Doctor's Life Simulator

Chapter 241 Oops, it's Mirizzi Syndrome!
Li Ming, who was on the side, was afraid that he would not be able to shake the blame completely, so he continued to add: "The whole operation was completed in one and a half hours, and the patient's prognosis is very good."

"An hour and a half?"

Professor Huang naturally understood the meaning of this time, and couldn't help being more interested in Qin Lang. He was very interested: "Xiao Qin, come, come with me to see the patients first, and talk while walking."

"Xiao Qin, please tell us your understanding and opinion on this single-port laparoscopic cholecystectomy using X-CONE and its single-channel special instrument."

"Xiao Qin, how do you view the anatomy of the gallbladder triangle, and how to identify the Rouviere groove and the common bile duct?"

"Hahaha, good, wonderful, wonderful."

Zhuang Tong and the others watched an old man and a young man walking in front, and there were back and forth conversations mixed with some arguments, which made them feel absurdly arguing with each other.

Tang Qichen was at the end, looking at this scene, he was very excited: "It's done!"

What better publicity could there be than a young doctor performing a single-port group laparoscopic cholecystectomy using their company's X-CONE and its single-port special instrument?

And this Dr. Qin, with such good looks, is simply the best image spokesperson.

After Qin Lang, Professor Huang and Lai Meiyun communicated before the operation, the operation officially started half an hour later.

Anesthesiologist Qian Zhe performed general anesthesia on Lai Meiyun with endotracheal intubation, and took a supine position with legs apart.

Qin Lang took a pen and made an incision mark 2cm below Lai Meiyun's delicate and small umbilicus. In order to cooperate with the operation, the umbilicus was obviously carefully cleaned once.

I don't know if it was too hard, but it was a little rosy.

Looking at Lai Meiyun's white and flat abdomen, it would be a bit violent to leave an ugly scar.

"veress needle puncture"

As an assistant, Li Ming performed the puncture.

"Carbon dioxide, pressure maintained at 12 mm Hg"

Due to the single-channel method, there is also a precise control of the air pressure.

Listening to Qin Lang's step-by-step control of the operation process.

Professor Huang and Director Zhuang who were guiding at the side nodded slightly.

"Scalpel"

After Qin Lang took the scalpel, he directly chose the pen-holding method, using the open method to incise the peritoneum through the linea alba to prepare for the insertion of the channel.

The whole movement is smooth and fast.

Looking at the incision technique in Qin Lang's tiny operating space, Professor Huang praised Director Zhuang: "Xiao Qin, the basic skills are very good."

Incision is an essential skill for every surgeon. It is easy to say, but difficult to say. It is quite skillful to be able to do it so accurately and smoothly.

Especially such a young man.

"X-CONE Single Channel System Preparation"

Soon the equipment nurse brought over the X-CONE single-channel inlet system that had been prepared.

Although he had heard Tang Qichen's introduction many times before and seen the video of the surgery, it was the first time Zhuang Tong saw the operation on site.

X-CONE single channel inlet system is composed of 2 pieces of metal and rubber sleeve.

Its incision only needs to be about 2cm, so after the operation is completed, it can be minimally invasive, which is very suitable for idols like Lai Meiyun who rely on their bodies and faces for food.

The establishment of the entire single-channel portal system is very simple. After the two metal sheaths are hooked to the abdominal wall and merged, the rubber sleeve is put on to complete the establishment of the single-channel surgical portal system.

The rubber sleeve is composed of four 4mm operation holes and one 5mm operation hole, of which the 1mm operation hole can be converted into a 12mm operation hole by inserting a matching converter, and is equipped with a venting part to reduce smoke interference.

The rubber sheath has a relatively large range of motion, combined with the pre-bent grasping forceps and the endoscope with a length of 50 mm and a diameter of 5.5 mm, it can effectively reduce the mutual interference of instruments and improve the success rate of the operation.

At the same time, the X-CONE single-hole inlet system can be reused many times after disinfection without additional medical expenses.

"The X-CONE single-channel entry system is very convenient and practical, and it has really improved the success rate of the operation."

Professor Huang has personally operated dozens of machines, and has a deep understanding. He sincerely hopes that it can be popularized, which is one of the reasons why he is willing to participate in this surgery.

Zhuang Tong nodded slightly. The innovation of surgery is closely related to the progress of medical equipment. Of course, the most important thing is the operator.

Advanced technology and a talented healer, combined, can often burst out infinite energy.

In front of the operating table, after completing the establishment of the single channel, Qin Lang slightly adjusted the patient's position, with the head high and the feet low.

The next step is to start the first step of dissecting the gallbladder triangle.

I saw that Qin Lang used the curved forceps to pull the bottom of the gallbladder toward the head side very delicately. The next step is to identify the Rouviere groove.

The Rouviere groove is the only visible landmark on the surface of the right liver and was first proposed by the French anatomist Rouviere in 1924.

During the development of hepatobiliary surgery, with the in-depth understanding of the anatomy of Rouviere's groove, it was realized that cutting the cystic duct above the plane of Rouviere's groove can effectively avoid extrahepatic biliary tract injury.

Therefore, when dissecting the gallbladder triangle, the Rouviere groove will be identified first, and the safe triangle area will be determined based on this.

On the screen, under Qin Lang's fine dissection, the confluence point was clearly revealed, and the safety triangle was quickly found along the Rouviere ditch.

"Xiao Qin, you have a very deep understanding of the anatomy of the Rouviere trench."

Professor Huang praised again.

"It's really quite skilled."

Zhuang Tong replied lightly, but he was very happy in his heart. It is rare to see a practitioner who can be seen by Professor Huang. He has a face.

Qin Lang has been working there quietly and attentively. After confirming the safety triangle, he opens the retroperitoneum directly downwards, and then separates the gallbladder fossa upwards and backwards.

"The movement is well controlled, and the mentality is also very stable, and I didn't get too greedy to free other structures."

Professor Huang continued to comment that the more you look at the Qin corridor, the more you like it. Many physicians have reached this point, and they will add superfluous things to synchronize and dissociate other structures. It seems very neat, but it is easy to accidentally damage the portal structure.

"Splitting Pliers"

Qin Lang was completely immersed in the operation. After dissecting the posterior triangle and anterior triangle of the gallbladder, he began to dissect the cystic artery and cystic duct with separating forceps non-stop.

"ultrasonic knife"

Another order, issued calmly.

The equipment nurse immediately handed over the equipment.

"It is quite decisive to cut off the cystic artery directly with an ultrasonic scalpel."

Professor Huang looked at Qin Lang's steps on the screen, and was very happy. He didn't expect that the operation in the First Hospital of Hecheng City would not be completed this time, but instead, he had an even bigger surprise.

The next step is to peel off the gallbladder. On the screen, the curved forceps controlled by Qin Lang pull the bottom of the gallbladder in the upper left direction.

The gallbladder was stripped from the right side of the gallbladder bed. It was obviously a single-channel operation hole, which gave Qin Lang a sense of relaxation for laparotomy.

Especially the operation that has been going on for so long, instead of being tired, it is getting more and more energetic.

"Xiao Qin's concentration and energy are very good, and he is really suitable for the operating room."

Professor Huang has taken too many interns and residents, and even some trainees from municipal hospitals who used to be chief physicians, what a vicious vision.

"Qin Lang is a well-known physical monster in our academy."

Zhuang Tong said quietly at the side, after all, he also suffered from it.

On the screen, Qin Lang continued to control the curved forceps to clamp the round ligament of the liver and pull it headward, peeling off the left side of the gallbladder bed.

After the left and right sides join forces, continue to peel off toward the hilum of the liver.

At this point, more than half of the work has been completed. The next step is to reconfirm the relationship between the cystic duct and the common bile duct. As long as there is no problem, the proximal end of the cystic duct can be clamped directly.After the ultrasonic scalpel is cut off, the gallbladder can be removed.

Zhuang Tong breathed a sigh of relief.Professor Huang was a little bit unsatisfied.

However, Qin Lang's hand on the screen suddenly stopped.

"what's the situation?"

Zhuang Tong was a little unexpected.

Professor Huang also looked at the screen, only to see that the camera stopped at the cystic duct and the neck of the gallbladder.

"The cystic duct is too long with the common hepatic duct"

"Stenosis of the hepatic duct caused by stones lodged in the neck of the gallbladder."

Professor Huang's eyesight is astonishing, he saw the clue at once, and Cheng Jian at the side also reacted, and the two of them almost blurted out at the same time:

"Oops, it's Mirizzi syndrome."

Professor Huang's complexion immediately darkened.

(End of this chapter)