Since 1981 Health School Chapter 538

  Chapter 538 Transoral Fundoplication

  President Chen wanted to perform an endoscopic "stomach cutting" operation in front of all the doctors in the hospital. This incident immediately caused a sensation in the hospital.

   If it is a layman who hears that "stomach cutting" is required, at least they are concerned about who has this disease? Or caring about who is too pitiful.

  But for professional doctors, it is quite incredible to complete a large-scale operation with only one gastroscope tube.

  So that night, there were a lot of discussions in various departments, and even Lan Lijuan was quite surprised and puzzled.

  Before going to bed, Lan Lijuan asked a little uneasy:

   "Chen Qi, is tomorrow's endoscopic surgery really okay? You know the gastroscope in our hospital. I really can't think of the possibility of stomach surgery."

   "Who said I'm going to cut my stomach?"

  Chen Qi asked rhetorically while flipping through the anatomy book and reviewing the structural diagram of the digestive system.

   "If you don't cut the stomach, how do you treat it? This is not gastric bleeding, you can solve it with electrocautery."

  Chen Qi closed the book, pulled the light cord, and turned off the lights in the room:

   "Okay, you'll know tomorrow, I'll make a joke first, you sleep first, I'll go to WC to have a big one."

   "The lazy man has a lot of shit, good night."

  Actually, Chen Qi didn't really want to get bigger, but took the opportunity to sneak into the space operating room, rummaging through the pile of "medical equipment garbage" collected by the Mayo Clinic for the tools he wanted to use.

  In fact, there are many ways to treat "refractory gastroesophageal reflux disease" in later generations, and conservative medical treatment is one aspect.

  As for surgery, there are many treatment options,

   Such as radiofrequency ablation (RFA), Medigus ultrasonic surgical endovascular stapler (MUSE), endoscopic full-thickness plication (EFTP), anti-reflux mucosal resection (ARMS), etc.

  However, these treatment methods not only require doctors to have superb clinical skills, but also need a full set of surgical instruments, and a tacit cooperation and high-level teamwork.

   But this is 1988, and many instruments have not yet been invented. Even if Chen Qi has this ability, he still lacks the tools at hand, so he can only give up.

   There is another surgical procedure called "transoral non-incision fundoplication (TIF.

  Fundoplication can be divided into two types. One is traditional surgery, which is to open the abdomen and perform surgery directly on the stomach.

  The other one is endoscopic surgery. This surgery does not require high equipment. It is also the method that Chen Qi wants to teach the surgery publicly tomorrow.

   But this operation also has one of the biggest disadvantages, and it is also one of the biggest controversial points.

  After gastric plication surgery, the folded part is often too tightly wrapped around the esophagus, which easily blocks the passage of food.

  This can easily lead to symptoms such as bloating, difficulty swallowing, and upper abdominal discomfort.

  In addition to the stimulation of the gastric fundus and esophagus during the operation, it can also cause congestion and edema of the gastric fundus and esophagus, causing dysphagia, which makes the patient very painful.

   Let's understand it this way. It turns out that the cardia connecting the upper end of the stomach to the esophagus is too loose, which causes the gastric contents to reflux up.

  The principle of the operation is to find a way to make the loose cardia tighter, tie the pockets tightly, and prevent the contents of the pockets from falling out.

   But this degree is difficult to control. It is not good if the pocket is too loose, and it is also not good if it is too tight. The things below you will not flow back up, but the things above you will also be difficult to go down.

  Or you have flatulence in the gastrointestinal tract, and indigestion causes gas accumulation in the gastrointestinal tract, which can be resolved by farting or belching a few times.

   Now it's better, because the pocket is too tight, the gas in your stomach is difficult to discharge, and the stomach will swell very much, which will also cause pain and annoyance to the patient.

Now Chen Qi has limited tools, so he has to use "fundoplication", but what he wants to do is "Rossetti's modified fundoplication" invented by the British surgeon Rossetti decades later. .

  No way, Chen Qi studied very hard in his previous life. He had 5 years of undergraduate studies, 3 years of master studies, and 2 years of doctoral studies. He has a full 10 years of medical education foundation.

   During these long 10 years, he either worked in the hospital, or read and studied in the library, reading a large number of medical magazines.

  This is also one of the important reasons why he didn't get married after 30 years old in his previous life.

  However, the countless lonely and lonely days and nights of studying hard in the previous life have finally blossomed and borne fruit in this life.

   Chen Qi, who has mastered countless advanced surgical methods and advanced technology, in the 1980s, just relying on "Wen Chao Gong" can make him a great doctor.

  Chen Qi was looking for the medical equipment at hand.

  The staff of the Logistics Department of the People's Hospital were also busy all night. They borrowed a set of the most advanced closed-circuit television from the Fourth Hospital, and prepared to live broadcast Chen Qi's operation the next day.

  People's Hospital has hundreds of doctors, and it is impossible for all of these doctors to go to the operating room to watch.

  Then it is necessary to gather them together and watch them together in the auditorium, and in order to stimulate and shock them, Chen Qi requested a live broadcast.

   It was a peaceful night, except that the emergency department was still as busy as a vegetable market.

   At noon the next day.

  The doctors rushed to the cafeteria early after work to eat, and then rushed to the auditorium to grab a seat after eating, wanting to sit in the front seat.

  In the operating room, apart from Lao Guo, several old directors of internal medicine and surgery came in.

  Because there were too many people, even the deputy director could only go to the auditorium to watch live TV. The operating room was too small to squeeze in.

  When Wu Agou was pushed into the operating room, he saw Chen Qi, and burst into tears:

"Dean Chen, I know that my disease must be hopeless. It should be stomach cancer. In fact, I don't want to be cured at all. I have gone to so many places, taken so many medicines, and spent so much money. They will all be tormented by me.

  But I know that my wife sincerely hopes that I can be cured, and my two sons are also filial, taking me to see a doctor everywhere, so I can't bear to refuse them, I don't want to let them down, and I want to give them a glimmer of hope.

  But Dean Chen, I feel so miserable. I used to be poor and couldn't get enough to eat, so I worked day and night to start a business. Now that my family's conditions are finally better, I have this terminal illness. Why do you think I am so unlucky? "

  Chen Qi was wearing a surgical gown, and he held Wu Agou's hand heavily, smiling and comforting:

"Old Wu, you are a good person. Even if you are a boss, you are a conscientious boss. As the saying goes, a good person is rewarded with rewards. Trust me, and you can rest assured that what you have is not stomach cancer. I am confident enough to cure you. good."

  People are always afraid of death. Although Wu Agou said that he was desperate, but when Chen Qi said that there was still a cure, he suddenly regained his energy.

   "Really? Dean Chen, you didn't lie to me? I won't die?"

   "Death, always going to die..."

   "Huh?! Didn't you say..."

   "Which person won't die? You will live another forty or fifty years at most, and your conscience can't be too fierce. It's almost the same, and you will always die."

   Wu Agou was taken aback for a moment, and then laughed loudly: "Thank you for your kind words, thank you for your kind words, if only I could live for forty or fifty years."

   After being comforted by Chen Qi, Wu Agou's mood obviously improved a lot. When he was pushed into the operating room by the nurse, he was still a little excited, and kept muttering:

   "I don't have to die, I won't die..."

  Old Guo and Zhu Huoyan also walked into the operating room wearing surgical gowns at this time. Seeing Chen Qi, Lao Guo asked loudly again:

   "Chen Qi, I don't know what kind of endoscopic surgery is used today. I will be your assistant together with Lao Zhu. You can do whatever you want."

   Chen Qi was moved when he heard this. After all, these two big bosses personally helped him as assistants for several key operations before, and gave him considerable support and help.

  Today, Lao Guo and Zhu Huoyan obviously planned to stand up for Chen Qi at the first moment.

"Uncle Guo, Mr. Zhu, don't worry, I have confidence in this operation, and endoscopic surgery is different from traditional surgery, and does not require too many assistants, so I appreciate your kindness, today, you can rest assured and look at me boldly." How to play endoscopic surgery, shock everyone's eyes."

   "Okay, as long as you have self-confidence, I'm afraid you'll blow it off, and I'm shaking with fright, hahaha."

  Old Guo laughed heartily, but Zhu Huoyan was still a little worried, so he proposed:

"Let's prepare with both hands. You go to the stage to do endoscopic surgery first. It's best if it succeeds. If it doesn't succeed, everyone in the hospital will watch it today, and there may be comrades from Brother Hospital coming. We can't let others see the joke. .

   When the time comes, Guo Shuji and I will take over the operation immediately. I already know the principle of fundoplication you mentioned, and I can try to use traditional surgical methods. In any case, today's operation can only be successful, and failure is not allowed. "

  Chen Qi nodded heavily: "Okay, listen to Mr. Zhu, and I will trouble you two godfathers to help me **** me."

  12:00 noon, this time period is the doctor's rest time, and there will be no delay in work.

  The auditorium of the People's Hospital was already full of doctors, including doctors from this hospital, doctors from the Second and Fourth Hospitals, and even in the corner, several doctors from the provincial capital.

   It can only be said that gossip news spread really fast enough, just overnight, and almost the whole province knew about it.

  Hundreds of doctors gathered and discussed with each other. Of course, the topic of discussion was today's endoscopic surgery.

   "Old Wang, how did President Chen perform this gastric surgery through endoscopy today?"

   "Yeah, I can't figure it out either. I was holding a stick last night, and I was thinking about how to use the stick to perform surgical procedures such as cutting and suturing? I can't think of it, I really can't think of it."

   "That's not necessarily true. Dean Chen used a gastroscope to treat gastric bleeding before. Didn't you also say that it was impossible, and he did it."

   "Yes, our dean is really amazing, maybe he can really create miracles."

  Because there were too many people, the logistics staff had to add a few more TVs and put them in every corner of the venue.

  No way, there are no large LED screens or projectors these days, and even color TVs are only 14 inches.

   It is obviously impossible for everyone to see such a small screen, so we can only use quantity to make up for this shortcoming. No, almost all the color TVs in the hospital have been moved.

   Fortunately, it is the People's Hospital. If it were any other hospital, it probably wouldn't be able to produce a color TV.

   Just as everyone was discussing, a voice suddenly came out from the big speaker at the scene:

   "Hey hey, can you hear me? Can you hear me?"

"Oh, I heard that. Okay, comrades, I am Zuo Liwei from the medical department. President Chen's surgery is about to start. Before we start, let me reveal the answer. Incisional fundoplication."

  As soon as Section Chief Zuo finished speaking, the surgeons whispered to each other.

  Fundoplication is not new in foreign countries, but because of certain side effects, it is more controversial in the medical field, so it is not a mainstream operation.

  Specifically in China, surgeons in top hospitals know about fundoplication, but surgeons at grassroots level do not.

  So when Chief Zuo said the name of the operation, everyone was full of question marks.

  At this time, Zuo Liwei's voice came out from the stereo again:

"To be honest, I don't know how to do this fundoplication, so I won't talk too much. Now that Dean Chen has completed the preoperative preparations, everyone is watching the TV screen and listening to the voice on the radio. It is a rare teaching operation, and I hope everyone will cherish this opportunity."

  In the operating room, Zuo Liwei stood beside him with a microphone in his hand, with a respectful attitude.

   On the other side, the camera is already in place, aiming at the gastroscope monitor and preparing to broadcast live.

  No way, the conditions are limited, there is no way to connect the lens of the gastroscope tube directly to the TV, so this stupid way can only be used.

  The patient was anesthetized and lay flat on the hospital bed. Chen Qi adjusted the gastroscope and prepared to inject the tube, and Lan Lijuan acted as the assistant herself.

   Surrounded by old directors of various clinical departments headed by Lao Guo, all of them dared not show their pride, wanting to see what incredible surgery is.

  Chen Qi said into the microphone:

"Comrades, the operation is officially starting now. Before we start, let me introduce the surgical instruments to everyone. This is a gastroscope, and this is a fundofolding device. The gastroscope is brand new, but this fundofolding device is second-hand. Presented by O.

  Okay, now I'm going to start the tube, see? Oral ulcers are everywhere, and so is the throat. Looking at the walls of the esophagus, the damage area exceeds 70%. From this we can conclude that these lesions are all caused by reflux.

This also explains that the patient has symptoms such as dysphagia and stomatitis. It is also reflux disease, which causes the contents of the stomach to enter the trachea and lungs and cause long-term chronic cough. damage. "

  The previous medical records have been discussed in the whole hospital, and everyone already knows, but many people question this diagnosis.

   After all, there are not many domestic researches on esophageal reflux disease. We must know that in this era, stomach diseases are difficult to cure, let alone the more recent reflux disease.

   Now that the images presented by the gastroscope are in front of everyone, many doctors suddenly realize that this is the case.

  Then each of them widened their eyes and surrounded the TVs to watch the operation process more carefully.

  (end of this chapter)

Chapter end