Chapter 1405

The preoperative case analysis was completed, the visual field was switched, and the live broadcast of the operation began 10 minutes later.

"Boss Zheng did the operation?" Lei Yinghua asked.

"Yes."

"What are you going to do?"

"..." Peng Jia was stunned.

Technique... I don't know. It has been less than three hours since I heard the news. The emperor is so busy that he has no time to take care of himself.

Lei Yinghua didn't say anything, just shook his head slightly.

It seems that this is the problem of xinglinyuan. The surgeon doesn't know what kind of operation to take.

This is definitely not what a medical professional website should look like.

But is the operation an emergency operation?

Impossible. If it were an emergency operation, PPT would not be so beautiful that I couldn't pick out any problems.

Let's look at the operation. According to the habit of the operator, it is likely to adopt the method of surgery.

Just thinking, Lei Yinghua saw something wrong with the picture.

Is this... Colonoscopy? ESD technology?!

It's really ESD technology!

ESD technology, also known as endoscopic mucosal dissection, is a minimally invasive technology to completely peel the diseased mucosa from the submucosa under endoscopy.

It was initiated and applied in clinic in Japan in the late 1990s. The main purpose of this operation is to diagnose and treat early gastrointestinal tumors. It has the advantage of complete resection of a certain area of superficial lesions at one time.

But the technical requirements are high and difficult.

Lei Yinghua repeatedly summarized his experience and finally determined that ESD technology is the best method for the treatment of MW syndrome.

But there are also problems - there are so many polyps in the patient's colon and rectum, and some polyps are still large. During the stripping process, intestinal perforation will occur accidentally.

Just before the preoperative case discussion, Lei Yinghua also saw the patient's film.

There are at least dozens of large polyps.

Should all these polyps be removed at one time? It should be done two or three times.

If I had my own operation, I would choose this way.

The patient has little damage and will not have too much risk. As for slow down, it's nothing.

But if the operation is broadcast live, half of it is done and half is left, what do you think and what's wrong.

The field of vision operator looks directly at the field of vision of the enteroscope screen. The enteroscope has been put in and is being operated.

Lei Yinghua held his breath and watched carefully.

The first polyp is 6cm from the rectum to the anus. The diameter is about 1cm, and the surface is not smooth.

An experienced doctor can tell at a glance that this polyp is probably in the precancerous stage. In other words, it has not been transformed into malignant tumor, but if it is not removed, there will be fundamental changes in a few months.

The spray pipe sprays out the dye, which seems to be 0.5% methylene blue solution. Lei Yinghua doesn't like methylene blue. He usually uses 0.4% indigo rouge.

However, this is determined according to personal preferences. No one is right or wrong.

Methylene blue is sprayed evenly. The operator's assistant is very good. Lei Yinghua is a little envious.

It seems like a small operation, but as an operator, this is the first difficulty.

The purpose of spraying dye is to clearly show the size and scope of the lesion.

Uneven spraying will make the operation more difficult.

The operator team is very strong, and the assistant operation is almost perfect. Just a simple little detail at the beginning, Lei Yinghua had his own judgment.

The sprayed methylene blue did not seem to fall completely, and the operator began submucosal injection.

Without repeating several times, the surgeon injected once, and the part of the polyp to be separated bulged, so as to have enough visual field when separating the submucosa and muscularis propria.

There are hemostatic drugs in the injection, which can ensure that some small capillaries break and will not produce too much blood.

After submucosal injection, electrocoagulation was marked, and the endoscopic scalpel began to drop at 5mm from the edge of the lesion.

It's too fast. What's the use of the magician just racing his hand? Lei Yinghua has some disdain.

Just trying to do the operation quickly, which belongs to sensationalism.

Endoscopic surgery was first performed by doctors in endoscopy room and gastroenterology department in China.

Because he is not a surgeon, the exploration process is very long.

After all, they have no access to the anatomy of the intestine, and there are some nuances that are difficult to deal with.

At first, surgeons... Including now, are still used to cutting to solve problems.

However, with the general trend of minimally invasive surgery, surgeons gradually began to do ESD surgery.

Lei Yinghua is one of them and a leader. He has a deep understanding of ESD surgery and even has his own unique views.

The operator is a young challenger, but it is useless to do the operation quickly.

Endoscopic surgery is most afraid of bleeding. Once there is blood vessel rupture and bleeding, it will take a long time to deal with it.

The patient's injury is also extremely huge.

This is something young people don't understand. Lei Yinghua looked at it calmly.

Sure enough, according to director Lei's idea, after the incision, the operation speed suddenly slowed down. Not only slow down, but also clumsy.

Lei Yinghua smiled. The craftsman was still manual and didn't do much by himself.

The mucosal layer of colorectal is relatively thin, and the electrocoagulation power cannot be particularly large, so as not to damage the muscular layer. The choice of the operator was correct. His electrocoagulation power was just good. Lei Yinghua was not surprised.

If you can't grasp this detail, how dare you live broadcast the operation? That's a joke.

After submucosal lifting, the mucosa was cut at the outer edge of the marked point with an endoscopic scalpel.

Lei Yinghua held his breath and successfully pre cut the surrounding mucosa is the key to the success of ESD treatment.

The endoscopic scalpel smoothly cuts the mucosa around the polyp, enters the submucosa through the pre cut incision, and then makes a circular incision along the outside of the methylene blue mark.

The technique is very skilled, not like a newcomer to ESD surgery just explored.

This sense of proficiency is completely different from my previous judgment of the operator. What's going on? Is it to show off the technology, some more invalid operations?

Well, it's possible. Young people, there is always a show of mind.

But looking at the operation process, Lei Yingjie even had an illusion that the operator had to do at least 1800 ESD operations to have this skilled hand feeling.

Has anyone done so many ESD operations in China?

No, there is no need to recall this. Lei Yingjie can be sure. Because he thought about it and couldn't do it himself.

After cutting, the separator was sent in.

Blunt separation, which is the most important node.

Many endoscopists and gastroenterologists are always bad at this, while general practitioners are much better.

After all, there are many times of cutting and freeing the intestinal tract in surgery, and the surgeon is very familiar with the intestinal tract.

Separator separation speed is not fast, but not slow, layer by layer, like a cook. The anatomical structure of each layer is very clear. Avoid opening some small blood vessels and stop bleeding at any time with electric burning and electrocoagulation.

After 1 ′ 22 ", a polyp was cut off.

This speed... Lei Yinghua nodded slightly, and the operator dared to live broadcast the operation. There is still some level.

The whole process of endoscopic resection of the outermost rectal polyp is as classic as a textbook.

Although there is no textbook on ESD surgery so far, Lei Yinghua imagined that the operation he just saw was perfect. If you have to find fault, you can only say that the speed is a little slower in the later stage, and there are some invalid operations.

Young people, in order to show off their skills, they have more operations out of thin air. At my age, but I can't.

"Director Lei, what do you think of boss Zheng's operation?" Peng Jia asked uneasily.