Surgical artist

Chapter 420
"When I was lecturing, I just casually expanded my knowledge points and proved the improvement method by the way."

Zhao Peiru smiled faintly in his heart, "Unexpectedly, I also caught a mission opportunity."

This new task chain has huge rewards, but it is also extremely difficult, and the time-consuming is expected to skyrocket.

Unexpectedly, the tasks were completed one after another, which was quite fast.

Not long after, everyone arrived at the Second Affiliated Hospital of the University of Medical Sciences.

Dean Hong said to the chief of the medical department next to him: "First arrange a rest room for Dean Zhao."

Zhao Peiru waved his hand: "It's okay, let's see the patient's condition first."

There was a flash of admiration in everyone's heart.

This 59-year-old doctor has great physical strength!
At the same time, it is also really professional!

After a round of rounds, a group of people returned to the small conference room.

Dean Hong had already left first, and besides Zhao Peiru, a foreign aid expert, sitting in the small conference room were Director Deng of the Department of Surgery of the Second Hospital of Medical University, the directors of the Departments of Hepatobiliary and Pancreatic, and senior doctors of various departments.

"Dean Zhao, can you... tell us about the deeper concept of layered anatomy?"

Everyone was curious, and their black eyes shone with anticipation.

Zhao Peiru said that this case can be treated with the idea of ​​layered anatomy.

This at least shows one thing, the idea of ​​layered anatomy is indeed mature and perfected by Zhao Peiru, and has a deeper "comment".

Zhao Peiru was expressionless, and said, "Let me first look at the treatment plan you gave."

Director Zhan Kuo took out several of their treatment plans.

"These are the four sets of plans we discussed, and we haven't decided which set to use in the end."

"There is also this one, which is the treatment plan of expert Xie Miao of Haishi Xuri Hospital."

Zhao Peiru looked through all the five proposals, but his brows were still frowning.

It wasn't until the last proposal that the brows eased a little.

Seeing Zhao Peiru's expression, everyone looked at each other in blank dismay, feeling a little nervous, not knowing what Dean Zhao meant.

At this time, Zhao Peiru said: "Director Zhan, turn on the reading light, and I will take everyone to read the film again."

All the experts in the room were a little dazed.

It's all this time, let's not talk about layered anatomy, but start from scratch?
Re-read the film?

To read the film is to re-observe the patient's preoperative imaging evaluation.

Could it be that they missed something in the film?
But to say omission... Expert Xie Miao from Haishi City also gave a similar treatment plan with minor differences. Doesn't it mean that expert Xie Miao from Haishi City also missed it?But this is unlikely, right?

Director Deng of the Department of Surgery also looked solemnly.

He is not from hepatobiliary and pancreatic surgery, but from cardiothoracic surgery. He doesn't know much about the field of hepatobiliary and pancreatic surgery. He is sitting here now, originally out of respect for Zhao Peiru.

But at this time, I also realized that the doctors in my hospital should have gone wrong since the stage of reading the films.

His gaze also became serious. No matter which department you are in, reading the film is an extremely important part. Once something goes wrong, it will cause a lot of accidents and troubles to the operation, and even make it impossible to proceed.

For example, in his cardiothoracic surgery, if the reading of the film is not good, the chest is forced to be closed and sutured after the thoracotomy, and there are many people who give up the operation.

He glanced around the office sternly, and everyone felt a burning sensation on the side, which was Director Deng's direction...

With the reading light turned on, Zhao Peiru pointed at the film and said:

"The most important observation point for complex pancreatic head cancer is the relationship between the tumor and the superior mesenteric artery, superior mesenteric vein, and portal vein."

"There is a dense celiac plexus surrounding the superior mesenteric artery. You can see here that the fat space around the superior mesenteric vein of the patient has disappeared, which indicates that the tumor has directly invaded the vein, or there is dense inflammatory adhesion between the vein and the vein."

"In this case, it should be considered in the treatment plan, plus the idea of ​​venous vessel resection and reconstruction."

As soon as he said these few words, the hearts of the people below thumped.

I also sighed helplessly in my heart, they really missed it!
However, they didn't see what was missing, but they clearly saw the disappearance of the fat gap, but they didn't pay attention to it, and didn't realize that the key point was there.

The four sets of plans they prepared seemed to be quite a lot, and they treated them from various angles, but no matter which plan they were in, they didn't take into account the key points that Zhao Peiru said.

If the treatment idea of ​​an operation fails to grasp the key points, it will fail.

Only the share of Haishi expert Xie Miao was more thoughtful than they thought. Looking back now, the few improvements made by expert Xie Miao should be based on this consideration.

In the room, while everyone felt frustrated with themselves, they also felt deep admiration for Zhao Peiru.

The other party has only read some paper documents, and obviously has not seen the patient's original imaging film, so he can deduce from the existing documents that they have missed important things.

This is really surprising!
Is this the true level of famous doctors who can rival the three founders?

It seems that they are still far behind!

Director Deng of the Department of Surgery was also feeling emotional in his heart, this kind of top famous doctor is really strong in all aspects and has no shortcomings at all.

In the past, I heard that he was strong in thinking improvement and was able to improve Academician Peng's techniques. Later, I heard that he was strong in practical skills and could be praised by Academician Xu and Academician Zou again and again.And now, he saw with his own eyes the other party's strength in pre-operative film reading.

There is simply no shortcoming.

"With the basis of film reading, next, I will talk about the concept of layered anatomy."

Zhao Peiru opened his mouth, and everyone was tense, sitting upright and straightening their backs.

With the foreshadowing just now, their understanding of Zhao Peiru has reached a whole new level.

In addition, this layered anatomy is a new idea, and they have been wondering what the more mature and deeper layered anatomy concept is like.

Zhao Peiru opened his mouth slowly, describing this new concept to everyone in words like a beautiful scene:
"The head of the pancreas is dissected in layers, separated and resected clockwise. The first layer is the dissection of the transverse colon, right colon, exposing the pancreas and duodenum..."

"The second layer is to dissect the pancreas, duodenum, hepatoduodenal ligament, and remove the lesion..."

"The third layer is to dissect the abdominal aorta, inferior vena cava, and portal vein after the specimen is removed, and remove the lymphatic fat tissue..."

"The anatomy is clockwise, and the anastomosis is reconstructed counterclockwise."

While talking, Zhao Peiru was also observing the crowd, taking everyone's expressions into his eyes.

Zhan Kuo obviously reacted the fastest, and the first expression of understanding appeared on his face.

The remaining directors of the three departments Zhuo are slightly stronger than the directors of the fourth department Lian.And the rest of the senior qualifications of the various subjects are a bit poor, and some people even frowned after listening to the whole thing.

So far, Zhao Peiru has selected who can be his first and second assistants later.

He continued: "The purpose of the layered anatomy is to make the surgical steps clear and the surgical field clear. The problems found in the film reading just now can be fully considered into the plan."

Everyone nodded frequently.There are already huge waves in my heart!
This layered anatomical thinking has indeed been materialized and matured by Director Zhao Peiru, and even the order of the anatomy has been clearly confirmed.

Zhan Kuo hesitated for the last time: "Dean Zhao, how do you consider this layered form and sequence?"

Zhao Peiru smiled and said, "Of course it's based on anatomy."

"Complicated pancreatic head cancer surgery has complex anatomical relationships, a wide range of resection, complicated surgical steps, and huge surgical risks."

"And this clockwise layered dissection is equivalent to reorganizing the anatomy of the pancreas. According to the anatomical relationship and the severity of the disease, the intraoperative layered anatomical separation and cleaning steps vary from person to person..."

He also told everyone how to consider it.

Feelings of gratitude suddenly surged in the hearts of several people!

It's not about teaching them "how", but about "why".It is time to teach them how to understand the logic behind "layered anatomy" more deeply.

None of the people at the scene were fools, and those who could become department directors and veterans in the Second Affiliated Hospital of Kyoto University of Medicine and Science were either smart people or experienced people.

After listening to Zhao Peiru's answers, coupled with his own pondering, he quickly understood this set of advanced concepts.

was persuaded.

At this moment, everyone looked at Zhao Peiru not only with worship, admiration, and admiration, but also with gratitude.

Such an advanced and mature concept must be the essence that Zhao Peiru has been thinking about for an unknown period of time.

It's so unreserved, and it's all taught to them.

Then, based on this set of advanced concepts, everyone came up with a specific treatment plan for each case.

Among them, Zhan Kuo and Zhuo Jing, who were designated as the first and second assistants by Zhao Peiru, naturally received more "care" from Zhao Peiru.

In the process of leading everyone to formulate a plan, Zhao Peiru subtly taught the two how to cooperate with him in the operation.

Director Deng of the Department of Surgery has been silently watching from the side.

"From reading the film to formulating a detailed plan, it's all under the leadership of Director Zhao."

"Xiao Zhan and the others are relatively excellent among their peers in their 40s, but compared with this Dean Zhao Peiru, the gap is still as huge as a gap."

From Zhao Peiru, he could vaguely see the level of excellence that academician Zou Bin can possess.

That is the feeling of controlling everything for one operation, one case, one team.

"Shenshuitan Hospital has Academician Chen Yongming. Xijing Hospital has Academician Zou Bin..."

"Every first-class hospital in the country has academicians in the field of liver, gallbladder and pancreas. Only our Second Affiliated Hospital of the University of Medical Sciences lacks such a heavyweight to sit in charge."

The longing eyes of the Chief of Surgery suddenly fell on Zhao Peiru.

I don't know, can you dig this one up?

At least, their Second Affiliated Hospital of Medical University should be better than that place in Jiangnan Province, right?

……

After making a detailed plan and setting the operation time.

Only then did Zhao Peiru go to the side to rest in the lounge arranged for him.Director Zhan Kuo arranged the patient's preoperative preparation according to the plan.

in the lounge.

Zhao Peiru glanced at the task chain.

"The operation is tomorrow morning."

"It seems that this second task can be completed tomorrow."

I came to Kyoto and completed two tasks in one go.More importantly, the reward for this second mission is very special.

Surgical status crit card.

Zhao Peiru really wanted to see how strong this triple state increase was, and what the so-called unparalleled state was like.

……

the next day.

When it's time for surgery, the patient is wheeled into the operating room.

Director Zhan Kuo, Director Zhuo Jing, and Director Lian in the observation room are all in place.

Everyone looked at the operating table expectantly, nervously, or curiously.

"This operation should be the first operation in which the new concept of layered anatomy is applied to an example."

In the observation room, Director Lian was full of anticipation: "If it succeeds, there will finally be another basic concept to consider in the field of pancreatic head cancer in the future."

This new concept is like a new way of thinking about solving problems.

In the past, when people encountered difficult problems, they could only use several inherent traditional problem-solving ideas to solve them. Even if they encountered some inappropriate or inapplicable problems, they could only bite the bullet and go around the corner to solve them. , is naturally unsatisfactory.

But in the future, with this new concept, there will be more appropriate solutions to those questions.

on the operating table.

Under the leadership of Zhao Peiru, Zhan Kuo and Zhuo Jing started the first layered dissection in their lives.

The first layer of dissection starts from the middle section of the transverse colon, along the avascular area of ​​the gastrocolic ligament, dissects rightward to the hepatic flexure of the colon, separates the hepatic flexure of the colon and the peritoneum of the ascending colon and folds back to the blind part, and divides the right colon and its system along the right space Membrane flipped to the left, free posterior gastric wall and anterior pancreas adhesions...

"These hands are so steady!"

Zhan Kuo was not qualified to observe Liang Zhongyue's surgery before, but he didn't realize until now that Zhao Peiru's hands, which were like steel pliers, made every movement calm and precise!
The hearts of the others also jumped when they saw it!
It has long been heard that Zhao Peiru's operation has been praised by Academician Zou Bin and Academician Xu Qin.Now, finally see it!

With Zhao Peiru's leadership, their dissection and separation work went very smoothly.

Director Deng of the Department of Surgery also widened his eyes.

"Excellent! In terms of operation alone, Dean Zhao Peiru is actually better than many academician-level figures."

"Dean Zhao's excellent operation is actually reflected in two aspects. One is dexterity, which can achieve fineness and precision. The other is good physical fitness, which can withstand the test of long-term surgery. In comparison, many academicians , it cannot be done at the same time.”

Is Academician Zou Bin's operation good?

Very good, those hands are extremely precise, able to "carve" flowers in a one millimeter surgical field area.

But the problem is, Academician Zou Bin is old and physically fit after all.No, if you persist in the surgery for an hour at most, your condition will drop rapidly.

But the dean Zhao Peiru in front of him is superior in both aspects.

This is terrifying.

Under the gaze of everyone, on the operating table, the anatomy and separation of the second and third layers were carried out in sequence.

(End of this chapter)