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Chapter 676: 【676】Liver



   The half-hour ward rounds are a no-brainer for a medical student like Xie Wanying who came to study in this department on her first day. Many patients\' faces can\'t be recognized, and they don\'t know what\'s going on. The teacher assigned tasks to her can only wait until after the afternoon, there is no need to hurry. After such a comparison, it seems that she was left out in the ward in Puwai Er was a good thing.

   Going to the operating room, Xie Wanying is very familiar with the operating room environment. It\'s just that this time it\'s about hepatobiliary surgery, not general surgery. Keep in mind what Sister Jiang said, where you go to study with the teacher, you must concentrate and not worry about your ex. Without meeting Mr. Tan and the others, she directly stood in the operating room of the hepatobiliary surgery to observe.

  This morning’s operation was to perform laparoscopy on a patient with primary liver cancer.

  All surgical departments tend to do minimally invasive surgery. Laparoscopy for liver cancer has been popularized a lot, but the threshold for doing it is much higher than that of laparoscopic surgery of the gastrointestinal tract. Like today\'s surgery, the seniors held a meeting that night and discussed it for a long time.

   Specifically, Xie Wanying did not participate in the group meeting that night and did not know the content. She could only stand in the operating room and observe.

   The main sword is Brother Tao, I heard it before.

  Issuke is Dr. He.

The mirror hand was not Dr. Qiu. Dr. Qiu went to help in another operation. It was another resident physician named Gong Xiangbin. of a doctor.

   Song Xuelin, who was called again and said that he wanted to try his hand, put on a surgical gown, and stood behind the first assistant and the mid-level chief surgeon, as if on standby.

  People are graduated, she is not, just an intern. So it is reasonable for the teacher to tell her to just watch. Xie Wanying watched intently. Ms. Tan has been working as a mirror-handling hand for a long time. She has a lot of experience with mirror-handling hands. This is the first time she came to the Hepatobiliary Surgery Department to see a laparoscopy for liver surgery. She could not help but carefully observe the operation of Dr. Gong.

   Dr. Gong\'s hand seemed to be motionless, and he had to look at it like a magnifying glass to detect the tiny amplitude. Unlike the gastrointestinal tract, the liver is a substantial organ that is fixed in one area. The operations performed around the liver are basically performed in this area, which requires considerable stability and meticulousness. The gastrointestinal tract is a hollow organ, and many twists and turns require more dexterity.

  The mirror hand has paid attention to caution, not to mention the first assistant and the chief knife, as Dr. He said, like deminers, they penetrated little by little, and they did not dare to operate greatly.

After all, the liver is full of very, very rich blood vessels. When removing the tumor, the liver should be cut. As long as the cutting position is slightly deviated, it is easy to hit various blood vessels in the liver, and the blood will bubbling on the entire liver wound. .

   If there is a large area of ​​bleeding in the parenchyma, the surgeon is in a hurry to directly press the liver wound with his hands to stop the bleeding during laparotomy. During laparoscopic surgery, the doctor\'s hand cannot get in, so he can only use a hemostatic gauze to press it. If you can\'t hold it down and you can\'t find the bleeding point, you can only turn to the abdomen. It can be seen that the difficulty of hemostasis is a major defect of laparoscopic liver surgery, which seriously restricts the size of the liver tumor in laparoscopic surgery, the location of the tumor cannot involve the portal vein, and the patient\'s liver function level has high requirements.

   (end of this chapter)


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