Chapter 171 Professional Extension (please ask for a monthly pass)
Get up early on Tuesday, feel tired, and have breakfast. Wu Xiaofu prepared luggage for Qu Ying, reluctantly sent Qu Ying into the airport passage, and watched the plane disappear in the sky, " Alas, I don’t know how I will live without my girlfriend from now on.”
Ding Ding Ding Ding!
"Xiaofu, come to me."
It's Yu Shifu! The Tian family's father and son's examinations are almost done, and they need to hold a pre-operative discussion meeting to prepare the surgical plan.
Rongqiao had just become the dean and had a lot of things going on. The operation had already been handed over to Yu Shifu.
In the gastrointestinal surgery office.
There were quite a few people in the medical office at this time, including Yu Shifu, Director Zheng, the director of the Department of Gastrointestinal Surgery, and other doctors, totaling more than ten people.
Seeing Wu Xiaofu coming in, Yu Shifu waved.
Yesterday Wu Xiaofu left after the night shift and did not attend the hospital meeting. Of course, most of the people who went there were department directors of the hospital. Even if he stayed, he would not be in the meeting sequence. , Rong Qiao was appointed as the dean of the First Affiliated Hospital, and Yu Shifu was appointed as the vice dean in charge of surgery of the first affiliated hospital. In other words, Yu Shifu, who was standing in front of Wu Xiaofu, was already the vice dean.
Well, the vice-chancellor’s disciple is convinced.
"Xiaofu, come and sit."
After sitting down, Wu Xiaofu didn't say much and just listened carefully.
In this kind of meeting, there are a lot of directors, just have an ear. Moreover, the operation is basically decided, just keep an eye on the details and confirm the people who will participate in the operation.
From the table, Wu Xiaofu took the medical records and examinations to look at.
Tian's father really also got rectal cancer, which Wu Xiaofu didn't want to see. Since the Tian family's direct lineage has rectal cancer, it is basically certain that the genes related to rectal cancer are inherited.
When I was in graduate school, my teacher told me a case.
There is a terrible family curse circulating in Ms. All got cancer, and both were colorectal cancer. Ms.
Later, after examination, it was discovered that Ms.
And this is just one example. Director Zheng of the Gastroenterology Department alone must have seen many such examples.
"Xiao Fu, you will be a helper when the time comes."
Him!
Xiao Fu was shocked when he heard this, but he immediately reacted and agreed quickly.
“Okay.”
Wu Xiaofu is naturally very interested in rectal cancer surgery. After all, the incidence rate of this cancer is not low, and it ranks among the many cancer surgeries in general surgery. At the forefront.
"Tian Celebrate this.”
Wu Xiaofu nodded when he heard this. His knowledge reserve about rectal cancer is actually not low.
The rectum is the last section of the intestinal system. Rectal cancer is generally located very low. Colonoscopy and radiographs are actually post-stage examinations. The easiest and simplest examination method is digital rectal examination. Well, just wear gloves, apply some paraffin oil, and then poke it. In order to check the completeness, most of them will also stir it.
Useful is really useful, not only for rectal cancer, but also for other diseases such as hemorrhoids and anal fistulas. You can basically touch it with certainty, but that feeling, well, everyone understands it, and absolutely no one knows it. Would love to experience it a second time.
The prognosis of early-stage rectal cancer is still good, at least much better than other cancers, and the ten-year survival rate is very high.
Of course, this is on the premise of doing radical surgery, but the difficulty lies here, because the rectum is deep into the pelvic cavity and the anatomical relationship is very complicated. Radical surgery is easier said than done. Without good technology, the operation will be difficult. It is really not easy to do it completely, and the recurrence rate after surgery will naturally be very high.
Moreover, middle and lower rectal cancer is close to the anal sphincter, so the preservation of the anus is involved during surgery, because intestinal resection must follow a principle: the proximal end must be at least 5 cm, and the distal end must be at least 5 cm away from the tumor. The lower edge of the rectal cancer is >2 cm, so if the rectal cancer focus is less than five centimeters from the anus, the anus generally cannot be preserved.
It has nothing to do with technology, it is simply to reduce the recurrence rate.
Tian's father is in the early stage, and the position is good. There is no problem in preserving the anus. But Tian Qing cannot do it. It is already a mid-term case, and the surgical principles must be strictly followed. Tian Qing's rectal cancer is far away from the cancerous area. The anus is less than 5 centimeters, so when it comes to Tian Qing, an artificial anus must be made.
As for incision or mirror surgery, surgery is developing rapidly now. For early rectal cancer, because it is discovered early and the lesions are small, mirror surgery is still very suitable.
Tianfu is very suitable for the mirror. Of course, in order to reduce the recurrence rate and ensure complete surgical resection, many people still choose to use incision as the main method.
As for Tian Qing, to be on the safe side, we decided to do an incision. Although the damage would be greater, Tian Qing was young after all and recovered quickly, so the incision would have little impact.
Yu Shifu also smiled when he looked at Wu Xiaofu. Now that Wu Xiaofu has completely decided to study for his doctoral degree, Yu Shifu naturally has to be more responsible.
Wu Xiaofu’s talent was noticed by Yu Shifu. Specializing in liver, gallbladder, pancreas and spleen must be a bit too wasteful. In fact, the operations of general surgery are all the same, as long as the state is reached, he can do it. Well done.
Nowadays, with the exception of major surgeries such as liver transplantation, Wu Xiaofu can hardly perform any other operations on the liver, gallbladder, pancreas and spleen. Wu Xiaofu can also start learning gastrointestinal surgeries.
People in the medical office looked at Wu Xiaofu with a little envy. After what happened in the ward that day, how could the medical staff in the gastroenterology department not know that Wu Xiaofu had become a disciple of Yu Shifu, a disciple of the vice president? Ah, this is something that many inpatient attendings in the gastroenterology department would not envy.
Following Yu Shifu, just think about how terrifying Wu Xiaofu’s future resources will be.
Just like now, they have a room full of people, all of whom are attending primary care, but Wu Xiaofu still got the last help casually. Some people may not only be envious, but also a little bit Jealous.
Especially Chu Jingming, the second assistant who has just been confirmed by Yu Shifu.
As the top hospital in Donghai, there are actually quite a few geniuses in the First Affiliated Hospital. Chu Jingming is one of them. He studied at Donghai Medical University with a bachelor’s, master’s and doctoral degree, plus a year of exchange abroad. After working in the hospital for one year, Chu Jingming spent ten years in total. This year, Chu Jingming is already the chief physician of gastrointestinal surgery.
Twenty-nine.
This is cultivated by being a subject leader. Yu Shifu is also very optimistic about Chu Jingming. The other assistant for this operation is Chu Jingming.
However, Yu Shifu wanted to train Wu Xiaofu for this operation, so Chu Jingming decided to be the second assistant.
It’s strange that Chu Jingming can have a favorable impression of such a boy who can’t compare to him in anything, and who puts him at a disadvantage just because he is lucky enough to get a doctorate in Yu Shifu.
Of course, if you don’t like it, you don’t like it. You will still take the surgery seriously and won’t say anything to embarrass Yu Shifu.
Chu Jingming also knows that he is a genius, but being a genius does not mean that you can resist the vice president. After all, surgeons have proven their skills in surgery. If Wu Xiaofu performs poorly by then, huh, he doesn't need to say it. Wu Xiaofu should also know that he is a genius. How embarrassing.
As for whether Wu Xiaofu is more suitable to be a supporter than him, it is just a joke. Chu Jingming has never thought about this possibility. Wu Xiaofu is also worthy?
It’s not like he didn’t know Wu Xiaofu. He had done some minor surgeries in the emergency department, all of which were related to liver, gallbladder, pancreas and spleen. As for radical surgery for rectal cancer, Wu Xiaofu had never done it before, and he probably had never been on stage. Bar.
According to Chu Jingming's idea, Yu Shifu wanted to find fault for himself, cultivate disciples, and let Wu Xiaofu slowly look at him first. He would be a help as soon as he came up, and he would not be afraid of defeating the seedlings.
Wu Xiaofu didn’t know so many thoughts of Chu Jingming. After the discussion, Wu Xiaofu started to prepare.
Qu Ying's plane landed in two hours.
After landing, Qu Ying quickly turned off the flight mode and reported to Wu Xiaofu that he was safe. It was not only Wu Xiaofu who was reluctant to leave, but also Qu Ying. It had only been more than two hours on the plane, but Qu Ying couldn't wait to let the plane go. Return to Wu Xiaofu and tell him that she is not leaving. Fortunately, the girl has not completely lost her mind.
Only after I got off the plane and made a video to Wu Xiaofu, the pain of lovesickness was relieved.
At the pick-up place at the airport, a beautiful woman was looking at the people coming out. After seeing Qu Ying's figure, she quickly waved. After Qu Ying saw her mother, she also hurriedly said to Wu Xiaofu and hung up. video.
"Mom, didn't you go to work today? You actually came to pick me up in person."
"Oh, my baby girl has been gone for two months. Why is she still working? If you hadn't said you were coming back, I would have gone to Donghai to find you. Hey, Xiaoying, how can I feel about you for two months? No, it’s changed so much?”
An Xiashu looked at Qu Ying and said with some suspicion, “Xiaoying, don’t you have a boyfriend?”
After being told by An Xiashu, Qu Ying was also displeased. His face turned red, and he secretly thought to himself, what kind of eyes are his mother's, how could he tell them at a glance, "Mom, you didn't ask someone to check me, did you?"
An Xia Shu heard this. Stunned, "Did you really find it?" Who? What are you doing? Are you from Donghai? "
Looking at An Xishu's appearance, Qu Ying was also a little helpless. Scam her.
"It's my colleague from the First Affiliated Hospital. Oh, don't ask. Let's go back quickly. I'm hungry."
"Colleague! Oh, please tell me more about it. No, you Dad knew you were coming back and arranged a meeting with the boy from the Li family."
Qu Ying stopped when she heard this.
"What? Why is dad like this? I can't see you. I'll see whoever I love."
Wu Xiaofu hung up the phone, opened the resources he found online again, and started to check, wanting to go on stage. After surgery, he was still an assistant. It was his first time to be an assistant to Yu Shifu. Naturally, Wu Xiaofu didn't want to lose his position. Therefore, it was necessary to prepare in advance. He found some videos of radical resection of rectal cancer and prepared to study it carefully.
During lunch, Wu Xiaofu kept watching. Not to mention, watching this kind of surgery video would make him stop eating.
However, after becoming a doctor, Wu Xiaofu found that he seemed to be used to everything. Apart from being a little uncomfortable at the beginning, later on, it smelled really good.
The surgery took place at two o'clock in the afternoon, and Wu Xiaofu entered the operating room at one o'clock.
I went through Tian Qing’s medical records and various examinations again so that I knew what was going on. The patient came in quickly and the nurses began to make preoperative preparations. When they saw Wu Xiaofu coming to the stage, they all got into a fight. Hello, Wu Xiaolin turned out to be the equipment nurse. After seeing Wu Xiaofu, she suddenly became a little angry.
“You fooled me that day.”
Wu Xiaofu couldn't help but smile bitterly when he heard the words, "Who is deceiving you? This is all about medicine, okay?"
Wu Xiaolin immediately glared at Wu Xiaofu, and she came to her senses after she went back, but she knew that she was being Wu Xiaofu refused. Although she was unhappy in her heart, Wu Xiaolin was also a person who dared to love and hate. Even if she was still a little unwilling, after a few days of relief, she was almost done.
"Huh, I believe your evil."
Looking at Wu Xiaolin's appearance, Wu Xiaofu also smiled. This girl has a good temperament and seems to be relieved.
Let’s not talk about feelings, we are still good friends.
"Doctor Chu."
At this moment, the door to the operating room opened and Chu Jingming walked in. The nurses obviously knew Chu Jingming and greeted him warmly. Wu Xiaofu also called out, "Brother Chu."
Don't mention it, Chu Jingming is indeed very good-looking. He is young and talented. He is probably popular with little girls in the operating room.
Seeing Wu Xiaofu taking the initiative to say hello, Chu Jingming also knew the rule of not hitting the smiling person, so he could only nod in response. Wu Xiaofu looked at his slightly proud look and didn't care. He's a genius, but Not every genius is as approachable and affable as him.
“Brother Wu.”
Tian Qing's voice sounded, and Wu Xiaofu looked over with some confusion. This change was really fast, and he was called brother.
"What's wrong? Are you feeling uncomfortable?"
"No, it's just my first time lying here, so I'm a little nervous. Brother Wu, I heard that this operation is under general anesthesia. I fell asleep immediately. Do you think I fell asleep directly and couldn’t wake up?”
Wu Xiaofu also smiled when he heard this. It could be seen that he was indeed very nervous. No wonder he screamed. As for brother, he is probably the only person Tian Qing is familiar with in this operating room of Nuo University. He is so nervous that he can only talk to him.
I can also understand that no matter who comes to the operating room for the first time, no matter how many times they come, they will be nervous. Going on the operating table is equivalent to handing over their life to Doctor, this feeling of not being able to control life or death is really powerless.
"Don't worry, it's okay. Teacher Yu does so many surgeries every year, and he has never failed. Just sleep peacefully and everything will be fine."
Listening to Wu Xiaofu's words, Tian Qing It’s also a lot of relief.
Yes, this surgery is not too difficult for Yu Shifu, and he will definitely not fail. "Thank you, Doctor Wu."
Chu Jingming stared at Wu Xiaofu and Tian Qing, and all their words were heard.
I suddenly murmured in my heart, it was quite warm to the patient.
There is a saying in hospitals that doctors who treat patients well are basically the same, because such doctors are generally very responsible and have basically the same character. Moreover, they care about the patient's condition and will work hard. He studies to improve himself so that the patient's condition can receive the best treatment. Chu Jingming feels that he is the same, so he still has a good impression of this type of doctor.
Squeak!
The door of the operating room opened again, and Yu Shifu also came in, followed by several other doctors, who probably wanted to come in and observe Yu Shifu's surgery.
“Lao Cai, how are you?”
Lao Cai was the anesthesiologist for this operation. Hearing Yu Shifu's question, he nodded, "It's time to start."
"Okay, let's start the anesthesia."
Lao Cai started anesthesia, and Yu Shifu stood beside Tian Qing and looked at Wu Xiaofu, "How do you think the posture should be positioned and how to choose the incision?"
There are many postures that can be adopted for radical resection of rectal cancer, commonly used ones They are lithotomy position, supine position, prone position, lateral decubitus position, knee-chest position and sitting position.
The specific position to choose depends on the patient's condition.
Just like Tian Qing's case, in Wu Xiaofu's view, the most suitable position is the prone jackknife position. The tumor is close to the anus and is less than five centimeters. An artificial anus will be required in the follow-up. This position can provide the greatest benefit for surgery. convenient.
"Lie prone in the folding knife position. If you want to make an incision, make a midline incision from the sacrococcygeal joint to the anal verge. The length should be about 10-12cm."
Hmm!
Yu Shifu nodded when he heard this. It was his first time to undergo radical surgery for rectal cancer. He was able to choose the most suitable position and incision based on the patient's condition. At least in terms of attitude, it was absolutely fine.
Chu Jingming also looked at Wu Xiaofu twice, thinking that Wu Xiaofu was somewhat prepared, but these were all preparations before the operation, and the most important thing was the performance during the operation.
Anesthesia is now complete.
“Come on, Xiaofu, you come and position yourself, we will cooperate with you.”
Wu Xiaofu did not refuse and stepped forward directly. He knew that Yu Shifu wanted to train him. , such a good opportunity must be grasped.
The positioning is not difficult, but the anesthesia has been completed and the patient's body is heavy, so it requires the cooperation of several people to complete it.
After the prone position is fixed, use wide tape to pull the left and right buttocks to their respective sides to open and shallow the gluteal groove. This can fully expose the posterior perineum and provide the best visual field conditions for the operation. .
The choice of body position is originally designed to serve this purpose.
Wu Xiaofu looked at Yu Shifu and saw that he had no objection, so he started to draw the line and completed it. Yu Shifu didn't say anything more and went straight to brushing his hands.
It seemed that everyone was satisfied. Wu Xiaofu felt relieved. Well, he was very happy to be recognized by the teacher.
In fact, with the foundation of another soul and the preparation before surgery, these are really not a problem. Even the other soul has been in many such positions, so it is easy to master.
However, the chief surgeon this time is Yu Shifu after all. This is the First Affiliated Hospital after all. The requirements will only be higher, and Wu Xiaofu must also perform better.
Wash your hands and come back and disinfect.
Because it involves contaminated areas, disinfection is still different from the gallbladder and appendix that were done before. Try to disinfect it as many times as possible. One thing to remember during surgery is to reduce the possibility of infection before surgery. Just don't be afraid of trouble.
With the cooperation of Chu Jingming, the draping was completed.
Wu Xiaofu’s seriousness is quite to Chu Jingming’s liking. To be honest, if Wu Xiaofu were his assistant, based on his current performance, Chu Jingming would still like him very much. No one would like a serious and smart assistant. Disgusting.
Of course, I am talking about the assistant. Now that Wu Xiaofu is the first assistant and he is the second assistant, it is not so happy.
"Here we go."
Yu Shifu greeted and started the operation. He started according to the marks drawn by Wu Xiaofu, making a midline incision from the sacrococcygeal joint to the anal verge, with a length of about 10 meters. Wu Xiaofu had gauze in one hand and gauze in the other. The suction device directly enters the first aid state. After incising the skin and subcutaneous fat, there is no need to remove the tailbone because the lower edge of the tumor is less than 5cm from the anal verge.
After the field of view is widened, just prepare to cut off the external anal sphincter directly after dissection.
This is also the key part of the front part of the operation. The external anal sphincter is generally divided into two groups in anatomy: deep and shallow, but that is in anatomy textbooks. The actual situation is another matter. The facts It is difficult to distinguish the so-called deep and shallow gaps between the two groups during surgery.
Since you can’t tell the difference, let’s not distinguish it. Both the deep and shallow groups are located above the anal verge. After using the vascular forceps to separate the upper forceps, just cut them off at one time.
Chu Jingming pulled the hook and stared closely at the movements of Yu Shifu and Wu Xiaofu. This was not the first time he had performed this kind of surgery. The second assistant was only responsible for pulling the hook. In his opinion, there was no technical content at all, so , what he is thinking more about now is to find fault, naturally not with Yu Shifu, but with Wu Xiaofu's shortcomings.
He had to use his eyes to prove that Wu Xiaofu was not suitable to be a supporter.
But the facts disappointed him, and he even had some doubts. Is this really the first time Wu Xiaofu had radical surgery for rectal cancer? Why can Wu Xiaofu keep up with Yu Shifu's pace? This level is no worse than him, but who is he? He is the genius Chu Jingming, and he has undergone many radical operations for rectal cancer.
It’s such a shame to compare with Wu Xiaofu.
Is Wu Xiaofu pretending to be a pig and eating the tiger? But with such a childish face, no matter how he pretends to be a pig, he is just a pig.
However, the technical content of being an assistant is limited after all. Wu Xiaofu is also a person who has done many laparoscopic gallbladder and appendix surgeries. It is understandable to have such a performance.
Wu Xiaofu didn't know what Chu Jingming was thinking. He only knew that this man was truly a genius and he could pull the hook really well.
Fortunately, Chu Jingming didn’t know Wu Xiaofu’s thoughts, otherwise, he would have been so angry that he vomited blood: Who is he, Chu Jingming, what is he doing? Isn’t it bad?
The external anal sphincter is very important to the anus. If there is a problem with this thing, it will either not be able to be pulled out or it cannot be retained.
The deep hypertrophied circular muscle above the external anal sphincter is called the puborectalis muscle. When cutting off the external anal sphincter, the puborectalis muscle must also be cut vertically. As the external anal sphincter and puborectalis muscle are completely cut off, The posterior wall of the rectum bulges backward due to the loss of the restraint of the puborectalis muscle.
At this time, the vision becomes clearer.
It is similar to the resection of liver cancer. Now we have to start the lymph node dissection. Because it is already in the advanced stage, the lymph nodes around the rectum have already metastasized cancer cells. For the dissection of the lymph nodes around the rectum, it is Be sure to do it carefully and completely.
And this is one of the most valuable points for Wu Xiaofu to learn from this surgery.
After all, it is not the same organ, but the lymph node dissection is still different.
At this time, Wu Xiaofu has also entered a deep state of surgery. In this state, his ability to comprehend, learn, and cooperate will be greatly improved.
This is not the first time Wu Xiaofu has entered this state, but this state was not very stable at first, but after so many surgeries, this state has completely stabilized.
Following in and out, this is why Wu Xiaofu dares to say that he can keep up with Yu Shifu's movements even if he undergoes radical surgery for upper rectal cancer for the first time. It is also because of this that he dares to say that he If you can pass this surgery, you can at least learn three or four points.
Yu Shifu glanced at Wu Xiaofu and had to say that Wu Xiaofu really gave him a big surprise. What a good boy. Originally, he was planning to slow down some of the surgery progress in case Wu Xiaofu couldn't keep up. , It hurt Wu Xiaofu's self-confidence, not to mention that it was not easy to learn things. Now it seems that he was worrying too much.
Wu Xiaofu's condition is not like someone who has never undergone radical surgery for rectal cancer, but like a veteran. He can even believe it now that Wu Xiaofu has performed surgery.
If Wu Xiaofu can maintain his condition in the future, maybe after this operation, he will consider preparing some similar surgeries for Wu Xiaofu to practice his skills.
After the lymph node dissection is completed and the rectum is incised, two needle traction lines should be made on the posterior edge of the anal canal, and the anal canal and the posterior wall of the rectum should be incised between the two needle traction lines until the lesions in the rectum can be clearly exposed.
Wu Xiaofu's brain was working rapidly. He was always thinking about what to do next if he was the chief surgeon.
Yu Shifu’s progress was basically similar to what Wu Xiaofu thought, but there were some highlights from time to time, which made Wu Xiaofu’s eyes light up and he secretly exclaimed, “I have learned something. This is the benefit of learning from a big boss.” , you can only guarantee that you will learn it by looking at ordinary doctors. After reading the expert's advice, even a tiny point can be a big help for you to do this surgery in the future.
Lymph node dissection, after so many experiences of dissecting lymph nodes around the liver, Wu Xiaofu has mastered it. As long as he has two opportunities to get started, he can master it. After all, this thing cannot be What you can only rely on is seeing and practicing.
However, everything remains the same, and the principles are the same.
The lesion is right in front of you now, and now comes the most critical part, which is to prepare to remove the lesion.
Wu Xiaofu also widened his eyes, scanning Yu Shifu's movements like radar.
All the preparations in the early stage are just paving the way for this step. The purpose of this operation is to remove the lesion. If the lesion cannot be completely removed, then everything done before will be in vain.
I saw Yu Shifu using a mastoid retractor to retract the newly opened rectal incision after protecting the incision. At this time, the incised rectum was like an open book, and the scene inside was clearly visible.
Hmm! He didn't know where the confidence came from. Looking at the lesion in front of him, Wu Xiaofu felt inexplicably that even if he did it himself, he could handle the lesion perfectly. Of course, just think about it.
It's often just the brain that says it's OK, but the hands that don't care. It's not Wu Xiaofu's first day as a doctor. He'll be good at it once he learns it, but lose it once he does it, and then be scolded by the teacher for being decadent. Well, it's all a necessary path.
"Watch it."
Yu Shifu explained, Wu Xiaofu did not dare to be careless. He saw Yu Shifu using the electric knife to first focus on the area to be removed, and then started Along the tangent line from shallow to deep, from right to left, the entire intestinal wall including the rectum and the fat outside the intestinal wall are completely removed.
Hmm!
That's enough. Wu Xiaofu suddenly realized that this was no different from cutting his own liver. No, this was much simpler than cutting his liver.
Since preparations for colonoscopy have been done, the rectum has been cleaned very clean, and not much dirt came out during the resection.
Hmm!
At this moment, Wu Xiaofu could not help but feel more confident. For him, this surgery was probably no more than digging out an acne head.
At this time, Wu Xiaofu also figured out that in general surgery, liver surgery accounts for the most difficulty. If you really have to perform liver surgeries, the surgeries on other organs will actually be the same. .
“Send for inspection!”
After taking away the specimen, Yu Shifu began to explain to Wu Xiaofu the areas that required special attention during the operation. Wu Xiaofu also took the opportunity to ask for advice on a few areas that he was unsure about. After asking and answering questions, Wu Xiaofu soon felt smoother.
For this operation, his expectation was to master three points, but now Wu Xiaofu feels that seven points is almost enough, and the remaining three points should be no problem as long as he practices it.
After all the lesions are cut away, the rest is healthy tissue, and normal intestinal function must be maintained.
Then we started to repair the rectal wound. I saw Yu Shifu using thin silk thread to make interrupted sutures on the fat layer outside the rectal wall. The principle is actually very simple. This suture method can reduce the tension of the wound. It also has a shaping effect on the suture of the second layer of intestinal wall, which can be said to have many benefits.
The second layer uses silk thread or absorbable thread to perform full-thickness interrupted suturing of the intestinal wall. Yu Shifu also uses silk thread here.
After completing this step, it is time to repair the posterior rectal wall, which is usually sutured in two layers. Yu Shifu first performed continuous inversion sutures on the inner layer, that is, the muscularis mucosae, and then sutured the seromuscular layer. Sometimes, interrupted inversion sutures are used.
At this point, it is basically the final stage.
The anus has been completely dug out, and artificial anostomy will be performed next.
This can be said to be a substitute for the anus.
Wu Xiaofu also saw artificial anostomy for the first time. He only saw that Shifu made an incision about 3cm in diameter on the left side of the abdominal wall, and then pulled out the stoma intestinal tube from the incision and sutured it in place. After the intestinal tube is cut open, the intestinal contents begin to flow out. It sounds difficult, but after seeing it, it is not difficult at all.
In fact, the anus is gone, and an opening is made in the belly, and the intestines are pulled out, allowing the contents to come out directly.
It means omitting the anus step. Well, there are benefits. You don’t have to exert force when you defecate in the future.
It is no different from the urology department who puts a tube in the abdomen to drain urine.
It’s just that no one hopes to use this kind of benefit one day.
(End of this chapter)