(Thanks to Zixing 87, Xingna monthly ticket encouragement)

"It's a very simple operation, and it's not a surgery without any external wounds, don't worry."

Liu Banxia, ​​who came to the operating room, was also soothing the patient's nervousness.

The patient with the tube nodded.

"I have also explained to you why you need to intubate? Because it is a prone position, this is to protect your airway from unobstructed." Liu Banxia said.

"Okay, after checking the patient's information, the patient's mood is also very beautiful, and we can face it more easily after the operation. Endometriosis is not very serious."

This is also for the patient to hear. She probably did not inform her family, but a young sister came to accompany her.

That is, this surgery is not very big, otherwise it would be difficult to deal with.

After a while, Li Liwei nodded to him and signaled that the anesthesia was successful.

Liu Banxia shook her neck, "This operation is very new today because we have never done it before. But this operation is very old because it was a technology that appeared a long time ago."

"The reason why we do it here is to accumulate more experience and prepare for the next NOSES procedure. Question 1, why does Li Tianyang use the prone position?"

After saying that, he gave Guan Wei a look next to him, and Guan Wei began to connect the pipe fittings.

"After the patient takes a prone position, the lesion is located directly below, which is convenient for operation." Li Tianyang said concisely.

"Not bad." Liu Banxia nodded.

"But there are flaws, because the definition of this is all about right-handedness. What if I suddenly become left-handedness, it will not be fun."

"The second question is, what is the key to this surgery? Is it the patient's choice? Or is it another factor. It's the first time I did it. Let's discuss it together, and Liu Yiqing will discuss it."

"Like laparoscopic surgery, the most important thing is proficient in the use of the instrument and suture skills." Liu Yiqing said.

There was still a little pride on his face, and he didn't fall into Liu Banxia's pit.

This really surprised Liu Banxia, ​​"It's amazing, the silly Liu Yiqing is not stupid anymore. She thought she would work hard on the screening of patients and she had a future."

"She said it's not bad. The most important thing is the operation of surgical instruments, and the other is the intra-cavity suture technique. This is what I want to say next."

"When facing tumors, we only have two choices. One is full cleavage and the other is local cleavage. In the cases we have seen before, fewer patients were found early, and most of them were malignant."

"It's rare that benign people will be our turn. They are almost killed directly when they have colonoscopy. In this regard, your teacher Guan is also an expert."

"The reason I asked him to give it to you on the spot is to make you feel deeper. Maybe you will use it in the future, but it depends on your level."

"It's already connected and ready to use it." Guan Wei said.

"Let's depend on my operation next. Why am I still nervous?" Liu Banxia said.

"The operation skills are actually not that complicated. You should know the first step even if I don't say it. You must gently expand the anus, otherwise it will cause a certain degree of damage, let alone learn from me."

"After the anal expansion, I put it in a special rectoscopy. Did you see it? There are not so many statements about the fixed position of the rectoscopy. The most important point is to provide you with the best view and facilitate your operation."

"It is an auxiliary component. If you can't help you, what else should he do? So the same is true for some other equipment. There are not so many standards. What is suitable for you to operate is the only standard."

"OK, the fixation is completed. Next is inflation, which is also a very simple job. Unless it is special patients, it can be automatically adjusted, otherwise the colon will be over-expanded. The pressure is 12-15mmHg, which is fine."

"Our patient is actually a little special. After all, she has three friends. The first and second ones are in good positions, while the third ones are in a slightly worse position."

"But I think although it is a little worse, I can take it off at the fixed position of the rectoscopy. You should pay attention to it when doing it in the future and don't take risks."

"Xu Yinuo, actually, I think sometimes you should be sent to the anorectal department for a walk. Many of our patients have rectal cancer, and the demand for anal protection is so high now. What should you pay attention to when resectioning rectal tumors?"

Xu Yinuo was a little depressed, "The main reason is to avoid nerve damage and blood vessel damage during the operation, and you also need to pay attention to prostate damage and maternal damage."

"Wait a minute, Banxia, ​​do you usually teach like this?" Guan Wei, who helped Liu Banxia put equipment into the casing, asked.

"See it? That's what he is like. But it's getting harder to find fault with them now, and I have a very thorough understanding of many surgeries." Li Liwei said.

"Brother Li, you can't praise them. Once you praise them, you will be sluggish." Liu Banxia said.

"Hey..., it's really incomparable. If I asked questions like this when I was teaching, many people would be confused directly." Guan Wei said with emotion.

This is not a praising Liu Banxia, ​​it is his true feelings.

Because he had never seen such a "unique" teaching operation, he asked questions with a hammer and axe, but his ideas were a little bit unsatisfied. Even if he mastered them proficiently, he would easily make mistakes when answering.

I just heard that the interns brought by Liu Banxia are very good, and today I have real insight. This guy used to be very good at training these interns, and it is really hard to persist in this product.

"In fact, it's not that inhumane. If they don't want to be strong, they will be banned on the operating table twenty-four hours a day, and they will be useless." Liu Banxia said.

"Brother Guan, can you tell Director Jiang about how many more days to use this device? Let them also familiarize themselves with the relevant usage skills. If possible, I may really apply for one in the future, and there is also a NOSES device."

"Didn't you also see Director Jiang yesterday? Why didn't you say that?" Guan Wei asked.

"Teacher Guan, let's learn more, too." Xu Yinuo said.

"Teacher Guan, otherwise, can you invite us to have an internship when you have a similar operation?" Liu Yiqing also spoke.

"Teacher Guan, Teacher Liu can actually arrange a lunch." Li Hao said.

"Stop, stop, I discovered that you don't have a single fuel-efficient lamp, you have learned bad things from him. For lunch, I can lend you another day, so we only have this one." Guan Wei hurriedly spoke.

Can it be okay if you don’t speak? He shouted at Teacher Guan, and his face was still pitiful. Who can stand it? If he doesn’t agree, it will affect the growth of an excellent surgeon.

"Thank you, Mr. Guan."

The seven people said thank you in unison.

"Hehe, it seems that you still have face. It's a must. Teacher Guan must be invited to lunch at noon." Liu Banxia said with a smile.

Guan Wei rolled his eyes, and he felt that he should come here less in the future. He just came here to work as an illegal worker, and he might agree to any other request.

"Okay, next is the key to the operation. We need to use a needle-shaped electric knife to mark the edges." Liu Banxia said.

"The most basic knowledge point is that the benign control is 0.5 cm away and the malignant control is 1 cm away. But what is different from usual is that we now need to mark the art."

"In fact, the TEM surgical system can also perform full-thickness resection, but the difficulty is too high. At present, I don't want to do too many attempts. Let's take it slowly. In the future, we can carry out multi-path surgery to choose for patients in need."

Guan Wei was very depressed when he looked at it because this was Liu Banxia's first operation, but he was using a needle-type electric knife to mark the edge cutting speed very quickly.

With just a few words, he has marked the first and second ones. Now he is working hard to make the third one, and his skill field is slightly worse, which makes it difficult to operate, but Liu Banxia's movements are still very straightforward and coordinated.

Anyway, judging from his evaluation, he himself can't do this speed, and Liu Banxia's proficiency is not like the first time he used it.

"Hehe, don't forget that before I came to the Second Hospital, I had been away for a while, so I still have some understanding of this set of equipment." Liu Banxia said with a smile.

"Actually, I think it's not very difficult to mark the edges or tumor removal. I have had a laparoscopic operation basis, and although I changed my equipment, it would be fine to cultivate the feel."

"The key is to look at the intraluminal suture technique. If the suture is well, the patient's prognosis will be better. Of course, there is another premise, that is, sufficient intestinal preparation."

"After all, it is a wound in the intestine, and even after suturing, it may cause a certain degree of contamination. Of course, it is still a little different from the anal fistula. Anal fistula has a fistula, so healing is so slow."

"Okay, let's change the elbow ultrasonic knife now. The operation will be faster, the aerosol dissipates faster, and the bleeding-stop effect will be better. Depending on personal habits, there is no fixed standard."

"Okay, grab one. Actually, after cutting the first one, I was confident. It must be an endometriosis tumor, and the bottom was so clean."

"The bleeding-resistance effect is also very good. In order to save trouble, let's take it all out and then stitch it one by one. This technique is quite interesting, and I seem to fall in love with it all at once."

Xu Yinuo and the others gritted their teeth when they heard this, even Guan Wei was the same.

He would agree to Liu Banxia's request to protect him, but what about this job? He was so easy to operate, how many abilities did he hide?

Xu Yinuo and the others were angry because they all knew very well. Seeing Liu Banxia’s operation so easily and the tumor was removed so quickly, but what if it was changed to himself? It would be very difficult.
Chapter completed!