Chen Cang glanced at the child and thought for a moment.
I don''t know whether I can''t live on my conscience or because of others. I can''t help reminding: "have you been in contact with gastroduodenal anastomosis?"
Hearing Chen Cang''s words, he Zhengzhi suddenly shocked his charming body and exuded cold sweat!
Is it
Dr. Chen, he''s not very good at "gastroduodenal anastomosis"?
Thinking of this, he Zhengzhi was really a little desperate. He felt that he was staring at the stomach, but at the abyss!
Fear filled my heart and was about to devour him!
He Zhengzhi took a look at Chen Cang and calmed his nerves: "Dr. Chen, don''t tell me you won''t do Biluo!"
Gastroduodenal anastomosis is Biluo''s operation.
Chen Cang shook his head and smiled: "I will. I mean, if you won''t, you can look at it carefully. It''s a rare opportunity."
He Zhengzhi finally breathed a sigh of relief!
Now he doesn''t expect to wait for director Ma. His wish is very small. He can finish the operation.
As for what Chen Cang learned more, he told the truth that he had no expectations.
This operation has learned many things more precious than operation!
"Thank you... Thank you, Dr. Chen!"
Chen Cang nodded and smiled: "Why are you sweating so much, young man, pay attention to your body!"
The little nurse heard Chen Cang''s words and was very sensible. She took the initiative to wipe the sweat for Dr. he.
He Zhengzhi was immediately flattered!
He... Where did he receive such treatment?
Looking at the gentle and lovely little nurse, he Zhengzhi quickly smiled and said, "not empty, not empty, too much yang, a little hot!"
A few little nurses were stunned and took a deep breath of the 22 ℃ cool air unique to the operating room. Is it hot?
There are basically two main anastomotic methods in subtotal gastrectomy, one is Biluo type, abbreviated as bi-1 type, and the other is Biluo type, abbreviated as bi-2 type.
The two methods have been used for a hundred years and have been constantly improved.
To put it simply:
Gastroduodenal anastomosis is bi-1.
Gastrojejunostomy is bi 2.
Bi-1 has great limitations, but its advantages are also very obvious, because it retains the structure and function of the duodenum and is not easy to cause gastrointestinal dysfunction after operation. If conditions permit, bi-1 should be used as much as possible.
However, in bi-1 anastomosis, attention must be paid to avoid anastomotic tension. Duodenal motility is small. If the resection of gastric body is too large, bi-1 can not be used.
It is precisely because of the limitations that the difficulty of operation is rising.
Chen Cang took a deep breath, bowed his head and began to observe carefully, preparing for the anastomosis operation.
Since it is called gastroduodenal anastomosis, it shows that the core element of the operation lies in the anastomosis between the gastric body and the duodenum.
Zhou he looked at Chen Cang and couldn''t help telling him: "Dr. Chen, the patient has intestinal paralysis. Now the intestinal peristalsis basically stops. When the postoperative obstruction is relieved and the paralysis disappears, the gastrointestinal peristalsis will recover. In addition, the tension of the gastric wall will recover, and the contraction of the gastric wall at both ends of the anastomosis may affect the healing of the anastomosis and even lead to the stricture of the anastomosis. Be careful."
Zhou he is kind.
In fact, never underestimate an anesthesiologist. When Chen Cang practiced, he saw the story of an anesthesiologist saving the field with his own eyes, which frightened Chen Cang at that time.
After all, in the eyes of many people, anesthesiologists are the escort of surgery, and the chief surgeon is the old driver, but they ignore that this escort sees too many operations every day, which may not work, but his vision and vision are very high!
Hearing Zhou he''s words, Chen Cang nodded gratefully: "thank you, teacher Zhou!"
Chen Cang''s Biluo is from Li Yue, but it is not exactly the same as Li Yue''s. after all, Chen Cang has his own considerations.
In order to avoid too large anastomosis, the broken end of the lesser curvature of the stomach needs to be sutured first before anastomosis.
Whether Biluo 1 or 2, the method of closing half of the incision on the side of the lesser curvature of the stomach can be used.
This step is actually the same as Chen Cang''s construction of mitral valve.
Chen Cang''s eyes began to compare constantly.
The tension of the gastric wall and the activity of the duodenum need to be taken into account, so the difficulty of anastomotic comparison suddenly increased.
After a while, Chen Cang turned around:
"Catgut 1."
The anastomosis of the lesser curvature of the stomach needs to be tight and firm. After all, the stomach belongs to the digestive organ and needs to be filled with food.
Chen Cang''s suture is very precise. The needle holding pliers hold the No. 1 intestinal suture and sew a row of full-layer continuous suture around the curved pliers from the lower end of the incision!
Then, Chen Cang said to he Zhengzhi, "take out the bending pliers and tighten both ends of the catgut!"
He Zhengzhi nodded quickly.
At this time, Chen Cang, return the upper intestinal suture to suture, and align it with the gap between the first row of suture and the second row of continuous suture from the cardiac end down!
This set of operation stunned Zhou he!
"This is... Li Yue''s method?"
Chen Cang smiled and nodded, "that''s right!"
He Zhengzhi looked at Chen Cang blankly: "what is this for?"
Chen Cang explained: "in order to make hemostasis reliable!"
He Zhengzhi nodded involuntarily. In fact... He didn''t understand... But he always felt that what Chen Cang said was very reasonable!
While talking, Chen Cang tied the two ends of the catgut after meeting at the lower end of the incision.
Then, the seromuscular layers on both sides were sutured and reinforced intermittently, and the rough surface of the stump was embedded.
Zhou he couldn''t help saying, "your basic skills are too solid!"
He Zhengzhi also brightened his eyes: "how powerful!"
Indeed, Chen Cang''s suture from beginning to end has limited damage to the gastric wall. When the needle tip goes in and out, it skillfully uses the needle tip distance to control the tension of the gastric wall, which is actually a very effective tension suture.
Chen Cang smiled: "basic exercises."
In fact, this is also the method Chen Cang has been studying!
This inspiration also comes from Chen Cang''s great blood vessel anastomosis. When Chen Cang anastomoses the great blood vessels in the chest, he needs to feel the pulsation and tension of the blood vessels because of the pulsation of the blood vessels!
At this time, Chen Cang realized the importance of tension suture. This tension suture can effectively accelerate healing and reduce secondary injury.
While Chen Cang was repairing just now, he suddenly had an idea. He found that this tension suture is actually more effective for the suture of gastric wall. Even when the gastrointestinal anastomotic stoma, this tension suture is more beneficial!
Thinking of this, Chen Cang couldn''t help being surprised.
After suturing the broken end of the small curvature of the stomach, Chen Cang closed the two pliers at the two stumps of the stomach and duodenum.
At this time, you need to feel the tension!
If yes, the duodenum must be separated to prevent excessive anastomotic tension, leading to the failure of the operation!
Fortunately, I didn''t feel the tension.
It can be sewn directly!
Chen Cang turned and looked at he Zhengzhi: "feel it. If there is tension here, remember to separate the duodenum. If not, you can suture directly."
He Zhengzhi nodded gratefully and quickly began to feel it.
In fact, surgery needs someone to take you seriously, not let you see it.
It won''t last long.
Feeling is very important, just like touching the pulse in traditional Chinese medicine. There is a teacher who teaches you to sink, delay and float, which is much different from your own speculation.
Therefore, a good master can avoid many detours for a surgeon.
He Zhengzhi couldn''t help smashing his mouth at this moment!
Emma... It smells good!
Dr. Chen was so powerful!