Chen Bingsheng stared at Li Xiyang for a long time, as if he wanted to see if he was telling the truth or a lie.

After all, no matter how high others rate the latter, he is just a young man after all.

The surgery for stage III stomach cancer, even if you look at the entire imperial capital, no one dares to say that it will be successful.

Did he actually do it?

It's just that the little guy has a calm temperament, and it doesn't look like nonsense.

At this time, Dong Lin on the side spoke, "Doctor Li, I believe in you!"

She has seen the other party's superb surgical skills with her own eyes, and he can even do a double lung transplant, no matter how tricky the current rectal cancer is, it must not be as good as a double lung transplant.

As a mature doctor, Dong Lin seems to have forgotten what it means to specialize in surgery.

Instinctively, I thought that Li Xiyang could even perform more difficult surgeries, and this rectal cancer surgery must also be possible.

Seeing that Dong Lin believed in the other party so much, Chen Bingsheng was no longer entangled.

"Okay, since you have faith, then you will be the main sword, and I will be your assistant!"

Saying that, Chen Bingsheng really let go of the position of the main knife.

"Thank you, Director Chen!"

Li Xiyang's expression was neither humble nor arrogant, and he stood directly on the main knife position.

Staring at the area where the tumor was located, Li Xiyang said slowly, "The fetus in the womb has had a certain impact on the tumor, and coupled with the volume of the tumor, the rectum has been seriously deformed.

The most important thing is that there are many blood vessels attached to the tumor area, and it is bound to cause a certain degree of hemorrhage when it is removed.

Therefore, the most important thing in this surgery is that the tissue is free!"

Chen Bingsheng nodded, "That's right!"

Because the rectum is deformed and squeezed, there is simply no room for a vascular clip where the tumor is located until the tumor is peeled off.

The only way to do this is to free up the nearby tissue enough to make room for the tumor.

The free work is simple to say, but the actual operation is a great test of the operator's skills.

According to the location of the tumor, Li Xiyang needs to complete the dissociation of at least 5 tissues in order to completely remove the tumor.

They are free mesocolon, free descending colon, free posterior rectum, free anterior rectum, and free lateral ligament.

Removing a tumor in such a small space is an extremely difficult technical task.

During the operation, whether it is a blood vessel that breaks a blood vessel and causes massive bleeding, or a tumor that breaks and causes cancer cells to spread, it will cause a fatal danger to the life of the patient and the fetus.

Chen Bingsheng had doubts to see if the latter could really do it.

At this time, Li Xiyang was also ready, and said, "The abdominal cavity automatically pulls the hook."

After rectal exploration, the first step is to free the sigmoid colon.

Dong Lin handed over the abdominal cavity automatic retractor for the first time, and Li Xiyang took it and quickly pulled the patient's abdominal cavity open.

"Xiao Qian, use a wet gauze pad to lead the small intestine to the right upper abdomen."

"Good!"

"Director Chen, pull the sigmoid colon forward to the right."

"Hmm!"

After instructing the two of them, Li Xiyang took the electric knife from the little nurse.

The electric knife quickly cuts the innate adhesions between the sigmoid mesocolon and the lateral peritoneum, and then makes a pelvic incision to the left posterior peritoneum of the rectum to the vicinity of the peritoneal flexion...

"Director Chen, further stretch the sigmoid colon to the right and forward, so that the ovarian blood vessels can be easily found at the iliac vessels and the left ureters can be found on the inside of the blood vessels."

….

"Good!"

Chen Bingsheng's technique is sophisticated, and his fingers pull the sigmoid colon slightly to the right and forward, and soon separates the soft tissue between the superior rectal artery and the fascia of the pelvic wall.

Then Li Xiyang was seen placing his left hand behind the free superior sigmoid mesocolonic artery as a guide protection, and holding an electric knife in his right hand to cut the root of the subperitoneal artery of the sigmoid colon upward.

Li Xiyang's technique was so fast that Chen Bingsheng's eyes straightened.

It is important to know that the slightest carelessness in this step can damage the nerves at the root of the inferior mesenteric artery.

It is an irreversible injury and is likely to lead directly to the failure of the operation.

In the past, when they operated on the anorectal department, they must have been careful and careful, and they didn't dare to be careless at all.

A second ago, Chen Bingsheng wanted to remind the other party out loud, but he didn't expect that before he opened his mouth, the other party completed the knife with one sword.

The horror is that it was done very well.

Is it absolute certainty, or is it luck?

Chen Bingsheng was a little stunned.

Unlike Chen Bingsheng's shock, Dong Lin only felt that his eyes were full of pleasing to the eye.

I finally saw Dr. Li's surgery again, it was so exciting.

Seeing that the sigmoid colon was almost free, Dong Lin asked, "Doctor Li, is it going to be ligated next?"

"Hmm!"

"Then is the ligation of the colon in a high position or a position?"

Dong Lin is not good at anorectal surgery, but many gynecological surgeries on the colon often have strict requirements for high and low ligation, and there will be no postoperative complications.

Li Xiyang smiled and said, "The ligation here is to move the descending colon down and facilitate the next step of freeness, so the low ligation is chosen.

However, in general, there are no strict requirements for the ligation of the sigmoid colon in the high and low positions, because this does not affect the survival rate of the patient.

However, it is important not to injure the left ureter during ligation at the mesenteric root, as the left ureter is on the left side of the inferior mesenteric artery pedicle, which is close to the pedicle and can be easily injured."

Dong Lin seemed to understand whether he understood or not, but Chen Bingsheng heard it clearly.

This kid said the key point of this operation in a few words, he turned out to be really proficient in anorectal surgery!

It seems that the previous knife can't be messed up.

At this moment, Chen Bingsheng stared at Li Xiyang as if he saw a piece of glowing gold.

Once the ligation is complete, the next step is the free colon of the descending colon.

Chen Bingsheng kindly reminded, "Dr. Li, one of the most common mistakes in the dissociation of the descending colon is to travel upstream to the spleen along the toldt white line.

The descending colon is usually forcefully pulled inwards and medially, but it is dissociated upside along the Toldt line alba and gradually dissociates medially, finding the Gerota fascia in the left kidney, where the colon is free on its superficial surface.

Do not detach from the deep surface of the Gerota, because the deep surface of the Gerata fascia is prerenal fat, which is very susceptible to injury."

The free difficulty of lowering the colon is the most difficult among the five-step free operations, and Chen Bingsheng can't help but be nervous for Li Xiyang.

It's good for young people to be confident, but you have to be cautious in this step.

Li Xiyang nodded, "Thank you, Director Chen, for reminding me."

But he only said that, because the blade in his hand was instantly slashed without the slightest hesitation.

It was even a few points faster than it was one step earlier.

"For the free of the descending colon, it is best to choose to close to the free colon and cut the diaphragmatic ligament, splenic and colonic ligament, and distal transverse mesocolon successively, and at this time, the inferior mesenteric vein can be cut at the lower edge of the pancreas to further make the colon easy to move downward.

When the free descending colon and splenic flexure are performed, it is more convenient for the surgeon to switch to the right side, because this angle of view is better, and the spleen is not easily damaged, and the incision can be extended upward for free if necessary.

Finally, the colon is cut with purse forceps, and the anvil of the tubular stapler is inserted proximal, and the distal end is sterilized and ligated."

Li Xiyang was unhurried, and explained to everyone while operating.

When his last note falls, the descending colon is free!

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