Come on, Dr. Wu

Chapter 121 An inexplicable sense of familiarity
  What do you mean?
  The director of the general surgery department of the county hospital looks confused at this time. Can you just make a decision together?

No, wait, what does Wu Xiaofu mean? If the liver cancer is not removed tomorrow, Wu Xiaofu should do it, right?
  Everyone looked at Duan Hao, who was even more confused at this time.

What a robbery!
  Today's six gallbladder machines and four appendix machines were indeed prepared by him for Wu Xiaofu, but the two machines tomorrow were not. He was here on a mission and couldn't just do nothing. The quality of these two liver cancer resection machines was still the same. Yes, he took it, and now it’s good that Wu Xiaofu wouldn’t think that this was also prepared for him.

Facing the doubtful looks from everyone, Duan Hao also felt a little numb.

This is liver cancer resection. This guy really dares to do everything. Is he really good at it?
  Thinking about Wu Xiaofu's performance during this period, it seems that this guy is not the kind of person who doesn't care about others. I thought he had to give up halfway when he had the appendix done, but he didn't want Wu Xiaofu to finish it completely and it was perfect. Later, he thought Wu Xiaofu wouldn't do it. Wu Xiaofu has also had his gallbladder and bile duct stones treated.

Wu Xiaofu was even surprised and gave him a liver hemangioma patient.

They all thought that Wu Xiaofu couldn't do it, but Wu Xiaofu was able to surprise him. Now it was his turn to remove the liver cancer. In fact, it was just a little more difficult to remove the liver hemangioma. Thinking of Wu Xiaofu's operation when removing the hemangioma, Duan Hao was horrified to find that Wu Xiaofu was really capable.

What's more, with so many people watching, he really didn't want to make Wu Xiaofu Bai happy.

How about giving it a try?
  If Wu Xiaofu does something unfavorable, he can keep up with him. In this way, Wu Xiaofu can also be trained. However, he also has to wear clothes this time. Otherwise, if there is a problem, it may not be in time.

Thinking of this, Duan Hao also made a plan.

The next morning.

At eight o'clock, the operation is almost ready. This is the difference between the flying knife. If it is done in this hospital, the surgeon has to finish the morning meeting, complete the ward rounds, and hand over the patients in the ward before the operation can be performed. This The time has to be half past eight anyway, and the same goes for outpatient visits.

The first operation was performed on a patient with early-stage primary hepatocellular carcinoma, and the lesion was in the right lobe of the liver.

The malignancy of liver cancer is still very high. Early detection and early treatment are better. If it is discovered late, it will progress very quickly and metastasize very quickly, because the liver is responsible for its own recovery. If it can be discovered early, through The primary lesion was surgically removed, and the postoperative physical condition was still very impressive.

Unlike other cancers, hepatocellular carcinoma is still less sensitive to radiotherapy and chemotherapy. It is basically impossible to kill cancer cells by means of radiotherapy and chemotherapy, unless there is no possibility of surgery. Otherwise, It is best not to choose radiotherapy and chemotherapy, because after radiotherapy and chemotherapy, it will be difficult for the body to meet the requirements for surgery.

Wu Xiaofu stood in the position of the chief surgeon.

I thought about the feeling of the last liver hemangioma surgery. Unlike benign tumors like liver hemangioma, liver cancer is a malignant tumor, and it is usually a sarcoma. It has a high chance of metastasis through the blood, lymph nodes, or directly infiltrating surrounding organs and tissues. , and they are all early-stage infiltrates, so patients who have not found metastasis in the early stages of this disease are actually really rare.

The difference between benign and malignant tumors can also be seen here.

The biggest difference between benign tumors is that they will not metastasize, whether it is intra-organ metastasis or extra-organ metastasis, and their growth rate is also very slow, just like the last hepatic hemangioma, which occurred in the liver After many people discovered it, decades later, it is still so big, basically within the controllable range, and may even shrink, so most of them don't pay attention to it.

But the liver cancer in front of me is different.

When many people discover the existence of liver cancer, they have already discovered metastasis. Even if the liver is resected, it is difficult to effectively curb the expansion of cancer cells. They can only do palliative treatment to extend life, and the growth rate is really It's so fast, it's like a magic star. Wherever it goes, the magic is stained, and then the place stained by the magic continues to be stained like this.

From the back of the body, it is like a world invaded by the fourth natural disaster. Unstoppable, the final outcome is the collapse of the world.

The most important thing is that during this process, the human body suffers from too many symptoms.

Liver cancer causes jaundice, ascites, worsening blood vessel conditions, rupture and bleeding, hair loss, etc.

Lung cancer causes coughing, phlegm and blood, chest pain, chest tightness, and shortness of breath, etc.

Many people may be able to tolerate the symptoms, but when these symptoms appear, the psychological problems, anxiety, insomnia, etc. they cause will gradually devour the person's spirit.

Many people end their lives early because of these reasons before they are completely attacked by cancer.

His eyes fell on the patient. Although it was in the early stage, the patient's symptoms were very obvious. He was thin and his skin was sallow.

Weight loss is a major characteristic of cancer patients. If ordinary people experience progressive weight loss without deliberately losing weight, they should pay close attention to it. It is best to go for a physical examination. Cancer is still a wasting disease, like It exists in the body like a bug. It starts to eat your nutrients and your flesh and blood. If you lose weight, it is a signal.

At this time, you should pay attention and check. If it is a gastrointestinal or other digestive tract problem, it is naturally best to adjust it as soon as possible to avoid the progression of the disease. If there is any malignant disease, it should be checked and treated early.

The emergence of jaundice is a specific symptom of liver cancer.

After liver cancer progresses, many bile ducts will be blocked, preventing bile from being discharged normally, resulting in obstructive jaundice. And because it is a wasting disease, it may cause damage to liver cells, affect liver function, and result in abnormal bilirubin metabolism. , leading to symptoms of jaundice.

The anesthesiologist was still the same as yesterday, and Wu Xiaofu glanced at him.

"Four hours."

The difficulty of this operation is not small, and Wu Xiaofu does not dare to overestimate it. The anesthesia time should be more stable. This communication is very necessary. Unlike yesterday's gallbladder appendix, today's liver cancer lesion removal is not easy, and it is the first time. This technique tells the anesthetist a psychologically estimated time and makes it easier for him to control the medication.

Position, wash hands, disinfect, lay down towels.

When Wu Xiaofu stood in the position of the surgeon again, his whole temperament had completely changed.

Different from the previous appendix gallbladder, Wu Xiaofu seemed to have entered the state before even picking up the knife this time.

Faced with his first liver cancer resection, Wu Xiaofu also paid 120% attention, and his overall condition was mentioned to be the best. In order to cope with these two surgeries with all his heart, Wu Xiaofu did not drink yesterday. Fell asleep.

Mo Xiaofeng, who was standing opposite Wu Xiaofu, also felt the difference between Wu Xiaofu and Wu Xiaofu.

At this moment, he looked at Wu Xiaofu as if he were seeing his teacher.

Mo Xiaofeng's teacher once said something to Mo Xiaofeng: Learning medicine is like learning martial arts, the emphasis is on understanding and perseverance; practicing medicine is like studying martial arts, the emphasis is on foundation and eternal self-confidence.

Only if you have enough background can you stand in this position.

Only by always being confident can you make the patient trust you, make other people involved in the operation believe, and the most important thing is to make yourself believe.

Some self-confidence radiates from the inside out. Techniques are easy to practice, but temperament is difficult to practice.

Mo Xiaofeng already knew that this was Wu Xiaofu's first time to undergo liver cancer resection. Such a difficult operation, even if the liver cancer was in the early stage, the liver function was good, and the physical condition was okay, but the difficulty of the operation was not the same as what Wu Xiaofu had done before. The surgery was comparable. It was supposed to be the first time. Even if Wu Xiaofu had a strong foundation, he would inevitably be nervous at this time.

But the expected tension didn't exist at all, there was only infinite confidence.

Some people are born to hold a scalpel, and some are born to be surgeons.

In the past, Mo Xiaofeng might not believe or understand this sentence. After all, whoever is born to do something must go through study and training, but today he believes it and understands that Wu Xiaofu is this kind of person. .

It’s just really jealous.

Even if a nouveau riche becomes a boss, it is easy for others to see at a glance his strong-willed nature but his temperament cannot be faked. If you have not been a boss for a period of time, you cannot fake the temperament that a boss should have. As people usually say, officials have official spirit, and business people have business spirit. But Wu Xiaofu is different. He seems to be born to be the surgeon.

Obviously knowing that it was Wu Xiaofu's first time to do it, but feeling Wu Xiaofu's aura and standing next to Wu Xiaofu, Mo Xiaofeng was no longer nervous. After all, he was an assistant. If something went wrong during the operation, he would be responsible. But after seeing Wu Xiaofu at this time, Mo Xiaofeng had an inexplicable feeling that the operation would be successful.

Wu Xiaofu's hands are very steady and beautiful.

Lift the knife and cut along the marked mark, and a ten centimeter-long incision on the right abdomen is made.

Mo Xiaofeng started electrocoagulation to stop the bleeding, and the retractor opened the surgical opening. The view of the abdominal cavity soon appeared clearly in front of Wu Xiaofu's eyes.

Under the operation, the patient's liver appeared in the center of Wu Xiaofu's field of vision.

In the right lobe of the patient's liver, a small area is obviously different from other liver areas. Granular packets appear on it, which makes people frown, just like a clean face with some black stains. People can't help but want to wipe it away. The dry lesions look like all the water has evaporated, which is in sharp contrast to the surrounding healthy liver area.

Just like most hepatic hemangiomas are hidden in the liver, the same is true for the lesions in front of us. On the surface, they seem to be only the size of a thumb, but the real bulk is still inside the liver.

I recalled all the information I had read before, all the papers on the subject, all the surgical videos, and the feeling when I had liver cancer surgery with Duan Hao.

Faced with such a lesion, Wu Xiaofu's vague idea of ​​removal had completely formed a perfect idea.

Duan Hao was a little nervous at this time. After the lesions appeared, Wu Xiaofu's biggest difficulty came.

Where did the first blow come from?

For surgeons, the most difficult thing when facing a lesion is the first cut, because the first cut represents the starting point of your thinking. The reason why many operations fail is basically because the first cut is wrong, and you have to make up for it again and again. After looking for compensation, I found that the operation time was lengthened and many difficulties increased, and many of these difficulties were artificially increased due to my own surgical ideas.

My self-confidence began to be undermined, and I became increasingly unable to cope with difficulties. If an accident suddenly occurred at this time and the entire operation failed, it would not be an accident.

Ah!
  At this moment, Duan Hao actually noticed that the facial muscles exposed by Wu Xiaofu's mask were slightly raised. Duan Hao automatically analyzed the reason. The most likely reason was that the corners of Wu Xiaofu's mouth were slightly raised at this time. Was he smiling?
  If he hadn't been wearing a surgical gown now, Duan Hao would have patted Wu Xiaofu and made him smile. Forget it if you're not nervous, are you still smiling? What, you dreamed that the lesion was removed?
  Thinking about it, Duan Hao felt inexplicably relaxed at this time.

Suddenly I remembered that when I was discussing things with my wife the day before yesterday, my wife scolded me that the emperor is not in a hurry and the eunuchs are in a hurry. Duan Hao didn't understand it before, but now he understands. Isn't he now the emperor is in a hurry and the eunuchs are in a hurry?

Wu Xiaofu's current state was like that of a hunter who had laid a trap perfectly, saw his prey fall into the trap, and was ready to harvest.

"Vessel Blocking Band."

it has started!

Everyone was shocked when they heard this, and the entire operating room was instantly filled with the sound of breathing.

They were not curious about what Duan Hao did, but they were really inexplicably concerned and curious about what Wu Xiaofu did and to what extent he could achieve it.

Portal block!

Duan Hao was also surprised when he saw this. You must know that although this hepatic portal blockade is not a very advanced technique, not many people can achieve the level of Wu Xiaofu, and without the guidance of a master, it will be difficult to achieve the desired effect. , this is the liver. It doesn’t matter if you tie it up. If one of them is not good, the liver will probably be dead before the operation is completed.

Moreover, this method seems somewhat familiar.

"Atraumatic forceps, hemostatic forceps..."

Wu Xiaofu didn't know what Duan Hao was thinking. He was in good condition now, and it was as if he had divine help. The portal block he used for the first time was already 90% as good as Duan Hao's before.

Wu Xiaofu is very familiar with the work of hepatic artery and vein occlusion.

The main reason is that the principles are similar. When cutting out the gallbladder, the arteries and veins related to the gallbladder must be blocked first. When cutting the spleen, the arteries and veins related to the spleen must be blocked. When the appendix is ​​cut, the arteries and veins related to the appendix must be blocked. , are all the same, both to prevent occurrence during the operation and affect the progress of the operation. On the one hand, they are also afraid of causing massive bleeding and affecting the patient's life.

The related blood vessel blocking technology is based on familiarity with the anatomy. As long as you are familiar enough with the anatomy and do not miss anything, the goal will be basically achieved.

At this time, Mo Xiaofeng's scalp was numb and his temples were sweating.

It was too fast. Wu Xiaofu's thinking was much clearer than him, and his actions were much more decisive. Just like a veteran who had done countless sets, an assistant should not just regard himself as an assistant.

A qualified assistant must first do his job well, and the prerequisite for doing his job well is to be able to understand the surgeon's thinking, provide the surgeon with the greatest help and the most timely help, and also provide the best vision. .

Then, you can’t just follow the surgeon’s ideas, you also have to have your own ideas. Before the operation, you should have your own surgical plan. Although you can’t perform the surgery, you have to think about how to do this. In Taiwan surgery, you are the surgeon to perform the surgery, and then you compare it with the surgeon to see who is better. You can check for any omissions and fill them in, so that you can progress faster.

If the surgeon is found to have made any mistakes, a subtle reminder can be given to ensure the safety of the patient.

Finally, you cannot get used to being an assistant. You have to think about what happens if the surgeon suddenly encounters a problem and cannot continue the operation, or if the surgeon suddenly encounters a problem that he cannot handle while performing the operation. At that time, , can you come forward? Although the magician won't do it, you most likely won't do it either.

But what if, if you know how to do it, if you can turn the tide, then the road will be widened. If you are a blockbuster, you will get the protagonist template.

If Duan Hao were to do it, Mo Xiaofeng would not dare to think about this, but now that Wu Xiaofu is doing it, Mo Xiaofeng feels that he is still somewhat qualified.

But he soon realized that he had thought too much.

This hepatic portal block, this knife technique, this idea, this efficiency, all, let alone having his own ideas, he couldn't keep up with Wu Xiaofu's ideas. If he didn't have a good foundation, he would be in a hurry. If that's the case, that would be too embarrassing. Yesterday, they said that working with him was a pleasure. If this is screwed up, how can he deserve their trust?

The more he thought about it, the more pressure he got, and Mo Xiaofeng felt that he was a little strange.

He actually surrendered to a master's student just like that.

Looking at Wu Xiaofu's movements, what Wu Xiaofu did was really great. This movement and this idea were simply art.

Soon the operation will proceed to the stage of sweeping the lymphatic membrane.

Duan Hao was also a little frightened at this time. His mood was getting more and more complex now. At first he said that after Wu Xiaofu had the surgery, something was wrong, so he would quickly do it himself. Then he said that when Wu Xiaofu had trouble blocking the blood vessels, he would take the initiative. Yes, now, he was actually thinking that if Wu Xiaofu had trouble with the lymphatic membrane scan, he would take the initiative.

Duan Hao couldn't help but doubt himself: Was he doting on Wu Xiaofu too much?

The lymphatic membrane dissection of liver cancer is different from that of benign liver tumors. For benign liver tumors, there is no need to consider the problem of metastasis. Therefore, the lymphatic membrane dissection is mainly aimed at the visual field and surgical safety issues, such as demining, and the dense lymphatic membrane must be removed under the All possible hidden dangers, such as hidden blood vessels, are eliminated to ensure the safety of the operation.

However, while cleaning, most of the lymph must be retained. After all, lymph is not useless. If too much is removed, it will still have an impact on the body's functions. The standard is that the less it is removed, the better.

　There is expected to be one more chapter, which will be posted later.

　　
  　
  (End of this chapter)