Chapter 122 Teacher, I understand (asking for monthly votes)
The lymphatic membrane dissection work for liver cancer is different.
Liver cancer cells can metastasize through lymph. Therefore, when cleaning the lymph membrane of liver cancer, we must strive to clean it completely without leaving any hidden dangers. After all, even if the operation is successful, if some hidden dangers are left, let If the liver cancer cells have a chance to make a comeback, the surgery may be in vain, or the results may even be worse.
This has precedent. Many liver cancer surgeries fail because of incomplete lymphadenectomy.
Wu Xiaofu has very high demands on himself, and he does not dare to be careless in this critical surgical process.
"Tweezers, cut finely."
Instruments Xiaowen was very smart this time. She put all the tools needed to remove liver cancer nearby. In this way, even Wu Xiaofu wanted them in a different order. , she could also hand it to Wu Xiaofu's hand as quickly as possible. Of course, there were times when she was at a loss, such as the blood vessel blocking band before.
However, until now, the entire operation seems to be urgent but not chaotic.
Urgent is the right thing to do. We should try our best to speed up the progress of the operation without affecting the quality. The postoperative effect is actually closely related to the length of the operation. The patient is over sixty and his age is already very high. Although he was small, the cancer failed to destroy him, but he collapsed due to surgery. Moreover, the liver was exposed for too long, which was detrimental to its recovery.
The main reason is that Wu Xiaofu is very organized, even when he talks, he reveals a calmness, which makes these assistants feel at ease.
Surgery is actually like fighting. Wu Xiaofu, the surgeon, is the general. As long as the surgeon does not panic and is confident, they will have confidence.
“Ten minutes.”
The patrol sound sounded, it was ten minutes for the porta hepatis blockade.
Wu Xiaofu nodded.
This is another key point of the operation, the control of the nodes, Wu Xiaofu set himself a lymphatic membrane cleaning time of up to one hour.
Loosen the tourniquet, wait for a while, and then continue.
Cleaning lymph nodes is a delicate job. The result of liver removal depends on the pathological report. In the eyes of everyone, it is not that obvious, but lymph node cleaning is different. This is a very intuitive performance. Although it is just a combination of tweezers and scissors, the difference is easily visible between clipping and cutting.
Some people look rough at first glance, but for others, it is like art, swift and elegant.
“What the hell!”
The onlookers were holding their breath at this time and did not dare to disturb, but when it really reached the climax, everyone could not help but scream out.
The director of the general surgery department shouted out at this time. After attracting everyone's attention, although he was a little embarrassed, he still couldn't help but marvel in his heart. This work of lymphatic dissection for liver cancer was not tailoring work. He was actually doing it between Wu Xiaofu's movements. After seeing Hua'er, compared to Wu Xiaofu's movements, when he thought about his previous surgical experience, he really felt like all the rice he had spent so many years had been in vain.
This has to be practiced. Even a genius cannot master fine work within a few years of practice.
Especially the lymphatic membranes of each system, which seem intricate and complicated, are actually orderly in chaos. As long as you experience it, you will have your own set of ideas and ideas, which can clean the lymphatic membranes as quickly as possible. It's clean. If it's just scissors on the one hand and tweezers on the other, it will be a disaster for the patient.
At this time, the director of general surgery really regretted it.
Yesterday, Mo Xiaofeng, that little chicken thief, took the opportunity to steal the surgery. Wu Xiaofu said it smoothly, which made him unable to get better. Then Duan Hao concluded, thinking that Wu Xiaofu did it, so It didn't matter whether he grabbed it or not, so he didn't fight with Mo Xiaofeng anymore. It was good now. What a loss. If he had known Wu Xiaofu's level, he would have snatched it back from Mo Xiaofeng.
A layman looks at the excitement, an expert looks at the door.
They are all used to doing surgeries. How could they not know the difference between being in the audience and working as an assistant? He dared to say that Mo Xiaofeng’s harvest from this surgery was definitely several times that of his. They wanted to train Mo Xiaofeng to be a subject leader, but they didn't mean to make Mo Xiaofeng the subject leader now. He was still the subject leader now.
He wants to retire after success, but he doesn’t want to be forced to abdicate.
Although the others were disturbed by the director of general surgery, no one blamed him. After all, the director of general surgery was just acting as a substitute, and they seemed to want to shout.
This is really a ghost.
How could a young man have such a good job?
Is it really possible to practice this for ten or eight years?
I won’t go into details soon. The most important thing is high quality. The quality of Wu Xiaofu’s lymphatic dissection is really too high. This is not the first time that the county hospital has hired people to do liver cancer resection. So have various experts. Quite a few, Wu Xiaofu may not be the best among these experts, but his performance is definitely top-notch. It doesn't matter if he is Duan Hao, how old is Wu Xiaofu.
If you can do this now, what level will you get in the future?
The dean and the vice dean in charge of surgery looked at each other. Such a talent must be grasped. It is probably impossible to grab him, but in the future, we must establish a good relationship. If it can make Wu Xiaofu more Come to Feidao, then maybe the county hospital can perform the first liver transplant surgery!
What's more, it's not necessarily possible to grab it.
In case of blindness in the affiliated hospital, Wu Xiaofu was not included in this program. Although their hospital level is low, they dare to make promises, resources, and various benefits. Young people are full of energy. They didn't believe that Wu Xiaofu was not moved.
The work of cleaning the lymphatic membrane is progressing steadily and is soon coming to an end.
Duan Hao knew that his demands would have to be lowered, and he would wait until Wu Xiaofu had trouble with liver transplantation.
However, Duan Hao had a feeling that his surgery might have been a waste of his surgical gown.
After the lymphatic dissection was completed, everyone breathed a sigh of relief. The operation was now in the middle stage.
The next step is the most critical moment, cutting out the diseased liver segment.
“Fix the liver.”
Wu Xiaofu signaled, and Mo Xiaofeng hurriedly helped to fix the liver.
The electric knife slowly penetrated the patient's abdominal cavity, and everyone became more focused. Wu Xiaofu's previous performance was at the level of a chef. Whether it was cutting vegetables into sections or cleaning shredded meat, he was top-notch. Yes, when people look at it, they have the feeling that Wu Xiaofu is very powerful and the dishes he cooks must be delicious.
But whether it tastes good or not depends on the finished product and its quality.
At least you have to smell it!
Hmm! The meaty smell comes out.
Wu Xiaofu is now starting to stir-fry. If the liver segments cannot be cut well, everything he has done before will be in vain. No one can guarantee whether Wu Xiaofu will miss this step.
呲呲呲……
The electric knife cut across the liver and cut it vertically. Duan Hao was relieved when he saw Wu Xiaofu's movements.
He was afraid that Wu Xiaofu would be too proud and start cutting off the lesions right away. Then he would really have to chase people away, and he couldn't afford the risk.
Fortunately, Wu Xiaofu is quite good, and he is not a TV protagonist.
In terms of general surgery, there are really not many people who dare to perform circumcision, and Duan Hao doesn’t dare to do it, because that is risking the patient’s life. They cannot do this just to preserve as much of the patient’s liver as possible. The adventurous way, this kind of vertical incision, cutting ten, can basically guarantee that nine will not cut the lesion with one cut, but circumferential incision is different.
Except for those few, with one cut, nine out of ten will be lesions. After all, people are not clairvoyant, can they still see the scope of the lesions?
As for the pre-operative CT scan, if you dare to believe it, you will regret it for the rest of your life.
From top to bottom, from the inside out, evenly and steadily, it is said that young people are prone to quick success, but Duan Hao has known Wu Xiaofu for more than half a month, and he has never seen Wu Xiaofu do anything random. At that time, the impression I had all along was that of "stable."
Shaked his head, his trust was not without reason.
Just like cleaning the lymphatic membrane and cutting the liver segments, the resection of liver cancer is also different from the liver hemangioma that Wu Xiaofu cut before.
Benign tumors do not metastasize, grow very slowly and are not likely to relapse. Therefore, on the premise of ensuring clear edges, it is necessary to cut as little as possible, and the thinner the cut, the better. After all, the recovery of the liver is also limited. Within the limit, the more preserved, the higher the patient's quality of life after surgery and their life span will be relatively longer.
However, the resection of cancer lesions is different. It is easy to metastasize, grows quickly, has a high recurrence rate, and is more harmful. Generally, old doctors who seek stability basically like to cut more. After all, there is nothing wrong with cutting more, and you will live less and live less. , but it is still possible to survive. If the patient is cut less, if it relapses, it is not a matter of living more or less.
Of course, it also depends on the patient’s specific physical condition.
For young patients with good physical condition, if more incisions are made, the impact will not be too great. For the sake of stability, more incisions can be considered. But it won’t work for those who are older or in poor physical condition. Cutting off a little less may reduce or alleviate many of their complications.
The patient in front of me is in his sixties, which is not bad. For patients in their eighties, sometimes, in fact, they don’t ask for a radical cure, but more for a follow-up life. The quality can be higher to extend life as much as possible. Therefore, doctors will have different considerations based on different demands.
The electric knife cuts across the liver, starting from the healthy part of the liver. Wu Xiaofu feels that his spirit seems to have established a connection with the electric knife at this time, and he can clearly feel the clear edges of the healthy part of the liver and the diseased part. .
Could this be the legendary fusion of man and sword?
I understand!
Wu Xiaofu felt that he really had enlightenment. He followed his feelings and the edges were clear.
The oval-shaped liver piece was removed by Wu Xiaofu. His eyes were a little dry, but it was impossible to rub them. When Wu Xiaofu withdrew the knife, Mo Xiaofeng quickly took out the liver piece and put it into a tray.
"Send it for inspection."
Wu Xiaofu's voice came out, and the patrol station hurried to send it, but no one noticed that Duan Hao's face was indeed ugly at this time.
Wu Xiaofu was very stable at the beginning, and he was relieved, but what happened next? Why is it becoming more and more risky? From his experience, Wu Xiaofu's electrosurgical knife is almost walking on the edge of the cliff. Generally, the lesions of the liver are cut out in a triangular shape. Although this will bring out a lot of normal liver. It’s cheap, but it’s safe enough.
Wu Xiaofu was lucky. He came almost close to the lesion, forming an oval shape.
If it weren’t for the fact that Wu Xiaofu was in good condition and his hands were very steady, Duan Hao would have been tempted to interrupt Wu Xiaofu. Even so, Duan Hao felt very bad. He was worried that this machine It is very likely that Wu Xiaofu was too unconservative during the operation and had to be re-operated. He was afraid of affecting the patient's condition and was even more afraid of the negative results, which affected Wu Xiaofu's self-confidence.
As an old doctor, Duan Hao knows very well the importance of self-confidence for doctors. Many doctors have failed because of one failure, especially genius doctors, who are even less able to accept failure than ordinary doctors.
But there are a lot of people now, and Wu Xiaofu looks confident. Duan Hao can't say much and can only wait for the result.
It’s just that he has already begun to think about how to deal with it if something goes wrong later.
I’m so tired!
Duan Hao has not hired interns for many years. Although he is already qualified to teach a master's degree, this year is also the first time for him to recruit. The new master's students have not come yet. Duan Hao has also taken Wu Xiaofu before. I didn't feel tired. After all, Wu Xiaofu basically didn't need much teaching. He could do very well by relying solely on self-realization. In many cases, it made him feel much more relaxed.
This is the advantage of bringing up geniuses. Just like those ancient sects recruiting disciples, they all like those with high bones. This is not without reason. It is too tiring to bring up a person with weak bones. But Duan Hao now discovered that this brings geniuses. It’s also very tiring. Geniuses seem to be able to avoid small troubles, but one big trouble like this is enough to bear.
Thinking of this, Duan Hao wondered whether he should raise the threshold higher when recruiting master's students next year. It would be better if he could not recruit them.
Everyone was waiting anxiously. Looking at Wu Xiaofu's calm and calm look, they almost all now understood what it meant that the emperor was not in a hurry and the eunuch was in a hurry.
Wu Xiaofu was not idle either. He began to check whether the lymph around the liver had been cleaned out, and he also electrocoagulated all the bleeding spots left over from the lymphatic cleaning.
Even the smallest bleeding point is not missed, and it is idle even if it is idle. The abdomen must be closed when pathology is done, for fear of wasting time. The time now is wasted if it is not used.
If pathology were not the only evidence, Wu Xiaofu would have wanted to deal with his liver.
He is confident that he will be right this time.
Duan Hao was a little angry when he saw that Wu Xiaofu could handle the small bleeding spots so calmly. It was really good. He was afraid of damaging Wu Xiaofu's self-confidence, but how strong is this self-confidence? It was the first time I had liver cancer resection, and I felt so calm and relaxed.
Thinking about the first time I had my liver cut, my dear, it shouldn’t be any easier than when I got the results of the college entrance examination, or even when I took the second subject.
Looking at it again, it was even more outrageous. Wu Xiaofu actually started to perform manual ligation to stop the bleeding.
Everyone looked at Wu Xiaofu with admiration. Brother, do you know what kind of surgery you had? Do you know what kind of reputation you will get if you succeed in everything this time? , becoming famous as a young man, becoming a blockbuster, it is all within easy reach, and you are not nervous at all.
They can still tell whether they are pretending to be calm or really not nervous. They are all old foxes. Their eyes may not be good, but their minds are definitely good.
Dong dong dong!
Footsteps appeared, yes, they were running back.
In the operating room, unless there is a patient who needs rescuing, and it takes time to start looking for medicine and shake people off, and the nurse will run, the other thing is that the nurse needs to run for examination.
Everyone's eyes converged on the door of the operating room, and even Wu Xiaofu stopped what he was doing.
"How is it?"
The dean couldn't help but ask.
The nurse was about to say something, but when she was asked this question, she choked for a moment, took a breath, and then quickly said, "The edges are clear."
"Okay!"
Everyone couldn't help but look at Duan Hao. What's going on? He's so unstable. If it wasn't hard to explain, the dean at this time would want to educate Duan Hao. He's so unstable. Can you learn from your junior brother? Look at you. Junior brother, when he heard the result, his eyebrows widened, he was simply too calm.
No matter how talented he is, he still has such a good character. The dean really likes her more and more.
“Okay!”
The vice-dean also shouted suddenly. The dean was just thinking about something when he was startled.
You scumbag, the dean stepped forward and looked at Wu Xiaofu, "Xiaofu, I have seen a lot of geniuses, but you, I can only borrow a sentence from my grandson who is obsessed with reading novels. It’s a rare talent that comes once in a thousand years.”
Everyone laughed, and Wu Xiaofu also smiled.
"The dean was so complimentary."
Wu Xiaofu was not slow in his movements. When the patrol officer said that the edges were clear, he started to treat the liver surface. Mo Xiaofeng was immersed in it at this time. In joy.
“Are you sick again?”
Ah! Um!
Mo Xiaofeng was stunned when he heard this. What were these words? Seeing Wu Xiaofu calmly starting to deal with his anger, Mo Xiaofeng was also shocked. Does this person have no emotions? However, he also realized that he was out of rhythm again, well, he was getting sick again.
Hurry up and keep up the pace.
Mo Xiaofeng and the others were even more amazed when they saw Wu Xiaofu handling the blood vessels on the liver section.
Vascular suturing is actually a test of ability. Wu Xiaofu’s surgery was really amazing for them.
Wu Xiaofu didn’t even notice Duan Hao’s complex expression at this time. If it weren’t for the mask, others would have suspected that Duan Hao had changed his face. He was feeling happy and worried at times, maybe he was also acting in a TV series. .
really.
At this time, Duan Hao did have mixed feelings, and the edges were clear! Wu Xiaofu actually became it!
As a senior, he is naturally very happy to be able to succeed. He also knows how far Wu Xiaofu’s reputation will reach in the medical community after today, after being exaggerated by the directors, doctors, and nurses of the county hospital. , I'm afraid it's no worse than Wang Buyi before, but he is very afraid that Wu Xiaofu is a coincidence.
If it was done by chance, what if Wu Xiaofu becomes more confident next time, cuts thinner, and something goes wrong?
Until the end of the operation, Duan Hao wanted to slap himself. He was so hopeless. He, Duan Hao, even had such a motherly moment.
The operation is over.
Duan Hao still decided to have a good talk with Wu Xiaofu.
"Xiao Fu."
"Teacher, I understand."
(End of this chapter)