Lower damage is smaller and more beneficial to the patient.

For an eleven-year-old boy, the best way to preserve more is to remove as little as possible.

…

Complete ligation.

Cut off blood vessels...

After that, continue to separate laterally along the plane between the descending mesocolon and retroperitoneum to the peritoneal attachment on the lateral side of the colon, separate the descending colon upward from the surface of Gerota's fascia to the splenic flexure, and free the right mesorectum...

Xu Qiu held the instrument in his left hand, grasped the junction of the rectum and sigmoid colon, and pulled it toward the patient's right side.

At this time, the attached tissue on the outside of the sigmoid colon is exposed.

Xu Qiu held the electric knife in his other hand and used it to separate the attached tissue.

Sizzling——

As the lateral peritoneum is opened, the retroperitoneal plane that was previously separated when the colon was freed also appears, and the two cavities merge into one.

Xu Qiu did not stop, he continued to separate the splenic flexure of the colon along the white line of Toldt.

The instrument of the left hand continued to move upward along the descending colon, and soon the attached tissues on the lateral and posterior sides were separated.

Deputy Director Chen and other gastroenterologists and hepatobiliary doctors became more and more obsessed with it.

"What a detail. The pulling force during the separation process is just right. The intestines have just enough tension but not tightness. The electrosurgery can accurately separate each layer of tissue!"

"I have already seen the sigmoid colon below...be sure not to cut it, otherwise the parasites inside will crawl all over the abdominal cavity!"

"What nonsense are you talking about? How could Dr. Xu make such a stupid mistake?"

"Indeed, Deputy Director Chen, be careful. You are an assistant. Don't nick the patient's intestines."

Deputy Director Chen, the first surgical assistant, had a dark face.

...I am also the deputy director after all. I have been working for so many years, so what?

Even so, he also increased his vigilance and cooperated with Xu Qiu to continue to separate the attached tissue below the rectum and sigmoid colon. Xu Qiu then used an electric knife to incise the left lateral peritoneum along the upper mesoenterum of the rectum to protect the ureter, and then

Mobilize the distal rectum further to obtain adequate margins...

Seeing Xu Qiu's smooth operation, Deputy Director Chen couldn't help but swallow.

Observing Dr. Xu's surgery is simply a pleasure.

At a cursory glance, Xu Qiu's surgery didn't seem to have anything too surprising. It was just smooth and smooth, with almost no pauses. It was like playing a group of difficult piano pieces, with each step connected without any pause.

This is difficult for a layman to do, but it is a routine practice for surgeons.

Just like an ordinary pianist and Beethoven, the two of them played a medium-difficulty piece at the same time, and both seemed to be able to do it with ease and in one go.

However, an expert can tell the force and rhythm of each key pressed.

When it comes to surgery, Xu Qiu's strength lies in his extremely precise control of every surgical operation, and he pays attention to "just right" in every detail.

The incision is just enough to be operated.

The cannula has just barely entered the abdominal cavity.

There is also the separation process. The distance, strength, etc. are also controlled to the limit. Anything less is a mistake, and anything more is redundant.

However, throughout the whole process, Xu Qiu made no mistakes and maintained it in perfect condition until now...

…

The operation lasted until the sixth hour.

The resection of the sigmoid colon is coming to an end, and only the final separation work remains.

Deputy Director Chen used the trocar in the left lower abdomen and grasped the junction of the rectum and the sigmoid colon. He exerted a little force and pulled upward and forward, and the rectosigmoid colon left the pelvic cavity.

Xu Qiu was very satisfied.

After such pulling and tugging, there was a good surgical field between the back of the mesorectum and the presacral space, which was enough for him to flex his muscles.

Deputy Director Chen stared at the screen and also paid attention to Xu Qiu's movements.

When the right side of the rectum is separated, he raises it.

When separating the distal part of the rectum, he pulled the rectosigmoid colon out of the pelvis as much as possible.

With strict cooperation, the initial separation step was completed.

Then, it's the cutter's turn to come into play.

The electrosurgery was used to incise the peritoneum at the transverse junction of the rectum and bacilli, and then use non-invasive intestinal forceps to separate the rectum and mesentery. Then, a cutting stapler was inserted from the cannula of the right lower abdomen to start cutting the intestines.

"It's such a good thing..." Deputy Director Chen couldn't help but sigh as he watched the cutting and suturing device completed with just one nail under the camera.

In previous surgeries, doctors could use very few instruments and mostly rely on their hands.

But there are too many medical tools today.

Such as cutting staplers.

In the past, it was necessary to cut slowly, then stop the bleeding and suture, a total of three steps.

And every step requires special attention. For example, in the cutting process, the edges of the incision need to be kept as neat as possible, otherwise the subsequent hemostatic suturing will be much more difficult.

But with the cutting and suturing device, cutting, hemostasis and suturing can be completed at the same time in one operation.

Moreover, the edges of the wounds completed with the help of instruments are extremely neat.

An operation that used to take nearly ten minutes can now be calculated in seconds.

Even Xu Qiu couldn't catch up with this speed.

This is also the reason why he chooses to use a cutting and suturing device - when his own skills have no obvious advantage, or when better results can be achieved by using medical equipment, he will also use medical equipment to assist.

"It's almost done!" Deputy Director Chen cheered up.

Only the last section is missing to completely transect the mesentery.

But before that, check the remaining ends and stop the bleeding completely.

Otherwise, after the assistant releases the pull and the bowel retracts into the pelvic cavity, the bleeding will not be observed.

"No bleeding spots."

After Xu Qiu completed the exploration, he cut off the last section of the mesentery.

At this point, the sigmoid colon has been removed.

The patient's intestines have been clamped, and all the obstructive worms inside are blocked inside.

Deputy Director Chen and several other assistants stared at the surgical area with their eyes wide open, looking for parasites that might crawl out of the remaining intestines.

Swish swish swish.

Six or seven white angiostrongylus worms were all quickly pulled out when they were about to climb out of the tube cavity.

Xu Qiu then used No. 0 polypropylene purse-string sutures to sew.

After solving this large group of parasites and clearing the intestines, the remaining scattered parasites can be dewormed with drugs.

"Re-establishing pneumoperitoneum."

After Xu Qiu finished speaking, he found the proximal colon and then connected the remaining distal rectum.

Without the middle section of the sigmoid colon, Xiaojie's life will definitely be affected, but compared to losing his life, this is a small matter.

And the good news is that the proximal colon can be placed naturally into the pelvic cavity without retraction. In this case, it means that the length is sufficient and the intestinal segment anastomosis can be completed without tension.

"Prepare the circular stapler." Xu Qiu said.

As soon as he finished speaking, the assistant said that the circular stapler was inserted into the patient's anus, entering the end of the rectum from the sphincter relaxed by anesthesia...

——
Chapter completed!