Chapter 1405： Perfect for textbooks

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

"Is surgery done by Zheng boss?" Lei Yinghua asked.

"Ok."

“What kind of surgery are you going to take?”

"..." Peng Jia stunned.

The surgery... I don’t know. From the time I learned the news to less than three hours now, the Emperor’s busy face did not have time to take care of himself.

Lei Yinghua did not say anything, but shook his head slightly.

It seems that the problem of the apricot forest is here, and the surgeons do not know what to do.

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

But is surgery an emergency operation?

Impossible, it is really an emergency operation, PPT will not be so beautiful, so that I can't pick up a little problem.

Still look at the surgery, the surgeon's habits, it is very likely to use surgical methods.

Just thinking, Lei Yinghua saw something wrong.

This is... colonoscopy? ESD technology? !

It turned out to be ESD technology!

ESD technology, also known as endoscopic mucosal dissection, refers to a minimally invasive technique that completely removes the diseased mucosa from the submucosa under endoscopy.

In the late 1990s, Japan was the first to be used in clinical practice. The main purpose of this procedure is to diagnose and treat early digestive tract tumors, and to have the advantage of completely excising a certain area of ​​superficial lesions at one time.

However, the technical requirements are high and difficult.

Lei Yinghua repeatedly summed up the experience and finally determined that the treatment of MW syndrome with ESD technology is the best means.

But the problem is also there - the patient's polyp tissue in the colorectal is so much, some polyps are still very large, in the process of peeling, a careless perforation will occur.

In the pre-operative case discussion, the patient's film Lei Yinghua also saw it.

There are at least dozens of big polyps.

Do these polyps have to be removed all at once? It should be done in two or three times.

If you do your own surgery, you will choose this method.

The patient's injury is small and there is no risk. As for the slow speed, I am afraid of anything.

But if it is a live broadcast, half done, stay half, how do you think it is not good.

The gaze operator looks directly at the view of the colonoscopy screen, and the colonoscope has been moved in and is operating.

Lei Yinghua held his breath and looked at it carefully.

The first polyp is 6cm away from the **** in the rectum. The diameter is about 1cm, and the surface is not smooth.

Experienced doctors can see from a quick eye that the polyp is in a precancerous condition. That is to say, it has not been transformed into a malignant tumor, but if it is not removed, it will be a fundamental change if it is a few months.

The spray tube sprays the stain and looks like a 0.5% methylene blue solution. Lei Yinghua does not like to use methylene blue, generally using 0.4% rouge.

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

Methylene blue spray is very uniform, the surgeon's assistant is particularly good, Lei Yinghua is a little envious.

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

The stain is sprayed to clearly show the size of the lesion and the extent of the lesion.

Uneven spraying can make the difficulty of surgery increase invisibly.

The team of the surgeon is very strong and the assistant operation is almost perfect. Light is the first small detail, Lei Yinghua has his own judgment.

The sprayed methylene blue does not seem to have completely fallen, and the surgeon begins submucosal injection.

Without repeated iterations, the surgeon injects once and the part where the polyp is to be separated is bulged so that there is sufficient field of view when separating the submucosa and the muscularis propria.

There is a hemostatic drug in the injection to ensure that some small capillaries are broken and there is not much blood.

Submucosal injection, electrocoagulation mark, endoscopic incision knife began to fall at the edge of the lesion 5mm.

This is too fast, what is the use of the surgeon? Lei Yinghua has some disdain.

It’s just that the surgery is done fast, which is a sensation.

Endoscopic surgery, the first in the country is the laparoscopic room and the doctor of gastroenterology.

Because it is not a surgeon, the process of groping is very long.

After all, they are not exposed to the anatomy of the intestines, and some subtleties are difficult to deal with.

And the surgeon started... including now, or getting used to solving problems.

However, under the general trend of minimally invasive surgery, surgeons have begun to do ESD surgery.

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

The surgeon is a young challenger, but the surgery is fast, it is useless.

Endoscopic surgery is most afraid of bleeding. Once a blood vessel ruptures, it takes a long time to dispose of it.

The patient's injury is also extremely large.

This is what young people don't understand, and Lei Yinghua looks at it with a calm heart.

Sure enough, according to Director Lei’s thought, after the incision, the speed of surgery suddenly slowed down. Not only is it slow, but the technique is still awkward.

Lei Yinghua smiled, the surgeon is still a hand, not much to do.

The mucosal layer of the colorectal is relatively thin, and the power of electrocoagulation cannot be particularly large, so as not to damage the muscle layer. The operator's choice is correct, his electrocoagulation power is just right, Lei Yinghua has no accidents.

If this detail can't be grasped, would you dare to do a live broadcast? That is just a joke.

After the submucosal lift is ideal, the endoscopic incision knife is used to cut the mucosa at the outer edge of the marker point.

Lei Yinghua holds his breath, and smooth pre-cutting of the surrounding mucosa is the key to the success of ESD treatment.

The endoscopic incision knife smoothly cuts the mucosa around the polyp, enters the submucosa through the pre-cut incision, and then cuts the ring along the outer side of the methylene blue mark.

The technique is very skilled, unlike the newcomers to the ESD surgery just explored.

This kind of proficiency is completely different from the previous judgment of the surgeon... What is going on? Is it for the sake of the show, and more invalid operations?

Well, it is possible. Young people, there is always a heart in the heart But looking at the operation process, Lei Yingjie even has an illusion, the surgeon doing ESD surgery, at least a thousand eight hundred, will have this skill Feeling.

Has anyone done so many ESD operations in China?

No, this does not have to remember at all, Lei Yingjie can be sure. Because he thought about it, he couldn't do it.

After cutting, the separator was sent in.

Blunt separation, this is the most important node.

Many laparoscopic doctors and doctors in the Department of Gastroenterology have never done well at this point, and the general practitioners are much better.

After all, there are many times of surgical cutting and free bowel, and the surgeon is very familiar with the intestines.

Separator separation speed is not fast, but not slow, layer by layer, 庖丁解牛. The anatomy of each layer is very clear, avoiding the opening of some small blood vessels, and stopping the blood by electrocautery and electrocoagulation at any time.

After 1'22", a piece of polyp was cut.

This speed... Lei Yinghua nodded slightly, the surgeon dared to do live surgery, the level is still there.

The outermost of these rectal polyps, the whole process of endoscopic resection, is like a classic in textbooks.

Although there are no textbooks for ESD surgery until now, Lei Yinghua's imagination, the operation just seen is perfect. If you have to pick a fault, you can only say that the speed is slightly slower in the later period, and there are some invalid operations.

Young people, in order to dazzle the tricks, more out of those operations. I am this age, but I can't do it.

"Director Lei, how do you see Zheng’s surgery?" Peng Jia asked in his heart.

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