"Don't teach my little Ji badly." Director Liu brushed his hands and came back, and was hearing the roving nurse chatting with Ji Xiang, he got dressed while eliminating his hands, "Tomorrow I will take Xiao Ji to the flying knife, how is it not better than being the head nurse." ”

"Just you, tired like a dog, you have a life to earn a life." The itinerant nurse didn't want to directly take Director Liu's words back.

"We have high ambitions in exosurgery, how can orthopedics compare with us." Director Liu got dressed and crossed his hands behind him.

"I won't wear it myself!"

"I'm used to it, it's been like this since I first started learning surgery, and I can't do surgery without anyone to tie my clothes and straps." Director Liu smiled and talked nonsense with the itinerant nurse.

"Why are you so ambitious?" The itinerant nurse tied the straps of the sterile gown, and squatted down to help Director Liu pull the lower corner of the sterile gown, making the clothes flatter and more comfortable.

"The poet saint Du Fu said in the Tang Dynasty that this is stamped and certified."

"What?"

"The middle man is definitely short, how can he guard the royal city."

“……”

After Ji Xiang finished laying out the list, he happened to hear what Director Liu said.

Tsk, what a cultured old rascal.

Director Liu just talked nonsense, which did not affect his concentration and concentration in the slightest.

Seeing that Ji Xiang stood directly in the assistant's position after laying out the list, Director Liu didn't say much, and stood in the operator's position to start the operation.

The patient was under general anesthesia, and Director Liu made a 1.5cm incision under the costal margin of the posterior axillary line to the retroperitoneal space.

The incision stopped the bleeding, and he put his finger along the incision to push open the peritoneum, insert a balloon, and inject about 800ml of air.

"If you want to talk about technological progress, it's really fast. When I first learned surgery, I had a total nephrectomy and a major surgery. The hand reached in and pinched the kidney pedicle and clamped it directly, and the operation was simple. After Director Liu injected air, he put his hands in the sterile area and began to chat.

It's going to take a while here, Ji Xiang knows.

"You said how much waist you have lost in your life." The itinerant nurse said disdainfully, "Aren't you afraid that you won't have a waist in your next life?" ”

"Healing and saving people, can it be called Ka waist?" Director Liu said, "You don't understand the matter of technological progress. ”

"Looks like you know."

Several people chatted nonchalantly, and Ji Xiang was carefully observing the difference between the equipment in the operating room and the system operating room.

The difference is huge, and the system operating room should be the upper limit of the current era, both hardware and software.

After staying for 5 minutes, Director Liu shut up and started the operation again, and he switched between the two states freely.

Director Liu expanded the retroperitoneal space, deflated the balloon, and selected an appropriate position to put in the cannula according to the location of the tumor.

The operation was done here, and Director Liu gradually became serious.

He is like a hero who wants to compete in martial arts and face a lifelong enemy, and he is gradually adjusting his state.

Director Liu fixed the posterior axillary line casing with No. 7 line, and then filled with CO2 gas to maintain the pressure at 12-14mmHg.

The spatial condition is observed laparoscopically, and the renal artery and renal vein are free from the renal fat sac on the surface of the psoas muscle. The perirenal fat is then freed and placed as close to the kidney tumor site as possible.

At this point, everything is no different from previous surgeries.

But when Director Liu continued to wander, he immediately found the difference.

The closer to the tumor the tissue, the more convenient it is for the tissue to be free, because of embolism, the tumor and the surrounding tissues within 1 cm have developed avascular necrosis, and after the initial edema phase has ended, the surrounding vascularized tissues have stratified.

So that's it!

Director Liu confirmed his guess.

Although it is a laparoscopic operation, it is impossible to feel the changes in the kidney tissue with his hands, but Director Liu has done similar surgeries for many years, and he can feel the local changes with long forceps.

He clamped the renal pedicle artery vascular clamp to control the blood supply to the renal pedicle.

After the clamp is firmly pressed, about 100 ml of ice saline is injected through the suction device, and the temperature is locally lowered to protect the kidneys.

Gradually separated close to the tumor, the tissue around the tumor becomes as simple as a mille-feuille.

In the past, the operation was very nervous during this countdown period, for fear that the operation could not be completed smoothly due to the delay.

After all, the renal artery is clamped and closed, and once the tumor cannot be removed in the countdown and the blood supply is opened again, the next closure will waste at least 10 minutes just to stop bleeding.

In that case, simple surgery will be complicated and the difficulty will increase dramatically.

However, the tumor resection after interventional surgery is completely different, and the difficulty of surgery plummets.

Soon, Director Liu realized another benefit.

In the countdown time, you can just free and cut along the part that has already appeared necrosis, because the embolized tumor artery, the place where there is no blood supply is the blood supply of the tumor artery.

What the hell!

The more Director Liu does it, the happier he becomes.

"Specimen bag." Director Liu said in a low voice.

"Director Liu, cut it off?" The anesthesiologist also reports the time once a minute to remind the surgeon. He didn't expect it to be so fast!

"Hmm." Director Liu nodded happily.

The anesthesiologist had just finished taking the anesthesia record and had not had time to look at the screen.

Looking up and carefully distinguishing, the anesthesiologist's mask moved.

"Director Liu, why do I feel different from the previous surgery?" The anesthesiologist asked, confused.

"Didn't you say that the patient first embolizes the blood supply vessels of the tumor, and the tumor tissue and surrounding tissues have a certain degree of necrosis." Director Liu put the tumor and adipose tissue into the specimen bag and pulled it out.

"The necrotic tissue and the surrounding normal kidney tissue are really layered, layered." Director Liu couldn't help but praise it.

"2 x 0 absorbable lines."

"I'll go, Director Liu, you're really researching new techniques!" The anesthesiologist said in surprise.

A doctor of Director Liu's age rarely comes into contact with new things, and his old book is thick enough, so why bother to find himself unhappy.

Besides, is mature technology also responsible for patients, the vast majority of old directors and professors think so.

Originally, the anesthesiologist was surprised to see the description in the medical record that the patient had undergone an interventional operation a few days earlier, and he did not know the significance of doing so.

However, from the perspective of the surgical process, the significance of this is simply too great, and the difficulty of the operation has plummeted.

The instrument nurse handed over the 2 0 absorbable threads and needles to Director Liu.

The word "8" was stitched, and Director Liu cautiously made up two more stitches.

The vascular clip was loosened to restore the blood supply to the renal pedicle, and Director Liu and Ji Xiang observed whether there was active bleeding in the wound.

There was no active bleeding, hemostatic gauze covered the wound, and a silicone drainage tube was placed around the kidney.

Before the itinerant nurses and instrument nurses had finished counting the instruments, the operation was over.

"Finished! Call it a day! "Director Liu is in high spirits.