Chapter 1386: Two Types

"The portal of the liver is blocked, count down to 15 minutes." Ling Ran gave an order, and the nurses inside and outside the operating room immediately adjusted the time.

Liang Xue took a deep breath while concentrating.

The most difficult part of liver surgery is that the blood supply of the liver is rich, and the bleeding caused by knife cutting and needle drilling is difficult to control. The big difference between modern medicine and early Western medicine is that the amount of bleeding must be controlled throughout the operation, and it cannot be like Like the barbaric medicine in the early days, it was quick to do a trick of amputating a limb in a few seconds and then stopping the bleeding.

However, compared with other organs of the human body, the liver is extremely fragile and important. After the blood supply of the liver is blocked, the probability of failure after the operation is completed and reperfused is very high. Therefore, early clinicians used Created "hypothermic anesthesia", the principle is a bit similar to cardiopulmonary bypass, using low temperature to reduce the body's resistance, so that blood flow can be blocked for a long time.

However, the damage caused by this method is also great, especially it will cause considerable pain to the patient. Therefore, when Wu Mengchao proposed the "intermittent hepatic portal blockage and liver resection method at room temperature", it will attract world-class attention. .

What Ling Ran used today was the traditional "intermittent hepatic hilum blocking and liver cutting method at room temperature". First of all, without hypothermic anesthesia, the patient's pain will be reduced and the prognosis will be better. Secondly, intermittently blocking the portal of the liver, that is, intermittently supplying blood to the liver, can ensure the activity of the liver to the greatest extent, and this time was determined by Wu Mengchao after many attempts with experimental dogs.

Blocking the portal blood supply for 15 minutes and releasing it for 5 minutes can greatly reduce the proportion of patients with acute liver failure after operation, and also reduce the occurrence of liver ischemia-reperfusion injury, thereby improving the safety and success rate of the operation . This model used to be the "magic weapon" of liver surgery in China. In that era, it was a trick that could be used to "shock" foreigners at any time.

Of course, after repeated shocks, it was promoted internationally very quickly, so that it soon became one of the standard procedures of international liver surgery.

However, no matter how good the solution is, it can only reduce the damage, and it is impossible to achieve no damage.

Therefore, during the 15-minute hepatic portal blocking time, the surgeon needs to go all out for the operation. In this 15-minute and 15-minute cycle, the fewer the number of cycles, the less physical damage to the patient will be.

From this perspective, the speed of surgery has become a very important indicator.

In addition to the addition of medical capitalization, the reason why modern surgical instruments and equipment are updated so quickly is that new technologies and new discoveries are time-critical.

The same surgeon, using a traditional surgical scalpel and needle and thread,

The speed of cutting and suturing must be much slower than that of a doctor using an electric knife. Similarly, the speed of a surgeon using an ultrasonic knife must be the best among doctors at the same level.

The robotic arm of the da Vinci robot synthesizes a large number of functions, and it is said that it also has the function of increasing the speed, but in actual use, the surgical space greatly limits the doctor's performance.

No matter how large the pneumoperitoneum can be manufactured, the surgical space cannot be compared with that of open surgery. The 720-degree rotation of the robot arm can only make up for it when it is used as a dojo in the snail shell. Therefore, the total time for Da Vinci robots to perform surgery may be longer than that, and the precision is correspondingly improved.

At this time, all doctors can do is to concentrate their energy and use technology to make up for the technical gap.

With a solemn expression, Liang Xue used what he had learned all his life to operate closely following Ling Ran's operation.

He is a doctor who was born in Dapu. If you talk about liver technology, you can say that he is first-class in the country. However, he is very powerful as an assistant in his position. His understanding of the anatomical relationship in the abdominal cavity, his mastery of various advanced theories, his experience in problems in clinical operations, and his early familiarity with the Da Vinci robot all belong to the position of assistant, which can play a role, but it is not necessary at all. Such a luxury skill.

Therefore, Liang Xue also confidently lay down on the console, cooperating with Ling Ran's operations.

Originally very simple operation.

The reality is also very simple. From the beginning of the operation until the first portal of the liver was blocked, Liang Xue cooperated very easily, and when the first portal of the liver was blocked, Liang Xue was even more confident and calm.

Then, Ling Ran yelled "Attention" again.

Liang Xue smiled and paid attention, and then...

He suddenly had doubts about the joystick of the da Vinci robot.

"Why can't you keep up?" Liang Xue muttered in his heart, and hurried to work on Ling Ran's operation, but it always felt a little slow.

After accumulating over 10 surgeries, Ling Ran's ability to control the Da Vinci robot is completely beyond the level of proficiency.

And when he can perfectly control the machine, the perfect liver resection skill becomes extremely powerful.

What is more different from open surgery is that because the manipulator of the Da Vinci robot can rotate 720 degrees, when the chief surgeon really rotates the manipulator, it has a huge impact on the doctor's spatial imagination. test.

If you want to describe it, normal surgeons using Da Vinci are like flying a civil aviation aircraft. Although this aircraft can rotate clockwise and counterclockwise, generally speaking, they will not do so. Even a doctor with wilder driving will try to ensure the rotation range as much as possible.

Ling Ran's operation today is like a crazy fighter pilot.

When needed, the manipulator under his control rotates almost all the time.

rotate.

Constant rotation.

Liang Xue felt that it was a gift from his body that he didn't vomit.

"The countdown is 10 seconds." Lu Wenbin in the operating room reminded.

Ling Ran acted like he didn't hear it, and continued to operate frantically.

"5, 4, 3..." Lu Wenbin's reminder also continued.

It was at the last moment that Ling Ran released the hepatic barrier.

"The countdown is 5 minutes." Lu Wenbin started the timer again.

At this moment, Ling Ran raised his head, looked at the console on the left, and asked, "How do you feel?"

Director Liang Xue raised his head and forced a smile: "No problem."

Facing the doctors inside and outside the room, Liang Xue still raised his head and showed a calm expression, but his heart roared like a typhoon: "Why doesn't the machine I use be the same as the one Ling Ran uses? "

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