Chapter 820 Improved Hassion Method

The next step is the brain abscess cleaning.

To be specific, it is the brain abscess puncture and drainage cleaning.

This operation is similar to the third ventricle floor fistula under neuroendoscopy, which is also a minimally invasive operation with little damage.

This is also the key reason why Xu Qiu dared to perform multiple combined operations on Xiaojie... The damage caused by multiple minimally invasive operations is much smaller than that of major operations. The three-incision vitrectomy and subretinal injection in the eye, plus the third ventricle floor fistula, brain abscess puncture and drainage cleaning, the four operations added up are not as big as one intestinal resection.

However, in terms of risk, intestinal resection ranks last.

Like the third ventricle floor fistula and brain abscess puncture and drainage, due to the deep location of some lesions, the risk factor is very high, and it is possible to die if you are not careful.

But fortunately... Xu Qiu did not use conventional intestinal resection.

…

After a short rest, Xu Qiu began to perform puncture and drainage.

The new brain puncture needle was used again. Under Xu Qiu's control, it entered the drill hole from shallow to deep.

On the screen, the brain stereotactic instrument showed that the puncture needle had reached the abscess.

At this time, Xu Qiu also felt the resistance from the puncture needle.

He slightly increased his strength, and the puncture needle gently pierced the abscess cavity.

Gurgling--

The pus slowly flowed out.

Xu Qiu fixed the brain puncture needle, and then used a needle to aspirate to remove all the pus inside.

Then inject antibiotic saline and rinse repeatedly.

Finally, inject iodine phenyl grease for disinfection.

During the whole process of abscess cavity puncture and drainage, Xu Qiu's movements were slow and gentle.

Until the disinfection was completed, he slightly increased the speed of pulling out the needle, and quickly pressed it gently with brain cotton after the puncture needle was detached to prevent the liquid from overflowing.

Continuous operation until all abscess cavities were cleared.

Then the scalp was sutured in turn.

After a few samples, Xu Qiu handed the task of suturing to Director Lin.

He rushed to the bathroom without stopping.

The next step was the abdominal intestinal resection.

As Xiaojie's fourth operation, although it was the same patient, due to the different positions, the gloves were likely to be contaminated, so repeated hand washing and disinfection were required.

This period of time also gave Xu Qiu a break.

Twenty minutes later, he re-entered the operating room.

At this time, the head operation had been completed, but Director Lin, Director Ge and others were reluctant to leave, and even the ophthalmologist was still there. Everyone wanted to watch Xu Qiu's operation.

"Get ready, the next step is laparoscopic colorectal surgery." Xu Qiu stepped into the operating room and ordered while putting on surgical clothes.

The fourth operation was originally a routine intestinal resection.

However, considering that Xiaojie could not tolerate it, Xu Qiu changed it to a laparoscopic operation after consideration.

The risk of death in combined surgery is very high, and it is also a great test for anesthesiologists. The difficulty is not a simple 1+1+2. Performing two operations separately and combining two operations together, the latter's risk soars sharply.

Four operations, even if the first three were minimally invasive, the next one was a large laparotomy. Even Xu Qiu could not guarantee that the patient could get off the operating table safely.

Therefore, he chose to take on the difficulties, giving up the easy conventional resection and challenging the difficult and skillful laparoscopic colorectal resection!

…

After putting on the surgical gown, Xu Qiu slowly came to the stage.

The operating table had been replaced at this time, and a layer of sterile bean-shaped inflatable bags was laid on it. After the patient lay on it, his legs were fixed on the Yellowfin footrests and his arms were fixed on both sides of the body.

This is the standard position for laparoscopic colorectal surgery.

Xu Qiu stood on the right side of the patient, close to the ascending colon. There were monitors on both sides, all adjusted by the assistant to a position suitable for Xu Qiu to watch; the patient's right shoulder was the first assistant, and the opposite was the second assistant.

The person from the Department of Gastroenterology was a deputy director.

Originally, the first assistant for this operation was Director Xiao, but he performed major abdominal surgery and was good at various laparotomy surgeries. He was not very proficient in delicate laparoscopic surgery, so he had to give up.

Then another deputy director of the gastroenterology department, Chen, who specializes in laparoscopic minimally invasive intervention, was replaced.

"Improved Hassion method."

Xu Qiu did not waste time and started the operation directly... The patient was still under anesthesia. The sooner the operation was completed, the lower the risk and the less damage to the patient.

The Hassion method is a classic laparoscopic puncture under direct vision. The process of opening the abdominal wall structure is clearly visible, and it can also avoid damaging the abdominal organs. It can also achieve layer-by-layer separation and layer-by-layer hemostasis, and is widely used in various laparoscopic surgeries.

But there are also many disadvantages.

For example, the distance between the cannulas is unreasonable, the peritoneum is damaged, the space is small, the instruments are easy to collide and the incision is infected.

In short, although it can reduce the damage to the abdominal organs, it hurts the peritoneum.

Although the hemostasis is good, the space is small and infection is easy to occur...

The modified Hassion method can overcome these shortcomings.

Moreover, it is also superior in other aspects.

For example, there is no need to make anatomical markings in advance.

The Hassion method requires that body surface markings be made in advance. Finding the lumbar triangle or the twelfth rib is not a problem for ordinary people, but for some obese patients, it is difficult to locate from the body surface, and sometimes it may even damage the pleura and costal nerves.

However, the modified Hasson method is about 1.5cm from the anterior superior iliac spine in the mid-axillary line. The anatomical position is very obvious, and there is no need to consider obesity, fat and other issues. It is very easy to identify.

The second and most important point is that the operating space is large!

Due to the limited range of finger exploration in the Hasson method, the distance between the cannulas may not be enough.

The second channel, that is, the lens channel, often causes the cannulas to pass through the subcutaneous and muscle to reach the retroperitoneal cavity because the fingers are not long enough. The retroperitoneal cavity space is too small, and it is easy to retreat into the muscle when the scope is withdrawn.

However, the modified Hasson method has a large cavity expansion range. Its operation method is to first complete the scope channel and enter the retroperitoneal cavity vertically, which can avoid passing through the muscle. The retroperitoneal cavity space established is very large, and there is enough space for the operator to operate.

If it is an ordinary laparoscopic surgery, such as exploration, or a biopsy sample, the small space of the Hasson method is not a problem, and Xu Qiu can control it with technology.

But this time it is a sigmoid colon resection!

Without enough space, it cannot be performed at all, and the resection cannot be completed!

It is precisely because the modified Hassion method does not pass through the muscle that another advantage of this method is that it does not cut the muscle. Unlike the Hassion method, which requires cutting the external oblique muscle and the internal oblique muscle, the modified puncture avoids the muscle, so there is no need to suture the muscle layer after surgery, and there will be no cannula incision hernia!

Gurgle...

Seeing Xu Qiu make a vertical incision 1cm below the navel, Deputy Director Chen couldn't help swallowing his saliva.

Although he knew the advantages of the modified puncture before the operation, he still felt like he was in a dream at this moment.

The advantages of this technology are too great. When the industry was generally still doing the Hassion method, Xu Qiu had already started to do the modified method... There will be another paper to be published in the next issue of "Linhai Dayi"!

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