Chapter 1406: ESD microsurgery

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"Doing well, very good." Lei Yinghua eyes looked at the screen, a faint evaluation.
Peng Jia was disappointed and somewhat pleased.
The mood is complicated, he does not know how to express himself.
While looking at the operation on the screen, he sneaked at the face of Lei Yinghua.
Although the director of Lei Yinghua Lei is over half a year old, he is young and handsome. It is no wonder that he started to pay attention to the top flow of operation t on the screen.
Peng Jia thought of it.
He is involuntarily distracted.
There are too many things in my mind and too much pressure. This is a self-protection method of the body.
Surgery, when I first started watching, there was some freshness.
The red and white intestines became the background, and the endoscopic instruments such as endoscopic incisors and separators were indifferent, and there was no change at all, and they were slightly indifferent.
There was no bleeding that caused sudden cardiac arrest, and there was no accident.
All operations are calm and even a little indifferent.
Although Peng Jia knows that this situation means that the surgeon is in control of the surgery, but from the perspective of viewing, it is not the best way.
Can you attract people by ups and downs?
But not everyone has the same idea of ​​Peng Jia, Director Lei Yinghua Lei did not look at the LCD screen.
Peng Jia can feel that his breathing is not uniform.
Some moments of dissociation and removal of polyps, Lei Yinghua's breathing sound will disappear briefly.
58'22", Lei Yinghua did not feel tired, when a polyp of diameter 23 appeared in the endoscope field, his back straightened.
The spray tube is evenly sprayed with the dye, and the endoscopic incision knife is cut and separated layer by layer.
It seems that the surgeon did not realize the difference between this big polyp and other polyps.
"Director Lei, this polyp should invade the muscle layer." Peng Jia also understood a few points, he whispered in the face of Lei Yinghua.

Yeah.
Lei Yinghua said,
When free, the muscle layer can easily penetrate, causing the intestine to rupture.

Peng Jia is worried.
But when he saw the splitting pliers on the screen, he didn't know where there was an inexplicable confidence.
Can Zheng boss make a mistake?
impossible!
This kind of confidence is inexplicable. It was accumulated through countless operations, but Peng Jia did not notice.
After the cut, the screen on the screen finally paused. It seems that the surgeon also realized that the polyp was different from the previous one.
However, after 6′′, the field of view begins to change and the resolution of the endoscopic lens is maximized.
Some of the endoscopes have this function, and Lei Yinghua knows it.
But I have never used it before, and the doctors in the endoscope room are rarely used. Because this is already the level of microsurgery, gastrointestinal surgery and microsurgery have nothing to do with it.
He looked at the camera, and the colon mucosa protruded into the lumen with many finger-like protrusions, each of which looked so huge, like a forest.
The sudden change of style, from the rigorous endoscopic surgery, the modern science and technology wind directly to the fantasy style, Lei Yinghua Huo stood up.
However, he later realized that his actions were a bit blunt and too excited. Forgot that this was a esd operation of a "secondary" doctor.
He is embarrassed.
"Director Lei, can you tell us something, we can't understand it." Peng Jia quickly stood up and said Qian Qian.
"Good." Lei Yinghua immediately said, lifted his foot to the front of the LCD screen.
An assistant handed the laser pointer and Lei Yinghua turned the laser pointer on.
He was also seen for the first time in the intestinal anatomy under high magnification microscopy. But the deep theoretical foundation has smoothed all obstacles for him.
"Here, it is the villi in the small intestine mucosa, and it is also an important digestive organ." Lei Yinghua used a laser pointer to point to the "huge" fluff appearing on the screen, trying to keep calm and calm.
But he did not notice that his voice had begun to hoarse.
The picture moves slightly, like a microscopic mount to support the lens.
The operator's operation is slow, and he is also looking for an anatomical structure.
"Here is the small intestine gland, opening between the villi. If pathological examination can be found that the glandular cells are columnar cells or goblet cells." Lei Yinghua points to a point that appears faintly after a few degrees of amplification, saying To.
"The mucous membrane of the small intestine is also a muscle layer, the inner ring, the outer longitudinal smooth muscle..." Just said here, the free pliers appeared on the screen.
On the LCD screen, the pliers are so huge that they seem to occupy more than half of the field of view.
But Lei Yinghua knows that this is just a head, and the surgeon controls the movement of the separation tongs.
This is 50 times the field of vision, the artificial means, can be controlled so accurately? Lei Yinghua is a bit embarrassed.
However, the separation forceps did not separate directly, the endoscopic incision knife appeared, and the muscle layer of the mucosa was clicked and then disappeared.
It turned out that Lei Yinghua saw this paragraph and realized what happened to the slightly indifferent operation he had seen before.
No wonder bleeding is so little!
The surgeon did not use a cutting knife to violently cut the mucosal muscle layer, but gently a little, and then use a separating forceps to make a blunt separation.
Obviously, the operation in the 50x field of view fully reveals the surgeon's surgical level.
Because of the ordinary vision, it is impossible to find that the surgeon has actually done so many operations.
But Lei Yinghua, a master of esd, changed other people. Even in the high-power field of view, it is estimated that the doctors of 99 can't understand the strength of the operation.
Some steps will even be considered invalid.
"Here, it is the inner ring smooth muscle of the intestinal mucosa. It is very thin and difficult to see." Lei Yinghua has already begun to get a little excited.
It was written in the textbook, but he never saw it so clearly.
It is different from the imagination. Lei Yinghua explained the microscopic anatomy while secretly remembering it.
The separation forceps gently move under the smooth muscle of the mucosa muscle layer to move away from the submucosal connective tissue between the smooth muscle of the inner ring and the muscular layer of the intestine.
The unhappiness of the march was not slow, and Lei Yinghua did not see any confusion about the micromanipulation. This extremely fine micromanipulation does not burden the surgeon. As before, the surgery is done without delay.
"This is the blood vessels in the submucosal layer of the intestine, d, how could it be so thick..." Lei Yinghua could not help but sigh.
Usually, he is passing by.
At 50x field of view, a large blood vessel appears in the field of view. The surgeon stopped, separated the connective tissue with a separating forceps, and then saw the electric burn appear. Gently, the blood vessel was blown after a smoky smoke.
The broken end is condensed and there is no bleeding.
"The operation is very fine. The blood vessels in this position are hard to see with the naked eye." Lei Yinghua's voice was a bit stunned.
The reason for the slower surgery was that he finally found out.