Chapter 897: Exploding Tumor
Laparoscopic teratoma surgery is not difficult.
Anesthesia in the supine position.
Make an arc-shaped incision at the lower edge of the navel.
Establish artificial pneumoperitoneum.
Insert the trocar and laparoscope.
Then, make three incisions on both sides of the navel and above the pubic bone to expose the teratoma, and drain, peel and remove it in turn.
Kong Huixia is a master in obstetrics and gynecology laparoscopy. Her student Li Xue has inherited her true teachings. In addition, Xu Qiu tutors her from time to time, so she can easily complete this operation.
Two and a half hours later, the operation is nearing its end.
At this time, the airtight door is stepped open with a hiss.
Xu Qiu, who had just finished a level 4 operation, then stepped in.
He sorted out the fatigue on his face, put on the surgical gown with the help of the nurse, and came under the shadowless lamp.
Li Xue had just finished the last stitch and naturally made way: "Doctor Xu, leave it to you!"
After saying that, he stood aside with a face full of envy.
It has to be Dr. Xu!
Although her skills are very good, she still has a gap to be as comfortable as Xu Qiu.
It takes several lifetimes of hard practice.
"Yeah."
Xu Qiu nodded lightly and looked at Pang Honggu who had completed the exposure, marking, disinfection and neck.
The anatomy of the thyroid gland is still very critical.
It's not difficult to say.
Remember the thyroid blood vessels, thyroid lymphatic return, thyroid nerves and parathyroid glands.
However, it is different from the conventional laparoscopic teratoma resection.
The thyroid gland is an organ with very rich blood function, and it is easy to bleed during surgery, so multiple venous access must be established in advance.
For example, this one uses a 22G intravenous indwelling needle, which is connected to the infusion access through a disposable triple extension tube. The anesthesiologist can give medication at any time during the operation, and there is no need to panic if something goes wrong.
Of course, there is a high probability that nothing will go wrong.
And the teratoma under the thyroid gland is more dangerous.
This principle is somewhat similar to pheochromocytoma.
Xu Qiu had also cut pheochromocytoma, which is very dangerous because once the tumor is slightly stimulated, it will suddenly secrete a large amount of catecholamines, leading to an inevitable hypertensive crisis.
The systolic blood pressure of a normal person is below 140, and the most serious level 3 hypertension is 180.
But after a hypertensive crisis occurs, the patient's blood pressure can soar to more than 300, and it is extremely difficult to save him.
The teratoma this time is similar.
No one can be sure whether the tumor contains substances related to anti-NMDAR encephalitis.
If it is the same as pheochromocytoma, the tumor will secrete a large amount after being stimulated, which may cause acute and malignant autoimmune encephalitis symptoms.
Therefore, Xu Qiu's spirit is particularly focused.
…
"Toothed forceps."
Xu Qiu stretched out his hand, and the alloy instrument was summoned.
After lifting the edge of the incision, surrounded by two pieces of dry gauze, the scalpel cut the skin, and a circle of fine blood beads oozed out from the skin incision, and then was immediately wiped away by the dry gauze.
"Thyroid retractor."
Pull the skin aside to expose the surgical site.
"Small right angle, small curved band."
Separation after ligation.
Electrocautery and ultrasonic scalpels were used in turn, cutting and expanding inwards, and 3/0 sutures were waiting beside, ready for ligation at any time.
Not long after, the culprit appeared in the surgical field.
A mass with an unhealthy color and obviously different from the surrounding area was exposed to everyone.
"Is this it..."
"So fast, it was found in a flash!"
"Doctor Xu is still awesome, there is no one in China who can fight."
"What do you mean, there is no one in China who can fight, is there someone in foreign countries who can fight?"
The assistants triggered the passive hug again.
Xu Qiu ignored the noise beside his ears and began to remove wholeheartedly.
Even the pheochromocytoma that exploded with a touch was taken down. This kind of teratoma with nerve cell activity may be a forbidden area for others, but in Xu Qiu's eyes, it is just a slightly serious level.
Scalpel, tissue scissors
Different cutting instruments were tumbling in Xu Qiu's hands, as if they had become his third hand, moving freely in the surgical field.
Ligating the tumor, cutting off the possibility of blood transfer, and then peeling off the various parts of the teratoma.
After about twenty minutes, with the skill of butchering a cow, the teratoma tightly attached to the thyroid gland was removed.
The people who were worried finally breathed a sigh of relief.
The anesthesiologist also sat down again and continued to play with his mobile phone.
Staring at the screen, his mind was in turmoil.
Damn, so cool.
When can I be as cool as Dr. Xu?
"Send it to pathology."
Xu Qiu cut a piece of the base tissue left after the tumor was removed and handed it to his assistant.
This step is to do rapid pathology.
There is also another name: intraoperative frozen diagnosis.
From sampling to the final diagnosis, the results can be obtained in at most thirty minutes.
This is also one of the necessary steps after many tumor resections. Through this method, it can be determined whether the tumor is completely removed and whether there is any residue at the base.
Although Xu Qiu was confident, he did not even take such safety measures, which meant that his professional attitude was problematic.
Ten minutes later, the results of the intraoperative frozen diagnosis came out.
No components of teratoma were found!
Xu Qiu also just finished the neck dissection.
After confirming that there was no problem, he began to suture.
The circulating nurse and others had already had experience and had already started counting the instruments.
When the number of instruments matched, only the curved needle, tweezers and needle holders in Xu Qiu's hand were left.
At the same time, the last needle came out of the skin, and Xu Qiu put down the instrument.
Clang.
As soon as it fell into the tray, the circulating nurse grabbed it and smiled: "The instruments have been counted and they are all there."
It doesn't have to be like this...
Others thought of this at the same time.
This excitement, if you don't know, you might think you grabbed Dr. Xu's hand...
Tsk.
On the other side, the assistant was preparing to send the cut tumor to routine pathology.
Seeing the condition of the tumor, Li Xue suddenly felt nauseous.
"Ugh, I didn't expect it. It looks so round, but it looks like this when it's cut open..."
Li Xue resisted the nausea and took a sample and sent it to the laboratory.
Others also looked at it one after another. When they saw the teratoma in the tray, they all felt physically uncomfortable.
Under the capsule, the tissue inside the teratoma was particularly chaotic.
It was like a mixture of all sorts of things.
Thick yellow fat, with tiny arteries like red silkworms in the middle.
White greasy flesh was clinging to the surroundings.
Dark red blood clots were everywhere.
Pieces of calcified tissue that looked like teeth were squeezed out of the gray cysts, and some pieces of flesh had sparse hair growing on them.
Even at the bottom of the mass, you could vaguely see structures similar to eyeball tissues...
This thing was simply challenging human acceptance.
Disgusting was secondary, but this thing was somewhat similar to a deformed fetus, and the happy bean effect was about to occur.
