Chapter 496: 496
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Resection of benign liver tumors is not difficult. This kind of surgery, compared with malignant tumors, is like one in the sky and one underground. And benign tumor, it despises normal cells.
It is self-contained and wrapped with a layer of clothes on the outside. To put it more popularly, it is to press a hole with your fist in the normal tissue of the liver, and then put a plastic film. There are benign tumors in the plastic film.
The operation is very simple. First ligate the surrounding blood vessels, then peel them off a little, peel them off, stop bleeding, close the abdomen and end.
Of course, everything is simple to say. It's not that time to do it.
A doctor, the most common doctor, five years of undergraduate course, three years of rotation, one year of retractor, one year of simple non consumable surgery such as appendix and hernia.
If the doctor is skilled and can be a man, then at this time, the doctor who teaches begins to let go slightly and let the doctor do the peripheral operation of the liver, that is, a simple gallstone cholecystectomy. Note that these are all open operations.
When your hands are familiar, you will start to do laparoscopy. Continue the above round and another round. First learn to make a hole, then learn to use laparoscopy to do the appendix, and then the gallbladder.
Here someone will ask, laparotomy has great damage, laparoscopy is advanced, and why do you still learn laparotomy. In fact, the truth is very simple. For example, not all appendicitis can be done by laparoscopy, but all appendicitis can be done by laparotomy.
A doctor who can't open the abdominal cavity is not qualified to do laparoscopy. Wait for this general doctor, boil bald head, boil old years.
When the green boy turned into a greasy uncle, the director slowly began to contact the liver when he was about to enter the countdown to retirement.
That is, Zhang Fan has a system, no system. At the age of a dog, he wants to have liver surgery and endure it. There is no luck in the matter of human life.
Sometimes, when you think about it, doctors want to rush to the top of the world in the industry.
In fact, just like cultivating immortals, if you want to get ahead in this industry, you need the excellence of your origin (school), the reputation of your school (Mentor), your talent and efforts, and the size of your gang (hospital).
Zhang Fan was really lucky. With the system, he came to a small place after graduation, had the opportunity to practice his skills, and met good leaders and teachers. It was really bad luck.
In fact, benign tumors of the liver can be done in municipal hospitals, not to mention provincial hospitals, but Zhang Fan has to do it himself when people pay a flying knife fee.
When Zhang Fan entered the operating room, the patient lay quietly on the operating bed with his upper body naked and a catheter inserted below. The rich or ordinary people, lying on the operating bed, are not afraid. Zhang Fan has never seen it.
The patient has not been anesthetized yet. After seeing Zhang Fan enter the operating room, the patient forced his face to show a smile. He hasn't spoken yet. He just wanted to speak. As a result, the anesthesiologist gave the drug. The patient was numbed and turned over in an instant, his tongue and eyes.
After the patient was arranged by the anesthesiologist, he disinfected and paved the surgical hole towel. At the beginning, Zhang Fan washed his hands and entered the operating room. The nurse quickly smiled and put on surgical clothes for Zhang Fan.
As the nurse tied the belt of clothes behind Zhang Fan, Zhang Fan stood beside the instrument nurse's operation vehicle, wearing gloves. And my mind is full of all kinds of tests of patients.
The results of imaging, such as CT, MRI and pet, suggest that the liver tumor is benign, and even the tumor markers in the laboratory suggest that the patient's tumor is benign, but the results of these examinations can only be used for reference, not as a diagnosis.
What is the gold standard for tumor diagnosis? It is to cut it down for pathology. Before there is no pathology, the diagnosis of patients is a question mark, that is, an uncertain diagnosis.
Therefore, during the operation, it is necessary to reserve the operation space for deterioration according to the standard of nausea and tumor. In surgery, there is a very classic saying: God is unwilling to correct a wrong incision.
When the hand rises and falls, there is no way back, and there is no way back for the doctor to repent. Therefore, when a doctor raises his knife, he must have a clear mind, which has been trained from easy to difficult and from small to large for many years.
The patient is ready for the operation. The head is high and the feet are low. Venous catheters have been implanted in both arms. Antibiotics are input on one side and energy is input on the other. In fact, these two channels are reserved for blood transfusion in case of accident during the operation.
Incision, Zhang Fan chose the subcostal incision. Many doctors like the median incision, which is the incision from the xiphoid process to the navel. It has many advantages, because the knife edge is in the middle, and the operation plan can be adjusted at any time due to the condition. There are many disadvantages. The biggest disadvantage is too much damage.
For benign liver tumor surgery, it's too simple for Zhang Fan. Most of the slightly famous instruments in the operating room are matte, and the only thing that can reflect light is the blade of the scalpel.
When a little cold light reflected from the tip of the knife, Zhang Fan began. The skin is like tofu, which is gently drawn in a big arc by Zhang Fan.
Separate the muscles, open the peritoneum, and click with the sound of surgical bending forceps! Click! With the sound of click, Zhang Fan opened a big hole in his abdomen, and the liver was exposed in front of the doctors.
Liver, liver with benign tumor, is very strange. Normal liver is like an irregular shaped blood tofu, flat and tender.
The liver of the wine boss is different. The painting style of his liver with benign tumors is completely different, like the liver with muscles, like digging a piece of meat from a Belgian blue cow.
Although it doesn't look as uncomfortable as malignant tumors, it's not as lovely as a normal liver.
Normal liver is just like little Zhengtai, which makes people feel pity or closeness.
The liver with benign tumors is like a giant stone Johnson. I can't wait to take a needle to let the air out of his body.
"It looks benign." Zhang Fan looked at the bumps on the surface of the liver and said to the two directors of the operation. Without waiting for their reply, Zhang Fan began to probe into the patient's body with both hands.
This is a necessary step in tumor surgery. No matter benign or malignant, the surgeon must make a diagnosis of the organs around the patient's liver with his own hands.
This action is like the action of shuffling cards with both hands after playing mahjong. Zhang fanshuang touched the organs around the liver and found no abnormality.
Then he said to the itinerant nurse, "electric knife!"
"Electric knife?"
The itinerant nurse looked at Zhang Fan and two directors of hepatobiliary surgery. The girl accompanied the doctors of hepatobiliary surgery on many operations for this benign tumor. None of them used an electric knife. They were separated by hand.
Before Zhang Fan didn't want to get through, this kind of operation will also be separated with his bare hands. However, since Zhang Fan wanted to get through, it can be said that there are moves but no moves. How to reduce the damage, how to come, how fast and how to come.
"To Zhang Yuan!" The director of the Fifth Department of liver and gallbladder was in a hurry. Seeing that the nurse hesitated a little, he said in a hurry.
"Hehe, it's all right. Give it to me." Zhang Fan smiled. The little nurse was helpless and handed the electric knife to Zhang Fan.
Then, I saw a faint smoke rising, the electric knife flying in Zhang Fan's hand, and there was no blood in the liver tumor.
"Beautiful!" The director of the second hepatobiliary Department couldn't help saying.
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Resection of benign liver tumors is not difficult. This kind of surgery, compared with malignant tumors, is like one in the sky and one underground. And benign tumor, it despises normal cells.
It is self-contained and wrapped with a layer of clothes on the outside. To put it more popularly, it is to press a hole with your fist in the normal tissue of the liver, and then put a plastic film. There are benign tumors in the plastic film.
The operation is very simple. First ligate the surrounding blood vessels, then peel them off a little, peel them off, stop bleeding, close the abdomen and end.
Of course, everything is simple to say. It's not that time to do it.
A doctor, the most common doctor, five years of undergraduate course, three years of rotation, one year of retractor, one year of simple non consumable surgery such as appendix and hernia.
If the doctor is skilled and can be a man, then at this time, the doctor who teaches begins to let go slightly and let the doctor do the peripheral operation of the liver, that is, a simple gallstone cholecystectomy. Note that these are all open operations.
When your hands are familiar, you will start to do laparoscopy. Continue the above round and another round. First learn to make a hole, then learn to use laparoscopy to do the appendix, and then the gallbladder.
Here someone will ask, laparotomy has great damage, laparoscopy is advanced, and why do you still learn laparotomy. In fact, the truth is very simple. For example, not all appendicitis can be done by laparoscopy, but all appendicitis can be done by laparotomy.
A doctor who can't open the abdominal cavity is not qualified to do laparoscopy. Wait for this general doctor, boil bald head, boil old years.
When the green boy turned into a greasy uncle, the director slowly began to contact the liver when he was about to enter the countdown to retirement.
That is, Zhang Fan has a system, no system. At the age of a dog, he wants to have liver surgery and endure it. There is no luck in the matter of human life.
Sometimes, when you think about it, doctors want to rush to the top of the world in the industry.
In fact, just like cultivating immortals, if you want to get ahead in this industry, you need the excellence of your origin (school), the reputation of your school (Mentor), your talent and efforts, and the size of your gang (hospital).
Zhang Fan was really lucky. With the system, he came to a small place after graduation, had the opportunity to practice his skills, and met good leaders and teachers. It was really bad luck.
In fact, benign tumors of the liver can be done in municipal hospitals, not to mention provincial hospitals, but Zhang Fan has to do it himself when people pay a flying knife fee.
When Zhang Fan entered the operating room, the patient lay quietly on the operating bed with his upper body naked and a catheter inserted below. The rich or ordinary people, lying on the operating bed, are not afraid. Zhang Fan has never seen it.
The patient has not been anesthetized yet. After seeing Zhang Fan enter the operating room, the patient forced his face to show a smile. He hasn't spoken yet. He just wanted to speak. As a result, the anesthesiologist gave the drug. The patient was numbed and turned over in an instant, his tongue and eyes.
After the patient was arranged by the anesthesiologist, he disinfected and paved the surgical hole towel. At the beginning, Zhang Fan washed his hands and entered the operating room. The nurse quickly smiled and put on surgical clothes for Zhang Fan.
As the nurse tied the belt of clothes behind Zhang Fan, Zhang Fan stood beside the instrument nurse's operation vehicle, wearing gloves. And my mind is full of all kinds of tests of patients.
The results of imaging, such as CT, MRI and pet, suggest that the liver tumor is benign, and even the tumor markers in the laboratory suggest that the patient's tumor is benign, but the results of these examinations can only be used for reference, not as a diagnosis.
What is the gold standard for tumor diagnosis? It is to cut it down for pathology. Before there is no pathology, the diagnosis of patients is a question mark, that is, an uncertain diagnosis.
Therefore, during the operation, it is necessary to reserve the operation space for deterioration according to the standard of nausea and tumor. In surgery, there is a very classic saying: God is unwilling to correct a wrong incision.
When the hand rises and falls, there is no way back, and there is no way back for the doctor to repent. Therefore, when a doctor raises his knife, he must have a clear mind, which has been trained from easy to difficult and from small to large for many years.
The patient is ready for the operation. The head is high and the feet are low. Venous catheters have been implanted in both arms. Antibiotics are input on one side and energy is input on the other. In fact, these two channels are reserved for blood transfusion in case of accident during the operation.
Incision, Zhang Fan chose the subcostal incision. Many doctors like the median incision, which is the incision from the xiphoid process to the navel. It has many advantages, because the knife edge is in the middle, and the operation plan can be adjusted at any time due to the condition. There are many disadvantages. The biggest disadvantage is too much damage.
For benign liver tumor surgery, it's too simple for Zhang Fan. Most of the slightly famous instruments in the operating room are matte, and the only thing that can reflect light is the blade of the scalpel.
When a little cold light reflected from the tip of the knife, Zhang Fan began. The skin is like tofu, which is gently drawn in a big arc by Zhang Fan.
Separate the muscles, open the peritoneum, and click with the sound of surgical bending forceps! Click! With the sound of click, Zhang Fan opened a big hole in his abdomen, and the liver was exposed in front of the doctors.
Liver, liver with benign tumor, is very strange. Normal liver is like an irregular shaped blood tofu, flat and tender.
The liver of the wine boss is different. The painting style of his liver with benign tumors is completely different, like the liver with muscles, like digging a piece of meat from a Belgian blue cow.
Although it doesn't look as uncomfortable as malignant tumors, it's not as lovely as a normal liver.
Normal liver is just like little Zhengtai, which makes people feel pity or closeness.
The liver with benign tumors is like a giant stone Johnson. I can't wait to take a needle to let the air out of his body.
"It looks benign." Zhang Fan looked at the bumps on the surface of the liver and said to the two directors of the operation. Without waiting for their reply, Zhang Fan began to probe into the patient's body with both hands.
This is a necessary step in tumor surgery. No matter benign or malignant, the surgeon must make a diagnosis of the organs around the patient's liver with his own hands.
This action is like the action of shuffling cards with both hands after playing mahjong. Zhang fanshuang touched the organs around the liver and found no abnormality.
Then he said to the itinerant nurse, "electric knife!"
"Electric knife?"
The itinerant nurse looked at Zhang Fan and two directors of hepatobiliary surgery. The girl accompanied the doctors of hepatobiliary surgery on many operations for this benign tumor. None of them used an electric knife. They were separated by hand.
Before Zhang Fan didn't want to get through, this kind of operation will also be separated with his bare hands. However, since Zhang Fan wanted to get through, it can be said that there are moves but no moves. How to reduce the damage, how to come, how fast and how to come.
"To Zhang Yuan!" The director of the Fifth Department of liver and gallbladder was in a hurry. Seeing that the nurse hesitated a little, he said in a hurry.
"Hehe, it's all right. Give it to me." Zhang Fan smiled. The little nurse was helpless and handed the electric knife to Zhang Fan.
Then, I saw a faint smoke rising, the electric knife flying in Zhang Fan's hand, and there was no blood in the liver tumor.
"Beautiful!" The director of the second hepatobiliary Department couldn't help saying.
Resection of benign liver tumors is not difficult. This kind of surgery, compared with malignant tumors, is like one in the sky and one underground. And benign tumor, it despises normal cells.It is self-contained and wrapped with a layer of clothes on the outside. To put it more popularly, it is to press a hole with your fist in the normal tissue of the liver, and then put a plastic film. There are benign tumors in the plastic film.The operation is very simple. First ligate the surrounding blood vessels, then peel them off a little, peel them off, stop bleeding, close the abdomen and end.Of course, everything is simple to say. It's not that time to do it.A doctor, the most common doctor, five years of undergraduate course, three years of rotation, one year of retractor, one year of simple non consumable surgery such as appendix and hernia.If the doctor is skilled and can be a man, then at this time, the doctor who teaches begins to let go slightly and let the doctor do the peripheral operation of the liver, that is, a simple gallstone cholecystectomy. Note that these are all open operations.When your hands are familiar, you will start to do laparoscopy. Continue the above round and another round. First learn to make a hole, then learn to use laparoscopy to do the appendix, and then the gallbladder.Here someone will ask, laparotomy has great damage, laparoscopy is advanced, and why do you still learn laparotomy. In fact, the truth is very simple. For example, not all appendicitis can be done by laparoscopy, but all appendicitis can be done by laparotomy.A doctor who can't open the abdominal cavity is not qualified to do laparoscopy. Wait for this general doctor, boil bald head, boil old years.When the green boy turned into a greasy uncle, the director slowly began to contact the liver when he was about to enter the countdown to retirement.That is, Zhang Fan has a system, no system. At the age of a dog, he wants to have liver surgery and endure it. There is no luck in the matter of human life.Sometimes, when you think about it, doctors want to rush to the top of the world in the industry.In fact, just like cultivating immortals, if you want to get ahead in this industry, you need the excellence of your origin school, the reputation of your school Mentor, your talent and efforts, and the size of your gang hospital.Zhang Fan was really lucky. With the system, he came to a small place after graduation, had the opportunity to practice his skills, and met good leaders and teachers. It was really bad luck.In fact, benign tumors of the liver can be done in municipal hospitals, not to mention provincial hospitals, but Zhang Fan has to do it himself when people pay a flying knife fee.When Zhang Fan entered the operating room, the patient lay quietly on the operating bed with his upper body naked and a catheter inserted below. The rich or ordinary people, lying on the operating bed, are not afraid. Zhang Fan has never seen it.The patient has not been anesthetized yet. After seeing Zhang Fan enter the operating room, the patient forced his face to show a smile. He hasn't spoken yet. He just wanted to speak. As a result, the anesthesiologist gave the drug. The patient was numbed and turned over in an instant, his tongue and eyes.After the patient was arranged by the anesthesiologist, he disinfected and paved the surgical hole towel. At the beginning, Zhang Fan washed his hands and entered the operating room. The nurse quickly smiled and put on surgical clothes for Zhang Fan.As the nurse tied the belt of clothes behind Zhang Fan, Zhang Fan stood beside the instrument nurse's operation vehicle, wearing gloves. And my mind is full of all kinds of tests of patients.The results of imaging, such as CT, MRI and pet, suggest that the liver tumor is benign, and even the tumor markers in the laboratory suggest that the patient's tumor is benign, but the results of these examinations can only be used for reference, not as a diagnosis.What is the gold standard for tumor diagnosis? It is to cut it down for pathology. Before there is no pathology, the diagnosis of patients is a question mark, that is, an uncertain diagnosis.Therefore, during the operation, it is necessary to reserve the operation space for deterioration according to the standard of nausea and tumor. In surgery, there is a very classic saying: God is unwilling to correct a wrong incision.When the hand rises and falls, there is no way back, and there is no way back for the doctor to repent. Therefore, when a doctor raises his knife, he must have a clear mind, which has been trained from easy to difficult and from small to large for many years.The patient is ready for the operation. The head is high and the feet are low. Venous catheters have been implanted in both arms. Antibiotics are input on one side and energy is input on the other. In fact, these two channels are reserved for blood transfusion in case of accident during the operation.Incision, Zhang Fan chose the subcostal incision. Many doctors like the median incision, which is the incision from the xiphoid process to the navel. It has many advantages, because the knife edge is in the middle, and the operation plan can be adjusted at any time due to the condition. There are many disadvantages. The biggest disadvantage is too much damage.For benign liver tumor surgery, it's too simple for Zhang Fan. Most of the slightly famous instruments in the operating room are matte, and the only thing that can reflect light is the blade of the scalpel.When a little cold light reflected from the tip of the knife, Zhang Fan began. The skin is like tofu, which is gently drawn in a big arc by Zhang Fan.Separate the muscles, open the peritoneum, and click with the sound of surgical bending forceps! Click! With the sound of click, Zhang Fan opened a big hole in his abdomen, and the liver was exposed in front of the doctors.Liver, liver with benign tumor, is very strange. Normal liver is like an irregular shaped blood tofu, flat and tender.The liver of the wine boss is different. The painting style of his liver with benign tumors is completely different, like the liver with muscles, like digging a piece of meat from a Belgian blue cow.Although it doesn't look as uncomfortable as malignant tumors, it's not as lovely as a normal liver.Normal liver is just like little Zhengtai, which makes people feel pity or closeness.The liver with benign tumors is like a giant stone Johnson. I can't wait to take a needle to let the air out of his body."It looks benign." Zhang Fan looked at the bumps on the surface of the liver and said to the two directors of the operation. Without waiting for their reply, Zhang Fan began to probe into the patient's body with both hands.This is a necessary step in tumor surgery. No matter benign or malignant, the surgeon must make a diagnosis of the organs around the patient's liver with his own hands.This action is like the action of shuffling cards with both hands after playing mahjong. Zhang fanshuang touched the organs around the liver and found no abnormality.Then he said to the itinerant nurse, "electric knife!""Electric knife?"The itinerant nurse looked at Zhang Fan and two directors of hepatobiliary surgery. The girl accompanied the doctors of hepatobiliary surgery on many operations for this benign tumor. None of them used an electric knife. They were separated by hand.Before Zhang Fan didn't want to get through, this kind of operation will also be separated with his bare hands. However, since Zhang Fan wanted to get through, it can be said that there are moves but no moves. How to reduce the damage, how to come, how fast and how to come."To Zhang Yuan!" The director of the Fifth Department of liver and gallbladder was in a hurry. Seeing that the nurse hesitated a little, he said in a hurry."Hehe, it's all right. Give it to me." Zhang Fan smiled. The little nurse was helpless and handed the electric knife to Zhang Fan.Then, I saw a faint smoke rising, the electric knife flying in Zhang Fan's hand, and there was no blood in the liver tumor."Beautiful!" The director of the second hepatobiliary Department couldn't help saying.
