Chapter 857: Inhuman Speed

"Doctor Xu has come in..."

While Yang Yuen was still meditating, the air-locked door behind him was stepped open, and Xu Qiu stepped in with a calm face.

Yang Yuen's eyes lit up instantly, and she followed Xu Qiu until she put on surgical clothes and came to the stage.

At 10:30 a.m., the operation began.

General anesthesia, double-lumen endotracheal intubation, collapsed lung on the affected side...

After completing the preparations, Xu Qiu sequentially opened a thoracoscopic cannula insertion port, an operating cannula insertion port, and a small chest wall incision of 5 to 8 cm long.

The positions of the three openings are pretty standard.

The thoracoscopic cannula insertion port is at the seventh intercostal space in the mid-axillary line;

The insertion port of the operating cannula is located in the fourth intercostal space in the anterior axillary line, approximately from the posterior edge of the pectoralis major muscle to the anterior edge of the latissimus dorsi muscle.

The small incision on the chest wall was located at the surface mark of the tumor in the upper lobe of the right lung.

Chichi——

Soon, Xu Qiu inserted the lung grasping forceps and lung retraction forceps into the opening, then used the grasping forceps to grasp the lung tissue and pull the right lung backward and downward.

The mediastinal pleura is incised around the upper part of the hilum.

Immediately afterwards, the mediastinal connective tissue is separated at the lower edge of the umbilical vein entering the superior vena cava, and the vagus nerve branches and accompanying small blood vessels are cut and ligated in sequence...

After completing these operations, the main trunk of the right pulmonary artery and the branches of the anterior tip of the right upper lobe of the lung were exposed.

Xu Qiu separated, ligated, sutured and cut off the leading branches one by one.

Then, Xu Qiu pulled the upper lobe upward and the middle and lower lobe downward, separating the lung tissue on both sides in opposite directions.

After incising the interlobar pleura at the confluence of the upper, middle, and lower interlobar fissures, three small blood vessels appeared below.

"This is...the artery in the posterior segment of the right upper lobe!" Yang Yuen recalled the anatomical memory in his mind.

Xu Qiu nodded... Yang Yuen indeed had experience in anatomy.

These blood vessels are difficult to identify, and ordinary doctors may not be able to guess them.

It is easy to be confused with the dorsal segmental artery of the lower lobe, etc.

After all, each lung segment can be easily distinguished in an anatomy book, but in reality, it is difficult to make a diagnosis immediately by just looking at the lung tissue picture on the screen.

Especially in places without obvious anatomical markings, it is even more difficult to identify.

After ligating and cutting these three small blood vessels, Xu Qiu continued to perform intrathecal dissection along the main trunk of the pulmonary artery.

This step is to expose the posterior segment of the upper lobe artery.

However, the patient's adhesions were severe and the separation was not effective.

Seeing this, Xu Qiu calmly cut off the upper lobe bronchus from the back, then clamped the distal bronchus and pulled it backward.

Yang Yuen's originally confused eyes immediately became smarter.

She stared at the screen in shock.

In the field of surgery, as Xu Qiu pulled, the middle and lower leaves slowly expanded, and the cracks between the leaves were immediately visible.

After seeing it clearly, there is no suspense about the next operation.

Xu Qiu exposed the right superior pulmonary vein in front of the hilum and behind the phrenic nerve, separated the upper lobe vein, then ligated the apical, anterior and posterior segment veins, added sutures and then cut off...

After completing all preparations, Xu Qiu finally used lung grasping forceps to lift the lung lobe to be removed.

Everyone in the operating room couldn't help but feel nervous.

At the same time, I was also shocked.

Before removing the lung lobes, it is necessary to ligate and cut off the blood vessels, nerves and bronchi of each part.

However, these complicated processes only took Xu Qiu seven minutes!

This speed... is simply inappropriate!

…

Everyone doubted his skill, but Xu Qiu had already used a rubber catheter to bypass the hilum of his lungs, and then led the other end of the catheter out from the chest wall incision.

Assistant Yang Yuen has quick eyesight and quick hands.

She put the thick end of the catheter on the TL60 endoscopic stapler and guided the stapler to block the hilum.

Then, he quickly removed the catheter from the stapler, pushed down the stuck needle, fired the stapler, and stapled the hilum.

After doing this, she carefully took out the suture device, reinstalled the staple clip, and inserted it into the chest through the incision.

The next steps are back in Xu Qiu's hands.

Most of the work inside the body is carried out by Xu Qiu, and this is a link that cannot be missed.

Although Yang Yuen is talented, he is not good enough to actually perform surgery.

Slowly advance the staple clip, clamp the hilum again at the distal end of the first staple, and then fire the stapler for the second time.

Click.

After a crisp sound, Xu Qiu cut off the lung lobe from the distal end of the suture device and put it into a specimen bag.

This is one of the most important details in thoracoscopy.

The cut tissue cannot be taken out directly.

There is metastatic cancer above it, and it passes through other tissues along the way, so there is no guarantee that it will not leave a hidden risk of recurrence...

After ensuring that the specimen bag was secure, Xu Qiu guided it through the opening of the instrument and took it out from the small incision.

when.

The small specimen bag landed on the surgical tray.

Everyone's eyes fell on it unanimously.

There is a pink substance in the tray, which is the patient's lung tissue. There is also a dark red substance on it that is similar in shape to a thrombus. It solidifies on top of the pink lung tissue, and the base grows in one piece. The color gradually became lighter, almost blending in with the original lung tissue.

Metastatic lung cancer from small round cell osteosarcoma!

It is the culprit of the tumor in the upper lobe of the right lung!

"In the face of disease, the human body is still very fragile..." Yang Yuen couldn't help but sigh.

After all, all kinds of notorious tumors are just cute little balls of flesh after being cut out, and they are not really that scary.

But if it grows on the body, it can kill people.

If someone who doesn't understand medicine suddenly sees such a small piece of meat, no one would associate it with the fatal osteosarcoma metastatic lung cancer, nor would they think it would have such serious harm...

"Go on, deal with the hilar blood vessels and bronchi."

Xu Qiu glanced at the surgical tray, confirmed that the resection was complete, and started the next step without stopping.

Electrocoagulation to stop bleeding.

Then, with the assistance of the endoscopic knotter and endoscopic vascular suture, the anastomosis and reconstruction of blood vessels and bronchi were completed one by one.

One of the difficulties of this step is to find the corresponding blood vessels, nerves, etc. in the complex diseased lung.

But Xu Qiu completed it as early as the beginning of the operation, and it was more of a delicate job at this time.

It is not a big problem to suture the marked blood vessels one by one.

It is a step that considers patience.

For the next twenty minutes, Xu Qiu stared at the screen, shaking his hands with a small amplitude, and slowly sutured all the corresponding blood vessels, nerves and bronchi.

Then, electrocoagulation to stop bleeding and flush the chest cavity again.

Switch to double lung ventilation and do an inflated lung experiment.

As the lungs gradually swelled, there was still no sign of air leakage in the bronchi.

Seeing this, everyone breathed a sigh of relief, and at the same time sighed in their hearts: Dr. Xu is worthy of it...

Surgery seems to be the most lazy, but in fact it is the most difficult to be lazy.

For example, suturing blood vessels, nerves and bronchi.

Under the microscope of minimally invasive surgery, no one can see how many stitches are sutured, the position and depth of the suture...