Vol 3 Chapter 2833: Speedy surgery


Dean Yan Yan accompanied Peng Lao to chat, and a few minutes later, Gu Lao of the chest department rushed up.
Laohe was busy performing without real objects, while listening to what they said. At this time, it is a big-class chat, and it is too uninteresting for an anesthetist to come up and talk about it.
But he was curious how boss Zheng took such a big job. Usually, other doctors are more cautious about the surgery of the more important people. Just after hearing from Yiren, it seems that Boss Zheng advised him.
From the conversation, Lao He could hear that Gu Lao didn't really agree with the operation. Whenever he kept talking, he should go to Shuaifu for consultation and participate in the diagnosis.
However, Gu Lao's opinion is not important. Lao He has nothing to worry about. He now has a nearly blind worship of Boss Zheng's level.
老板 Boss Zheng's level is positive, the key is stability! No matter what a rare operation, Boss Zheng will take it down steadily. Lao He has an "illusion", just like Boss Zheng has done countless such operations.
I may be "illusion", Lao He thought to himself. He was just a little curious. After an expert consultation, the old couple Peng also gave up surgery to return to their hometown. Ye Luogui returned to the roots. How confident did Boss Zheng be before leaving them?
Soon, the flat car sounded and the patient came in.
Lao He helped lift the patient to the operating table and asked softly, "Boss Zheng, are there any special needs?"
"Left position, lean forward 30 °, right chest," Zheng Ren said in a deep voice. While talking, he inserted the patient's film into the reader, habitually held his arm to watch the film, and had no idea of ​​talking to Peng Lao at all.
"Good," Lao He said in a low voice.
"Anesthesia, I'll brush my hands right away." Zheng Ren said.
So anxious? Old He froze for a moment.
"The operation should be completed within 45 minutes from the start of anesthesia, and strive for the lightest possible surgical blow. The elderly are old, and they can be as fast as possible." Zheng Ren explained with a smile.
Lao He knew this time why Gu Lao felt that this operation was unnecessary, which was determined by the patient's own physical conditions.
Counting anesthesia for 45 minutes, even laparoscopic surgery is too fast, boss Zheng really dare to think.
Seeing Boss Zheng brushing his hands, Lao He glanced at Su Yun. Seeing that Su Yun had already installed auxiliary equipment such as a hand stand, he whispered, "Brother, am I starting?"
开始 "At first, I started posing after you inserted the tube." Su Yun's voice passed through Laohe's ears through the three-layer mask, a little stuffy. Lao He knew that Yun Geer might be a little nervous today. After all, even if Dean Yan took away a group of people, there were still many gang-level tasks to prepare for the viewing platform.
Intubation, anesthesia, and postural position. After 4′22 seconds, Zheng Ren had brushed his hands, laid a sterile sheet, and stood in front of the operating table.
Lao He stared closely at Boss Zheng's movements, and started left-lung ventilation at the most appropriate time.
Zheng Ren placed a thoracoscopy in the 7th intercostal hole on the right posterior axillary line. The two holes on the 3rd intercostal line on the midaxillary line and the 8th intercostal line on the scapular line were operation holes. Punching the card and going down the camera, Lao He breathed a sigh of relief, and the single-lung ventilation was perfect, which did not affect Boss Zheng's operation time.
However, boss Zheng did not start directly on the mediastinum, but began to use the long-nose pliers to deftly, and soon the venous arch appeared in the surgical field.
A straight-line cutting and suture device was tapped in Zheng Ren's hand. After cutting the sphenoid vein arch, the mediastinum was released. Soon a huge diverticulum appeared on the screen.
At the level of the bulge, the pupa was freed out of the esophagus and lifted around the band. Zheng Ren released upward along the esophagus, exposing the lower end of the diverticulum.
只有 In the operating room, only the song of good fortune wafted. The others stood behind Zheng Ren, watching the operation that was so familiar to the bones, no one spoke, but only occasionally raised his head to glance at the electronic clock hanging on the lintel.
12′22 ″, the diverticulum has been fully exposed.
For laparoscopic surgery of the esophagus, this is already a time for all surgeons to be dumb.
Normally, all that can be done in such a short period of time is after the anesthesia is completed and the posture is finished. The medical team, which is slightly slower, is afraid that the operation order is not paved. But boss Zheng has already seen the esophagus.
I was quick, but not enough.
After looking at Gu Lao for a while, the black and white eyebrows under the sterile cap wrinkled.
Only now has the real surgery started, can boss Zheng finish it?
并不是 He is not disapproving of Zheng's surgical plan, but he doubts whether the operation can be completed within one hour. Although it is said that the oldest patient he has undergone is the 104-year-old patient, but that is a condition of physical fitness.
Dr. Zheng's operation seemed a bit Meng Lang.
Time is not a problem for Zheng Ren. After exposing the diverticulum, he made a small hole in the lower end of the diverticulum with an electric knife to enter the diverticulum, and then sutured it after 2 stitches. The limitations of the endoscope did not seem to affect Zheng Ren's technique, the suture was clean and smooth, and the cooperation between the assistant and the equipment nurse was perfect.
After quilting, Su Yun clamped it with a pair of pliers and used it for lifting.
打 Make a small hole in the right wall of the esophagus horizontally at the bottom of the diverticulum, and similarly sew 2 needles and retract.
Then Zheng Ren used an endoscopic cutting suture to enter the esophageal cavity and diverticulum cavity through the esophageal opening and diverticulum opening ~ EbookFREE.me ~ and cut and suture the diverticulum and esophageal side wall.
The cutting and stitching device made a creak, although it was clean and tidy, it still made everyone's hearts tremble.
Boss Zheng didn't even do a comparison. He just started working after cutting the stapler. This is too confident.
The operation time was 23′54 ″, and the diverticulum was completely opened.
The open diverticulum and the esophageal iliac crest have formed a common cavity between the diverticulum and the compressed upper esophagus.
This way to relieve pressure on the esophagus is rare, but looking at the anatomy can clearly find that the squeezed esophagus has begun to restore the shape of the lumen. Simply put, if the operation is successful, the patient should be able to eat.
The biggest problem with this is the fistula.
Then, the diverticulum and esophageal incision formed after cutting and suture were intermittently sutured.
Regarding the old eyebrows, the more wrinkled and tighter, now is the most critical part of the operation.
Regardless of how fast and delicate the previous surgery is, once an esophageal fistula occurs after surgery, it is an unbearable blow for an 84-year-old poor man.
However, the anatomical structure of the esophagus itself, blood flow countless reminders of surgeons, doctors, the probability of esophageal fistula is very high.
Is it just a suture?
It seems that is not enough. If this is the case, even if jejunal nutrition is performed after surgery, it is difficult to ensure the healing of the esophagus.
Boss Zheng sew up very carefully. This period took a lot of time. When Gu Lao looked at the electronic clock again, the operation time had already taken 33 minutes.

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