As expected, Xu Qiu nodded.

He took out the patient's abdominal ultrasound film and analyzed: "If you want to avoid scars, just enter the natural cavity."

"Natural accent?"

Yan Na was stunned for a moment and guessed: "Esophagus?"

This place is very close to the gallbladder area, which is theoretically feasible.

Using the ercp minimally invasive lithography, a duodenoscope can be used to pass through the oral, esophagus, stomach, and the gastrointestinal anastomosis input loop into the duodenal nipple, and reverse lithography can also be performed.

However, because it is a reverse lens, the screen lenses are reversed, and the subsequent treatment is quite difficult. In addition, the device itself has defects, so it is difficult to reveal the gallbladder and is generally rarely used.

Xu Qiu naturally considered this.

Therefore, he chose another way.

"Vaginal." Xu Qiu spoke calmly.

"Is this... OK here too?" Yan Na was a little surprised.

Xu Qiu spread out the patient's abdominal cavity ct tablet and moved his fingers on it: "A incision is made from the posterior wall of the vagina, and the soft gastroscopy and bipolar endoscopy are combined to rewind from the bladder cervix and then into the abdominal cavity. Finally, the pneumoabdominal abdomen can be established here and reach the gallbladder area."

To have surgery, surgery is inevitable.

However, Xu Qiu's plan hid the incision in the vagina.

Even if you have scar constitution, there is no harm in growing a little wrinkle there.

"God!"

"Doctor Xu, I admire your approach. Entering from Qionglong, follow your route, the path is very short!"

"It's not difficult, but it's feasible to avoid the equipment defects of the esophageal approach!"

Everyone couldn't help but applaud.

This operation was confirmed.

...

"Yin...will it be stretched when you go in from there?"

In the ward, Du Lingling heard the surgical plan, raised her legs and gritted her teeth and asked.

Xu Qiu shook his head: "The diameter of the instrument is very small, only 3.2mm."

"That's how... I really won't leave scars."

Du Lingling suddenly smiled.

She was surprised and realized why Xu Qiu asked her if she had sex during the morning rounds.

Did he think of this surgical plan at that time?

Du Lingling originally thought that Xu Qiu's words "No scars as much as possible" were just perfunctory.

But unexpectedly, he really took it to heart and gave a solution...

...

Three o'clock in the afternoon.

The operation is ready to begin.

Surgeon: Resident Xu Qiu, attending physician Yan Na, hepatobiliary surgery resident, etc.

instrument:

Soft gastroscopy.

1 multi-curved double-channel treatment endoscopy.

The latter is very commonly used in gynecology. It has two working channels with a diameter of only 3.2mm, but it can enter two accessories at the same time to complete the mirror operation.

There are three control knobs on the handle, and the lens is also very moving.

In addition, the double-channel endoscope is equipped with a high-frequency generator, suction device, and an insulated knife in the front section to treat blood vessels and the gallbladder is almost invincible.

Three:15.

Du Lingling adjusted to the stone cutting position, and the operation officially began after tracheal intubation and venous anesthesia!

Regularly disinfect the abdomen, vulva, and vagina.

Lay sterile towels.

"Hook." Xu Qiu whispered.

After preoperative discussion, everyone in the operating room was very clear about the entire process and what to do at which step, and they were all familiar with it.

As soon as he finished speaking, he opened his vagina with a hook.

Xu Qiu chose the posterior torsion approach and cut the vagina and tissues layer by layer.

"It's a little... troublesome!"

Yan Na glanced at the screen and her face changed slightly.

Du Lingling's adhesion to the posterior uterus and the anterior rectal wall is relatively serious.

Considering that the patient had undergone a cyst surgery, this situation occurred, either because the cyst surgery was not done at that time, causing postoperative adhesions, or she did not regularly take progesterone drugs such as dinogoxin tablets.

The passage is like this, and it is not so easy to enter the abdominal cavity!

"Sewers."

Xu Qiu's face remained unchanged.

He quickly closed the incision of the rear dome with an absorbable line, and then opened a new path in the front dome.

Incision of vaginal mucosa...

Cut the cervical ligament of the bladder...

Then bluntly separate the bladder and cervical space...

Bang.

It seemed like a light sound, and the road was clear and bright, and it suddenly became clear!

"So decisive!"

Yan Na and others were all amazed.

On the anterior dome, if you are not careful, it will damage the ligament and cause the uterus to sag.

It may damage the bladder and cause sequelae of the urinary system.

If they weren't afraid to make a decision like Xu Qiu - it was extremely dangerous and he had no confidence, who would dare to use the knife?

"So fast!"

In the picture, Xu Qiu had already turned back into the peritoneum from the bladder cervix, cut open the peritoneum, and completely entered the abdominal cavity.

"Endoscope."

"5mm stamp card."

Xu Qiu spoke one after another.

Soon, the curved double-hole inner diameter and small pole card were placed in the patient's surgical area through the anterior fork, and the pneumoperitoneum was successfully established.

Xu Qiu adjusted the vision of the endoscopic and explored the structures such as the abdominal cavity.

"There is no abnormality in the abdominal cavity."

“There is no bleeding in the vaginal incision.”

"There is no damage to the surrounding organs!"

Yan Na stared at the screen while reporting.

At this time, two foreign body clamps were sent in through the endoscopic dual channels. Under Xu Qiu's control, the bottom of the gallbladder was successfully grasped.

Immediately afterwards, a laparoscopy was placed through a vaginal poking card, and the gallbladder was pulled to the upper right with a grasping forceps.

Under the surveillance of the endoscopy, the gallbladder was completely exposed to everyone.

Then, the knife was also sent in.

This is a special high-frequency electric knife for endoscopy. The advantage is that it can slide flexibly while incising and prevent deep mucosa damage.

The old version of the I-knife has no insulation protection, so it is very easy to cause accidental damage and perforation when peeled off.

Of course, after the improvement, the only insulating knives will be left on the market.

...

The 93rd minute of the operation.

Xu Qiu used an It knife to free the gallbladder duct and gallbladder artery, clamp it, expand the forward and reverse direction, graft the stone, and take the stone.

Da da da da da!
To be continued...