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   It was written on the medical record that this patient was cirrhosis of the liver. Most of the late stage of liver cirrhosis is the shrinkage of the liver. On the contrary, this patient belongs to the rare liver enlargement, which does not seem to be in the early stage.

  The reason is that Budd-Chiari syndrome causes hematoma of parenchymal liver congestion. Doctors have good reason to suspect that his cirrhosis may be caused by Budd-Chiari syndrome, which is not the same as most cases.

   Hepatic vein and superior inferior vena cava obstruction are the main causes of Budd-Chiari syndrome.

   Laparoscopic observation of the contour and outer surface of the liver, combined with the results of preoperative CT and other examinations, can temporarily determine that there is no tumor in the liver.

   No doctor was relieved.

  Because the preoperative examination has shown that the main lesion of this patient is not in the liver but in the inferior vena cava. This operation screen shows that it is equivalent to confirming that there is cancer in the patient's body.

   The real-time atmosphere of the operating room was conveyed to the exchange meeting site.

   The noisy noise that had just been lively disappeared, and the low air pressure spread.

   Every surgeon can't wait to be slapped in the face after opening the abdominal cavity. As long as it's not cancer, everything is fine, but now he has to adjust his mentality and continue.

  Jiang Mingzhu grabbed the collar of her clothes and exhaled to adjust her breathing. She was about to sweat. At this moment, she admired the little sister Xie Wanying who died in the operating room. You know, as a medical student, it is unimaginable to be so calm.

   She clearly knew that she was doing a live broadcast, but Xie Wanying's hands were always as steady as Mount Tai in the picture. Even if there were some bad results, she couldn't control herself, and she had to shake her hands.

   The previous operation is about to enter the deep water area, and all the conditions of the inferior vena cava must be understood. At this time, an important anatomical structure called the hepatic hilum is touched. The hepatic hilum, like the spleen hilum and the renal pedicle, is an important part of various important tissues such as blood vessels, nerves, and lymphatic vessels entering and exiting the liver. Therefore, the importance of the hepatic hilum in hepatobiliary surgery should only be experienced by specialists. If one is not careful, it can cause severe bleeding. Among them, the hepatic vein is very thin-walled and has little surrounding connective tissue, which leads to common hepatic vein injury in hepatobiliary surgery.

Before reaching important anatomical parts, the separation forceps are used to separate the peritoneum around the liver. It is not ruled out that improper operation will tear the inferior vena cava, left hepatic vein or left inferior phrenic vein. This result often leads to the formation of horrible air emboli other than massive bleeding. .

   An air embolism is an air embolism. When it comes to the harm of air embolism, ordinary people who have had a sling injection know that air in the infusion tube into the blood vessels of the human body will cause death. In this operation, since the inferior vena cava is connected to the right atrium, the patient may die faster when the air reaches the right atrium.

   The breath that everyone held back was to see the delicate and meticulous movements of the separation forceps.

  The difference between the team of star doctors and ordinary doctors is here.

  Look at the previous operation for liver tumors, which also involved hepatic hilum separation. But what people make is not as good-looking as this.

  What is the reason?

   Even lay photographers could feel it, and fixed the live broadcast directly on the laparoscopic monitor. Because the field of view of laparoscopic surgery given by people's mirror hands is already very good, lay photographers who cut the focal length of the lens randomly are not as good as expert surgeons.

   "The light source of this mirror arm is very slippery."

   (end of this chapter)