Chapter 893: : Maka

沧 Cang Cang glanced at the child for a moment.
I do n’t know if I ca n’t live with my conscience, or because of something else, I ca n’t help but remind me:
Have you ever had gastroduodenal anastomosis?

He heard Chen Cang's words, He Zhengzhi suddenly shocked her body, and she was so scared that the cold sweat leaked out!
I wonder ...
Dr. Chen, he is less likely to "gastroduodenal anastomosis"?
Thinking of this, He Zhengzhi was really desperate. He felt that he was staring at the stomach, but staring at the abyss!
Fear filled my heart, and was about to devour him!
He Zhengzheng glanced at Chen Cang and calmed down: "Doctor Chen, don't tell me you won't be Bi Luo!"
The gastroduodenal anastomosis is the Biero style.
沧 Cang Cang shook his head and smiled: "I will, I mean if you don't, you can take a serious look at it, a rare opportunity."
After listening to Zheng He Zhengzhi, finally relieved!
Now he doesn't want to wait for Director Ma anymore. His wish is very small, just to finish the operation.
As for how much Chen Cang learned, he told the truth that he had no expectation.
手术 This operation has learned a lot more precious than surgery!
谢谢 "Thank you ... Thank you, Dr. Chen!"
沧 Cang Cang nodded and smiled: "Why do you sweat so much, young people, pay attention to your body!"
Little Nurse heard Chen Cang's words and was very sensible, and came forward to wipe Dr. He's sweat.
This made He Zhengzhi suddenly flattered!
Hit him ... did he receive this treatment?
Looking at the gentle and pleasant nurse, He Zhengzhi smiled quickly and said, "It's true, it's true, the yang is too strong, a little hot!"
A few little nurses took a moment to take a deep breath of the 22 degrees Celsius air peculiar to the operating room. Is it hot?
Subtotal gastrectomy basically has two main anastomosis methods, one is the Biro type 1 referred to as Bi 1 type, and the other is the Biro type 2 referred to as Bi 2 type.
The two methods have been used for hundreds of years, and they have been continuously improved.
Simply say:
The gastroduodenal anastomosis is Bi-style.
The gastrojejunostomy is Bi-2.
The type 1 is more limited, but the advantages are also very obvious, because it retains the structure and function of the duodenum, it is not easy to cause gastrointestinal disorders after surgery. If conditions allow, it is still possible to type 1 as much as possible.
However, when performing Bi-1 anastomosis, care must be taken to avoid tension at the anastomosis. Duodenal activity is small. If the gastric body is removed too much, Bi-1 cannot be used.
It is because of the limitations that the difficulty of surgery continues to rise.
Chen Cang took a deep breath, lowered his head and began to observe carefully, preparing for anastomosis.
Since it is called gastroduodenal anastomosis, this shows that the core element of the operation lies in the anastomosis of the stomach body and duodenum.
Zhou He looked at Chen Cang and could not help but tell him: "Doctor Chen, the patient has intestinal paralysis, and now basically the bowel movements stop. When the postoperative obstruction is resolved and the paralysis disappears, the gastrointestinal motility is restored, plus the stomach wall is restored. Tension, the contraction of the stomach wall at both ends of the anastomosis, may affect the healing of the anastomosis, and even cause the anastomosis to narrow. Be careful. "
Zhou He is kind.
In fact, never underestimate an anesthesiologist. When Chen Cang practiced, he had seen a story about an anesthesiologist saving the field. Chen Cang was scared.
After all, in the eyes of many people, the anesthesiologist is the of the operation, and the chief surgeon is the old driver, but they have ignored it. The sees too much surgery every day and may not be able to operate, but the vision and vision are high. !!
Hearing what Zhou He said, Chen Cang nodded gratefully: "Thank you Teacher Zhou!"
Chen Cang's Bi Luo style comes from Li Yue, but it is not exactly the same as Li Yue, after all, Chen Cang has his own considerations.
In order to avoid the anastomosis being too large, the anastomosis of the small curvature of the stomach needs to be sutured first before anastomosis.
Regardless of Biro's 1 or 2, you can use the method of closing the incision on the small curved side of the stomach.
This step is actually the same as Chen Cang's construction of the mitral valve.
Chen Cang's eyes began to compare.
The tension of the stomach wall needs to be taken into account, as well as the movement of the duodenum, so the difficulty of comparing the anastomosis is raised.
After a while, Chen Cang turned:
"Gut No. 1."
The anastomosis of the small curvature of the stomach needs to be tight and strong. After all, the stomach belongs to the digestive organs and needs to be enriched for food.
Cang Cang's suture is very precise, holding the No. 1 bowel line with needle pliers, and sew a full row of continuous sutures around the curved forceps at the lower end of the incision!
接着 Then, Chen Cang said to He Zhengzhi: "Withdraw the bending forceps and tighten the two ends of the bowel line!"
Hega Zhengzhi nodded quickly.
At this time, Chen Cang, then return the upper intestine to suture, from the end of the cardia, align the first row of sutures and continue the second row of sutures!
一套 This set of operations made Zhou He tremble a bit!
"This is ... Li Yue's method?"
Chen Cang smiled and nodded: "Yes!"
He Zhengzhi stared blankly at Chen Cang: "What is it for?"
Chen Cang explained: "To make hemostasis reliable!"
He He Zhengzhi nodded involuntarily, in fact ... he didn't understand ... but always felt that Chen Cang said something very reasonable!
After talking, Chen Cang knotted the bowel line after meeting at the lower end of the incision.
Then, the serosal layers on both sides were reinforced with intermittent sutures, and the rough surface of the stump was embedded.
Wu Zhouhe couldn't help but said, "Your basic skills are too solid!"
Ji He Zhengzhi also brightened his eyes: "It's amazing!"
It is true that Chen Cang's suture from the beginning to the end has very limited damage to the stomach wall. When the needle tip is in and out, the distance between the needle tip is used to control the tension of the stomach wall. This is actually a very effective tension suture.
沧 Cang Chen smiled: "Gao Cao."
Actually, this is the method that Chen Cang has been studying!
灵感 This inspiration is also from Chen Cang ’s anastomosis of large blood vessels. When Chen Cang ’s anastomosis of large blood vessels in the chest cavity, because of the pulsation of blood vessels ~ EbookFREE.me ~ need to feel the pulse and tension of blood vessels!
At this time, Chen Cang realized the importance of tension suture. This tension suture can effectively speed up healing and reduce secondary injuries.
When Chen Cang was repairing just now, he suddenly realized that this tension suture is actually more effective for the suture of the stomach wall, and even when the gastrointestinal anastomosis, this tension suture is more beneficial!
I thought of this, and Chen Cang couldn't help but be surprised.
After the small curved end of the stomach was sutured, Chen Cang closed the two pliers on the stump of the stomach and duodenum.
At this time, you need to feel the tension!
If there is, you must separate the duodenum to prevent excessive anastomotic tension, which will lead to failure of the operation!
I was lucky and didn't feel the tension.
Can be directly stitched!
Cang Cang turned and glanced at He Zhengzhi: "If you feel the tension, remember to separate the duodenum, if not, you can sew it directly."
Kaji Masaharu nodded gratefully, and quickly began to feel it.
Actually, surgery requires someone to take you seriously, not show you.
I do n’t know how long I can see.
Feelings are very important. Just like the pulse of traditional Chinese medicine, there is a teacher who teaches you how to think about floating numbers and try to figure it out yourself.
So, there is a good master who can take a lot of detours for a surgeon.
He He Zhengzhi could not help but smash his mouth at this moment!
Emma ... Really sweet!
Dr. Chen turned out to be so powerful!