In the operating room, Liang Fatzi has completed the anesthesia.

Liao Yiyi took the left side decubitus position, and when he was attached to the second, the nurse had already done the colon cleansing work, and all the operations could be operated on.

Tang Fei took the standard trainee disinfection sheet, and then put on the stage in a surgical gown, she inserted the endoscope from the anus, gently followed the intestine retrograde, passed through the anal canal, rectum, descending colon, transverse colon, ascending colon, and finally the camera arrived at the destination - the end of the cecum, and the appendix communicated with the cecum in various parts.

Tang Fei found the position of the inner opening of the appendix here, fixed the lens in this position, stopped what he was doing, and waited for Yang Ping to come on stage.

The front is just the preparation for the operation, and the back is the real operation of the operation, and from this point on, the camera is turned on.

Therefore, the entire surgical video is taken under the scope of the intestine and the abdominal cavity, and there is nothing else.

Yang Ping washed his hands and went on stage, and Tang Fei helped fix the camera as an assistant.

The doctors in the classroom are watching a live video on a high-definition screen.

Endoscopic ultrasound begins with a small incision around the appendix fossa, through which it reaches and begins to look for the separation of the appendix and the mesangium.

Barely staying, Ultherapy separates the appendix and mesangium from the periphery, and the appendix is mostly necrotic and perforated.

Ultherapy serves as both a separation tool and a cutting tool, and the two functions are used intersecting, and the use is extremely skillful, and the appendix artery and vein are quickly separated intact and undamaged.

The most difficult step of endoscopic transcecal appendectomy is actually this step: separating and ligating or clipping the appendiceal artery, but for Yang Ping, it is not a problem.

The absorbable vascular clamp clamps the appendix artery, and the ultrasound knife precisely cuts it, and finally along the edge of the appendix fossa in the inner wall of the cecum, the appendix is decisively and completely removed.

The price of absorbable vascular clips is a bit expensive, but it can be dissolved and disappeared in the body in the future, so it is worth the cost.

The operation continues, and every instrument under the scope is more flexible than the doctor's fingers, and it has been done as he wants, and he has realized what he thinks and does.

Just now, when the separating device gently plucked the appendix, the appendix and the surrounding adjacent organs could be seen almost 360 degrees, and the operation vision was excellent.

The adhesions that were originally regarded as tigers were no threat to Yang Ping, and his instruments were always operating in the dissecting gap, like a fish in water, and he was able to swim with ease, although the gaps had been eliminated by the adhesions, Yang Ping was still able to find their location.

Appendectomy is very simple, but it is very difficult to remove the cecum endoscopically, and the appendix is adherent to the surrounding area, an abscess is formed around it, and there are adhesions in the bowel, so this operation is extremely complicated and difficult.

No one dares to use this new procedure to deal with such complex acute appendicitis, neither the ability to operate the instrument, nor the field of vision, nor the operating space.

The appendix has been completely removed, removed from the body and put into a specimen bag, and sent to the pathology department for pathological examination after surgery.

According to medical practice, any organ or tissue cut out from the human body must be sent to the pathology department for pathological examination.

After the appendix was removed, a small incision appeared in the cecum where the appendix had originally opened, and with this incision, Yang Ping's instruments entered the abdominal cavity again and began to clean the pus.

The suction device under the endoscope sometimes suctions and sometimes flushes, and begins to suction and rinse without dead angles in the carpet style.

This is the most difficult step of surgery, compared with open surgery or laparoscopic appendectomy, this step of endoscopic transcecal surgery will be limited by the operation field and operation space, because the instrument entering from the incision of the cecum wall cannot be as comfortable as open surgery or laparoscopic surgery, and it has an inevitable field of vision and operation blind area.

Moreover, this blind spot is very large, which means that it is simply impossible to completely deal with abscesses and adhesions with this method, which is why others dare not use this procedure.

Director Fang stared at the high-definition screen, and his eyes didn't dare to blink, for fear of missing the most critical step, after all, this kind of surgery is hard to come by, and once he misses it, maybe it will be difficult to see it in the future.

He also has many questions in his heart, such as how to deal with abscesses and intestinal adhesions, and the blind spots and blind spots of the instruments are objective difficulties, and it is impossible to rely on the proficiency of the operation to make up for them.

The next operation completely broke through Director Fang's imagination.

The attractor under the mirror is both a blunt separation tool and a flushing suction tool, and I don't know why, but the field of view and operation space on the video are completely unrestricted.

The parts of the abdominal cavity that need to be treated are gradually all displayed in the field of vision, and under the gentle operation of the instrument, the abscess appears in the field of vision little by little, without a trace of omission, just like laparoscopic surgery, there is no blind area and dead end.

What's going on?

Obviously, it is endoscopic transcecal resection, and the field of vision and operating space are as free as laparoscopic surgery.

Has it been converted to laparoscopic surgery?

Impossible, the whole live video of the operation has been continuous, without any interruption, not even stuck, how can it be possible to change the surgical style.

If you want to change the technique, the current video will inevitably need to be interrupted, and the video after the change will inevitably start after the interruption, and there must be a pause period in the middle.

Director Fang didn't dare to think too much, for fear of being distracted and missing some shots, he continued to watch.

The suction device thoroughly flushes and suctions the abscess, and even expands the scope to the surrounding normal area, Director Fang saw that in the end, the entire field of vision was no longer a little turbid under the irrigation of normal saline, and it was completely clear and clean.

When Director Fang was puzzled, the adhesion treatment of the intestinal tube also appeared a similar magic, the dead angle and blind area did not exist at all, the intestinal tube seemed to pass through all under the field of vision, and the adhesions were gently separated by the ultrasound knife.

Even Director Fang didn't see the energy used by the ultrasonic knife, and the whole process was used as a purely mechanical separation forceps, and under the skillful separation of the ultrasonic knife head, all the existing adhesions were easily separated.

This is followed by an orderly and thorough rinse, and the entire abdominal cavity is cleanly treated.

In the end, the intestinal tube, which seemed to be disturbed, was completely returned to its place after treatment.

Perfect! It's hearty and refreshing.

Any surgeon who sees this kind of surgery will have the first impression that the postoperative results will definitely be good.

Cleanliness is a guarantee of quality, and the same applies to surgery.

The source of infection was the appendix, which has now been completely removed, and the surrounding abscess caused by the appendix has been treated cleanly, and the natural infection has been eliminated.

Director Fang has only recently carried out endoscopic transcecal appendectomy, and there are only three cases, which is very inexperienced.

Not to mention this complex acute appendicitis, even if it is simple edematous appendicitis, he has to tinker for two or three hours, sometimes longer, the step of separating the appendiceal artery is not skilled at all, and the separation can only be successful for a long time.

In fact, this new type of surgery has not been carried out in the country for a long time, and many first-class hospitals have just carried out it and achieved zero breakthroughs.

Whether it is the imperial capital or the magic capital, the situation is similar, it has only been carried out recently, and the number of surgeries has not accumulated much.

As for the second attachment saying that he also carried out this kind of surgery, it is still unknown whether he will carry it out or not.

The appendix has been removed, the abscess and adhesions have been treated, the irrigation has been so thorough, and the operation should be over.

The small incision left in the inner wall of the cecum due to the removal of the appendix is tightly sutured and sealed.

The instrument exits at the end of its work, and even the instrument exits on the screen appear smooth and silky, and it quickly shuttles and exits in a safe gap.

When the instrument retreats to the ascending colon, the video is terminated and the screen is turned off.

Endoscopic transcecal appendiceal resection, as well as dealing with a wide range of abscesses and intestinal adhesions, is faster and easier than opening the surgery yourself.

This blow made Director Fang completely forget the shame of "driving sheep".

The doctors of general surgery were like watching a blockbuster movie, and they looked at their companions with puzzled eyes, hoping to get an answer.

Because what they see is different from what they first imagined, and it conflicts with their knowledge and experience.

This surgery should be done slowly and carefully, and Yang Ping's surgery was obviously very fast.

The most incomprehensible thing is how Yang Ping managed to break through the field of vision and operate the blind spot, he also used the hospital's endoscopic system, how could there be no blind spot, impossible.

It is easy to think of such objective blind spots from the professional perspective of surgeons, but today's surgery clearly does not exist.

Where did you get a 360-degree rotating lens? I don't think I've heard of such a lens, and even if there is, the device can't rotate 360 degrees.

Everyone looked at Director Fang, hoping that the director could explain a few words, Director Fang knew what everyone wanted to ask, and his old face was slightly hot: "I don't know, I have time to ask Professor Yang." ”

"Tang Fei, you come and exit the camera and equipment."

Yang Ping withdrew the instruments to the ascending colon, stopped the operation, handed over the rest of the work to Tang Fei and Gui Peisheng, took off the surgical gown, and returned to the classroom.

"Professor Yang, how can your camera see the entire abdominal cavity, and the instrument can also handle the target of the entire abdominal cavity?" Seeing Yang Ping coming to the classroom, Director Fang couldn't help but seize the opportunity to ask.

Yang Ping smiled and said, "Director Fang, the intestinal tube is soft, and the cecum is naturally soft-——

"Professor-——"

Halfway through Yang Ping's words, Song Zimo, who was standing at the door of the classroom, seemed to have something to look for Yang Ping.

"We'll talk when we have time." Yang Ping got up and left.

What do you mean?

The intestinal tube is soft, and the cecum is naturally soft?

Is it that when the intestine is hard, or someone has a hard intestine?

I didn't know that the cecum was soft? Don't know if the bowel is soft?

A doctor knows that the intestinal tube must be soft, and the cecum is also the intestinal tube, and it must also be soft, is there a problem?

Director Fang scratched his head and looked at the skull pain during the operation.

"Director, what did Professor Yang say just now?" A general surgeon asked.

Director Fang said angrily: "The intestinal tube is soft, and the cecum is naturally soft. ”

The doctor who asked was confused, what Director Fang meant by this.

Director Fang's phone vibrate, and the old classmates of the second attached pair wanted to come to see the operation and also wanted to learn and learn, after all, it was a new technology, and it was exciting to use the new technology to make such a complex appendix.

"The road is very congested, and half of it hasn't been reached yet, is it convenient to park in your parking lot?" The anxious voice of the doctor attached to the second.

Director Fang sighed and said, "Don't come, turn around and go back." ”

The doctor in the second part of the appendix couldn't cry or laugh: "What's the matter? -——”

Thinking of the sad and sad tone of the old classmate, I instantly understood, is it that people are hanging? I didn't even have a chance to operate, hey, the second doctor regretted it very much, and was very sad, if I had told my family at that time, I would have had surgery as soon as possible, and I would have a good life.

"That's- I'm going back, next time I'll get together." The second doctor is not feeling good in his heart, and he is also very uncomfortable.

Director Fang hung up the phone and sneered in his heart: I really don't know the market here, people came back from the last trip to the toilet, the operating room has begun to be cleaned, and you still drive to see the operation? I haven't seen the world.

"Director, what do you mean by that sentence just now?" The general surgeon next to him thought for a long time but didn't understand.

Director Fang stared at the doctor: "You think slowly, you have to learn to use your brains and open up your minds, understand?" Don't ask any questions at once. ”

The doctor nodded.

The anesthetic dose of Liao Fatzi was used very accurately, and soon after the operation, Liao Yiyi woke up from anesthesia, and she saw Liang Fatzi at first sight.

"The surgery is done, and there will be no scars." Liang Fatzi helped her to wipe away her tears.

Liao Yiyi was a little confused, but she understood Liang Fatzi's words, nodded, her hand reached out and grabbed Liang Fatman's hand, and her heart was instantly steady.

——

Waiting area for dependents.

Just when Liao Yiyi's parents were anxious and uneasy, the door to the operating room finally opened, and Liao Yiyi was pushed out.

"Yiyi, what's wrong!"

The two old men immediately rushed up and held on to the handrail of the flat car.

"Everything went well, the surgery was perfect, there were no incisions, no punches, no scars." Liang Fat said proudly.

This can make Liao Yiyi's parents very happy, a feeling of the rest of their lives, looking at Liao Yiyi, who is already sober, the old couple just want to cry now.

"Xiao Liang, thank you really this time."

Liao Yiyi's father held Liang Fatzi's hand and couldn't let go for a long time.

"Yiyi, can you hear your parents?" Liao Yiyi's mother touched her daughter's face.

Liao Yiyi nodded, but after all, he had just finished the operation, and it was very difficult to speak.

"Dr. Liang, thank you so much." Yu Yihan also thanked Liao Yiyi.

Everyone sent Liao Yiyi to the ward, and the head nurse Cai had already arranged the suite ward of Corey and personally greeted Liao Yiyi with the nurse.

"Dr. Liang, I heard that you are a relative, I will prepare a room in advance and live in this suite." Head Nurse Cai helped push the cart together.

Some passing patients in the corridor are also curious, what kind of person can live in this suite ward, in the general surgery, this suite ward is not just anyone can live, even if you have money, you must agree to it.

The success of the operation, the enthusiasm of the doctors and nurses, and the luxurious ensuite ward made Liao Yiyi's parents feel very comfortable.