Section 57

"The vital signs are stable, the blood pressure is normal, and the time is 9:12 am."

Zhang Yi nodded: "Okay, the operation begins."

Chapter 48 Zhang Yi! You are my god

Midline incision in the upper abdomen.

One centimeter above the navel, cut the anterior sheath of the rectus abdominis muscle horizontally for one centimeter. This position is the linea alba.

This is the most stable and least likely to injure the abdominal muscles.

After cutting the skin to expose the abdominal cavity, use a spreader to pull and fix the skin on both sides to fully expose the surgical field.

Place the laparoscope and start exploration.

Chen Fang assisted Zhang Yi. He scanned around the stomach with a laparoscope and found several swollen lymph nodes.

In addition to the lymph nodes, before cutting the stomach, you should also check several organs around the stomach.

For example, whether there are any abnormalities in the pancreas, pelvis, uterus, duodenum, etc.

Once abnormalities are found, they must be removed.

After the exploration was over and several lymph nodes and the proximal duodenum that had to be removed were marked, Zhang Yi reached into the abdominal cavity with a bipolar electrocoagulation forceps and began to separate the fascia, ligaments, and fat connected to the stomach bit by bit.

The method of radical resection of gastric cancer is actually to remove 2/3 or all of the gastric tissue.

Then the remaining gastric tissue is directly sutured to the intestine/esophagus.

The duodenum is connected to the stomach below, and the jejunum is behind the duodenum.

Most radical resections of gastric cancer also remove the duodenum.

Because cancer cells are most likely to metastasize to the duodenum.

After the duodenum is removed, the jejunum is connected to the remaining gastric tissue.

Although the patient has lost most of the digestive and absorptive functions of the stomach from then on.

But it is still worth it to save a life.

Radical resection of gastric cancer is not difficult to say.

It is mainly troublesome.

There are too many tissues that need to be freed in the entire abdominal cavity.

The gastropancreatic ligament, gastrosplenic ligament, hepatogastric ligament, omental sac...

Even several large and small arteries and veins are included.

Anyway, in Chen Fang's opinion, he would need to practice this radical gastrectomy for at least three or four years before he dared to perform it.

He felt overwhelmed just by freeing these intricate ligaments and blood vessels.

But.

How could this thing be so easy for Zhang Yi?

"Teacher Zhang... Can I ask a question?"

An intern in the operating room asked boldly.

Zhang Yi stopped: "Ask."

"Well... If you want to free, which position should you free in the first step? You... You move too fast, I can't see clearly..."

After the intern finished speaking, several interns around him nodded frequently.

Even the doctor who came to learn from the monitoring room next to him nodded.

It was too fast!

It was so fast that I couldn't see what was what!

Zhang Yi said: "Radical gastrectomy is actually the part that is particularly troublesome to free. But you remember the order, from left to right, from bottom to top, from front to back, so that the freeing is faster."

"Also, the omental bursa resection is the most troublesome, but if it can be removed completely and clearly, it will give people an artistic enjoyment. Remember, when separating the anterior lobe of the transverse mesocolon, this place is the easiest to break, and you should pay attention to switching surgical instruments at this time."

"I suggest combining electrosurgical separation with blunt separation, but it is best to use a non-electric electrosurgical head for blunt separation, and cut it horizontally from left to right. This saves time and ensures that the separation plane can be advanced in parallel, avoiding uneven force causing tissue tearing."

After Zhang Yi finished speaking, a group of interns nodded in confusion.

I don't know if they understood it.

But Chen Fang understood it!

For a moment, he cast an inquiring look at Zhang Yi again.

What kind of genius is Zhang Yi? !

How come he is so good at all surgeries? !

He can do the surgery for mitral stenosis.

He can also do the difficult surgery in neurosurgery.

He can even handle gynecology!

In addition, he can always find the problem of the patients who come to the department for consultation and make the correct diagnosis.

Now, he can do this radical gastrectomy, a surgery that tests proficiency, even better than Director Kong of gastrointestinal surgery!

Chen Fang was numb.

He was convinced!

He couldn't figure out what kind of person Zhang Yi was...

How could he be so awesome?

How could he know everything?

Chen Fang sighed.

God, give me half of Zhang Yi's talent...

Oh no.

Not half, just one-third of the talent, I will take off!

One and a half hours later.

The operation was over.

In a sterile curved tray next to the operating table, there were two large pieces of deep red stomach tissue.

The color was darker, and there was a little blackened and deteriorated tissue in it.

In another sterile curved tray, there were several lymph nodes.

Zhang Yi removed 2/3 of Li Xiaoxia's stomach and a small section of the esophagus near the cardia.

"Thank you for your hard work, clean up the equipment."

Zhang Yi said to the people in the operating room.

Everyone twitched their lips.

Why are we so hard-working? You are the one who works the hardest.

However, they didn't learn much in the one and a half hours they stood there today.

Why?

Because Zhang Yi's technique is too fast!

It's fast and steady. They all shouted "Big brother is awesome" while watching.

How could they remember that they are students who come here to learn...

Forget it, come again next time if there is a chance!

The interns left the operating room reluctantly.

Chen Fang followed Zhang Yi out.

Two girls were standing outside the operating room with a worried look on their faces.

"Doctor Zhang, how was the operation?!"

"Don't worry, the operation was successful. Your mother is now being sent to the ICU for observation and will be transferred to the general ward tomorrow."

"Thank you! Thank you, Doctor Zhang! I really can't repay your kindness! I... I... Or I will..."

"Hey, don't, don't, don't!" Zhang Yi interrupted Zhao Yuting quickly.

"You don't have to do anything, just take good care of your mother."

Zhao Yuting and her sister looked at Zhang Yi with tears in their eyes.

Doctor Zhang~~ You are such a good doctor!

...

In the afternoon, the news that Zhang Yi performed a perfect radical resection of gastric cancer spread in the hospital again.