Chapter 244

The patient was lying flat on the operating table. As the third bag of red blood cells was transfused, the blood pressure increased significantly.

Because the spleen is located in the left upper abdomen, it is very difficult to perform traditional surgery. Therefore, Xiao Chenguang chose the four-hole method for safety reasons.

The observation hole was established 1 cm to the left of the navel, and the puncture needle was inserted at 30 degrees to avoid blood vessels and mucosa.

"Wenxia, ​​connect the gas cylinder."

"Okay."

As soon as the voice fell, the half-human-high blue carbon dioxide gas cylinder made a buzzing sound.

The patient's lower abdomen began to bulge slightly. Xiao Chenguang glanced at the blood oxygen saturation on the monitor and maintained above 90%.

It means that there is no problem with the establishment of the puncture card.

"Gao Yang, you come to establish the operation hole and the auxiliary hole."

In laparoscopic surgery, the establishment of the observation hole needs to be carried out close to the abdominal wall. The puncture is the most difficult and the most likely to go wrong.

The last time Lao Wang rescued the pulmonary embolism, it was most likely that the establishment of the puncture card accidentally injured the blood vessel.

When carbon dioxide gas was continuously pumped in, the intra-abdominal pressure was too high, and the gas entered the blood circulation, which caused the blood pressure and oxygen saturation to drop.

"Okay."

Lin Gaoyang took the puncture needle, but the last rescue was still vivid in his mind, which made him hesitate to insert the needle.

"Don't worry, I'll watch, it's okay."

The pneumoperitoneum is now fully established, the peritoneum is pushed open, and the puncture is simpler than the observation hole, so Xiao Chenguang asked Lin Gaoyang to do it.

Then, under Xiao Chenguang's guidance, the operation hole and auxiliary hole were established in the patient's left axillary line, the left midclavicular line rib margin and the left side under the xiphoid process.

The instrument entered, and as the screen lit up, the abdominal cavity structure was visible at a glance.

"The patient's spleen is too big, this is already considered a giant spleen."

There was a cry of surprise in the operating room.

The spleen of a normal adult is 10 long, 6 wide and 3 thick, and weighs no more than 100-200 grams.

But the spleen on the screen was deformed and enlarged, and it almost filled the entire screen.

Judging from its weight, it is estimated to be seven or eight times that of a normal spleen.

"Boss, can this still be cut?"

As the mirror hand, Lin Gaoyang not only checked the patient's spleen when exploring the abdominal cavity, but also just looked at the liver.

As the culprit of this emergency.

The condition of the liver is also not optimistic. The hardened and atrophied part accounts for 90% of the whole liver, and irregular wrinkles have appeared on the surface of the liver, which is likely to induce liver cancer.

If this is not done carefully, the patient may lie on the stage and cannot get up.

"At least she can say goodbye to her family soberly."

The situation of the abdominal cavity is worse than Xiao Chenguang imagined.

Generally, at this stage of exploration, most doctors will go down the stage to talk to the family members and then give up the operation.

Because 80 to 90 percent of the patients have lost the meaning of surgery and are likely to not get up.

But Xiao Chenguang at this moment did not think so.

"Electrocautery, prepare to free the spleen."

Seeing that Xiao Chenguang was going to continue, Li Wenxia immediately took the high-frequency electric knife equipment.

Crackling...

The electric knife started, making a buzzing sound.

Xiao Chenguang stepped on the pedal, controlled the electric knife, and began to operate in the abdominal cavity.

"Negative pressure suction."

"Understood."

When the electric knife freed the spleen and stomach ligament from the upper part of the greater curvature of the stomach, a puff of smoke rose from the screen.

Lin Gaoyang held the mirror with one hand and inserted the negative pressure suction device from the auxiliary hole with the other hand and started it.

The smoke dissipated and the spleen hilum was exposed.

Then Xiao Chenguang began to separate the splenic artery, ligated it, and freed the lower pole of the spleen, the retroperitoneum, and the upper pole of the spleen in turn.

Fully free the spleen.

The whole process was very fast. Lin Gaoyang held the camera and almost couldn't keep up with Xiao Chenguang's speed.

"4-0 line, change to long forceps, and deal with the splenic pedicle blood vessels."

This step is the key and difficulty of freeing the spleen.

If you are not careful, the blood vessels will be torn, which will cause heavy bleeding again.

At this time, Xiao Chenguang missed the vascular linear cutting stapler commonly used in later generations, which can clamp and cut all blood vessels with one shot.

Save time and effort.

But now, Xiao Chenguang can only ligate and cut one blood vessel at a time.

No one in the operating room dared to disturb Xiao Chenguang at this moment.

Everyone looked at the screen at the same time. In the whole picture, only the needle holder and separating forceps controlled by Xiao Chenguang were operated in a limited space.

The hand muscles moved slightly, and the instrument on the screen rotated with it, wrapping the black silk thread around the blood vessel, and then pulling it tightly to ligate and cut the blood vessel.

Over and over again, in a cycle.

"Put on a condom, put down the net to fish out the spleen."

I don't know how long it took, when Xiao Chenguang's words rang in the operating room, everyone breathed a sigh of relief.

At this time, Xiao Chenguang had completely freed the splenic pedicle and enlarged the puncture hole in the left upper abdomen to 20cm.

"Director Xiao, I'll give you a condom."

Li Wenxia handed the plastic recycling bag that had been prepared long ago to Xiao Chenguang.

He manipulated the clamps on both sides, grasped them tightly and stretched them open, and then a spleen larger than a fist was put into the bag and taken out.

With a heavy dark red spleen placed in the treatment bowl, the operation came to an end.

The remaining gastric vascular disconnection, although also difficult, was much simpler than this operation.

Like the coronary vein of the gastric branch, the esophageal branch, the left inferior phrenic vein, and the left gastric artery and vein located in the pancreas.

Xiao Chenguang treated all the parts that caused the blood vessels to dilate.

At least for him, after this operation, the patient will no longer suffer from upper gastrointestinal bleeding during his lifetime.

As for the liver problem, Xiao Chenguang could only sigh helplessly.

Many hepatitis patients will not develop serious liver cirrhosis as long as they pay attention to their diet and treatment.

Naturally, there will be no problems like the ones faced by patients undergoing this surgery.

In the final analysis, insufficient publicity and lack of attention by oneself accounted for a large part of the reason.

The operation was successfully completed and the patient was successfully weaned and extubated.

The moment he woke up, his whole person seemed like a different person.

He has a gentle attitude and speaks slowly and softly, but he doesn't look like he was acting like a fool just now.

This made Lin Gaoyang, who had been waiting in front of the patient's table, look a little surprised.

"Brother Liu, Wenxia, ​​thank you for tonight."

The operation was successfully completed, and Xiao Chenguang expressed his gratitude in the operating room.

After all, he was summoned for surgery in the middle of the night, and he was not just a follow-up. He came only because of Xiao Chenguang's face, so he had to remember this favor.

"It's okay. I had to stay up all night writing music, but I didn't expect that you could complete such a big operation in two or three hours. It's really amazing."

Liu Tie couldn't help but sigh.

This Xiao Chenguang is really a man who does great things quietly. He had never heard of laparoscopic surgery for splenectomy, let alone when he was studying laparoscopy in Yingcheng or the provincial capital.

Fortunately for Xiao Chenguang, he performed the operation secretly at night. If he could write a paper and publish academic research, it would make a group of people excited.

No, I have to talk to Xiao Chenguang carefully next time. If there is such a surgery in the future, record it in advance.

Even if he doesn't have time to do it, he can still help. After all, he has the most credit for the same operation, but anesthesia can also play a role. When the article and technology are published, he can also take advantage of it.

"Xiao Xiao, it's okay. Let's go back. At this point, we might be able to watch a football match in case we win."

Hearing Liu Tielin's words when he left, the muscles at the corners of Xiao Chenguang's mouth twitched.

He really wanted to tell Liu Tie that for the sake of his own health, it was better not to have any expectations for this sport.

Otherwise, it is easy to have high blood pressure.

Later, with the gratitude of the family, the patient was safely pushed back to the ward and monitored 24 hours a day to observe vital signs.

Xiao Chenguang, after explaining the precautions to Lin Gaoyang, returned to the small intensive care unit.