When the Doctor Uses A Hack-Chapter 892 - 893 Truly Delicious (Additional
Chapter 892 -893: Truly Delicious (Additional chapter for Alliance Hierarch Jiu-Xueer 2)
Chapter 892 -893: Truly Delicious (Additional chapter for Alliance Hierarch Jiu-Xueer 2)
Chen Cang glanced at the child, lost in thought for a moment.
He couldn’t resist reminding, “Have you ever encountered a gastroduodenal anastomosis?”
Hearing Chen Cang’s words, He Zhengzhi’s delicate body shook violently, his cold sweat seeping out in fear!
Could it be…
Dr. Chen wasn’t skilled in “gastroduodenal anastomosis”?
Thinking this, He Zhengzhi truly felt despair. It felt like he was not staring at the stomach but gazing into an abyss!
Fear crept into his heart, almost swallowing him whole!
He Zhengzhi looked at Chen Cang, pulling himself together, “Dr. Chen, please don’t tell me you don’t know the Billroth I procedure!”
Gastroduodenal anastomosis is the Billroth I procedure.
Chen Cang shook his head and smiled, “I do, what I meant was if you’re not familiar with it, you should watch closely, it’s a rare opportunity.”
Upon hearing this, He Zhengzhi finally breathed a sigh of relief!
Now, he was not hoping for Director Ma anymore. His wish was modest – to simply complete the surgery.
As for learning more from Chen Cang, to tell the truth, he no longer held any expectations.
This operation had already taught him many things more precious than the surgical skills themselves!
“Thank you… Thank you, Dr. Chen!”
Chen Cang nodded with a smile, “How come you’re sweating so much? You should take care of your health, young man!”
The young nurse, hearing Chen Cang’s words, thoughtfully stepped forward to wipe the sweat from Dr. He’s forehead.
He Zhengzhi was pleasantly shocked by this treatment!
When had he… ever been treated like this?
Looking at the gentle and sweet nurse, He Zhengzhi quickly laughed and said, “No, no, just an excess of yang energy, a bit hot!”
The nurses were taken aback for a moment, inhaling the unique cool air of 22 degrees Celsius from the operating room. Hot?
There are basically two main methods of gastrectomy anastomosis: the Billroth I procedure, abbreviated as BI, and the Billroth II procedure, abbreviated as BII.
Both methods have been in use for a century and have been continuously refined.
Simply put:
Gastroduodenal anastomosis is the BI.
And gastrojejunal anastomosis is the BII.
The limitations of BI are relatively significant, but the advantages are also very clear. Since it retains the structure and function of the duodenum, it’s less likely to cause postoperative gastrointestinal dysfunction. If possible, BI should be chosen.
However, during the BI anastomosis, one must be careful to avoid tension at the anastomotic site. The duodenum doesn’t move much, and if a large part of the stomach is removed, BI cannot be used.
It is because of these limitations that the surgical difficulty continues to escalate.
Chen Cang took a deep breath and bent his head down to start the meticulous observation, preparing for the anastomosis.
Since it’s called a gastroduodenal anastomosis, it implies that the core element of the operation lies in the anastomosis between the stomach and the duodenum.
Zhou He watched Chen Cang and couldn’t help but remind him, “Dr. Chen, the patient has intestinal paralysis, and the bowel motility has virtually stopped. Once postoperative obstruction is relieved, and paralysis disappears, gastrointestinal motility will be restored. Plus, with the recovery of the gastric wall’s tension, the contraction and traction at both ends of the anastomotic site might affect the healing of the anastomosis, even leading to its narrowing. Be careful.”
Zhou He meant well.
Never underestimate an anesthetist. During Chen Cang’s internship, he saw an anesthetist save the day, which shocked Chen Cang himself.
After all, to many people, anesthetists are the guardians of surgery, while the lead surgeons are the veterans. However, they overlook that these guardians witness an abundance of surgeries every day – they may not be skilled operators, but their vision and perspective are high!
Hearing Zhou He’s words, Chen Cang nodded gratefully, “Thank you, Teacher Zhou!”
Chen Cang’s Billroth I technique was derived from Li Yue, but it wasn’t completely identical to Li Yue’s, as Chen Cang had his own considerations.
To avoid an excessively wide anastomotic site, it was necessary to first suture the lesser curvature’s open end before the anastomosis.
Whether Billroth I or II, one can opt to suture half of the incision on the lesser curvature side closed.
This step was akin to the time Chen Cang had repaired the mitral valve.
Chen Cang’s eyes began to make careful comparisons.
He had to consider the tension of the stomach wall and the mobility of the duodenum, which suddenly increased the difficulty of matching the anastomosis.
After a moment, Chen Cang turned around:
“No. 1 intestinal thread.”
The anastomosis at the lesser curvature of the stomach needed to be tight and secure, since the stomach is a digestive organ and needs to contain food.
Chen Cang’s suturing was very precise, clamping the No. 1 intestinal thread with a needle holder and wrapping it around the curved forceps, stitching a row of full-thickness continuous sutures from the lower end of the incision!
Immediately afterward, Chen Cang spoke to He Zhengzhi, “Remove the curved forceps, and tighten both ends of the intestinal thread!”
He Zhengzhi nodded quickly.
At this time, Chen Cang brought the upper end of the intestinal thread back for suturing, starting from the cardia and moving down, aiming for the gaps between the first row of sutures for a second row of continuous suturing!
This set of operations momentarily stunned Zhou He!
“Is this… Li Yue’s method?”
Chen Cang smiled and nodded, “That’s right!”
He Zhengzhi looked at Chen Cang, puzzled, “What’s this for?”
Chen Cang explained, “To ensure reliable hemostasis!”
He Zhengzhi nodded involuntarily, not really understanding… but he somehow felt that what Chen Cang said made a lot of sense!
While talking, Chen Cang tied the two ends of the intestinal thread together after meeting them at the lower end of the incision.
Then, he intermittently sutured and reinforced the two sides of the seromuscular layer and buried the rough ends.
Zhou He couldn’t help saying, “Your fundamentals are so solid!”
He Zhengzhi’s eyes lit up, “Incredible!”
Indeed, Chen Cang’s suturing from beginning to end caused very limited damage to the stomach wall, and when the needle tip entered and exited, he cleverly used the distance of the needle tip to control the tension of the stomach wall, which was actually a very effective tension suturing.
Chen Cang smiled, “Basic operation.”
New n𝙤vel chapters are published on freeweɓnøvel.com.
In fact, this was a method Chen Cang had been researching all along!
The inspiration also came from Chen Cang’s major vascular anastomosis; while suturing in the thoracic cavity, due to the beating of the vessels, he needed to feel the pulse and tension of the blood vessels!
At that moment, Chen Cang realized the importance of tension suturing, which can effectively speed up healing and reduce secondary injury.
However, while Chen Cang was repairing just now, a flash of inspiration hit him; he discovered that this kind of tension suturing is actually more effective for the suturing of the stomach wall and even more beneficial at the gastroduodenal anastomosis!
Thinking of this, Chen Cang couldn’t help but feel a surge of excitement.
After suturing the end of the lesser curvature, Chen Cang brought the two forceps holding the ends of the stomach and duodenum together.
At this time, he needed to feel for any tension!
If there was tension, the duodenum must be separated to prevent excessive tension at the anastomosis site, which could lead to the failure of the operation!
Fortunately, he didn’t feel any tension.
Direct suturing was possible!
Chen Cang turned to look at He Zhengzhi, “You feel it; if there’s tension here, remember to separate the duodenum, if not, we can suture directly,”
He Zhengzhi nodded with gratitude and quickly began to feel for himself.
In fact, surgery requires someone to seriously guide you in doing it, not just let you watch.
No matter how long you watch, you won’t learn.
Feeling is important, just like traditional Chinese medicine pulse diagnosis; there is a big difference between having an experienced master teach you the various intricacies and trying to figure it out on your own.
Therefore, having a good mentor can save a surgeon from taking many wrong turns.
At this moment, He Zhengzhi couldn’t help but smack his lips!
Oh my… it’s amazing!
Dr. Chen is actually this impressive!
