead in this business, you must have excellent background (school), reputation of teacher (mentor), talent and effort, and the size of your gang (hospital). .

Zhang Fan was really lucky. Not to mention the system, he came to a small place after graduation that year, had the opportunity to practice his hands, and met good leaders and teachers. It was really bad luck.

Benign liver tumors can actually be done in municipal hospitals, not to mention in provincial hospitals, but Zhang Fan has to do it himself if he pays the flying knife fee.

When Zhang Fan entered the operating room, the patient was lying on the operating table with his upper body naked and a urine tube inserted underneath.Regardless of the rich or ordinary people, lying on the operating bed, not afraid, Zhang Fan has never seen it.

The patient has not yet been anesthetized. When he saw Zhang Fan enter the operating room, the patient forced a smile on his face. He didn't speak yet, and just wanted to speak. As a result, the anesthesiologist gave the medicine and the patient was suddenly turned over by anesthesia. Sticking out his tongue and rolling his eyes.

After the patient was arranged by the anesthesiologist, he disinfected and spread the surgical drapes. At the beginning, Zhang Fan washed his hands. After entering the operating room, the nurse hurriedly smiled and put on Zhang Fan's surgical gown.

As the nurse tied the belt of his clothes behind Zhang Fan, Zhang Fan was standing beside the instrument nurse's surgical cart wearing gloves.And my mind is full of various examinations of patients.

Imaging studies, such as CT, MRI, and PET test results report suggest that liver tumors are benign, and even laboratory tumor markers indicate that the patient’s tumor is benign, but the results of these tests can only be used for reference and cannot be used as a diagnosis.

What is the gold standard for tumor diagnosis? It is cut down for pathology.Before pathology, the diagnosis of patients was always questioned, that is, the diagnosis of uncertainty.

Therefore, during surgery, it is necessary to reserve operating space for worsening conditions in accordance with the standards of nausea tumors.In surgery, there is a very classic saying: God is not willing to correct a wrong incision.

When the knife is up and down, there is no way back, there is no way back for the doctor to repent.Therefore, when a doctor raises a knife, he must have a clear mind. This brain is created through years of experience from easy to difficult, and from childhood to adulthood.

The patient is ready. The surgery position is head-high and feet-low. Intravenous catheters have been implanted in both arms. One side is injected with antibiotics, and the other side is injected with energy. These two channels are actually used for the emergence of the operation. Accidental need blood transfusion and reserved.

For the incision, Zhang Fan chose a subcostal incision. Many doctors like a midline incision, which is an incision from the xiphoid process to the belly button. It has many advantages. Because the incision is in the middle, the surgery plan can be adjusted at any time due to the condition.There are many shortcomings, the biggest shortcoming is excessive damage.

For benign liver tumor surgery, as far as Zhang Fan is concerned, it is too simple. Most of the slightly famous instruments in the operating room are matte, and the only thing that can reflect light is the blade of the scalpel.

When a bit of cold light reflected from the tip of the knife, Zhang Fan started.The skin is like tofu, gently drawn by Zhang Fan in a big arc.

Separate the muscles, cut open the peritoneum, and click with the surgical curved forceps!Click!With the sound of clicking, Zhang Fan opened a big opening in his abdomen, and his liver was exposed in front of the doctors.

The liver, the liver with benign tumors, is very strange.A normal liver is like a piece of blood tofu with an irregular shape, smooth and tender.

The wine owner’s liver is different. His liver with benign tumors is completely different, as if the liver has grown muscles, like a piece of meat from a Belgian blue cattle.

Although it seems not as uncomfortable as a malignant tumor, it is not as cute as a normal liver.

A normal liver is like Xiao Zhengtai, which makes people feel affectionate or close.

The liver with benign tumors is like Dashi Johnson.Looking at it, I wanted to take a needle to release the anger in his body.

"It looks like it is benign." Zhang Fan looked at the bumps on the surface of the liver, and said to the two directors who had undergone the operation. Before they could reply, Zhang Fan began to put his hands into the patient's body to see. It is probing.

This is a necessary step for tumor surgery. Regardless of benign or malignant, the surgeon must use his own hands to make a diagnosis of the organs around the patient's liver.

This action was like shuffling the cards with both hands after a game of mahjong was over. Zhang Fan touched the organs around the liver and found nothing abnormal.

Then he said to the itinerant nurse: "Electric knife!"

"Electric knife?"

The itinerant nurse looked at Zhang Fan uncertainly, and then at the two directors of hepatobiliary surgery.The girl accompanies the hepatobiliary surgeon to perform many operations on benign tumors. None of them used an electrosurgical knife to separate them with bare hands.

Before Zhang Fan wanted to be transparent, he would also be separated by hand during this kind of surgery, but since Zhang Fan wanted to be transparent, it can be said that there are no tricks, how the damage is small, how to come, how to speed, how to come. .

"Give it to Zhang Yuan!" The director of the Fifth Hepatobiliary Department was anxious, and he hesitated to see the nurse, so he said anxiously.

"Haha, it's okay, give it to me." Zhang Fan smiled.The little nurse was helpless, and handed the electric knife to Zhang Fan.

Then, a faint smoke came out, the electric knife was flying in Zhang Fan's hand, and the liver tumor, no trace of blood was visible.

"Pretty!" the director of the Second Hepatobiliary Division couldn't help saying.