This doctor is very stable

Chapter 120 Interventional Surgery for Hepatic Cysts

"Doctor Lin, you are talking about Doctor Qian!"

Lin Ran nodded suddenly, "That's right! Isn't Fatty Qian a man?"

"Dr. Qian was an accident. Dr. Lin is not suitable for joining the nurse group because of your personality."

Lin Ran: "..."

…………

At [-]:[-], Lin Ran and the others came to the locker room early.

Besides Lin Ran and the Three Musketeers from the surgery team, Xu Hong also came.

Although interventional embolization surgery for liver cysts is not as dangerous as interventional embolization surgery for hepatic hemangiomas, Lin Ran and the others are just residents after all, and tertiary surgery cannot be performed without the presence of a chief physician.

Don't be afraid of [-], just be afraid of what.

What's more, the patient is also a patient with multiple underlying diseases!

……

After brushing your hands, disinfect them aseptically and put on a surgical gown.

Entering the operating room, Li Canghai was still sitting on his small bench.

Seeing Xu Hong walking in, he stood up.

Lin Ran didn't talk nonsense, and directly stood in the position of the chief surgeon.

"Ms. Li, anesthetize, it will last for two hours."

Under the anxious gaze of the patient, Li Canghai began to administer the medicine.

The uncle of the patient who was nearly seventy years old gradually fell into a coma. Li Canghai asked cheerfully... "Lin Ran, this is the eighth liver resection patient with severe illnesses!"

Lin Ran stretched out his hand, and the nurse handed Lin Ran the tweezers tacitly, "The last of the eight liver resection patients admitted in the first batch."

After speaking, Lin Ran added alcohol cotton to stick iodophor, and began to disinfect the patient's upper right abdomen.

Xu Hong did not grab the first aid position this time.

Interventional embolization surgery for liver cysts is different from interventional embolization surgery for hepatic hemangiomas.

Interventional embolization of hepatic cyst is performed by transabdominal puncture and catheterization, that is, the site where the puncture needle is inserted is directly punctured from the belly into the abdominal cavity, and the direct interventional treatment is performed on the site of the hepatic cyst.

Without puncturing an artery there is not as much risk.

So Xu Hong naturally didn't have to be too cautious.

Ultrasound positioning, confirmation of puncture needle puncture point, and laparoscopic puncture point.

Interventional embolization surgery requires image guidance, and laparoscopic guidance is the most practical for hepatic cyst interventional embolization.

Therefore, two holes have to be punched in the belly of the patient.

After the positioning is completed, draw the positioning point, Lin Ran stretches out his hand, "Scalpel."

Two incisions were made in the patient's upper right abdomen.

Laparoscopic puncture was performed first, followed by needle puncture.

Seeing Lin Ran receive the laparoscope in an orderly manner, Xu Hong nodded in relief.

The others were a little fascinated by watching, Lin Ran stably inserted the laparoscope into the retroperitoneal cavity.

The vision of the patient's intra-abdominal cavity is also clear on the laparoscopic display.

However, due to the influence of the lymph node tissue and the angle setting of the laparoscope, the field of view of the liver cannot be seen clearly for the time being.

Lin Ran looked at it, adjusted the angle of the laparoscope, and said, still a little dissatisfied, "Charge some carbon dioxide."

Pump air into the patient's stomach, the purpose is to make the patient's abdomen swell up.

So that the field of view of the laparoscope can more easily capture the field of view of the liver.

As for how much to inflate, it depends on the field of view of the laparoscope, but it should not be inflated too much. If the gas is inflated too much, it will compress the abdominal organs of the patient, and it may cause pneumoperitoneum syndrome.

The nurse held the gas tube and connected it to the special vent hole on the laparoscopic end, and started to pump air.

Lin Ran checked the laparoscopic field of view on the laparoscopic monitor while watching the pumping situation, and also manually adjusted the field of view angle of the laparoscope.

After the patient's belly swelled slightly, Lin Ran found the angle he needed, "Okay."

At this time, the laparoscopic monitor presents a clear and complete view of the liver, cysts, and multiple cystic cavities bulging on the surface of the liver, which can be seen at a glance.

"it is good."

After watching Lin Ran's series of smooth operations, Xu Hong couldn't help cheering in a low voice, "Lin Ran, this technique of piercing the field of view of the cavity-adjusting mirror is enough for you to learn for half a year! Watch it carefully!"

Qian Xuan...'It looks very simple! '

Fan Jianye...'It looks simple but hard to use! '

Liu Chengtao...'Anyway, I don't know how to fuck you. '

Lin Ran looked at the second assistant Qian Xuan lightly: "Hold the laparoscope, hold on, no matter what happens, don't move the laparoscope to understand?"

The stability of the laparoscopic field of view sometimes determines the success or failure of the operation.

Surgical field of view is too important for the surgeon.

Maybe because of a shudder from the assistant of the endoscope, Lin Ran would insert the wrong position if he couldn't see clearly.

Qian Xuan also became serious, "Okay, I understand, I won't move even if there is an earthquake."

"Puncture needle." Lin Ran stretched out his hand, and then chatted, "Qian Xuan, don't tell me, the earthquake happened during the operation is a real case."

Qian Xuan... "No way! Then what if there is an earthquake during the operation?"

Xu Hong chuckled, "What can we do? If the earthquake is not strong, we can continue the operation after the earthquake. If the earthquake is strong, take emergency measures immediately and take the patient to a safe place. Anyway, we can't abandon the patient and escape alone."

Xu Hong doesn't know what other people are like, but his student Xu Hong definitely wants this teaching.

As a doctor, if he abandons his patients, he might as well go home and grow sweet potatoes.

Of course, Dongyue Province is located in the southeast of China, and earthquakes rarely occur.

"Oh!" Qian Xuan replied seriously, but no one knew what he was thinking.

Lin Ran took the puncture needle and punctured along the incision. Under the laparoscope, it was clearly seen that the puncture needle pierced the greater omentum of the abdomen.

Lin Ranyou slightly adjusted the angle to aim at the cyst in the liver, "puncture sheath."

Insert the puncture sheath and pull out the puncture needle.

Lin Ran looked at Fan Jianye, "Come and hold the puncture sheath, don't move the position, understand."

Fan Jianye nodded busy.

Interventional drainage surgery is not too complicated in terms of steps, and the difficulty is not very high, but it requires very precise operation techniques, which will test the degree of understanding of abdominal anatomy and understanding of liver diseases.

Insert the catheter, stably penetrate the cystic cavity of the liver cyst and connect the syringe to extract the cystic fluid.

Lin Ran supported the catheter and watched the position change of the cyst on the laparoscopic monitor, and ordered Liu Chengtao to suck the cyst fluid.

As the cyst fluid was extracted, the cyst cavity that was still swollen just now shriveled up.

"Okay, let's inject normal saline to clear the cyst cavity."

Qian Xuan saw that Liu Chengtao was a little nervous being directed by Lin Ran, so he smiled and said, "Doctor Liu, don't be nervous! You are better than the nurses who give patients infusions outside the operation."

Lin Ran glanced at Qian Xuan, "Don't look crooked when you look at the mirror."

Liu Chengtao looked at Lin Ran, "Why don't you come, Doctor Lin? I'll take care of it."

Lin Ran nodded, "Then change hands!"

It is natural to be nervous when doing something unfamiliar for the first time, and you have to be careful about injecting normal saline into the cyst cavity, otherwise too much injection may cause the cyst cavity to rupture and cause massive bleeding.

"Steady, don't shake."

The other end of the catheter is connected to the cystic cavity, and the hands are shaking like the second uncle is definitely not good.

Not shaking hands is also a basic requirement for a surgeon.

His hands were trembling like a second uncle, so he had to leave the operating table quickly, otherwise he would definitely hurt himself and others.

The two exchanged positions, and Liu Chengtao felt relieved to take over the job of supporting the supervisor.

The operational steps are still up to the master!
The chief surgeon is the backbone of all doctors and nurses in the operating room!
Xu Hong didn't say a word, but he frowned at Liu Chengtao who was holding on to the catheter.

Lin Ran operated the syringe in his hand, stared at the cystic cavity on the abdominal display screen, and injected normal saline into the cystic cavity.

With the injection of normal saline, the cyst cavity swelled up again.

Repeated injection and suction of normal saline to achieve the purpose of flushing the inside of the cyst cavity.

Finally, all the normal saline was drawn out, and an appropriate amount of absolute ethanol was injected to fill the cyst cavity.

The purpose of injecting absolute ethanol is to destroy the cyst wall cells, so that the cyst will harden and no longer grow.

So as to achieve the purpose of curing, but generally speaking, it is relatively rare to achieve the purpose of curing immediately after an interventional treatment, but it depends on the postoperative recovery of the patient.

After one cyst was treated, Lin Ran put down the syringe in his hand, took over the catheter and aimed at the other cyst again.

By analogy, as many as six cysts on the patient's right liver lobe were treated separately.

The whole operation took an hour and a half.

……

After walking out of the operation, the patient's family immediately greeted him worriedly.

Lin Ran immediately looked at Qian Xuan, this guy is getting better and better at dealing with the patients' families.

Lin Ran was also very relieved to give him the miscellaneous tasks such as explaining the operation to the patient's family and issuing doctor's orders.

Fan Jianye, Liu Chengtao and nurses pushed the patient to the intensive care unit.

Lin Ran and Xu Hong walked to the locker room side by side.

"Lin Ran, what do you think of Dr. Liu Chengtao Liu?"

Lin Ran didn't understand Xu Hong's question, "Dr. Liu is very good! It may be the first time for him to perform an embolization operation, so it's understandable that he was a little nervous."

Xu Hong nodded, as long as Lin Ran thinks it's good, Liu Chengtao can stay and observe.

(End of this chapter)