Sedum quickly flashed the results of the previous examination in his mind.

Hypothalamic hamartomas are brain metastases that are malignant, hereditary, and present with cerebral edema, but are not original.

The retroperitoneal tumor is suspected to be a primary lesion, malignant, with genetic factors, accompanied by a large area of polyps, with a near-dentate line two centimeters away, excluding ESD, 5.6 cm from the anal margin, and radical rectal cancer resection and transabdominal perineal resection are preferred.

Melania polyp syndrome is hereditary, malignant, located in rectal smooth muscle, intussusception and intestinal obstruction are not seen, but it has progressed to an advanced stage, and drug suppression of the COX-2 inhibitor celecoxib is excluded, and radical ostomy and total mesorectal resection are preferred.

Jingye knew that the situation she was facing was very complicated, and she needed to prescribe the right medicine in turn.

Although the retroperitoneal tumor and the melanomaly polyp appear to be in the same location, the melanomaly polyp is already close to the valley tract, so Jingye prefers total mesorectal resection.

As early as in the past, for the treatment of the rectum, there was rectal drag-back surgery, transnatural orifice endoscopy, and valley endoscopic rectal microradical resection, and it was not until 13 years that total mesangial rectal resection was officially introduced.

Due to the emergence of total mesangrectal resection, compared with traditional surgery, it has more advantages, such as anal preservation, avoiding clamping and ligation, which is conducive to the protection of the pelvic plexus, which greatly improves the success of the operation in the hospital, and the successful cases are distributed all over the country, which directly attracts great attention and learning from abroad.

"It seems that Sedum Night is about to begin, and I don't know if he can finish it. ”

"Who knows, anyway, this patient has already suffered from a lot of advanced tumors, and no matter who performs the surgery, the result will not be tomorrow. ”

"What's going on? Why are you alone in the operating room at night? What about the others? Don't you want a nurse?"

"Send him two nurses. ”

As he spoke, Shadujin beckoned the people from the emergency department and beckoned two nurses to come over.

At this time, Seduma had already slid a little sweat down his cheeks.

Under the spread of the traction hook, the surgical field is broader, and the mosquito hemostats, surgical forceps, surgical scissors, suture removal shears, and suction devices are ready to be replaced at any time.

The sequence of free perirectal space is the same as that of laparoscopic surgery, with presacral loose connective tissue opened first.

Sedum was the first to cut open the skin, and the scalpel began to sharpen the patient's presacral space, and a large amount of blood instantly stained the surroundings.

First, the inferior mesenteric vein was dissected from the left free sigmoid colon, and the submesenteric artery vein was ligated 1cm away from the aorta and splenic vein, respectively, and the lymph node dissection was quickly completed.

Although it was the first time for Jing Ye to perform such an important operation, with years of experience in dissecting toads, he calmly continued to perform the separation, and at the same time kept the visceral layer of the pelvic fascia intact to avoid unnecessary damage to other parts of the patient.

As for why there are few experiments on mice, it's entirely because when I was in medical school, the girls in a group with Jing Ye liked to experiment with cute mice, and the toad that looked a little ugly and infiltrating naturally belonged to Jing Ye, and at the same time, the girls didn't forget to say thank you, you are a good person, which gave Jing Ye a wonderful illusion of fame and fortune.

"The operation has begun, and I want to see if this kid Jingye can complete the operation. ”

"The risk of surgery in this location is extremely high, after all, the tumor is located in a relatively deep place, although we have a lot of experienced people in the hospital, but it is clear that even if the older people are very experienced, they are far less good at vision than the younger ones. ”

"You're right, but young doctors also have the disadvantage of not having rich surgical experience, not to mention that he is only a regular trainee, and it is very likely that if he is not careful, his scalpel will touch the normal area of the patient, so that the injured person is still the patient, and the patient knows, it will definitely cause unnecessary trouble to our hospital." ”

"But when you look at Jingye's hands, there is no trembling in the slightest, which means that he has done enough homework before the rotation, so don't underestimate the young people now, as the so-called people outside the world, there is a sky outside the sky, the back waves of the Yangtze River push the front waves, and the generation is stronger than the generation. ”

"Hehe, this is just the beginning, the show is still to come, the more you go to the back, the more it will test the comprehensive strength of a doctor, even the chief physician of the emergency department does not dare to guarantee 100% of the patients who have collected the three major tumors, so what can be so powerful as a regular trainee. ”

Although everyone expressed their opinions and talked about it, everyone's eyes were very resonant and gathered on Jingye's body.

I saw that Jing Ye was immediately replaced with surgical scissors under direct vision, and the medial visceral fascia of the left and right lower abdomen, malignant tumors and perirectal mesangium were completely separated along the patient's pelvic visceral layer and parietal fascia, until the levator ani muscle level, and the integrity of the visceral fascia still reached 100%.

At the same time, when dealing with the lateral ligament of the rectum, the pelvic wall should be sharply separated as close as possible, and the clamping and ligation should be avoided as much as possible, so that the pelvic fascia can avoid injury and thus protect the autonomic plexus.

"It seems that young people nowadays are really amazing! Sharp separation seems to be a small step, but I don't know much about it, after all, this kind of surgery is too rare, and I have only done it seven or eight times in the two years I have been here. One of the emergency department residents sighed.

"Yes, I have practiced this small step hundreds of times, but I am still unstable after surgery, and I will still accidentally let other positions suffer trauma, which is why those patients still scold me, alas, it is all bitter tears. ”

"I really didn't expect that this is the first time that Sedum has done sharp separation, and its proficiency has reached such a high level, is it ...... When he was in medical school before, he was already taught this lesson by a master-level person?"

"Who knows, it is estimated that his technique is very skilled, I think it may also be self-taught, if this is the case, then it can only be said that in our Jiangnan Hospital, it is rare to see a legendary genius in the medical field once in five hundred years. ”

At the same time, everyone's eyes saw that Sedum set the gas pressure device to about 10mmHg, and then began to suture the purse in the rectal cavity 2cm away from the lower edge of the tumor, and then lifted the full thickness of the outer edge of the purse fold, and the cold blade directly cut the rectum in an instant.

The wonderful smell of blood attracted the eight crows to come and watch, and their sharp eyes wanted to divide the corpse.

At this moment, the patient's rectum is instantly split in two, and the blade enters the presacral space, and at this time, the sharp separation is almost complete.

Jing Ye took a breath and did not rest, and continued the operation, after dissociating the lateral ligament of the rectum, he began to separate the anterior wall of the rectum, and then opened the peritoneum to fold back into the abdominal cavity, and the blade was easily controlled.

Retrograde ligation of submesenteric arteries and veins through the valley tract and release of the sigmoid colon. Finally, the rectum is dragged out of the valley canal, and a large area of polyp specimen is removed under direct vision, and it is anastomosed with the rectosigmoid colon.

After the rectum is dissected, the pelvis and rectum are flushed with normal saline to fully wash the stool residue and exfoliated cancer cells in the valley tract of the distal rectum.

After doing this, the next step is to use a stapler for anastomosis, which is fast, easy and convenient, and extremely accurate, and is highly respected by doctors and loved by patients.

But Jingye decided to carry out a manual anastomosis.