Chapter 893 True Fragrance

Chen Cang glanced at the child and thought for a moment.

I don't know if it's because of my conscience, or because of other reasons, I couldn't help but remind: "Have you ever been in contact with gastroduodenal anastomosis?"

He Zhengzhi was shocked when he heard Chen Cang's words, and he was so scared that cold sweat oozes out!

Is it...

Dr. Chen, he is not very good at "gastroduodenal anastomosis"?

Thinking of this, He Zhengzhi was really a little desperate. He felt that he was staring at the stomach at this time, but staring at the abyss!

Fear came to my heart, and it was about to devour him!

He Zhengzhi glanced at Chen Cang, and calmed down: "Doctor Chen, don't tell me you can't do the Biluo style!"

Gastroduodenal anastomosis is the Billow method.

Chen Cang shook his head and smiled: "I will, I mean if you don't, you can take a serious look at it, the opportunity is rare."

He Zhengzhi finally breathed a sigh of relief upon hearing this!

Now he no longer expects to wait for Director Ma, his wish is very small, it is enough to finish the operation.

As for Chen Cang's learning more, to be honest, he has no expectations.

This surgery has learned a lot more precious than surgery!

"Thank you...Thank you Doctor Chen!"

Chen Cang nodded and smiled: "Why are you sweating so much, young man, pay attention to your body!"

The little nurse heard Chen Cang's words very sensible, and took the initiative to wipe the sweat for Dr. He.

This made He Zhengzhi instantly flattered!

He...he received this kind of treatment there?

Looking at the gentle and pleasant little nurse, He Zhengzhi quickly said with a smile: "It's not false, it's not false, the yang is too strong, it's a little hot!"

A few nurses froze for a moment, and took a deep breath of the 22-degree cold air unique to the operating room. Is it hot?

There are basically two main anastomosis methods in subtotal gastrectomy, one is the Bi Luo type 1 for short, and the other is the Bi Luo type 2, referred to as the Bi 2 type.

The two methods have been used for hundreds of years and have been continuously improved.

Simply put:

Gastroduodenal anastomosis is the Bi 1 type.

The gastrojejunostomy is complete 2 type.

The limitations of the Bi-1 formula are relatively large, but the advantages are also very obvious. Because the structure and function of the duodenum are preserved, it is not easy to cause gastrointestinal dysfunction after surgery. If conditions permit, the Bi-1 formula should be used as much as possible.

However, when the Bi-1 anastomosis is performed, care must be taken to avoid tension at the anastomotic stoma. The mobility of the duodenum is small, and if the gastric corpus is too large, the Bi 1 formula cannot be used.

It is precisely because of the existence of limitations that the difficulty of surgery continues to rise.

Chen Cang took a deep breath, lowered his head and began to observe carefully, preparing for the anastomosis operation.

Since it is called gastroduodenal anastomosis, this shows that the core element of the operation is the anastomosis between the gastric body and the duodenum.

Zhou He looked at Chen Cang and couldn't help but say: "Doctor Chen, the patient has intestinal paralysis, and now his bowel movements have basically stopped. When the postoperative obstruction is relieved and the paralysis disappears, the gastrointestinal peristalsis will resume, and the stomach wall will recover. The tension, the contraction of the stomach wall at both ends of the anastomosis, may affect the healing of the anastomosis, and even lead to anastomotic stenosis, you should be careful."

Zhou He is kind.

In fact, never underestimate an anesthesiologist. When Chen Cang was an intern, he saw the story of an anesthesiologist saving the field with his own eyes, which scared Chen Cang.

After all, in the eyes of many people, the anesthesiologist is the escort of the operation, and the chief surgeon is the old driver, but they ignore that this escort sees too many operations every day, and it may not work, but his vision and vision are very high. !

Hearing Zhou He's words, Chen Cang nodded gratefully: "Thank you, Teacher Zhou!"

Chen Cang's Bi Luo style comes from Li Yue, but it is not exactly the same as Li Yue's. After all, Chen Cang has his own considerations.

In order to avoid the anastomotic stoma being too large, the broken end of the lesser curvature of the stomach should be sutured first before anastomosis.

Regardless of Biro 1 or 2, the method of closing the half incision on the side of the lesser curvature of the stomach can be used.

This step is actually the same as when Chen Cang built the mitral valve.

Chen Cang's eyes began to compare constantly.

The tension of the stomach wall and the mobility of the duodenum need to be considered, so the difficulty of anastomotic comparison suddenly increases.

After a while, Chen Cang turned around:

"Gut No. 1."

The anastomosis of the lesser curvature of the stomach needs to be tight and firm. After all, the stomach is a digestive organ and needs to be filled with food.

Chen Cang's suture is very precise. The needle forceps hold the No. 1 catgut and wrap a row of full-thickness continuous sutures around the curved forceps at the lower end of the incision!

Immediately afterwards, Chen Cang said to He Zhengzhi, "Take off the curved pliers and tighten both ends of the catgut!"

He Zhengzhi nodded quickly.

At this time, Chen Cang, then return the upper catgut to suture, from the cardia end down, align the gap between the first row of sutures and sew the second row of continuous sutures!

This set of operations made Zhou He stunned for a moment!

"This is... Li Yue's method?"

Chen Cang smiled and nodded: "That's right!"

And He Zhengzhi looked at Chen Cang blankly: "What is this for?"

Chen Cang explained: "In order to make hemostasis reliable!"

He Zhengzhi nodded involuntarily, in fact...he didn't understand...but he always felt that what Chen Cang said made sense!

While talking, Chen Cang tied the ends of the catgut together after meeting at the lower end of the incision.

Then, the seromuscular layers on both sides were reinforced with intermittent sutures, and the rough surface of the stump was embedded.

Zhou He couldn't help but say, "Your basic skills are too solid!"

He Zhengzhi's eyes also lit up: "It's amazing!"

Indeed, Chen Cang's suture from the beginning to the end caused very limited damage to the stomach wall. When the needle tip went in and out, he cleverly used the distance of the needle tip to control the tension of the stomach wall. This was actually a very effective tension suture.

Chen Cang smiled: "Basic."

In fact, this is also the method that Chen Cang has been researching!

This inspiration also comes from Chen Cang's anastomosis of large blood vessels. When Chen Cang is anastomosed with large blood vessels in the chest cavity, because of the pulsation of the blood vessels, he needs to feel the pulsation and tension of the blood vessels!

At this time, Chen Cang realized the importance of tension suture, which can effectively speed up healing and reduce secondary damage.

Just now, when Chen Cang was repairing, he suddenly had an idea. He found that this kind of tension suture is actually more effective for the suture of the stomach wall, and even in the gastrointestinal anastomosis, this kind of tension suture is even more beneficial!

Thinking of this, Chen Cang couldn't help being surprised.

After the stump of the lesser curvature of the stomach was sutured, Chen Cang closed the two forceps at the stumps of the stomach and duodenum.

At this time, you need to feel whether there is tension!

If there is, the duodenum must be separated to prevent the anastomotic tension from being too large, resulting in the failure of the operation!

Fortunately, no tension was felt.

Can be sewed directly!

Chen Cang turned and glanced at He Zhengzhi: "You can feel it. If there is tension here, remember to separate the duodenum. If not, you can suture it directly."

He Zhengzhi nodded gratefully, and quickly began to feel it.

In fact, surgery requires a person to take you seriously, rather than letting you see it.

You won't be able to see it for a long time.

Feeling is very important, just like feeling the pulse in traditional Chinese medicine, there is an old master who teaches you how to measure up and down and figure it out on your own, which is a lot worse.

Therefore, a good master can save a lot of detours for a surgeon.

He Zhengzhi couldn't help smashing his mouth at this moment!

Emma...so delicious!

Dr. Chen is so amazing!