Chapter 48
The operation was done in a straight line.
A midline incision was made in the upper abdomen.
A horizontal incision was made one centimeter above the navel, and the anterior sheath of the rectus abdominis was cut open one centimeter. This position is the linea alba.
This is the most stable position and least likely to injure the abdominal muscles.
After the skin was cut open to expose the abdominal cavity, the skin on both sides was pulled open and fixed with a spreader to fully expose the surgical field.
A laparoscope was placed to start the exploration.
Chen Fang was Zhang Yi's assistant. He took the laparoscope and scanned around the stomach and found several swollen lymph nodes.
In addition to the lymph nodes, several organs around the stomach should be checked before the stomach is removed.
For example, whether there are any abnormalities in the pancreas, pelvic cavity, uterus, duodenum, etc.
Once abnormalities are found, all of them must be removed.
After the exploration was over and several lymph nodes and the proximal duodenum that had to be removed were marked, Zhang Yi reached into the abdominal cavity with a bipolar electrocoagulation forceps and began to separate the fascia, ligaments, and fat connected to the stomach bit by bit.
The method of radical resection of gastric cancer is actually to remove 2/3 or all of the gastric tissue.
Then the remaining gastric tissue is directly sutured to the intestine/esophagus.
The duodenum is connected below the stomach, and the jejunum is behind the duodenum.
Most radical resections of gastric cancer also remove the duodenum.
Because cancer cells are most likely to metastasize to the duodenum.
After the duodenum is removed, the jejunum is connected to the remaining gastric tissue.
Although the patient has lost most of the digestive and absorptive functions of the stomach since then.
But it is still worth it to save a life.
Radical resection of gastric cancer is not difficult to say.
It is mainly troublesome.
There are too many tissues that need to be freed in the entire abdominal cavity.
Gastropancreatic ligament, gastrosplenic ligament, hepatogastric ligament, omental bursa...
Even several large and small arteries and veins are included.
In Chen Fang's opinion, he would have to practice this radical gastrectomy for at least three or four years before he dared to perform the operation.
Just freeing these numerous ligaments and blood vessels was a headache for him.
But.
How come this thing is so easy for Zhang Yi?
"Teacher Zhang...can I ask a question?"
In the operating room, an intern asked boldly.
Zhang Yi stopped: "Ask."
"Well...if you want to free, which position should you free in the first step? You...you move too fast, I can't see clearly..."
After the intern finished speaking, several interns around him nodded frequently.
Even the doctor who came to learn from the monitoring room next to him nodded.
Too fast!
So fast that I couldn't see what was what!
Zhang Yi said: "Radical gastrectomy is actually the part that is particularly troublesome to free. But you should remember the order, from left to right, from bottom to top, from front to back, so that the freeing will be faster."
"Also, the omental bursa resection is the most troublesome, but if it can be removed completely and clearly, it will give people an artistic enjoyment. Remember, when separating the anterior lobe of the transverse mesocolon, this place is the easiest to separate, and you should pay attention to switching surgical instruments at this time."
"I suggest combining electrosurgical separation with blunt separation, but it is best to use a non-electric electrosurgical head for blunt separation, and cut it horizontally from left to right. This saves time and ensures that the separation plane can be advanced in parallel, avoiding uneven force causing tissue tearing."
After Zhang Yi finished speaking, a group of interns nodded in confusion.
I don't know if they understood it.
But Chen Fang understood it!
For a moment, he cast an inquiring look at Zhang Yi again.
What kind of genius is Zhang Yi? !
How come he is so good at all surgeries? !
He can do the surgery for mitral stenosis.
He can do the difficult surgery in neurosurgery.
He can even handle gynecology!
In addition, he can always find the problem of the patients who come to the department for consultation and make the correct diagnosis in the first time.
Now, he can do this radical gastrectomy, a surgery that tests proficiency, even better than Director Kong of gastrointestinal surgery!
Chen Fang was numb.
I am convinced!
I can't figure out what kind of person Zhang Yi is...
How can he be so awesome?
How can he know everything?
Chen Fang sighed.
God, give me half of Zhang Yi's talent...
Oh no.
Not half, just one third of the talent, I will take off!
One and a half hours later.
The operation is over.
There are two large pieces of deep red stomach tissue in a sterile curved tray next to the operating table.
Color
It was a little deeper, and there was a little blackened and deteriorated tissue inside.
A few lymph nodes were placed in another sterile curved tray.
Zhang Yi removed 2/3 of Li Xiaoxia's stomach and a small section of the esophagus near the cardia.
"Thank you for your hard work, clean up the equipment."
Zhang Yi said to the people in the operating room.
Everyone twitched their lips.
Why are we working so hard? It's obviously you who are the hardest working.
However, they didn't learn much in the one and a half hours they stood today.
Why?
Because Zhang Yi's technique is too fast!
It's fast and steady, and they all shouted "Big brother is awesome" while watching.
How could they remember that they are students who come here to learn...
Forget it, come again next time if there is a chance!
The interns left the operating room with reluctance.
Chen Fang followed Zhang Yi out.
Two girls were standing outside the operating room with worried faces.
"Doctor Zhang, how was the operation?!"
"Don't worry, the operation was successful. Your mother is now being sent to the ICU for observation and will be transferred to the general ward tomorrow."
"Thank you! Thank you, Doctor Zhang! I really can't repay your kindness! I...I...or else I will..."
"Oh, don't, don't, don't!" Zhang Yi interrupted Zhao Yuting quickly.
"You don't have to do anything, just take good care of your mother."
Zhao Yuting and her sister looked at Zhang Yi with tears in their eyes.
Doctor Zhang~~You are such a good doctor!
...
In the afternoon, the news that Zhang Yi performed a perfect radical resection of gastric cancer spread in the hospital again.
A group of female nurses who secretly admired Zhang Yi shouted in their hearts:
Zhang Yi! You are my god! (Attached is a picture of Haiqing kneeling on one knee)
And Chen Fang went to the operating room to retrieve the video of Zhang Yi's radical resection of gastric cancer.
How could such a superb operation be buried?
Then I have to post it on the forum for everyone to see.
Chen Fang edited the topic:
‘Mr. Z’s latest surgery, radical resection of cardia cancer, welcome everyone to enjoy and discuss! ’
Chen Fang’s account has more than 30,000 followers because it posted three surgery videos of Zhang Yi.
As soon as the video was released.
Many newbies in the workplace flooded the screen below, shouting: Big brother 666~~
However, some people also left a message below:
“Huh? Isn’t this an operation in our hospital? It was a radical resection performed by Zhang Yi, the big brother of our hospital!”
Someone asked him which hospital it was, but this person did not reply again.
Someone in Zhang Yi’s classmates group also followed Chen Fang’s account.
At this time, he saw someone leave a message saying that Mr. Z who had the operation was called Zhang Yi.
Immediately, he thought of a classmate named Zhang Yi in his class.
Immediately, he posted a screenshot of the comment in the classmates group.
Mao Jun: "Look, Mr. Z is having surgery again! It's a radical gastrectomy! So awesome! When can I be as awesome as Mr. Z?!"
Mao Jun: "By the way, Mr. Z's real name is Zhang Yi? Hahaha."
Wang Jing: "Haha? Damn! @Zhang Yi you have the same name as the boss!"
Gong Shiming: "Oh my god, this person is not Zhang Yi, right?"
Li Xiuhui: "It's impossible. Mr. Z is so amazing that he looks like a chief physician with many years of experience. How could he be a fresh graduate?"
Gong Shiming: "That's right. Just looking at the operation, it can't be Zhang Yi in our class."
Lu Gao also said:
"Haha, how could it be him? How could an intern in a third-tier city practice such an awesome operation?"
Zhang Yi was originally lurking quietly, secretly enjoying watching everyone brag about themselves.
I didn't expect Lu Gao to say such a thing.
After thinking for a while, Zhang Yi replied:
"What would I say if it was really me?"
Lu Gao sneered disdainfully: "If it was really you, I would shit upside down immediately!"