When it comes to the liver, this is the key point, because the patient's clinical symptoms are basically related to the liver.
The medical record stated from the beginning that this patient had liver cirrhosis. Most cases of late-stage liver cirrhosis show a shrinking liver, but this patient had a rare enlarged liver, which seemed not to be in the early stages.
The reason is that Budd-Chiari syndrome causes hepatic congestion and swelling. Doctors have reason to suspect that his cirrhosis may be caused by Budd-Chiari syndrome, which is different from most cases.
Obstruction of the hepatic veins and the upper inferior vena cava is the main cause of Budd-Chiari syndrome.
Laparoscopic observation of the liver's contour and outer surface, combined with preoperative CT and other examination results, can temporarily determine that there is no tumor inside the liver.
No doctor was relieved by this.
Because the preoperative examination had shown that the main lesion of this patient was not in the liver but in the inferior vena cava. This surgical video showed that the patient had a cancerous tumor.
The real-time atmosphere in the operating room was conveyed to the exchange meeting.
The lively and noisy sounds just now disappeared, and low pressure spread.
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Every surgeon is eager to be slapped in the face after opening the abdominal cavity. As long as it is not cancer, everything is fine. But now they have to adjust their mentality and continue.
Jiang Mingzhu grabbed the collar of her clothes and exhaled to adjust her breathing. She was about to sweat. At this moment, she admired her junior sister Xie Wanying in the operating room. You know, as a medical student, it is unimaginable that she can be so calm.
Although she knew it was a live broadcast, Xie Wanying's hands in the picture were always as steady as a rock. Even if some bad results came out, she would definitely not be able to control herself and her hands would shake.
The operation is about to enter the deep water area, and all the conditions of the inferior vena cava must be understood. At this time, an important anatomical structure called the hepatic portal is touched. The hepatic portal, like the spleen portal and renal pedicle, is an important part for various important tissues such as blood vessels, nerves, and lymphatic vessels to enter and exit the liver. Therefore, the importance of the hepatic portal in hepatobiliary surgery is well known to all specialists. If you are not careful, it will cause severe bleeding. The hepatic vein has a very thin wall and little surrounding connective tissue, which leads to common hepatic vein injury in hepatobiliary surgery.
Before reaching the important anatomical site, the separation forceps separate the peritoneum around the liver. Improper and unstable operation may tear the inferior vena cava, left hepatic vein or left inferior phrenic vein. Such a result often leads to the formation of horrible air embolism in addition to massive bleeding.
Air embolism is also called air embolism. Speaking of the dangers of air embolism, ordinary people who have received intravenous drips know that if air in the infusion tube enters the human blood vessels, it will cause death. In this operation, since the inferior vena cava is connected to the right atrium, if the air enters the right atrium, the patient may die faster.
Everyone held their breath to watch the separation forceps move with great precision.
This is the difference between a celebrity doctor’s team and an ordinary doctor’s team.
Look at the previous surgery for liver tumor, which also involved the separation of the liver portal. But the result was not as good-looking as this one.
What is the reason?
Even amateur photographers could sense it and fixed the live broadcast screen on the laparoscopic monitor. Because the laparoscopic surgery field of view provided by the operator was already very good, amateur photographers randomly cutting the lens focus would not be as good as the expert surgeons.
"This cameraman has a very good light source."
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