Yin Yuan's cancer is not too big, from the CT scan done before the operation and the fingertips of the liver hilum to see that the diameter of the tumor is six centimeters, which is also why she found it relatively early, if the tumor is not good in the evening for a month or two, the tumor can grow to ten centimeters, or even larger, this is no way to do rectal cancer The growth rate is so fast, or it will not become one of the worst cancers in the future.

With the development of medicine, rectal cancer can also be done with endoscope, and the use of endoscope can reduce the trauma to patients, but this surgical method is only suitable for patients with a cancer diameter of less than 5 mm, and few patients can find themselves with rectal cancer when the cancer is so small.

Yin Yuan's cancer is six centimeters in diameter, which is even more impossible to do with an endoscope, and there is no way to do the operation if you choose an endoscope, and because Yin Yuan's cancer is only five centimeters away from the anus, which belongs to the lower rectal cancer, so Su Hongwen chose the surgical method is transabdominal perineal combined resection, the English name is Miles surgery, which is a radical surgery, but the conventional transabdominal perineal combined resection is to make a permanent colostomy in the abdomen, that is, an artificial liver door, but Su Hongwen will not do this, He wants to save Yin Yuan's anus and give her a good quality of life after surgery.

Before the operation, Su Hongwen also talked to Yin Yuan a few words, after the jumping incident, the girl finally ignited the hope of living again, she was very strong and optimistic before the operation. This is what Su Hongwen is happy to see.

Now that the anesthesia is over, Su Hongwen looked up at the anesthesiologist and saw if the operation could be performed now, and the anesthesiologist looked at the ECG monitor and nodded, "You can start." After saying that, he pressed the operation timer, and the red word 1 appeared.

Su Hongwen took the scalpel with a cold light and made an incision of seven centimeters in the middle of Yin Yuan's lower abdomen, today's surgery ordinary doctors will make an incision of 10 centimeters or even longer, the reason is that it will go deep into the patient's pelvis for a while, the anatomical structure in the pelvis is already complex, and if the incision is too small, it is not conducive to the operation.

Zhou Haidong is also an expert in surgery, and in addition to Su Hongwen, the oncology department is highly skilled, and he has not done this kind of surgery when he is abroad. But that time he didn't dare to make the incision so small. It was too laborious to operate such a small opening, and even Zhou Haidong's teacher, who claimed to be the best oncologist in the world, did not dare to make such a small opening, but Su Hongwen did it.

Zhou Haidong couldn't help but say, "Director Su, isn't this incision too small?" ”

Su Hongwen knew what Zhou Haidong meant, and he handed the scalpel to the instrument nurse while taking the electric knife and began to cut fat. When everyone smelled a scorched smell, Su Hongwen said, "It's not small." This incision is just right. It is not good for a patient when it is big. ”

Su Hongwen's so-called bad treatment for patients is that he doesn't want to make too big incisions to leave Yin Yuan with a big scar, and a girl who loves beauty doesn't like to leave too big a scar on herself.

Su Hongwen said so, Zhou Haidong was very interested, and he didn't say anything, anyway, this operation was done by Su Hongwen. It was also his problem that he insisted on making such a small incision and not being able to do the operation clean for a while.

Fat, muscle, and peritoneum were opened by Su Hongwen one by one, and Zhou Haidong first put the skin pad on both ends of the incision to tightly wrap the cortex, fat, muscle layer and peritoneum, and then used an automatic hook device to open the incision, the skin pad is to prevent the appearance of implantation, the so-called implantation is that the surgeon is contaminated with cancer cells on the gloves during the operation, and then the gloves are in contact with the cortex, fat, muscle layer, and peritoneum on both sides of the incision, and artificially let the cancer cells enter these tissues to grow. It also prevents cancer cells from falling onto these tissues during the process of cutting out the cancer.

Su Hongwen looked down at Shu Ye and didn't rush to continue the next steps, but put his hand in and touched the omentum, he was afraid that there were also metastatic cancer cells on the omentum, and after checking it out, Su Hongwen breathed a sigh of relief, and there were no metastatic swollen cancer cells on the omentum, which is a good thing, indicating that Yin Yuan's cancer has not completely spread out, otherwise it will be troublesome.

The instrument nurse handed over two dressings, and after Su Hongwen took them, he used long tweezers to stuff these two dressings into Yin Yuan's abdomen, and directly used these two dressings as obstacles to block the omentum on the top.

As soon as the omentum was pushed up, the lower part of the intestine was exposed, and the sigmoid colon and the lower rectum appeared a certain degree of adhesions, and there were some orange-yellow particles on the top, and there were no enlarged cancer cells on the mesentery, which is also a good thing, if the mesentery is full of swollen cancer cells, there will be a lot of intestines to be removed, and once there are too many intestines removed, Su Hongwen will not be able to save Yin Yuan's anus, even if there is a mustard seed.

Why not? First of all, let's briefly talk about the principle of this operation, the so-called radical rectal cancer surgery is to remove the cancer and the intestine at a certain distance above and below the cancer, this distance has a standard in the textbook, but it is not a standard during the operation, the real standard is the intraoperative situation, the size of the cancer, whether there are enlarged cancer cells on the intestine and mesentery, these are the standards, and an experienced surgeon will decide how long the upper and lower ends of the cancer are removed according to these conditions.

The intestinal tube is like a twisted and coiled line, cut a piece in the middle, if you want to connect the two threads together, it depends on whether the remaining two ends of the line are long enough, once the intestinal tube is removed too much, the length is definitely not enough, how can this fit together? In the end, you can only give up the anus and make an artificial anus in the left abdomen, in this case mustard machine qì people can't help, they are to remove cancer cells, not to increase the length of the intestine.

Yin Yuan's condition is not bad, at least she saw that there were no enlarged cancer cells on the sigmoid colon, and those orange-yellow particles were fat granules, or adherent secretions.

Su Hongwen wanted to go through a long forceps and began to free the adherent intestines, he had adhesion reliever in his hand, but this thing was a little shady, and it was difficult to explain it if the people next to him really used words, and the adhesions in Yin Yuan's abdominal cavity were not strict, and the adhesions could be quickly lifted by conventional free methods.

Zhou Haidong admired Su Hongwen for the operation, he could see that Su Hongwen's surgical skills were quite skilled, and all the steps from laparotomy to free adhesion were done smoothly, which made people look comfortable and gave people a pleasing feeling.

This kind of pleasing feeling Zhou Haidong only has it when he watches his teacher do surgery, and he can't do it himself, so he feels that Zhou Haidong also admires Su Hongwen's surgical ability, he really doesn't know how Su Hongwen has such skilled and clever surgical skills at such a young age, but these are not important, the important thing is that his plan today will finally have a huge breakthrough, so Zhou Haidong can't wait for Su Hongwen to do it quickly, the sooner the better, he is already a little impatient.

Su Hongwen opened all the adhesions little by little, and the next thing is to sharply dissect the pelvic fascia wall layer around the mesorectum and the nonvascular interface between the visceral layer, this step is the difficulty of the whole operation, as mentioned above, the reason why rectal cancer has a poor recovery is because the operation has to go deep into the pelvis, there are too many organs here, and the space is small, it is very difficult to dissect clearly, and the average doctor wants to do a good job of rectal cancer surgery without decades of experience is not to think about it, This shows how difficult this surgery really is.

But these are not difficult things for Su Hongwen at all, the incision is only seven centimeters, but his hands can still dance unhurriedly like two flying butterflies, and those intricate structures in the pelvis are dissected little by little as they dance.

The steps of dissecting the pelvis that seem difficult to other doctors give people a very simple feeling when they come to Su Hongwen, as if he is not doing radical rectal cancer surgery, but doing a very simple appendicitis, which is shocking and contradictory.

Qin Shengjie, Ouyang Yuqin and Su Hongwen have undergone many surgeries, so it is not surprising that Su Hongwen can dissect the pelvic cavity so skillfully and easily, and Zhou Haidong, who had surgery with Su Hongwen for the first time, felt very shocked, today he is convinced, and he also understands the sentence that people are human beings and there are heavens outside the sky, he used to think that his teacher level was already very high, but now he is nothing compared to Su Hongwen, and he can't catch up with Su Hongwen.

At the same time, Zhou Haidong was shocked and rejoiced in his heart, the better Su Hongwen's surgery worked, his death will not be far away, at this time Zhou Haidong moved his head slightly, there was a small pinhole camera on his hat, all the processes of this operation were filmed by him today, and this surgical video will be Su Hongwen's life-saving talisman.

Su Hongwen's dissection is not to destroy the pelvis, but to make the surgical field clearer through sharp dissection, so as to facilitate the removal of cancer and lymph node scanning.

It took him an hour to do this step, and when the pelvis was thoroughly dissected, the dark red with a little black cancer appeared in everyone's field of vision, Su Hongwen held the cancer with one hand and gently stretched it, and the other hand stretched out and touched the lower end of the intestinal tube of the cancer, and then said: "Prepare the intestinal forceps, I want to cut the cancer." (To be continued......)