(Thanks to [Floating Fairy Brother] 68,000 rewards, becoming the first alliance leader of this book!Thanks to [Librarian Administrator] 41,000 rewards, congratulations on the birth of the first elder!)

The next step is the critical step of surgery.

Under laparoscopic surveillance, Ruan Bin pulled the transverse colon cephalad to determine the position of the Treitz ligament, and grabbed the control intestine with non-invasive forceps at a distance of 15 cm, removed the umbilical trocar, and enlarged the incision to 1.5 cm. The jejunum is lifted out of the abdomen and disconnected, the distal jejunum is closed, and the 40 cm jejunum is pulled out distally.

Then the proximal end and the anterigrade roux-y anastomosis of the jejunum at 35 cm distal side!

At this time, it is the moment when the common hepatic duct of this operation is anastomosed with the jejunum-Roux-Y, and it is also the technical core of this operation. If you fit well, everything will be fine.

If the anastomosis is not good, it is almost equivalent to the failure of the operation, which will cause complications of anastomotic stenosis after surgery, postoperative leakage, and touching and other conditions.

"Do you want me to come? You haven't done this match. Director Ye couldn't help but ask.

After all, this is the key to surgery, and success or failure is here.

"I can, give me a chance, and if there is anything wrong later, please point it out to Director Ye. Ruan Bin politely refused. Just kidding, if I give it to you, I won't be able to complete the mission.

"Okay. Director Ye didn't force it, because the other party had no mistakes after the operation just now, and there were zero mistakes. Faster than him. The worry in his heart is not very great.

The choledochal-jejunal roux-y anastomosis begins!

Director Ye saw that Ruan Bin did not raise the common bile duct and jejunum to the outside of the abdomen for surgical anastomosis, and he immediately asked in shock, "Do you plan to anastomosis in the abdominal cavity?"

"Yes. Ruan Bin nodded.

"If it is a laparoscopic anastomosis, the difficulty of the operation is infinitely increased, the intra-abdominal operation space is small, the surgical field is not clear, when I was training, the teacher said that it takes 3 or 4 hours more to perform jejunal anastomosis in the abdominal cavity! Director Ye frowned. He felt that Ruan Bin was still untrained and didn't know the surgical experience explored by his predecessors.

The most important thing is that if the choledochokyejunostomy is performed laparoscopically, it is not only very difficult to operate, but also does not have the fineness and accuracy of the extra-abdominal anastomosis, and it is easy to cause excessive intestinal fluid to flow into the abdominal cavity and cause abdominal cavity contamination!

The experience of countless predecessors over the years is that the common bile duct jejunostomy anastomosis is the most ideal method for extra-abdominal (extracorporeal) anastomosis.

"I know, but I have a unique anastomosis that allows me to anastomosis in the abdominal cavity with great precision, precision, and simplicity without adding time to the operation. Ruan Bin said.

"A unique method?" Director Ye and Director Qian were both stunned.

"Well, it's a modified operation based on the common bile duct jejuno-roux-y anastomosis! Don't you think this common bile duct-jejuno-roux-y anastomosis is relatively backward?" Ruan Bin said with a smile.

He currently has world-class laparoscopic congenital choledochal cystectomy.

Although it has not yet reached the level of innovation, it is impossible to innovate a truly new procedure.

However, the current laparoscopic congenital choledochal cyst resection is still in the stage of development and improvement, and it is not yet very mature. But now he's world-class.

The most mature version of laparoscopic congenital choledochal cystectomy in the mind is more advanced and mature than the current version in the world.

Its advanced and mature place is in the common bile duct jejunostomy technique of laparoscopic congenital choledochal cyst resection.

"Backwardness, ......" Director Qian was speechless.

But the improved version of the surgery does not mean that it can be improved by improvement!

Could it be that the brain of a genius is so rebellious?

"Are you sure you can?" Director Ye couldn't believe it.

"You see, all right. It only takes 15 minutes for me to have a common bile duct jejunal anastomosis!" said Ruan Bin with a smile.

As he spoke, his hands flew up.

I saw Ruan Bin holding the needle, inserting the needle, moving the needle and exiting the needle under the laparoscope, and every movement was dazzlingly fast, like a breeze sweeping away the leaves.

"This is a feeling that is faster than anastomosis outside the abdomen!" Director Ye was dumbfounded.

Laparoscopic suturing and knotting is one of the most difficult techniques to master in laparoscopic surgery, which is often very difficult for beginners because laparoscopic operation is limited by space and degrees of freedom, and it is an indirect operation using instruments.

Not to mention that this common bile duct jejunal roux-y anastomosis has been tested by countless predecessors, and it is recommended that the best anastomosis is in the abdomen. But if you look at this Ruan Bin, it's like being possessed by a god!

And this girl is still one-handed operation!

Of course, Ruan Bin has an innovative debridement suture and a world-class laparoscopic congenital choledochal cyst resection, and the combination of the two is invincible.

"My anastomosis method is to insert the needle at an angle of 45 degrees, and the force acts on the tip of the needle, following the direction of the needle and the arc of the needle. You see, isn't the speed up? And it's very simple. ”

"The suture method should not be with the conventional figure-eight suture and purse suture. Instead, I used this 'Nguyen' sewing method that I invented! In this way, it is easy to make and easy to use, and the effect is very good. Ruan Bin said very shamelessly. Anyway, it's the experience in his mind that is plagiarized, and it's basically his own.

"You also know that it's very difficult, so you can't use the conventional C-ring or D-ring ligation! That's why it takes you 3 or 4 hours, you should use this E-ring! Well, I figured it out, and it looks very easy to use. Ruan Bin continued.

This modified version of the common bile duct jejunal roux-y anastomosis is the world-class laparoscopic congenital choledochal cyst resection in his mind, and the experience summed up after tens of thousands of surgeries, and then improved and upgraded anastomosis!

"E-ring ligation? Director Ye and Director Qian were stunned.

"Hey, it looks quite suitable for intra-abdominal choledochal-jejunal roux-y anastomosis! No matter the size of the anastomosis, you can change the control anastomosis at any time, my God, it's really too practical!" When Director Ye saw that Ruan Bin began to anastomosis in the second half, he was already completely shocked by this unique and improved version of the anastomosis method.

Fifteen minutes later, the match was successful, and it seemed to be very accurate and tight.

"How's that, the effect is good, isn't it? After all, my hand speed is fast, if you change it, it is estimated that it can be done in about half an hour, and it can be completed in 40 minutes at the worst, and it is estimated that it will be about an hour for novices. Ruan Bin did not forget.

Director Qian: ......

Director Ye: ......

Did you slap them in the face?

"Are you sure it's the first time you've had this kind of surgery?" asked Director Ye steadily.

"Yes, is there a problem?"

"No, it's your performance that made me want to change careers. ”

“......”