Chapter 306 Bleeding!

This is also understandable, Lin Yu has already done dozens of this operation in the simulation system, Director Yang is the first in reality, and it is normal to be unfamiliar with the instruments.

"Here, why do we cut off the gallbladder artery first? This is also said! We first cut the gallbladder artery, and the surgical field will be clearly identifiable, which is very conducive to the next step of dealing with the cystic duct, and when dealing with the cystic duct, we must not confuse it with the common bile duct!" Lin Yu continued.

Now comes the critical moment, and that is the identification of the cystic duct!

"Is this a cystic duct?" Director Yang studied for a long time and still didn't find the tube, the difference between what the book talks about and real life is sometimes quite big, at this time, Director Yang is a little nervous because he wants to do this operation too much.

A person who wants to do one thing too much will be nervous, and when he is nervous, he will be overwhelmed, Director Yang has already reached this feeling at this time, and he is a little hesitant.

"Well, this cystic duct is relatively short, but it is still easier to recognize, sometimes it should be noted that if the cystic duct is embedded in the neck of the gallbladder, when the two are adhered tightly, this time will make the common bile duct ectopic, and some doctors will treat the common bile duct as a cystic duct removal!

Han Qiang was stunned by Lin Yu's words, he really didn't understand, how could the gap between the doctors of Huaqing Hospital be so big! He knew, I didn't know, in the books, many knowledge points are actually just one sentence, like this kind of surgical precautions, really not much.

Han Qiang held on to the mirror and looked at Lin Yu, secretly saying How can this guy know so much? At the level of the chief physician of general surgery, he not only does well, but also understands so many "side doors", this special mother is too powerful, he has to be convinced.

"There is still a little distance!" Lin Yu saw that Director Yang was about to cut off the cystic duct! This position is very critical, although it is a small tube, because the proximal end of the cystic duct is connected to the common bile duct, and the cut is too short, and when it is ligated, it will cause compression on the common bile duct, which is also called scar compression, which is easy to cause common bile duct stenosis.

If it is left too long, it may form a small gallbladder lesion!

"Hmm!Is this enough?" Director Yang has done many surgeries in laparotomy, and he also knows that it is better to leave 0.5cm here, in the past, the abdominal cavity was opened, and the surgical field of view was under his eyes, but now it is different, the entire field of view is transmitted to a small screen through the camera, because of this, it is still a little difficult to judge the distance!

The difference between a master and a rookie in the surgical field is here, he knows the knowledge points, you also know, in the actual operation process, he is handy, you have no way to start, this is the essential difference.

"Well, this position is okay!" Lin Yu continued to instruct.

"Okay" Director Yang dealt with it according to Lin Yu's instructions, although he was nervous, after all, he took a big step! This is not easy, this is also the first time that he has treated the cystic duct through laparoscopy, and he has handled it well.

"Let's do gallbladder stripping, the patient has edema recently! In order to facilitate the stripping, Han Qiang, tell me, how do we deal with it?" Lin Yu saw that Han Qiang had taken the mirror crookedly again, and felt like he was sleeping, so he simply asked him a question first.

Han Qiang saw Lin Yu asking himself again, his heart was not very happy, he had no chance to do it, only to do this kind of basic work, he said that he was very unhappy!

"This is too simple, right! If the separation is not clear, we can inject normal saline or 0.25% procaine under the gallbladder serous membrane!" Han Qiang said disdainfully.

Secretly asked, can you take the test a little difficult!, I feel like I'm mentally retarded when I answer this kind of question.

"The answer is correct! It is indeed like this! Han Qiang has made great progress, but there is still a lot of room!" Lin Yu directly praised him.

Han Qiang just vomited blood, and secretly said Are you acting or not? My special mother sounds like the rhythm of criticism, you actually came to test me on this question, do you really think I haven't read any books.

"I feel that there is a big difference between this laparoscopic forceps and the operation of holding forceps in your hand!" Director Yang is a kind of self-deprecation, the difficulty of gallbladder stripping directly exceeds his imagination!

In the past, it was easy to peel off with a finger, but now it feels so difficult to operate with a laparoscopic hook, and there are more hooks and I am afraid of breaking the gallbladder, or I am afraid of hooking the liver, in short, I want the hook to go, but the hook just can't get to that place, which feels seriously uncomfortable!

Director Yang was already sweating profusely at this time! The progress was not going well.

"Otherwise, you start from the bottom of the gallbladder and the neck, and converge in the middle!" Lin Yu suggested.

The gallbladder is like a glutinous cake stuck to the bottom of the pot, not too big, it may be the size of a person's nose, removing the gallbladder and separating the gallbladder is the last step, and it is also the most important step!

The upper part of the gallbladder is the liver, and there are some tissues between them to form adhesions, when you remove the gallbladder, you can't hurt the liver, it's better not to puncture the gallbladder!

The gallbladder is a storage organ, which stores bile, if punctured, bile will flow into the human abdominal cavity, in this case, it may cause abdominal infection, increasing the difficulty of later surgical treatment, so this step is also an important reference to test the level of a surgeon.

"Poof!" Suddenly, the laparoscopic field of vision suddenly turned red!

"Ahh

"It should be blood vessels, right? What should I do now?" Director Yang was startled, there should be no blood vessels between the gallbladder and the liver, or it is the traffic branch!

"What should I do now? The whole thing is full of blood, do you want to open your stomach?" Han Qiang held the mirror next to him, watching the excitement and not afraid of big things.

Director Yang wanted to cry directly, and finally was able to separate 70% of the gallbladder, who would have thought that he would encounter a rupture of the communication branch blood vessel, although even if this blood vessel is ligated, it will not affect the blood flow of the liver, but at present, this ultrasound knife is very difficult to use by itself.

"Let's suck the blood clean first! It's not a big problem!" Lin Yu suggested, because he "looked" in his eyes, Yang argued that what he touched was indeed a traffic branch, which had no effect, and now the whole field of vision was full of blood, and it was good to attract the blood clean, and it was good to directly tie the blood vessels.

For Lin Yu, it was not a problem at all.

Director Yang is different, he doesn't have a gold finger, and now he uses the new method, he is too unfamiliar with the equipment, and he started to catch some ducks on the shelf, and now the situation is special, although it is a small blood vessel, but he is not familiar with the operation and cannot find the direction.

"It's... Director Lin, it's better for you to do it, my hands are shaking now! Today's harvest is already very big, I have to go home and practice hard!" Director Yang had to choose to retreat, there is no way to do this, the operation is different from others, you can do it, if you can't do it, don't do useless persistence, wait until you hurt your liver, it will be more troublesome, and if you do it here today, you will indeed gain a lot."

"Okay!" Lin Yu saw that he was sweating profusely, and said to the head nurse: "Head nurse, please wipe the sweat of our Director Yang!"

The head nurse came over to help Director Yang wipe his sweat.

Lin Yu had already skillfully ligated the blood vessels, then sucked out the blood, and quickly peeled off the gallbladder with ultrasound.

If it is an open surgery, Director Yang deals with such a problem, every minute and every second, and now it is laparoscopy, and Lin Yu is every minute and every second to deal with such a problem.

Lin Yu stripped the gallbladder one by one!

His speed is unimaginable!

This is not that Director Yang was surprised! What surprised him was that when Lin Yu ligated the blood vessel just now, he didn't suck the blood out first, but directly used a needle and thread to tie the traffic branch!

Although it is a communication branch, the blood vessels are not small!

Why can he see the blood vessels clearly in his blood? This is what bothers Director Yang! This is a blind operation! This is too good.

Director Yang couldn't imagine that a doctor could actually ligate blood vessels in the blood! Lin Yu left him with too many surprises, these days, since he knew his identity, he had been a little skeptical about him, but now it seems that these attitudes are useless!

Lin Yu looks young, but his surgical ability and level have long exceeded his age, and even many chief physicians can't catch up with him, the patient's adhesion is so serious, he actually did it, and the speed is still so fast! He feels handy when he starts the operation, there is no action without the slightest hesitation, he is also a surgeon, and he will doubt it many times before doing it himself, and then he has to confirm it again before starting.

Today's Lin Yu's performance directly startled Director Yang in two places, one is that he didn't hook out the stone of the common bile duct with the help of anything, and the other is that just now, he first ligated the blood vessels, and then sucked the blood clean! This operation is simply against the sky.

Director Yang was completely convinced of Lin Yu!

Han Qiang also saw it in his eyes just now, but last time, Lin Yu had already praised it once, he was not too surprised, he also asked him later, he still said the same thing, he had done this kind of work when he was an intern before, so he didn't need to suck the blood clean, and then he could also ligate the blood vessels.

This guy is simply a wonder in the world of surgery.

After the operation was done, Lin Yu began to instruct the postoperative precautions!

"The T-tube will be clamped 10 days after surgery, and a cholangioscopy will be performed a month and a half later, and the T-tube can be removed if there are no residual stones!"

Lin Yu stepped down after speaking.

"Oh! this... Then go to your hospital, we don't have cholangioscopes in our hospital!" Director Yang was not very embarrassed.

"Oh, then you can only go to our hospital, but now it's fine, it's convenient! Unlike before, you have to drive for three or four hours!" Han Qiang drove back and forth last time, and he was too tired to do it.

"That's too!" Director Yang agreed.

"Oh! Since that's the case, forget it! No need to go for a cholangioscopy! I've already seen it, there are no residual stones, and there are no other problems, there is no need to spend that unjust money!" Lin Yu directly suggested.

"Brother, this is a medical routine! There is no way to trouble a little!" Han Qiang was frightened by Lin Yu's words, and secretly said that your head is convulsive, I admit in good conscience that you did a beautiful operation, but you should also think that this is a treatment routine, don't talk nonsense if you shouldn't say it!

Lin Yu was a little embarrassed!

"Director Yang, because the patient is your mother, I said this, other patients, I won't say this, because today's operation went very smoothly, there is no problem, you can rest assured! Everyone is so familiar, I don't want you to make this trip!" Lin Yu said sincerely.