"You're talking about a laparoscopic single-stage liver transplant?" asked Ruan Bin.

"Yes, it's too difficult! Although the 70-year-old man's liver function is quite normal, barely usable. It's a blessing in misfortune, but it's ...... difficult operation."

Ruan Bin nodded in agreement.

Directly remove a part of the liver from the grandfather and transplant it to the granddaughter, that is, the living donor liver!

Liver transplantation from a living-donor liver is a highly technical surgical procedure that not only removes a portion of a healthy person's liver intact, but also ensures the integrity of the portal vein, hepatic artery, hepatic vein, and biliary system for transplantation. This procedure can be very traumatic for the donor even the most skilled surgeon.

Especially if the patient's grandfather is 70 years old, if the traditional laparotomy is used to remove the liver at such an age, needless to say, the damage to the grandfather is definitely the greatest, and it is very likely to cause many complications or cause hepatic artery embolism.

Therefore, only laparoscopic liver removal can be used!

You must know that the first case of total laparoscopic living donor liver transplantation in China was only released in 2014!

This is still a multi-segment liver or even a hemiliver.

Compared with single-stage liver extraction, the technical content is undoubtedly the difference between heaven and earth!

What is a single-segment liver?

The liver is divided by a hepatic vein as a segmented boundary.

The hepatic vein divides the liver into the left hepatic hemisphere, the right hepatic hemisphere, 5 lobes and 8 segments.

Each segment is the functional anatomical unit of the liver, and each segment of the liver has a branch of the Glisson system that supplies blood and drains bile, and the hepatic vein between each segment drains the return blood of adjacent liver segments.

The upper part of the left lateral sector is 2 segments, the lower part is 3 segments, and the left internal sector is 4 segments.

It is delimited by the level of the right branch of the portal vein, and the upper part of the right anterior sector is 8 segments, the lower part is 5 segments, the lower part of the right posterior sector is 6 segments, the upper part is 7 segments, and the caudate lobe is 1 segment.

Any of these 8 sites can be called a single liver!

Take only any single segment of the whole liver!

Moreover, the single segment of the liver must not only be completely removed, but also the integrity of the portal vein, hepatic artery, hepatic vein, and biliary system needs to be intact for transplantation. Compared with traditional liver disease, liver resection techniques are countless times more difficult!

Therefore, while ensuring that her grandfather's liver is obtained, the volume should not only be smaller, but also the thickness should be thinner, because during the operation, if the liver donated by the grandfather is too thick, the child's belly will not be closed if it is less than one year old. If you are not careful, the transplanted liver may also compress the blood vessels in the child's body, which can cause large liver syndrome and even lead to death.

Therefore, only an anatomical single-segment transplant can be performed, and only a small portion of the donor's blood vessel that is properly sized is removed!

This is a bit of a technical overlap with Ruan Bin's previous invention of patient swapping part of the liver!

But not exactly overlapping either!

This time it is laparoscopic biovital liver retrieval, which is more difficult!

"It's a pity, it's a pity, although our hospital has adopted laparoscopic minimally invasive liver retrieval as a routine surgical method for living donor liver transplants. At present, the right hemiliver, the left hemiliver, and the left lateral lobe have been obtained under full laparoscopy. However, we are still in the state of research on this single-stage liver transplantation using laparoscopic donor liver acquisition! The surgical certainty is really very small, and it is not even certain. Xia Donghua sighed.

"What the family told you before was that this is the operation?" asked Ruan Bin. Before he went to Jianxi Hospital, the team led by Academician Zhou Jiazhen was studying the topic of "developing new technologies for living donor liver transplantation among various relatives of children", which is the same problem that Xia Donghua has encountered at present! This is also the problem that all liver transplant doctors in China want to solve!

If Ruan Bin remembers it well, this laparoscopic single-stage liver transplantation obtained by a laparoscopic donor liver can only be done in four or five hospitals in the West! There is still no record in China! This operation has just come out two years ago! Because it needs to complete the separation, ligation, and severance of the left hepatic artery, middle hepatic artery, and biliary duct with a diameter of about 2 mm under laparoscopy, and successfully obtain an effective left lateral lobe donor liver, and at the same time protect the liver intact on both sides and ensure the absolute safety of the donor.

"Yes, if you can't wait for a suitable liver source. I can only take the liver from his grandfather and try it!"

"Actually, I also wanted to recommend them to go to those hospitals in the West for this surgery, but I inquired through my connections, and these hospitals are the only ones in the world who can carry out this new type of surgery. The patients have been in line for a year!They can't get in line when they go~ So I suggest that they wait for a suitable liver source, but if it doesn't work, they just give it a go. ”

"I see!" Ruan Bin nodded.

This operation can only be performed in a few hospitals, and an operation can last for seven or eight hours or even longer, even if a liver transplant doctor in a hospital does it day and night, how many or hundreds of units can be done in a year?

But how many patients are in this way around the world? There must be a lot of them, and you can't get in line.

The most important thing is that there is a 90% chance that this disease will burp at the age of one, which is too painful!

You don't have time to procrastinate at all.

"Then Director Xia, what are your plans?" asked Ruan Bin curiously.

"What can I do? Wait and see if I can wait for a suitable liver source, but if I have the consent of my family, I will have to fight hard, and I can only be a dead horse and a live horse doctor." Xia Donghua said in a deep voice.

"Yes, in fact, we understand that the family members were messing with us just now. But that woman is really excessive!" said Huang Qi, the deputy chief doctor who was scolded by Xiao Xiaoruo just now.

"Director, can't we ask for help from those hospitals abroad?

"People are busy like dogs, will they have time to help us?"

Ruan Bin looked at a few doctors shaking his head and sighing, and said with a smile: "How sure are you sure?"

"Well, there's almost no certainty. Huang Qi said embarrassedly.

"At most, Issei will be it. Xia Donghua said with a headache.

"Oh, you can't. Ruan Bin pouted.

"Ahem...... Doctor Ruan, don't you lose our face like this, who can do it in China? Now this operation is not the first in China!" Xia Donghua spread his hands and said.

"You don't want to ask me, okay?" said Ruan Bin with a hesitant smile.

？？？

"What?," Huang Qi was stunned.

"Are you sure about this operation?" Xia Donghua was shocked!

It feels a little hard to accept!

"Yes, not much, seventy percent. Ruan Bin said.

！！！

"Shhh...... Are you sure why didn't you say it just now?" Xia Donghua didn't have much doubt that Ruan Bin was bragging, after all, they created a liver for three purposes, and developed a pediatric partial liver swap, which was originally similar to this laparoscopic single-stage liver transplantation operation.

Now he says he will have this operation, but there is evidence!

n.