In addition, one of the things that Murphy's mother is worried about is that the private clinics she goes to in Los Angeles usually don't do surgery.

In other words, just look at some minor problems, and if there is a major illness, immediately refer to the affiliated hospital or a higher level hospital.

This iris clinic, okay?

Zhou Qiao seemed to see her worry, so he smiled and said to her: "Our operation was carried out in the operating room of the community hospital. ”

Because of the operating room of the iris clinic, the conditions really can't keep up, mainly because of the supporting problems.

Once there is a serious accident in major surgery, the supporting rescue facilities are naturally more complete in the community hospital, and the rescue is a race against time, saving people is like fighting a fire.

So usually, major surgeries are performed in community hospitals or higher-level hospitals.

But if the clinic is bigger, especially rich, like the Mayo Clinic, the hardware and software are listed in the forefront of the world, almost not weaker than any big hospital. That's another story.

Therefore, whether or not doctors in private clinics in the United States can perform surgeries and what kind of surgeries they can perform is mainly determined by the level of clinic doctors, rather than legal issues.

Murphy's mother was worried, but she didn't have a say.

After making preoperative preparations, Zhou Qiao took a group of people to the operating room of the community hospital. The anesthesiologist is still the senior Nancy team.

Nancy was a little busy this afternoon, and she had to support three surgeries in succession.

Change shoes, change clothes, brush hands, disinfect, and go to the operating room......

The anesthesia is ready, and the time is out......

It's still Ava as a roving nurse, Elena as an instrument nurse, Zhou Qiao as the surgeon, and Murphy as a surgical assistant!

Murphy stared intently at Zhou Qiao's operation.

This time, the surgical method chosen by Zhou Qiao is "minimally invasive surgery for gastric tumor resection combined with double scope" combined with laparoscopy, that is, LECS surgery.

Because the tumor is very small.

LECS surgery, which combines laparoscopic gastrectomy with endoscopic submucosal dissection, accurately visualizes the location of the tumor and determines the precise resection line, so as to remove the gastric tumor while minimizing the margins.

The original LECS (classical LECS) was indicated for gastric submucosal tumors (SMT) without ulcers.

Subsequently, the indication for LECS was expanded to include gastric SMT with ulcers and gastric cancer without lymph node metastases.

However, one of the major drawbacks of classical LECS is the risk of contamination of the peritoneal cavity by gastric contents and intraperitoneal spread of tumor cells.

In order to expand the indication for LECS to include gastric epithelial neoplasia, a number of modified LECS have been developed, such as reverse LECS, non-exposure endoscopic gastric wall reversal (NEWS), clean non-exposure technique (CLEAN-NET), and closed-LECS, which are currently used to treat patients with gastric epithelial tumors.

To put it simply, the advantage of gastroscopy lies in precise positioning, which can enter the inside of the stomach, accurately locate the specific location of the tumor, and remove the tumor from the inside of the stomach, but when the wound is large after full-thickness resection under gastroscopy, it is difficult to suture the wound.

The laparoscope can be very convenient for a series of operations such as resection, suturing, and hemostasis, but its disadvantage is that it can only be operated on the outside of the stomach and cannot explore the precise location of the internal tumor.

Therefore, the combination of the two is to develop the strengths and avoid the weaknesses, combine the advantages of both sides, work together inside and outside the stomach, and echo the inside and outside, which can not only improve the accuracy of the operation, but also greatly shorten the operation time and increase the safety of the operation.

Murphy has naturally never done this kind of surgery, but Zhou Qiao is a master! It's just 15 o'clock medical mystery point, and Ilena has two high-quality interactions!

Although it is not easy to accumulate medical mysteries, it is very difficult to "make a big fortune", but "small wealth" is really at your fingertips. So Zhou Qiao didn't cherish it so much.

As long as the baby is still there, Zhou Qiao's body is okay, and he can have a master-level medical skill every day!

It's too tiring to learn and practice, and the skills are instantly on the body, including theory and practice, it's so simple and rough!

Zhou Qiao chose the reverse LECS.

And with the assistance of Murphy and Elena, he also played a particularly handsome "left and right fight"!

Anyone who has watched Jin Yong's martial arts knows that the old naughty boy's left-right fight is a must, and even Huang Rong can't learn it, only Guo Jing, Xiaolongnu and other simple-minded people can master it.

At this moment, Zhou Qiao's left and right hand movements are different!

He manipulated the gastroscope with his left hand to accurately locate the location of the gastric neuroendocrine tumor, and used the gastroscope to cut the submucosa from the inside of the stomach along the edge of the tumor.

The right hand, on the other hand, controls the laparoscope and performs other movements.

Under the guidance of the gastroscope, the laparoscope is like an eye, peeling off the serous muscle layer from the outside, leaving the left and right hands, and at the same time "tunneling" from the inside and outside of the stomach.

As soon as this stunt came out, it was simply amazing on the spot!

Immediately, Murphy's body with an iceberg-like facial expression shook slightly, and the turmoil in her heart was indescribable, as if the world had opened another window for her!

"There is still such an operation? It turns out that you can still do this! What a dexterity of Dr. Chow's hands! ”

Murphy's heart was like a stormy wave, and her admiration was like a surging river, but her expression was still wooden. Only the essence of the blue eyes that flashes from time to time can reveal such a trace of emotion!

Reverse LECS differs from classical LECS, which flips the tumor into the abdominal cavity after peeling off the serous muscle layer, while reverse LECS turns the tumor inward into the stomach cavity.

Zhou Qiao explained in detail while walking smoothly and lifting weights lightly.

In order to make Murphy hear more clearly, he even asked Ava to turn off the stereo.

For the first time, there was no music for the surgery.

Originally, Ava still wanted to listen to "Sunshine Rainbow Little White Horse"!

It is said that this Chinese song is particularly cheerful and magical, anyway, what you can't understand is Gaodashang! For Elena and Ava, almost all Chinese songs are tall!

Just like some bars they went to in high school, the Chinese songs were played, which was called foreign atmosphere.

It's a pity that Zhou Qiao didn't know them at that time, if he followed, he would know, what are they putting together, good bar jumping, you show me a "Family with Children"?

After endoscopic incision of the submucosa to determine the resection line, sutures are used to suspend the stomach wall around the tumor like a crown.

Pull each suture out of the abdominal cavity using the Endo Close closure device and secure it at the level of the skin with clamps.

Endoscopic and laparoscopic full-thickness resection is performed, during which traction sutures are used to turn the tumor into the gastric cavity to prevent contamination of gastric juice and contact between the tumor and the abdominal wall.

The tumor is removed into the stomach cavity and the specimen is removed by mouth.

Then, the edge of the incision line is temporarily closed by manual sutures, and then the incision line is closed using a laparoscopic suture device.

The surgery went very smoothly, and the tumor of about 2.5 cm x 2.5 cm was removed very completely, and the sutures of the stomach wall were carried out smoothly.

Now that there is a surgical assistant, the finishing work such as suturing in the back does not need to be done by Zhou Qiao himself, and it is directly thrown to Murphy!

Murphy is also quite willing, firstly, it is a rare opportunity to practice, and secondly, this is to stitch up her grandfather!

So, Murphy did it quite carefully and seriously!

She secretly thought that if she had a chance, she would have to ask Zhou Qiao for advice on the kung fu of "fighting left and right"! Of course, she didn't know that this was called "fighting left and right", she only knew that it was quite rare!