Chapter 580: 580
If audio player doesn't work, press Stop then Play button again
There are people in the hospital who are easy to handle affairs, and there are people in the hospital who are easy to check, not to mention the head nurse in the hospital.
The nurses and sisters are very accommodating. After a day's effort, the preliminary examination results came out and gastric cancer was diagnosed~
"Zhang Yuan is right. What should we do now?" The head nurse of the special needs department is out of order.
"Go find Zhang Yuan, wait." While talking, he thought about it and asked, "do you smoke and drink in Zhang Yuan?"
"I haven't seen smoking, but I know he can't drink. I can't use... "
The head nurse felt that they were all her colleagues. Although she was a superior, Zhang Fan was also very approachable at ordinary times. It was not that she was reluctant to give things, or that she felt that she didn't have enough face after giving things.
"What do you know! It doesn't matter to ask others for an examination. In this case, you listen to me... "
Sometimes people are too complicated. In fact, it's better to be simple. Just when they are tangled, Zhang Fan has seen the inspection results from the computer.
"Director Zhao, how's it going? How's your physical assessment, head nurse's mother-in-law?"
"It's OK. The anesthesiology department said it could be anesthetized. We don't have a big problem. " Lao Zhao replied.
"Then prepare for the operation! I'll do it myself. "
"OK, Zhang Yuan."
Stomach, digestive tract. To be honest, in the digestive tract, the stomach is actually very thick, just like a car in a country. You can take good care of it and serve you all your life.
It is not as delicate as other digestive organs. Let's say ulcer. In fact, gastric ulcer accounts for a low proportion of peptic ulcer.
Especially for young people, the most common is twelve finger ulcer. For example, some young people feel uncomfortable before the meal arrives. They feel uncomfortable in their stomach. Take two bites of rice, OK!
This is typical hunger pain! What can't run away is duodenal ulcer. Moreover, this place is particularly prone to ulcers.
There is a reason for this. There is a lot of gastric acid in the stomach, but there is a bicarbonate barrier on its surface to protect the stomach wall.
But the intestinal tract doesn't have this thing. It relies on bile and pancreatic juice to neutralize gastric acid. The gallbladder and pancreas open together in the intestinal tract, and the liquid they secrete is alkaline.
However, there is a distance from the stomach to the opening of the pancreas, which is the place that is easy to cause ulcer, that is, the famous duodenal ulcer.
If you don't eat on time, you will be hungry and full. If you have a delicious meal, you will walk on the wall. If you don't like to eat, it's called to lose weight.
These are the killers of duodenal ulcer.
The stomach is not so delicate. If you eat more and eat less, it can generally deal with it. However, when it drinks and gets angry, it is afraid. The most afraid is Helicobacter pylori.
Cancer, in short, is actually a quantitative change of cells to qualitative change under an inducing factor.
Any cell in the human body has the possibility of canceration, and inflammation is the biggest inducing factor. Therefore, doctors have a saying that there are no more than two kinds of diseases, either inflammation or cancer.
Helicobacter pylori is the biggest inducer of gastric cancer in China.
A patient said that in my life, I never ate barbecue, didn't drink, and didn't like to be angry, but how could I get gastric cancer?
Results the previous physical examination report showed that Helicobacter pylori was positive!
Is this bacterium contagious? Infection. Chinese people have a bad problem. When eating, especially for children, old people love to feed their chewed food to children.
Children eat whatever food they are at any age, eat chyle food and drink milk without teeth.
Let him chew when he has teeth. It's not necessary. Let your mouth rich in Helicobacter pylori chew for children!
In addition, in order to reflect their enthusiasm and politeness, they have to bring dishes to the guests. If the other party doesn't eat the food, you must look at it until the other party eats it.
This is the transmission route of Helicobacter pylori. Most gastric cancer in other countries is caused by other factors.
In China, most gastric cancer is caused by Helicobacter pylori.
The surgical requirements for gastric cancer are actually similar to gastric ulcer, perhaps slightly more difficult than gastric ulcer.
Many people feel that gastric ulcer doesn't matter. To tell the truth, they don't pay attention at ordinary times. Once an ulcer occurs, it will be super troublesome. Sometimes you don't have a chance to have an operation. Even if you have an operation, it's a super big operation.
Gastric ulcer surgery and gastric cancer surgery are high-level operations in general surgery.
For example, for refractory gastric ulcer, once surgery is needed, in China, it is generally to choose large-scale gastrectomy. What does it mean, that is, you cut most of your stomach, which almost directly becomes the existence of the connection between the esophagus and the intestine.
You can think about the horror of eating white steamed bread and swallowing it directly into stool. What's more, what if you swallow half and spit it out?
Around the world, countries that can't eat enough fish and make smoked fish have high gastric cancer, such as meatball countries and Iceland.
Although Marubeni is an odd country, people are more skilled in gastric cancer than Iceland. Even in the world, people's technology is also the largest, but Iceland is not.
Meatball countries do well in gastric cancer, and then the endoscope is also powerful. Think about it carefully. This country is very good at making a dojo in this kind of snail lion shell. Its small hand is very powerful.
The head nurse looked at the two cigarettes and two bottles of wine in her hand and complained to her husband, "you think everyone is the same as you! Our Zhangyuan is different. "
Zhang Fan didn't hear this, because he had brought Ma Yichen, Zhao Quanping and old song into the operating room. If he heard this, he might be proud for a while.
The difficulty of gastric cancer surgery is not tumor resection. The stomach is not like the liver. The liver is like a honeycomb with various vascular pathways. One thing is whether it can be done well
The stomach is a meat bag. After ligating the blood supply, it can be cut. Its difficulty lies in the suture and lymph node cleaning after resection.
In the operating room, Ma Yichen made preparations before the operation. The young man worked hard. When Zhang Fan fought for the liver, he was also fighting for the liver. Technology has improved rapidly, and now I feel a little ahead in general education.
"Zhang Yuan, director Zhao, brush your hands!" The anesthesiologist said to Zhang Fan.
"OK!" Zhang Fan answered and went to brush his hands with Lao Zhao. Lao Zhao has been enjoying himself recently.
Because several deputy directors did not revolt, they were all frightened by Zhang Fan. They were so skilled that they could have a liver. They all fainted. It is estimated that there is no one.
At the beginning of the operation, Zhang Fan took the lead, Lao Zhao Yizhu and Ma Yichen were originally three assistants, that is, the hook puller, but I don't know how he secretly mixed up with Lao song. Now Lao song has become three assistants and he has become two assistants.
It's hard for Zhang Fan to say this kind of thing. He can only rely on whether he has enlightened himself.
Tumor resection surgery, which has remained unchanged for thousands of years, is to ligate the blood vessels of the stomach first. It can be said that it is mainly divided into two parts.
How to say the shape of the stomach? In fact, it is a crescent. For thin and long people, the size of the stomach is thin crescent. For short and strong people, most of the stomach is fat crescent.
The inner side of the crescent is called the lesser curvature of the stomach, and the outer side of the crescent is called the greater curvature of the stomach. The blood supply of the small bend comes from the abdominal trunk hidden under the stomach. This thing is the thickest blood vessel in the abdomen, which is the trunk road from the heart.
The blood supply of the great bend comes from the splenic artery near the stomach.
The old lady's stomach cancer hasn't eroded through the stomach, but the area is too large, so Zhang Fan decided to have a total gastrectomy.
Zhang Fan dares to do it. There is a saying about cancer. The old, the weak, the sick and the disabled can't do it. Generally, they choose palliative treatment.
It means to live for a few days! It's not the doctor's cruelty, but the fear that the patient will die on the operating table.
Enter the abdomen, open it, and Zhang Fan begins to ligate blood vessels. With the metal click of pliers, blood vessels are clamped by Zhang Fan.
The only trouble is that the blood vessels of the greater curvature of the stomach are all dressed in a yellow coat, that is, they are all hidden in the omentum.
What is omentum? Yellow fat. It's opaque, not silk stockings“ It should be noted here that no matter how sure you are, you must see it with your own eyes and touch it with your own hands. "
Zhang Fan said the key points to Ma Yichen while doing it.
"Yes!" Ma Yichen listened carefully.
Old song, a passer-by's hook pulling doctor, is so envious that he has nothing to do and can't do anything, because he can't see the operation field. This operation is just with his hands and doesn't need to bring his brain.
"Hey, pony, I'm lucky to meet such a good teacher! I wish I had such a hand-in-hand teacher. "
Old song was not old, but he was embarrassed. He was seven or eight years younger than the deputy directors. When he entered the Department, it was just when the deputy directors were rushing to practice.
So, he has had an appendix for many years. At the age of long technology, there is no chance, and finally the upper limit is not high.
The blood vessels were ligated and the ligaments hanging from the stomach were separated. Most abdominal organs were fixed with ligaments.
If you don't have this ligament, you can't do strenuous exercise. Otherwise, the kidney may fall out of the urethra first.
After separation, hold the esophagus and intestines connecting the gastric body, "knife!" Zhang Fan said to the instrument nurse.
The scalpel, Zhang Fan with the scalpel, directly cut off the stomach from the esophagus and intestines along the edge of the pliers. Then Zhang Fan explored his hands and took out the stomach from the abdominal cavity like holding a watermelon.
At this time, from the shadowless light, the abdominal cavity became a big hole, and the isolated spleen on the right and the large blood vessels below were all exposed.
Zhang Fan's level of general education can't be underestimated now. If the field of surgery is described by an adjective, it is clean! Yes, it's clean.
Almost no blood can be seen, just like a knife on a rubber doll. This is the level.
Some doctors do not pay attention to small blood vessels, but more small blood vessels are large blood vessels. After an operation, it is like a broken bottle of ketchup. Not to mention the patient, even he himself is dyed into a red ball.
That's it, he's still proud! I have an operation! I don't know. I thought he killed pigs.
Lao Zhao, I admire Zhang Fan's level very much. In Zhang Fan's spare time, he takes out his stomach.
"Zhang's operation is like art. The cleanliness of the operation field is perfect," he said
But I didn't say much, because the difficulty of surgery came. Where is the difficulty of cancer surgery? Lymph node dissection.
It can be said that lymph is like Yellow Sesame sprinkled near blood vessels. More times, seven or eight or ten people gather together, and less times, three or four.
Cancer surgery pays attention to a clean, because many cancer metastases are lymph nodes.
If you want the patient to live a few more years, you must clean up the lymph nodes. These things are hidden in fat.
And hidden in fat, it also relies on blood vessels to clean lymph nodes. It is not only slow, but also dangerous.
This thing is either lying on the big blood vessels or hidden near the big blood vessels.
It is not dangerous to pick the needle during cleaning, but it is estimated that the patient will hang up after picking the needle, because it takes too long.
It is to use a curette, an enlarged ear scoop, and scrape it down the large blood vessels.
How dangerous it is. In this way, not to mention the large blood vessels in the abdominal cavity. It's life-threatening to dig a smaller abdominal artery.
This kind of artery is like a snake's head. Once it is broken, its powerful muscles will retract, which is particularly difficult to serve.
Zhang Fan began to dig around the abdominal trunk with a curette.
This force should be quite stable. If it's light, it can't be scraped off or cleaned, and the operation will be done in vain. If it's heavy, the blood vessels will be scratched and the operation will be done in vain.
Zhang Fan scrapes very fast. The patient is too old. She can't hold on for too long. Zhang Fan must be fast.
WOW!
WOW!
Zhang Fan scraped it down as fast as a greedy fat man digging ice cream.
Not to mention Ma Yichen, Lao Zhao squeezed his hands into fists. It's so scary. The metal curette, visible to the naked eye, works on the thick abdominal cavity, and Zhang Fan is faster than each other.
Lao Zhao, who was sweating hard, couldn't help looking at Zhang Fan. Although he saw that Zhang Fan was very concerned, he was still worried.
Because Zhang Fan's operation is too fast, he has never seen anyone with such a fast technique.
He wanted to persuade, but seeing Zhang Fan dry in his abdominal cavity, he dared not say.
He was deeply afraid of disturbing Zhang Fan.
"Damn it, damn it!" Lao Zhao's hands are shaking a little.
As the second assistant, Ma Yichen was excited.
He shouted in his heart, "this is technology, this is technology, handsome!"
Newborn calves are not afraid of tigers. Although he knows the danger of surgery, Zhang Fan's skill is too handsome.
"I don't know when I can learn this skill!"
Zhang Fan's hand is too stable.
After cleaning the lymph, the inside of the curved plate is like a plate of ice cream with strawberry juice in yellow cream, even small particles on the surface of strawberries. Red is blood and small particles are lymph. It's so similar.
After cleaning, Zhang Fan reconfirmed and began to sew again. What?
Suture the esophagus and sew it on the small intestine.
The esophagus doesn't have a coat because it doesn't have to squeeze together like the intestine, so there is no serosa layer on its outer layer.
If the esophagus doesn't wriggle, what does it rely on to clean up the esophageal residue? It depends on saliva. Some people like to spit when they have nothing to do. Don't spit. If you spit again, the esophagus will get sick.
Without this coat, stitching is very troublesome, directly in the exposed muscles.
At this time, the muscles are like wires without insulating tubes, and the steel wires inside are scattered.
It's good for doctors with poor skills to sew the esophagus on the intestines and cut the esophagus.
"Line 0! Open the absorbable line at the inlet. " Zhang Fan said nonsense to the instrument.
The imported line is more expensive than the domestic one, with a difference of more than ten times. However, this line is really easy to use.
Sewing layer by layer, thread ends flying in Zhang Fan's operation, and the suture of esophagus and intestine is so beautiful. It's just like they grow together. It can't be seen that they are sewn twice.
After suture, the pulled up duodenum must be fixed, because there is less stomach, if the duodenum is not fixed.
It's terrible. Maybe a cry, pull together, break your intestines, and then spit out a section of blood from your mouth.
Six hours later, Zhang Fan and his team finally finished the total gastrectomy. After the suture closed the abdominal cavity, the matter was not over. Zhang Fan took a knife to lay hands on the cut stomach.
At this time, because of the lack of blood and the loss of temperature, the fat on the surface of the stomach has been Qin. If it is steaming, it will be directly like the French feast pig tripe and goose liver.
When the stomach is opened, the tumor inside is exposed, just like the heterosexual insect nest in the film. The surface is blood vessels, and the inside is rotten, such as yellow phlegm.
"Take it to let the family see the same, and then do a medical examination!"
"OK."
Please report us if you find any errors so we can fix it asap!
There are people in the hospital who are easy to handle affairs, and there are people in the hospital who are easy to check, not to mention the head nurse in the hospital.
The nurses and sisters are very accommodating. After a day's effort, the preliminary examination results came out and gastric cancer was diagnosed~
"Zhang Yuan is right. What should we do now?" The head nurse of the special needs department is out of order.
"Go find Zhang Yuan, wait." While talking, he thought about it and asked, "do you smoke and drink in Zhang Yuan?"
"I haven't seen smoking, but I know he can't drink. I can't use... "
The head nurse felt that they were all her colleagues. Although she was a superior, Zhang Fan was also very approachable at ordinary times. It was not that she was reluctant to give things, or that she felt that she didn't have enough face after giving things.
"What do you know! It doesn't matter to ask others for an examination. In this case, you listen to me... "
Sometimes people are too complicated. In fact, it's better to be simple. Just when they are tangled, Zhang Fan has seen the inspection results from the computer.
"Director Zhao, how's it going? How's your physical assessment, head nurse's mother-in-law?"
"It's OK. The anesthesiology department said it could be anesthetized. We don't have a big problem. " Lao Zhao replied.
"Then prepare for the operation! I'll do it myself. "
"OK, Zhang Yuan."
Stomach, digestive tract. To be honest, in the digestive tract, the stomach is actually very thick, just like a car in a country. You can take good care of it and serve you all your life.
It is not as delicate as other digestive organs. Let's say ulcer. In fact, gastric ulcer accounts for a low proportion of peptic ulcer.
Especially for young people, the most common is twelve finger ulcer. For example, some young people feel uncomfortable before the meal arrives. They feel uncomfortable in their stomach. Take two bites of rice, OK!
This is typical hunger pain! What can't run away is duodenal ulcer. Moreover, this place is particularly prone to ulcers.
There is a reason for this. There is a lot of gastric acid in the stomach, but there is a bicarbonate barrier on its surface to protect the stomach wall.
But the intestinal tract doesn't have this thing. It relies on bile and pancreatic juice to neutralize gastric acid. The gallbladder and pancreas open together in the intestinal tract, and the liquid they secrete is alkaline.
However, there is a distance from the stomach to the opening of the pancreas, which is the place that is easy to cause ulcer, that is, the famous duodenal ulcer.
If you don't eat on time, you will be hungry and full. If you have a delicious meal, you will walk on the wall. If you don't like to eat, it's called to lose weight.
These are the killers of duodenal ulcer.
The stomach is not so delicate. If you eat more and eat less, it can generally deal with it. However, when it drinks and gets angry, it is afraid. The most afraid is Helicobacter pylori.
Cancer, in short, is actually a quantitative change of cells to qualitative change under an inducing factor.
Any cell in the human body has the possibility of canceration, and inflammation is the biggest inducing factor. Therefore, doctors have a saying that there are no more than two kinds of diseases, either inflammation or cancer.
Helicobacter pylori is the biggest inducer of gastric cancer in China.
A patient said that in my life, I never ate barbecue, didn't drink, and didn't like to be angry, but how could I get gastric cancer?
Results the previous physical examination report showed that Helicobacter pylori was positive!
Is this bacterium contagious? Infection. Chinese people have a bad problem. When eating, especially for children, old people love to feed their chewed food to children.
Children eat whatever food they are at any age, eat chyle food and drink milk without teeth.
Let him chew when he has teeth. It's not necessary. Let your mouth rich in Helicobacter pylori chew for children!
In addition, in order to reflect their enthusiasm and politeness, they have to bring dishes to the guests. If the other party doesn't eat the food, you must look at it until the other party eats it.
This is the transmission route of Helicobacter pylori. Most gastric cancer in other countries is caused by other factors.
In China, most gastric cancer is caused by Helicobacter pylori.
The surgical requirements for gastric cancer are actually similar to gastric ulcer, perhaps slightly more difficult than gastric ulcer.
Many people feel that gastric ulcer doesn't matter. To tell the truth, they don't pay attention at ordinary times. Once an ulcer occurs, it will be super troublesome. Sometimes you don't have a chance to have an operation. Even if you have an operation, it's a super big operation.
Gastric ulcer surgery and gastric cancer surgery are high-level operations in general surgery.
For example, for refractory gastric ulcer, once surgery is needed, in China, it is generally to choose large-scale gastrectomy. What does it mean, that is, you cut most of your stomach, which almost directly becomes the existence of the connection between the esophagus and the intestine.
You can think about the horror of eating white steamed bread and swallowing it directly into stool. What's more, what if you swallow half and spit it out?
Around the world, countries that can't eat enough fish and make smoked fish have high gastric cancer, such as meatball countries and Iceland.
Although Marubeni is an odd country, people are more skilled in gastric cancer than Iceland. Even in the world, people's technology is also the largest, but Iceland is not.
Meatball countries do well in gastric cancer, and then the endoscope is also powerful. Think about it carefully. This country is very good at making a dojo in this kind of snail lion shell. Its small hand is very powerful.
The head nurse looked at the two cigarettes and two bottles of wine in her hand and complained to her husband, "you think everyone is the same as you! Our Zhangyuan is different. "
Zhang Fan didn't hear this, because he had brought Ma Yichen, Zhao Quanping and old song into the operating room. If he heard this, he might be proud for a while.
The difficulty of gastric cancer surgery is not tumor resection. The stomach is not like the liver. The liver is like a honeycomb with various vascular pathways. One thing is whether it can be done well
The stomach is a meat bag. After ligating the blood supply, it can be cut. Its difficulty lies in the suture and lymph node cleaning after resection.
In the operating room, Ma Yichen made preparations before the operation. The young man worked hard. When Zhang Fan fought for the liver, he was also fighting for the liver. Technology has improved rapidly, and now I feel a little ahead in general education.
"Zhang Yuan, director Zhao, brush your hands!" The anesthesiologist said to Zhang Fan.
"OK!" Zhang Fan answered and went to brush his hands with Lao Zhao. Lao Zhao has been enjoying himself recently.
Because several deputy directors did not revolt, they were all frightened by Zhang Fan. They were so skilled that they could have a liver. They all fainted. It is estimated that there is no one.
At the beginning of the operation, Zhang Fan took the lead, Lao Zhao Yizhu and Ma Yichen were originally three assistants, that is, the hook puller, but I don't know how he secretly mixed up with Lao song. Now Lao song has become three assistants and he has become two assistants.
It's hard for Zhang Fan to say this kind of thing. He can only rely on whether he has enlightened himself.
Tumor resection surgery, which has remained unchanged for thousands of years, is to ligate the blood vessels of the stomach first. It can be said that it is mainly divided into two parts.
How to say the shape of the stomach? In fact, it is a crescent. For thin and long people, the size of the stomach is thin crescent. For short and strong people, most of the stomach is fat crescent.
The inner side of the crescent is called the lesser curvature of the stomach, and the outer side of the crescent is called the greater curvature of the stomach. The blood supply of the small bend comes from the abdominal trunk hidden under the stomach. This thing is the thickest blood vessel in the abdomen, which is the trunk road from the heart.
The blood supply of the great bend comes from the splenic artery near the stomach.
The old lady's stomach cancer hasn't eroded through the stomach, but the area is too large, so Zhang Fan decided to have a total gastrectomy.
Zhang Fan dares to do it. There is a saying about cancer. The old, the weak, the sick and the disabled can't do it. Generally, they choose palliative treatment.
It means to live for a few days! It's not the doctor's cruelty, but the fear that the patient will die on the operating table.
Enter the abdomen, open it, and Zhang Fan begins to ligate blood vessels. With the metal click of pliers, blood vessels are clamped by Zhang Fan.
The only trouble is that the blood vessels of the greater curvature of the stomach are all dressed in a yellow coat, that is, they are all hidden in the omentum.
What is omentum? Yellow fat. It's opaque, not silk stockings“ It should be noted here that no matter how sure you are, you must see it with your own eyes and touch it with your own hands. "
Zhang Fan said the key points to Ma Yichen while doing it.
"Yes!" Ma Yichen listened carefully.
Old song, a passer-by's hook pulling doctor, is so envious that he has nothing to do and can't do anything, because he can't see the operation field. This operation is just with his hands and doesn't need to bring his brain.
"Hey, pony, I'm lucky to meet such a good teacher! I wish I had such a hand-in-hand teacher. "
Old song was not old, but he was embarrassed. He was seven or eight years younger than the deputy directors. When he entered the Department, it was just when the deputy directors were rushing to practice.
So, he has had an appendix for many years. At the age of long technology, there is no chance, and finally the upper limit is not high.
The blood vessels were ligated and the ligaments hanging from the stomach were separated. Most abdominal organs were fixed with ligaments.
If you don't have this ligament, you can't do strenuous exercise. Otherwise, the kidney may fall out of the urethra first.
After separation, hold the esophagus and intestines connecting the gastric body, "knife!" Zhang Fan said to the instrument nurse.
The scalpel, Zhang Fan with the scalpel, directly cut off the stomach from the esophagus and intestines along the edge of the pliers. Then Zhang Fan explored his hands and took out the stomach from the abdominal cavity like holding a watermelon.
At this time, from the shadowless light, the abdominal cavity became a big hole, and the isolated spleen on the right and the large blood vessels below were all exposed.
Zhang Fan's level of general education can't be underestimated now. If the field of surgery is described by an adjective, it is clean! Yes, it's clean.
Almost no blood can be seen, just like a knife on a rubber doll. This is the level.
Some doctors do not pay attention to small blood vessels, but more small blood vessels are large blood vessels. After an operation, it is like a broken bottle of ketchup. Not to mention the patient, even he himself is dyed into a red ball.
That's it, he's still proud! I have an operation! I don't know. I thought he killed pigs.
Lao Zhao, I admire Zhang Fan's level very much. In Zhang Fan's spare time, he takes out his stomach.
"Zhang's operation is like art. The cleanliness of the operation field is perfect," he said
But I didn't say much, because the difficulty of surgery came. Where is the difficulty of cancer surgery? Lymph node dissection.
It can be said that lymph is like Yellow Sesame sprinkled near blood vessels. More times, seven or eight or ten people gather together, and less times, three or four.
Cancer surgery pays attention to a clean, because many cancer metastases are lymph nodes.
If you want the patient to live a few more years, you must clean up the lymph nodes. These things are hidden in fat.
And hidden in fat, it also relies on blood vessels to clean lymph nodes. It is not only slow, but also dangerous.
This thing is either lying on the big blood vessels or hidden near the big blood vessels.
It is not dangerous to pick the needle during cleaning, but it is estimated that the patient will hang up after picking the needle, because it takes too long.
It is to use a curette, an enlarged ear scoop, and scrape it down the large blood vessels.
How dangerous it is. In this way, not to mention the large blood vessels in the abdominal cavity. It's life-threatening to dig a smaller abdominal artery.
This kind of artery is like a snake's head. Once it is broken, its powerful muscles will retract, which is particularly difficult to serve.
Zhang Fan began to dig around the abdominal trunk with a curette.
This force should be quite stable. If it's light, it can't be scraped off or cleaned, and the operation will be done in vain. If it's heavy, the blood vessels will be scratched and the operation will be done in vain.
Zhang Fan scrapes very fast. The patient is too old. She can't hold on for too long. Zhang Fan must be fast.
WOW!
WOW!
Zhang Fan scraped it down as fast as a greedy fat man digging ice cream.
Not to mention Ma Yichen, Lao Zhao squeezed his hands into fists. It's so scary. The metal curette, visible to the naked eye, works on the thick abdominal cavity, and Zhang Fan is faster than each other.
Lao Zhao, who was sweating hard, couldn't help looking at Zhang Fan. Although he saw that Zhang Fan was very concerned, he was still worried.
Because Zhang Fan's operation is too fast, he has never seen anyone with such a fast technique.
He wanted to persuade, but seeing Zhang Fan dry in his abdominal cavity, he dared not say.
He was deeply afraid of disturbing Zhang Fan.
"Damn it, damn it!" Lao Zhao's hands are shaking a little.
As the second assistant, Ma Yichen was excited.
He shouted in his heart, "this is technology, this is technology, handsome!"
Newborn calves are not afraid of tigers. Although he knows the danger of surgery, Zhang Fan's skill is too handsome.
"I don't know when I can learn this skill!"
Zhang Fan's hand is too stable.
After cleaning the lymph, the inside of the curved plate is like a plate of ice cream with strawberry juice in yellow cream, even small particles on the surface of strawberries. Red is blood and small particles are lymph. It's so similar.
After cleaning, Zhang Fan reconfirmed and began to sew again. What?
Suture the esophagus and sew it on the small intestine.
The esophagus doesn't have a coat because it doesn't have to squeeze together like the intestine, so there is no serosa layer on its outer layer.
If the esophagus doesn't wriggle, what does it rely on to clean up the esophageal residue? It depends on saliva. Some people like to spit when they have nothing to do. Don't spit. If you spit again, the esophagus will get sick.
Without this coat, stitching is very troublesome, directly in the exposed muscles.
At this time, the muscles are like wires without insulating tubes, and the steel wires inside are scattered.
It's good for doctors with poor skills to sew the esophagus on the intestines and cut the esophagus.
"Line 0! Open the absorbable line at the inlet. " Zhang Fan said nonsense to the instrument.
The imported line is more expensive than the domestic one, with a difference of more than ten times. However, this line is really easy to use.
Sewing layer by layer, thread ends flying in Zhang Fan's operation, and the suture of esophagus and intestine is so beautiful. It's just like they grow together. It can't be seen that they are sewn twice.
After suture, the pulled up duodenum must be fixed, because there is less stomach, if the duodenum is not fixed.
It's terrible. Maybe a cry, pull together, break your intestines, and then spit out a section of blood from your mouth.
Six hours later, Zhang Fan and his team finally finished the total gastrectomy. After the suture closed the abdominal cavity, the matter was not over. Zhang Fan took a knife to lay hands on the cut stomach.
At this time, because of the lack of blood and the loss of temperature, the fat on the surface of the stomach has been Qin. If it is steaming, it will be directly like the French feast pig tripe and goose liver.
When the stomach is opened, the tumor inside is exposed, just like the heterosexual insect nest in the film. The surface is blood vessels, and the inside is rotten, such as yellow phlegm.
"Take it to let the family see the same, and then do a medical examination!"
"OK."
There are people in the hospital who are easy to handle affairs, and there are people in the hospital who are easy to check, not to mention the head nurse in the hospital.The nurses and sisters are very accommodating. After a day's effort, the preliminary examination results came out and gastric cancer was diagnosed~"Zhang Yuan is right. What should we do now?" The head nurse of the special needs department is out of order."Go find Zhang Yuan, wait." While talking, he thought about it and asked, "do you smoke and drink in Zhang Yuan?""I haven't seen smoking, but I know he can't drink. I can't use... "The head nurse felt that they were all her colleagues. Although she was a superior, Zhang Fan was also very approachable at ordinary times. It was not that she was reluctant to give things, or that she felt that she didn't have enough face after giving things."What do you know! It doesn't matter to ask others for an examination. In this case, you listen to me... "Sometimes people are too complicated. In fact, it's better to be simple. Just when they are tangled, Zhang Fan has seen the inspection results from the computer."Director Zhao, how's it going? How's your physical assessment, head nurse's mother-in-law?""It's OK. The anesthesiology department said it could be anesthetized. We don't have a big problem. " Lao Zhao replied."Then prepare for the operation! I'll do it myself. ""OK, Zhang Yuan."Stomach, digestive tract. To be honest, in the digestive tract, the stomach is actually very thick, just like a car in a country. You can take good care of it and serve you all your life.It is not as delicate as other digestive organs. Let's say ulcer. In fact, gastric ulcer accounts for a low proportion of peptic ulcer.Especially for young people, the most common is twelve finger ulcer. For example, some young people feel uncomfortable before the meal arrives. They feel uncomfortable in their stomach. Take two bites of rice, OK!This is typical hunger pain! What can't run away is duodenal ulcer. Moreover, this place is particularly prone to ulcers.There is a reason for this. There is a lot of gastric acid in the stomach, but there is a bicarbonate barrier on its surface to protect the stomach wall.But the intestinal tract doesn't have this thing. It relies on bile and pancreatic juice to neutralize gastric acid. The gallbladder and pancreas open together in the intestinal tract, and the liquid they secrete is alkaline.However, there is a distance from the stomach to the opening of the pancreas, which is the place that is easy to cause ulcer, that is, the famous duodenal ulcer.If you don't eat on time, you will be hungry and full. If you have a delicious meal, you will walk on the wall. If you don't like to eat, it's called to lose weight.These are the killers of duodenal ulcer.The stomach is not so delicate. If you eat more and eat less, it can generally deal with it. However, when it drinks and gets angry, it is afraid. The most afraid is Helicobacter pylori.Cancer, in short, is actually a quantitative change of cells to qualitative change under an inducing factor.Any cell in the human body has the possibility of canceration, and inflammation is the biggest inducing factor. Therefore, doctors have a saying that there are no more than two kinds of diseases, either inflammation or cancer.Helicobacter pylori is the biggest inducer of gastric cancer in China.A patient said that in my life, I never ate barbecue, didn't drink, and didn't like to be angry, but how could I get gastric cancer?Results the previous physical examination report showed that Helicobacter pylori was positive!Is this bacterium contagious? Infection. Chinese people have a bad problem. When eating, especially for children, old people love to feed their chewed food to children.Children eat whatever food they are at any age, eat chyle food and drink milk without teeth.Let him chew when he has teeth. It's not necessary. Let your mouth rich in Helicobacter pylori chew for children!In addition, in order to reflect their enthusiasm and politeness, they have to bring dishes to the guests. If the other party doesn't eat the food, you must look at it until the other party eats it.This is the transmission route of Helicobacter pylori. Most gastric cancer in other countries is caused by other factors.In China, most gastric cancer is caused by Helicobacter pylori.The surgical requirements for gastric cancer are actually similar to gastric ulcer, perhaps slightly more difficult than gastric ulcer.Many people feel that gastric ulcer doesn't matter. To tell the truth, they don't pay attention at ordinary times. Once an ulcer occurs, it will be super troublesome. Sometimes you don't have a chance to have an operation. Even if you have an operation, it's a super big operation.Gastric ulcer surgery and gastric cancer surgery are high-level operations in general surgery.For example, for refractory gastric ulcer, once surgery is needed, in China, it is generally to choose large-scale gastrectomy. What does it mean, that is, you cut most of your stomach, which almost directly becomes the existence of the connection between the esophagus and the intestine.You can think about the horror of eating white steamed bread and swallowing it directly into stool. What's more, what if you swallow half and spit it out?Around the world, countries that can't eat enough fish and make smoked fish have high gastric cancer, such as meatball countries and Iceland.Although Marubeni is an odd country, people are more skilled in gastric cancer than Iceland. Even in the world, people's technology is also the largest, but Iceland is not.Meatball countries do well in gastric cancer, and then the endoscope is also powerful. Think about it carefully. This country is very good at making a dojo in this kind of snail lion shell. Its small hand is very powerful.The head nurse looked at the two cigarettes and two bottles of wine in her hand and complained to her husband, "you think everyone is the same as you! Our Zhangyuan is different. "Zhang Fan didn't hear this, because he had brought Ma Yichen, Zhao Quanping and old song into the operating room. If he heard this, he might be proud for a while.The difficulty of gastric cancer surgery is not tumor resection. The stomach is not like the liver. The liver is like a honeycomb with various vascular pathways. One thing is whether it can be done wellThe stomach is a meat bag. After ligating the blood supply, it can be cut. Its difficulty lies in the suture and lymph node cleaning after resection.In the operating room, Ma Yichen made preparations before the operation. The young man worked hard. When Zhang Fan fought for the liver, he was also fighting for the liver. Technology has improved rapidly, and now I feel a little ahead in general education."Zhang Yuan, director Zhao, brush your hands!" The anesthesiologist said to Zhang Fan."OK!" Zhang Fan answered and went to brush his hands with Lao Zhao. Lao Zhao has been enjoying himself recently.Because several deputy directors did not revolt, they were all frightened by Zhang Fan. They were so skilled that they could have a liver. They all fainted. It is estimated that there is no one.At the beginning of the operation, Zhang Fan took the lead, Lao Zhao Yizhu and Ma Yichen were originally three assistants, that is, the hook puller, but I don't know how he secretly mixed up with Lao song. Now Lao song has become three assistants and he has become two assistants.It's hard for Zhang Fan to say this kind of thing. He can only rely on whether he has enlightened himself.Tumor resection surgery, which has remained unchanged for thousands of years, is to ligate the blood vessels of the stomach first. It can be said that it is mainly divided into two parts.How to say the shape of the stomach? In fact, it is a crescent. For thin and long people, the size of the stomach is thin crescent. For short and strong people, most of the stomach is fat crescent.The inner side of the crescent is called the lesser curvature of the stomach, and the outer side of the crescent is called the greater curvature of the stomach. The blood supply of the small bend comes from the abdominal trunk hidden under the stomach. This thing is the thickest blood vessel in the abdomen, which is the trunk road from the heart.The blood supply of the great bend comes from the splenic artery near the stomach.The old lady's stomach cancer hasn't eroded through the stomach, but the area is too large, so Zhang Fan decided to have a total gastrectomy.Zhang Fan dares to do it. There is a saying about cancer. The old, the weak, the sick and the disabled can't do it. Generally, they choose palliative treatment.It means to live for a few days! It's not the doctor's cruelty, but the fear that the patient will die on the operating table.Enter the abdomen, open it, and Zhang Fan begins to ligate blood vessels. With the metal click of pliers, blood vessels are clamped by Zhang Fan.The only trouble is that the blood vessels of the greater curvature of the stomach are all dressed in a yellow coat, that is, they are all hidden in the omentum.What is omentum? Yellow fat. It's opaque, not silk stockings It should be noted here that no matter how sure you are, you must see it with your own eyes and touch it with your own hands. "Zhang Fan said the key points to Ma Yichen while doing it."Yes!" Ma Yichen listened carefully.Old song, a passer-by's hook pulling doctor, is so envious that he has nothing to do and can't do anything, because he can't see the operation field. This operation is just with his hands and doesn't need to bring his brain."Hey, pony, I'm lucky to meet such a good teacher! I wish I had such a hand-in-hand teacher. "Old song was not old, but he was embarrassed. He was seven or eight years younger than the deputy directors. When he entered the Department, it was just when the deputy directors were rushing to practice.So, he has had an appendix for many years. At the age of long technology, there is no chance, and finally the upper limit is not high.The blood vessels were ligated and the ligaments hanging from the stomach were separated. Most abdominal organs were fixed with ligaments.If you don't have this ligament, you can't do strenuous exercise. Otherwise, the kidney may fall out of the urethra first.After separation, hold the esophagus and intestines connecting the gastric body, "knife!" Zhang Fan said to the instrument nurse.The scalpel, Zhang Fan with the scalpel, directly cut off the stomach from the esophagus and intestines along the edge of the pliers. Then Zhang Fan explored his hands and took out the stomach from the abdominal cavity like holding a watermelon.At this time, from the shadowless light, the abdominal cavity became a big hole, and the isolated spleen on the right and the large blood vessels below were all exposed.Zhang Fan's level of general education can't be underestimated now. If the field of surgery is described by an adjective, it is clean! Yes, it's clean.Almost no blood can be seen, just like a knife on a rubber doll. This is the level.Some doctors do not pay attention to small blood vessels, but more small blood vessels are large blood vessels. After an operation, it is like a broken bottle of ketchup. Not to mention the patient, even he himself is dyed into a red ball.That's it, he's still proud! I have an operation! I don't know. I thought he killed pigs.Lao Zhao, I admire Zhang Fan's level very much. In Zhang Fan's spare time, he takes out his stomach."Zhang's operation is like art. The cleanliness of the operation field is perfect," he saidBut I didn't say much, because the difficulty of surgery came. Where is the difficulty of cancer surgery? Lymph node dissection.It can be said that lymph is like Yellow Sesame sprinkled near blood vessels. More times, seven or eight or ten people gather together, and less times, three or four.Cancer surgery pays attention to a clean, because many cancer metastases are lymph nodes.If you want the patient to live a few more years, you must clean up the lymph nodes. These things are hidden in fat.And hidden in fat, it also relies on blood vessels to clean lymph nodes. It is not only slow, but also dangerous.This thing is either lying on the big blood vessels or hidden near the big blood vessels.It is not dangerous to pick the needle during cleaning, but it is estimated that the patient will hang up after picking the needle, because it takes too long.It is to use a curette, an enlarged ear scoop, and scrape it down the large blood vessels.How dangerous it is. In this way, not to mention the large blood vessels in the abdominal cavity. It's life-threatening to dig a smaller abdominal artery.This kind of artery is like a snake's head. Once it is broken, its powerful muscles will retract, which is particularly difficult to serve.Zhang Fan began to dig around the abdominal trunk with a curette.This force should be quite stable. If it's light, it can't be scraped off or cleaned, and the operation will be done in vain. If it's heavy, the blood vessels will be scratched and the operation will be done in vain.Zhang Fan scrapes very fast. The patient is too old. She can't hold on for too long. Zhang Fan must be fast.WOW!WOW!Zhang Fan scraped it down as fast as a greedy fat man digging ice cream.Not to mention Ma Yichen, Lao Zhao squeezed his hands into fists. It's so scary. The metal curette, visible to the naked eye, works on the thick abdominal cavity, and Zhang Fan is faster than each other.Lao Zhao, who was sweating hard, couldn't help looking at Zhang Fan. Although he saw that Zhang Fan was very concerned, he was still worried.Because Zhang Fan's operation is too fast, he has never seen anyone with such a fast technique.He wanted to persuade, but seeing Zhang Fan dry in his abdominal cavity, he dared not say.He was deeply afraid of disturbing Zhang Fan."Damn it, damn it!" Lao Zhao's hands are shaking a little.As the second assistant, Ma Yichen was excited.He shouted in his heart, "this is technology, this is technology, handsome!"Newborn calves are not afraid of tigers. Although he knows the danger of surgery, Zhang Fan's skill is too handsome."I don't know when I can learn this skill!"Zhang Fan's hand is too stable.After cleaning the lymph, the inside of the curved plate is like a plate of ice cream with strawberry juice in yellow cream, even small particles on the surface of strawberries. Red is blood and small particles are lymph. It's so similar.After cleaning, Zhang Fan reconfirmed and began to sew again. What?Suture the esophagus and sew it on the small intestine.The esophagus doesn't have a coat because it doesn't have to squeeze together like the intestine, so there is no serosa layer on its outer layer.If the esophagus doesn't wriggle, what does it rely on to clean up the esophageal residue? It depends on saliva. Some people like to spit when they have nothing to do. Don't spit. If you spit again, the esophagus will get sick.Without this coat, stitching is very troublesome, directly in the exposed muscles.At this time, the muscles are like wires without insulating tubes, and the steel wires inside are scattered.It's good for doctors with poor skills to sew the esophagus on the intestines and cut the esophagus."Line 0! Open the absorbable line at the inlet. " Zhang Fan said nonsense to the instrument.The imported line is more expensive than the domestic one, with a difference of more than ten times. However, this line is really easy to use.Sewing layer by layer, thread ends flying in Zhang Fan's operation, and the suture of esophagus and intestine is so beautiful. It's just like they grow together. It can't be seen that they are sewn twice.After suture, the pulled up duodenum must be fixed, because there is less stomach, if the duodenum is not fixed.It's terrible. Maybe a cry, pull together, break your intestines, and then spit out a section of blood from your mouth.Six hours later, Zhang Fan and his team finally finished the total gastrectomy. After the suture closed the abdominal cavity, the matter was not over. Zhang Fan took a knife to lay hands on the cut stomach.At this time, because of the lack of blood and the loss of temperature, the fat on the surface of the stomach has been Qin. If it is steaming, it will be directly like the French feast pig tripe and goose liver.When the stomach is opened, the tumor inside is exposed, just like the heterosexual insect nest in the film. The surface is blood vessels, and the inside is rotten, such as yellow phlegm."Take it to let the family see the same, and then do a medical examination!""OK."
