Under the surgical field, the tumor boundary was blurred, and it was much larger than previously predicted. The safest way is to separate most of the muscles and soft tissues on both sides of the larynx, and peel directly to the upper edge of the arytenoid cartilage and the pear-shaped fossa on both sides. In this case, a large transplant flap is bound to be used. There is very little subcutaneous fat in the neck, and the flap is too large. There is no blood supply inside, and it is easy to necrosis. Once necrosis occurs, the patient loses not a throat, but life. Director Hou paused, and he didn't know how to make a decision. At this moment, Xu Qiu's calm voice sounded, and he said calmly: "Total laryngectomy." "But... blood supply..." "Leave it to me." These plain words made Director Hou startled.
He looked at Xu Qiu several times, and the other party's expression never changed, as if he had already anticipated all this. At this moment, Director Hou had a strange feeling in his heart. He has been the director for seven or eight years. For a long time, the junior doctors in the ENT department have never been too cautious when performing surgery. Because Director Hou always has their backs. But in this operation, when Director Hou expressed his embarrassment, he found that he seemed to have a backer! "Okay!" Director Hou nodded excitedly. The total laryngectomy took a total of two hours. After that, Xu Qiu took over and completed the lymph node dissection. "Done..." "Cleaning the wound!" The next steps were handed over to the assistant. Xu Qiu and the others walked out of the operating room. Total laryngeal tumor resection and lymph node dissection are both contaminated operations that have been contaminated by tumors. To continue with the pectoralis major muscle flap transplantation, you must wash your hands again and wear new surgical gowns and gloves. Ten minutes later. Huh—— Next to the operating table, Xu Qiu breathed a sigh of relief.
After the warm-up of the dissection, his touch was also improved to the extreme. Fingers arched, and he seemed to have countless silk threads on his body, carefully controlling every subtle movement and every slight change in force. "Let's start..." Xu Qiu's voice was neither salty nor bland, as if it was just an ordinary operation in front of him. Qiu Bo's chest had already been incised with methylene blue. Xu Qiu's scalpel fell and cut along the marked line, making a paddle-shaped incision on one side of the skin, with almost the same width of six centimeters. On the other side, it extended from the armpit to the fourth intercostal space, parallel to the clavicle, and made an oblique rectangular incision. The chest incision was opened! Next, it is to separate the muscle flap... "Line 0." Xu Qiu stretched out his hand. The instrument nurse and the third assistant next to him were stunned for a moment. Why do we need sutures in the separation process? Director Hou opposite also had doubts in his heart and did not understand the significance of this move. But Xu Qiu took the suture needle, and the line 0 shuttled quickly, suturing the pectoralis major muscle flap and the skin cut edge. "This..." "Is it to prevent the muscle and skin from separating during the separation process?" Director Hou and others immediately realized Xu Qiu's purpose, and a trace of shock flashed in their eyes. Has Xu Qiu's control over the details of the operation been so terrifying? ... On the operating table, Xu Qiu ignored the eyes of others. Is he immersed in the world of surgery, constantly switching between the suture needle and the scalpel in his hand, and soon separated the pectoralis major muscle toward the axilla, and then neatly cut off the attachment of the sternocostal fibers on the inner side of the pectoralis major muscle. Director Hou looked into the surgical field, and the next moment his eyes were filled with astonishment. "Is that a blood vessel?!" Under the bright shadowless lamp, there is a blood vessel running from the outside to the inside under the pectoralis major muscle flap separated by Xu Qiu. This is the muscle vascular pedicle! Director Hou was stunned. No wonder... Xu Qiu asked him to let go and remove the laryngeal body, and it turned out that he had already prepared!
The formation of a muscle vascular pedicle in the flap can artificially establish blood supply to prevent infection and necrosis! "He seems to have anticipated everything..." Director Hou's eyes widened, and his emotions became more and more complicated when he looked at Xu Qiu. ... The operation was in its eighth hour. Director Hou had already taken a break in the middle, and several other doctors also felt dizzy. This was hypoglycemic dizziness caused by overusing the brain and no sugar source supplement. "I'll go get some glucose..." "I'll go too." "I can't stand it anymore!" The physical strength and energy consumed by the operation were far greater than expected. A team of different doctors was divided into several groups and took turns to exchange. The operating area is equipped with a refrigerator. Generally speaking, no drinks are allowed in it. Only glucose and saline can be stored. But... As long as you have drunk these things, you will know how difficult it is to drink. It's so sweet and disgusting. Therefore, many operating room refrigerators will stock some Coke. Although it does not meet the regulations. But who can resist, in the case of dry mouth and stuffy body, drinking a sip of cold Coke? Gulp gulp... After finishing a bottle of Coke in a few gulps, the young chief physician burped for a long time. The deputy chief physician drank it in small sips, glanced at the chief physician, and shook his head. "Director, is Dr. Xu a robot? He has been doing this operation for six hours straight!" the young chief physician sighed. When it comes to this topic, the deputy director's pupils also shrank, and his heart was deeply touched. All of them, the assistants, were exhausted. As the chief surgeon, Xu Qiu's energy and physical consumption rate was two or three times that of theirs! But... Until now, Xu Qiu is still standing on the stage! "Deputy director, don't drink anymore, I feel guilty, let's go back quickly..." The young chief surgeon said, and quickly drank another bottle, went through the sterile process again, and went back to the operating room. The deputy director held the Coke and stood there blankly.
You showed off two bottles, and I didn't even finish half a bottle... You told me not to drink? ... Unconsciously, the city has ushered in dusk, and neon lights are lit. Outside Linhai First Hospital, all kinds of hot snacks are set up. Across the street, there is another store that is being renovated. On the half-covered sign, the words "Shared Kitchen" can be vaguely seen. There is a constant flow of traffic on the road, and the noisy car horns whistle past. In the warm light, the white Linhai First Hospital looked particularly cold. "It's nine o'clock in the evening!" "The operating room started at eleven in the morning, and it's been ten hours now!" In the emergency department, many doctors knew that Xu Qiu was doing a major operation, so many people were paying attention to the situation there. However, the hospital has moved to the night clinic, and only a part of the "24-hour operating room" is still in operation. Xu Qiu's operating room is still busy, and there is no news. However, for such a large operation, no news is good news. "If it succeeds, then this operation will create history..." "Yes, I heard from my colleagues in the ENT department that the operation is very complicated and the steps are cumbersome. It will take more than ten hours to get off the stage!" "Doctor Xu is still the main surgeon, and no one can take over. Can he hold on?" In the emergency department, doctors and nurses are very worried. At this time, the door of the emergency hall was pushed open, and a person came in pushing a wheelchair. Seeing the person coming, Liu Susu and other nurses were startled, and then a happy smile appeared on their faces.
