The anesthesia has achieved effect, and the operation has finally begun!

Because this operation is extremely complicated, if laparoscopy is used, the surgery is not enough, so traditional laparoscopy is used!

After Director Qian and Director Wu opened their abdomen, they entered the retroperitoneal approach and completely lifted up the right half of the colon. That scene would definitely make you unable to eat.

The next moment, the entire inferior vena cava was fully exposed, and they placed blocking belts at the far and proximal ends and major branches!

"Ruan Bin, it's your turn to play!" Director Qian said to Ruan Bin.

Because the next step is to isolate the tumor from the adhesion of the duodenum, pancreas, and liver caudal lobes. This step was discussed before and asked Ruan Bin to separate, and the requirement was to be fast, accurate and stable!

Separate the tumor from the adhesions of the duodenum, pancreas, and liver caudal lobes at the fastest speed to shorten the surgical time.

"Okay!" Ruan Bin nodded and replaced the position of the chief surgeon with Director Qian.

With innovative debridement and suture, he is absolutely not worried about his basic surgery skills. He also has a world-class pancreatic duodenectomy and is absolutely well aware of the structure of the duodenum, pancreas, and liver caudal lobes.

Pick up the electric knife and start separation!

The first knife was very slow and mediocre.

But starting from the second and third slashes, one slash is faster than the other.

Half a minute later, his hands were like they turned into dancing elfs, flying up and down, and the tumors in the duodenum were separated by him little by little.

A dazzling operation!

Zero mistakes!

It seemed as if he was like a sophisticated instrument, without any mistakes.

Especially for the structure of the duodenum and pancreas, it seems like an automatic radar, which can be touched there and cannot be touched there.

The strength and accuracy used by the knife in your hand are so powerful that it makes people proud!

One slash is just right, no second slash is needed!

"Hiss... I was as fierce as a tiger, and I looked like two hundred and five. How did he do it?"

"This hand speed is a waste not to play professional e-sports!"

Experts from the eight subjects saw Ruan Bin's sharp operation and the expressions on his face were all wonderful.

As directors or experts, they are very aware of the complex structure of the duodenum and pancreas, let alone adhesions to tumors.

It's so difficult to separate!

But when you look at the person in front of you, it seems like you are cutting the mess with a quick knife.

After 35 minutes.

"The separation is over. Director, please see if there is any problem?" Ruan Bin breathed a sigh of relief, his forehead was slightly sweating. This highly concentrated and continuous operation made him a little tired.

A group of people came over and checked it carefully.

This cannot be careless!

"The duodenum is separated very cleanly, leaving no trace of tumor tissue."

"The pancreas is also separated very cleanly."

"There is almost no problem. The next step should be to isolate the tumor of the right renal vein. This step must be careful. The speed can be slower. I am afraid of hurting the venous network." Director Wu of Urology said seriously.

The main reason is that the right renal vein and tumor adhesion is too wide, and more than half of the blood vessels in the right renal vein are adhesions to the tumor. It is even more difficult to separate at that time than the previous separation.

"I understand." Ruan Bin nodded.

The separation of the right renal vein began. Ruan Bin first separated the tumor from the right kidney and the right renal vein, fully freeing the right renal vein, right renal artery, right ureteral upper section, right kidney and left renal vein...

Ruan Bin's operation was completely like dancing on the tip of a knife and stomping on the waves in the sea!

His various types of scalpels float on the venous blood vessels, separating and removing tumor tissue.

Almost just trying to die crazy on the verge of death!

If you are not careful, you may cut any tiny vein blood vessel, but Ruan Bin still makes zero mistakes!

After 25 minutes, the separation is complete!

The two waves are separated, and it takes 60 minutes in total! It just takes one hour to complete, and do what you say.

Everyone was shocked and numb at this time.

If this surgery is successful, Ruan Bin will make an indelible contribution.

"Next, it's my turn!" Director Wu of Urology said in a deep voice.

After Director Wu took over Ruan Bin's main surgery position, he first cut off the left renal vein, then cut off the right renal artery, and injected the low-temperature renal protective fluid through the right renal artery. After the clear perfusion fluid flows out of the right renal vein, the right kidney and the upper ureter are removed. Then, with the assistance of other experts, the cold perfusion of the free right kidney under the stage, the trimming of the renal blood vessels and the low-temperature preservation.

Finally, the inferior vena cava and tumor can be removed!

Then, the director of vascular surgery came on stage and saw him blocking the inferior vena cava above and below the tumor. After breaking the inferior vena cava branch one by one, he removed the inferior vena cava invaded by the tumor, and anastomosis with an artificial blood vessel with a diameter of 22mm and about 15m long with the upper and lower ends of the vena cava. The anastomosis process was smooth and there was no obvious blood leakage on the anastomosis mouth!

After the vascular surgery was completed, Director Qian and Director Wu and others performed an autologous renal transplantation of the patient's right kidney. After full evaluation, they decided to anastomose the right renal vein and the lower segment of the inferior vena cava, the right renal artery and the right common iliac artery, and the right ureter and the lower end of the right ureter were end-end anastomoses. The vein was successfully completed, the artery anastomosis, and the blood flow was opened and the right kidney transplanted quickly restored rosy and tension. After about 1 minute, clear urine flowed out from the broken end of the right ureter, and the autologous renal transplantation was successful!

Seeing this step, the experts were originally very tired, but they were all excited when they saw this.

They knew that most of the surgery had been completed at this point!

Subsequently, Director Qian trimmed the large omentum and made a "j"-shaped omentum flap, which wrapped the inferior vena cava from the right side to the bottom, transplanted the kidney and iliac blood vessels, and used the powerful blood supply and absorption function of the omentum to provide safety guarantees for artificial vascular anastomosis and transplanted kidneys.

It has been 7 hours since the operation began!

It was mainly vascular anastomosis, and it took three or four hours to transplant the autologous kidney! It also took one hour to remove the inferior vena cava.

"The operation is over!" Director Qian and others breathed a sigh of relief.

This operation took 7 hours in total!

Median experts basically perform surgery in the "forbidden zone" of surgery.

Whether it is the separation of Ruan Bin in two waves, or the anastomosis of venous and arterial vascular diseases by Director Qian and others, the tumor resection or autologous renal transplantation.

In case of failure after venous and arterial vascular anastomosis, either the kidney cannot circulate after autologous kidney transplantation. Basically, all previous efforts are wasted.

Fortunately, it succeeded!

Next, the patient was transferred to the intensive care unit for treatment. Although the operation was successfully completed, there were still many difficulties waiting for him after the operation. Because after such a complicated operation, postoperative complications will definitely occur after the operation! The next step is to ICU and the peritoneal oncology surgery department to take over.
Chapter completed!