Chapter 822 Perfect Surgery
Lower position will cause less damage and be more beneficial to the patient.
For an eleven-year-old boy, it is better to keep more and remove as little as possible.
…
Complete ligation.
Cut off the blood vessels…
After that, continue to separate outward along the plane between the descending colon mesentery and the posterior peritoneum to the attachment of the outer peritoneum of the colon, and separate the descending colon upward from the surface of the Gerota fascia to the splenic flexure, and free the right side of the rectal mesentery…
Xu Qiu held the instrument in his left hand, grabbed the junction of the rectum and sigmoid colon and pulled it to the right side of the patient.
At this time, the outer attachment tissue of the sigmoid colon was exposed.
Xu Qiu held the electric knife in his other hand and separated the attachment tissue by electric knife.
Zizizizi——
As the outer peritoneum was opened, the posterior peritoneal plane separated when the colon was freed before also appeared, and the two cavities merged into one.
Xu Qiu did not stop, he continued to separate along the Toldt white line to the splenic flexure of the colon.
The instrument in his left hand kept moving upward along the descending colon, and soon, the outer and posterior attachment tissues were separated.
Deputy Director Chen and other gastroenterologists and hepatobiliary doctors were becoming more and more obsessed.
"What a great detail. The pulling force during the separation process is just right. The intestines have tension but not tight. The electric knife can accurately separate each layer of tissue!"
"I have seen the sigmoid colon below... Don't cut it, otherwise the parasites inside will crawl all over the abdominal cavity!"
"What nonsense are you talking about? How could Dr. Xu make such a low-level mistake!"
"Indeed, Deputy Director Chen, be careful. You are an assistant. Don't cut the patient's intestines."
Deputy Director Chen, the first surgical assistant, had a dark face.
... I am also a deputy director after all. I have been working for so many years. Is it necessary?
Although so, he also became more vigilant and cooperated with Xu Qiu to continue to separate the attached tissue below the rectosigmoid colon. Then Xu Qiu used the electric knife to cut along the left lateral peritoneum of the upper rectal mesentery to protect the ureter, and then further freed the distal end of the rectum to obtain a sufficient cutting margin...
Watching Xu Qiu's smooth operation, Deputy Director Chen couldn't help swallowing his saliva.
Watching Dr. Xu perform surgery is simply a pleasure.
At first glance, Xu Qiu's surgery doesn't seem to be too amazing. It's just smooth and free, with almost no pauses, like playing a group of difficult piano pieces, with each step connected without any pauses.
This is difficult for laymen, but it is a routine operation for surgeons.
It's like an ordinary pianist and Beethoven, both of them playing a medium-difficulty piece at the same time, and they both look free and easy and complete in one go.
However, experts can see the force and rhythm of each key pressed.
In surgery, Xu Qiu's strength lies in his control of every surgical operation to the extreme, and every detail is "just right".
The incision is just one centimeter that can be operated.
The cannula can also just enter the abdominal cavity.
There is also the separation process, which also controls the distance, force, etc. to the limit. A little difference is a mistake, and a little more is redundant.
However, throughout the whole process, Xu Qiu did not make any mistakes and maintained his perfect condition until now...
...
The operation was in the sixth hour.
The sigmoid colon resection was about to come to an end, and only the final separation work was left.
Deputy Director Chen grabbed the junction of the rectum and the sigmoid colon through the cannula in the left lower abdomen. He exerted a little force and pulled it upward and forward, and the rectum and sigmoid colon left the pelvic cavity.
Xu Qiu was very satisfied.
After such a pull, there was a good surgical field between the posterior rectal mesorectum and the presacral space, which was enough for him to show his skills.
Deputy Director Chen stared at the display screen and also paid attention to Xu Qiu's movements.
When separating the right side of the rectum, he raised it.
When separating the distal end of the rectum, he pulled the rectum and sigmoid colon out of the pelvic cavity to the maximum extent.
With close cooperation, the initial separation step was completed.
Afterwards, it was the turn of the cutting and suturing device to play.
The electrosurgical knife cuts the peritoneum at the cross section of the junction of the rectum and the rectum, and then uses a non-destructive intestinal clamp to separate the rectal intestine and the mesentery. Then, the cutting and suturing device is inserted from the sleeve in the right lower abdomen to start cutting the intestine.
"What a good thing..." Deputy Director Chen couldn't help but sigh as he watched the cutting and suturing device complete the operation with one cut and one nail under the camera.
In the past, doctors had very few instruments to use for surgery, and most of them relied on their hands.
But now there are too many medical tools.
For example, the cutting and suturing device.
In the past, it was necessary to cut slowly, then stop bleeding and suture, a total of three steps.
And each step needs special attention, such as the cutting link, it is necessary to try to control the edge of the incision to be neat, otherwise the subsequent hemostasis and suturing will be much more difficult.
But with the cutting and suturing device, cutting, stopping bleeding and suturing are completed at the same time in one operation, all in one step.
Moreover, the edges of the wounds completed with the help of the device are extremely neat.
The operation that used to take nearly ten minutes can now be calculated in seconds.
Even Xu Qiu can't catch up with this speed.
This is also the reason why he chose to use a cutting and suturing device - when his own skills do not have a clear advantage, or when medical devices can achieve better results, he will also use devices to assist.
"It's almost done!" Deputy Director Chen cheered up.
Only the last section is left to completely transect the mesentery.
But before that, check the remaining end and stop the bleeding completely.
Otherwise, when the assistant releases the traction and the intestine retracts into the pelvic cavity, it will be impossible to observe the bleeding.
"No bleeding point."
After Xu Qiu finished the exploration, he cut off the last section of the mesentery.
So far, the sigmoid colon has been removed.
The patient's intestine has been clamped, and the obstructing worm group inside is all blocked inside.
Deputy Director Chen and several other assistants stared at the surgical area with wide eyes, looking for parasites that may crawl out of the remaining intestine.
Swish.
Six or seven white roundworms were quickly pulled out when they were about to crawl out of the lumen.
Then Xu Qiu used No. 0 polypropylene purse suture to suture.
After solving this large group of worms and clearing the intestine, the remaining scattered parasites can be dewormed with drugs.
"Re-establish pneumoperitoneum."
After Xu Qiu finished speaking, he found the proximal colon and then connected the remaining distal rectum.
Without the middle section of the sigmoid colon, Xiaojie's life will definitely be affected, but compared to losing his life, this is a small matter.
And the good news is that the proximal colon can be naturally placed in the pelvic cavity without retraction, which means that the length is sufficient and the intestinal segment can be anastomosed without tension.
"Prepare the circular stapler." Xu Qiu said.
As soon as the voice fell, the assistant inserted the circular stapler into the patient's anus, and entered the end of the rectum through the sphincter relaxed by anesthesia...
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