When a doctor opened a plug-in

Chen Cang glanced at the child and thought for a moment.

I don’t know if it’s conscientious, or because of other reasons, I can’t help but remind: "Have you ever touched the gastroduodenal anastomosis?"

Hearing Chen Cang's words, He Zhengzhi's body was shocked, cold sweat oozing out of fright!

Could it be...

Dr. Chen is not good at "gastroduodenal anastomosis"?

Thinking of this, He Zhengzhi was really desperate. He felt that he was staring at his stomach at this time, but staring at the abyss!

Fear filled my heart, almost swallowing him!

He Zhengzhi glanced at Chen Cang, then slowly said, "Doctor Chen, don't tell me you can't do it!"

The gastroduodenal anastomosis is the Pi Luo style.

Chen Cang shook his head and smiled: "I will, I mean if you can't, you can look at it seriously, the opportunity is rare."

He Zhengzhi heard it and finally heaved a sigh of relief!

Now he no longer expects to wait for Director Ma, his wish is very small, and he can complete the operation.

As for what Chen Cang had to learn more, he hadn't reported any expectations to be honest.

This operation has learned a lot more precious things than the operation!

"Thank you... Thank you Dr. Chen!"

Chen Cang nodded and smiled: "Why are you sweating so much, young man, pay attention to your body!"

The young nurse was very sensible when he heard Chen Cang's words, and took the initiative to wipe Dr. He sweat.

This made He Zhengzhi immediately flattered!

He... Has he received this kind of treatment?

Looking at the gentle and pleasant little nurse, He Zhengzhi quickly said with a smile: "It's not empty, it's not empty, Yang Qi is too strong, a little hot!"

Several young nurses froze for a moment, and took a deep breath of cold air at 22 degrees Celsius unique to the operating room. Is it hot?

Subtotal gastrectomy basically has two main anastomosis methods, one is the Pi Luo type 1 for short, the Bi 1 type, and the other is the Pi Luo type 2 for short, the Bi 2 type for short.

Both methods have been used for a hundred years and have been continuously improved.

Simply put:

The gastroduodenal anastomosis is completed in type 1.

The gastrojejunostomy is the completion of type 2.

The limitations of the formula 1 are relatively large, but the advantages are also very obvious. Because the structure and function of the duodenum are retained, it is not easy to cause gastrointestinal disorders after the operation. If conditions permit, it is better to complete the formula 1.

However, in the case of Bi-1 anastomosis, care must be taken to avoid tension in the anastomosis.Duodenal mobility is small, if the gastric body is too large, the Bi 1 formula cannot be used.

It is precisely because of the limitations that the difficulty of surgery continues to rise.

Chen Cang took a deep breath, lowered his head and began to observe carefully, preparing for the anastomosis operation.

Since it is called gastroduodenal anastomosis, this shows that the core element of the operation is the anastomosis of the stomach and duodenum.

Zhou He looked at Chen Cang and couldn't help but exhorted: "Dr. Chen, the patient has intestinal palsy. Now the bowel movement has basically stopped. After the postoperative obstruction is relieved and the paralysis disappears, the gastrointestinal motility will resume, and the stomach wall will recover. Tension, contraction and involvement of the stomach wall at both ends of the anastomosis may affect the healing of the anastomosis and even cause the anastomosis to become narrow. Be careful."

Zhou He is kind.

In fact, never underestimate an anaesthetist. During the internship, Chen Cang saw the story of an anaesthetist saving the field with his own eyes, which frightened Chen Cang.

After all, in the eyes of many people, the anesthesiologist is the escort of the operation, and the surgeon is the old driver, but they ignore it. This escort sees too many operations every day, and may not be able to operate, but the vision and vision are very high. !

Hearing Zhou He's words, Chen Cang nodded gratefully: "Thank you Teacher Zhou!"

Chen Cang's Bi Luo style comes from Li Yue, but it is not exactly the same as Li Yue's. After all, Chen Cang has his own considerations.

In order to avoid the anastomosis being too large, it is necessary to suture the broken end of the lesser gastric curvature before the anastomosis.

Regardless of Pi Luo 1 or 2, the method of closing half of the incision on the lesser curvature of the stomach can be used.

This step is actually the same as when Chen Cang built the mitral valve.

Chen Cang's eyes constantly began to compare.

It is necessary to consider the tension of the stomach wall and the mobility of the duodenum, so the difficulty of the anastomotic comparison is suddenly increased.

After a while, Chen Cang turned around:

"Gut No. 1."

The anastomosis of the minor curvature of the stomach needs to be tight and firm. After all, the stomach is a digestive organ and needs to be filled with food.

Chen Cang's sutures are very precise. The needle-holding forceps hold the No. 1 gut suture from the lower end of the incision and surround the curved forceps with a row of continuous sutures!

Immediately afterwards, Chen Cang said to He Zhengzhi: "Remove the curved forceps and tighten both ends of the gut!"

He Zhengzhi nodded quickly.

At this time, Chen Cang returned the upper end of the gut to suture again, from the cardia end down, aligning the gap between the first row of sutures and the second row of continuous sutures!

This set of operations made Zhou He stunned for a moment!

"This is... Li Yue's method?"

Chen Cang smiled and nodded: "Yes!"

And He Zhengzhi looked at Chen Cang blankly: "What is this for?"

Chen Cang explained: "In order to make hemostasis reliable!"

He Zhengzhi nodded involuntarily. In fact...he didn't understand...but he always felt that what Chen Cang said was reasonable!

While talking, Chen Cang tied the bow at both ends after meeting the incision.

Then, the seromuscular layer on both sides was reinforced with interrupted sutures, and the rough surface of the stump was embedded.

Zhou He couldn't help but said, "Your basic skills are too solid!"

He Zhengzhi also brightened his eyes: "It's amazing!"

Indeed, Chen Cang's suture from beginning to end has limited damage to the stomach wall. When the needle tip goes in and out, the distance between the needle tip is used to control the tension of the stomach wall. This is actually a very effective tension suture.

Chen Cang smiled: "Basic exercise."

In fact, this is the method Chen Cang has been studying!

This inspiration also came from Chen Cang's great vessel anastomosis. When Chen Cang was anastomosed with great vessels in the chest cavity, he needed to feel the pulsation and tension of the blood vessels because of the pulsation of the blood vessels!

At this time, Chen Cang realized the importance of tension suture. This tension suture can effectively speed up healing and reduce secondary injuries.

But when Chen Cang was repairing, he suddenly had an idea. He found that this kind of tension suture was actually more effective for the suture of the stomach wall. Even in the case of gastrointestinal anastomosis, this tension suture was even more beneficial!

Thinking of this, Chen Cang couldn't help being surprised.

After the stump of the small curvature of the stomach was sutured, Chen Cang closed the two pliers on the two stumps of the stomach and duodenum.

At this time, you need to feel the tension!

If there is, the duodenum must be separated to prevent the anastomotic tension from being too strong, leading to the failure of the operation!

Fortunately, there is no tension.

Can be stitched directly!

Chen Cang turned and glanced at He Zhengzhi: "You come and feel it. If there is tension here, remember to separate the duodenum. If not, you can directly stitch it up."

He Zhengzhi nodded gratefully and quickly began to feel it.

In fact, surgery requires a person to take you seriously, not let you see it.

It won’t take long.

Feeling is very important, just like the pulse of TCM, there is a master who teaches you how to figure out the numbers of Chifu and figure it out by yourself, which is much different.

Therefore, having a good master can save a lot of detours for a surgeon.

He Zhengzhi couldn't help but smash his mouth at this moment!

Emma... it smells so good!

Doctor Chen turned out to be so good!