Chapter 331

"Boss, shall we make three holes for this laparoscopic surgery?"

Because it is not a hepatobiliary surgery, the conventional five holes are not needed.

It is just a simple intestinal resection, so Lin Gaoyang prefers the three-hole method.

However, Xiao Chenguang shook his head.

"The material cost is too expensive, so let's make two holes."

The establishment of the operation hole is not just a simple hole, but also a punch card should be set on the hole to facilitate laparoscopic operation.

One material is nearly one thousand yuan.

Xiao Chenguang can perform the operation for free, saving the patient's operation fee, but the material fee is calculated separately.

"Two holes?"

Lin Gaoyang was stunned for a moment.

He knew that Xiao Chenguang wanted to save money for the patient.

But one of the two holes is an observation hole. Lin Gaoyang uses a laparoscope, and the remaining operation hole has to be put in two instruments.

The operating space will definitely be greatly reduced.

There will even be a phenomenon of "fighting" between the two instruments. Lin Gaoyang thought about it before, but never dared to try it because it was too difficult.

"It's okay. Special cases require special treatment." Xiao Chenguang said calmly.

Although the operation has limitations, Xiao Chenguang's hands have become much more stable and coordinated through practice during this period.

Let alone the two-hole method, as long as there is suitable equipment, the conventional five-hole method for cholecystectomy can be solved with one-hole method.

"Okay, then I'll make two holes."

Lin Gaoyang obeyed Xiao Chenguang's decision 100%.

As long as the boss can do it, it can be done.

Skin disinfection, puncture needle puncture around the umbilicus, and establish pneumoperitoneum.

Then establish another operation hole in the upper abdomen to facilitate the operation of abdominal instruments.

Xiao Chenguang is very confident about Lin Gaoyang's puncture and perforation skills.

Even the people led by Xu Guoqiang in the provincial capital are at this level.

The laparoscope was quickly extended into the patient's body, and as the TV screen turned on, the abdominal structure was clearly visible.

The old man just had a simple superior mesenteric artery embolism. Because it was discovered in time, there was no suppuration or inflammation in the intestinal cavity.

Unlike the previous case of obstructive cholangitis, the organs in the old man's abdominal cavity were clearly visible, without edema and congestion.

Lin Gaoyang explored very quickly, and in a moment, he found the swollen intestinal cavity.

Because of ischemia and hypoxia, the mucosal surface of this section of the intestinal cavity began to turn black compared with the surrounding intestinal cavity.

It was only one step away from necrosis.

"Separation forceps, long scissors."

Xiao Chenguang stretched out his hand, and the instrument nurse handed over the assembled instrument.

It was extended into the body through a single hole.

Xiao Chenguang crossed his left and right hands, and began to ligate the thrombus embolism site downward along the starting part of the superior mesenteric artery.

The thrombus was very large, almost blocking the entire blood vessel.

This situation was as Xiao Chenguang expected, if he really followed the family's wishes and only treated it with drugs.

The thrombus could not be melted.

Even if the interventional methods commonly used in later generations were used, facing such a large thrombus, they could only be transferred to surgical treatment.

"Boss, thanks to you for talking to the family. If they choose conservative treatment, within two days, the necrotic intestinal cavity will begin to become inflamed and fester in the body, and the old man will only suffer more and more."

"If you want to have surgery at that time, I'm afraid you can't escape death."

Lin Gaoyang is very clear about the final outcome of the old man. He has experienced such examples and understands the patient's thoughts.

Often in order to save surgery fees in the early stage, more money will be spent to make up for it in the later stage.

It can only be said that the gain does not outweigh the loss.

"Gaoyang, move the camera back a little."

After determining the embolized blood vessels and intestinal cavity, Xiao Chenguang began to free and cut.

Because it is a single-hole operation, the field of view of the surgical area is limited, Xiao Chenguang directly adjusted the abdominal camera back a few centimeters.

"Boss, can you still see clearly like this?"

Although the adjusted field of view is wider, some details become blurred.

"No problem."

Xiao Chenguang said in a flat tone.

He was concentrating, his eyes fixed on the screen, his hands were as steady as a mountain, but his operation was flexible and changeable.

The speed was very fast, and the people watching were dazzled.

The instrument separated the embolized mesenteric blood vessels, followed the direction, found the ischemic intestinal cavity, and performed small intestinal resection.

The resected part was only 30 centimeters.

In the human body, the length of the small intestine alone is 3 to 4 meters long, which will not cause any impact compared to the short 30 centimeters.

After clamping the intestinal cavity on both sides and removing the embolized intestinal cavity, the broken ends were anastomosed.

The needle and thread flew on the screen, and Xiao Chenguang was doing his best, which made Lin Gaoyang on the side a little dumbfounded.

Compared with the previous cholangitis surgery that required delicate operation, the large-scale suture in front of him gave Lin Gaoyang a more intuitive feeling.

After a while, the small intestinal end was anastomosed, the clamp was released, and the warm saline gauze was covered.

There was no trace of bleeding or intestinal fistula.

The whole small intestine was restored to its original state. With the net set, the small intestine connected to the mesentery was taken out of the body. The whole operation took less than an hour.

This still includes the time for intubation and establishment of pneumoperitoneum in the early stage.

If we take out the operation part alone, Lin Gaoyang estimated that it would take less than half an hour.

This is based on the two-port laparoscopic surgery with higher operation difficulty, which is based on saving money.

"Boss, why do I feel that your operation is more sharp than before."

Lin Gaoyang was shocked and directly used the word sharp to describe Xiao Chenguang.

As the operation was completed, he also talked about the problems that he had buried in his heart for these days.

"I felt it, too."

Liu Tie, who had been in charge of the patient's anesthesia, nodded in agreement.

According to previous experience, this operation would take at least two hours.

This was still a conservative estimate.

But now, the patient would be able to leave the stage soon, which frightened Liu Tie, who was gradually reducing the anesthetic.

Xiao Xiao's operation seemed to have evolved again.

Looking at Xiao Chenguang, who was performing the operation on the stage calmly and leisurely, Liu Tie was full of doubts at this time.

How could this person on the stage not feel any bottleneck? How did he train his hands to reach such a terrifying level?