Chapter 1452: with translation of chapter title

Preoperative case analysis ended, the view switched, and 10 Minute later Surgery live broadcast began.

"Is the surgery being done by Zheng Lao Ban?" Lei Yinghua asked.

"Hmm."

"What procedure are you preparing to use?"

"……" Peng Jia was stunned for a moment.

Procedure…… I don't know. From when I got the news until now, less than three hours have passed, and the Di Du side is so busy that there's no time to attend to me.

Lei Yinghua didn't say anything, just slightly shook their head.

It seems the problem with Xinglin Yuan lies right here—the person performing the surgery doesn't even know what procedure to use.

This is absolutely not what a professional medical website should look like.

But is the surgery an emergency surgery?

Impossible; if it were truly an emergency surgery, the PPT wouldn't be made so beautifully that I couldn't find a single flaw.

Or just watch the surgery; given the surgeon's habit, they are likely to use a surgical approach.

While thinking that, Lei Yinghua noticed something off with the screen.

This is…… a Colonoscope? ESD Technique?!

It actually is ESD Technique!

ESD Technique is also called Endoscopic Mucosal Resection, which refers to the minimally invasive Technique of completely stripping the diseased mucosa from the submucosal layer under endoscopy.

At the end of the 1990s, Riben first created and applied it clinically; the main purpose of this procedure is to diagnose and treat early gastrointestinal tumors, with the advantage of being able to completely remove a certain area of superficial lesions in one go.

But the Technique requirements are high and the difficulty is great.

Lei Yinghua repeatedly summarized experience and finally determined that using ESD Technique to treat MW syndrome is the best approach.

But there is also a problem—the patient's colorectal area has so many polyps, some of them quite large, and during the stripping process, a little carelessness can lead to intestinal perforation.

In the preoperative case discussion just now, Lei Yinghua also saw the patient's images.

The large polyps number at least several dozen.

Do all these polyps need to be removed in one go? They should probably be done in two or three sessions.

If I were doing the surgery, I would choose this approach.

The patient would suffer little injury and not face much risk; as for being a bit slower, what's there to fear?

But if it's a Surgery live broadcast, doing half and leaving half, however you think about it, it's not good.

The surgeon's view is directly looking at the colonoscope screen; the colonoscope has already been inserted and is being operated.

Lei Yinghua held their breath and focused, watching carefully.

The first polyp is located 6 cm from the anus in the rectum. Its diameter is about 1 cm, and the surface is somewhat uneven.

An experienced doctor can tell at a glance that this polyp is likely in a precancerous state; that is, it hasn't yet turned malignant, but if not removed, it could undergo fundamental changes within a few months.

The spray tube sprayed out a dye; it looks like a 0.5% methylene blue solution. Lei Yinghua doesn't like to use methylene blue, usually opting for 0.4% indigo carmine.

However, this is decided by personal preference, and there's no right or wrong.

The methylene blue was sprayed very evenly; the surgeon's assistant is excellent, and Lei Yinghua feels a bit envious.

It looks like just a small maneuver, but for the surgeon, this is the first difficulty.

Spraying the dye is to clearly show the size and extent of the lesion.

Uneven spraying will invisibly increase the difficulty of the surgery.

The surgeon's team is strong, and the assistant's operation is nearly perfect; just from the very beginning, a simple small detail, Lei Yinghua has formed their own judgment.

The sprayed methylene blue seems not to have fully settled yet, and the surgeon already begins submucosal injection.

Without needing several repetitions, the surgeon's single injection causes the area to be lifted, providing enough vision to separate the submucosal layer from the muscularis propria.

The injection contains a hemostatic agent that can ensure that if small capillaries rupture, there won't be too much bleeding.

After submucosal injection is complete, electrocoagulation marking is done, and the endoscopic knife begins cutting at the edge of the lesion 5 mm away.

This is way too fast—what's the point of the surgeon just flashing hand speed? Lei Yinghua feels somewhat disdainful.

They're just aiming for speed in the surgery, which is showing off to win favor.

Endoscopic surgery, domestically it was initially performed by doctors in the laparoscopy suite and the Department of Gastroenterology.

Because they weren't surgeons, the exploratory process was very lengthy.

After all, they couldn't access the anatomical details of the intestine, and some fine points are hard to handle.

As for surgeons, from the beginning… including now, they are still accustomed to solving problems by cutting open.

But with the overall trend toward minimally invasive surgery, gradually surgeons have begun performing Endoscopic Submucosal Dissection.

Lei Yinghua is one of them, and indeed an outstanding one. He has a deep understanding of Endoscopic Submucosal Dissection and even has his own unique insights.

The surgeon is a young Challenger, but doing the surgery quickly is useless.

Endoscopic surgery fears bleeding the most; once a Blood Vessel ruptures and bleeds, managing it takes an extremely long time.

The patient's injury is also extremely severe.

This is something young people don't understand; Lei Yinghua watched, having calmed their mind.

Sure enough, following Director Lei's idea, after the incision the surgery speed suddenly slowed down. Not only did it slow, but the technique also became somewhat clumsy.

Lei Yinghua smiled; the surgeon is still inexperienced, not as skilled as I am.

The mucosal layer of the colorectum is relatively thin, so the electrocoagulation power shouldn't be too high to avoid damaging the muscular layer. The surgeon's choice is correct; his electrocoagulation power is just right, and Lei Yinghua had no surprise.

If even this detail can't be mastered, how dare they do a Surgery live broadcast? That would be a joke.

After achieving ideal submucosal lifting, use the endoscopic knife to cut the mucosa outside the marked point.

Lei Yinghua held their breath; successful precutting of the surrounding mucosa is the key to successful Endoscopic Submucosal Dissection treatment.

The endoscopic knife smoothly cut the mucosa around the polyp, entered the submucosal layer through the precut opening, and then made a circumferential cut along the outside of the methylene blue marking.

The technique is very skilled, not like a newcomer who has just begun exploring Endoscopic Submucosal Dissection.

This sense of proficiency is completely different from my earlier judgment of the operator—what's going on? Could it be that they added some unnecessary maneuvers just to show off?

Hmm, it's possible. Young people always have a desire to show off.

But watching the procedure, Lei Yingjie even had the illusion that the operator must have performed at least 1,800 Endoscopic Submucosal Dissections to have this level of proficiency.

Has anyone in the country performed that many Endoscopic Submucosal Dissections?

No, there's no need to even think about it—Lei Yingjie can be certain. After thinking, he knows he couldn't do that many.

After the incision, the dissector was inserted.

Blunt dissection—this is the most critical step.

Many laparoscopic doctors and Xiao Hua Nei Ke doctors always struggle with this step, whereas general surgeons are much better at it.

After all, surgeons frequently cut and dissect the intestine, so they are very familiar with it.

The dissector's speed is neither fast nor slow—layer by layer, like a butcher dissecting an ox. Each anatomical layer is very Clarity, avoiding small Blood Vessel, using electrocautery and electrocoagulation to stop bleeding as needed.

After 1′22″, a polyp was cut off.

That speed…… Lei Yinghua nodded slightly; the operator dares to perform a surgery live broadcast, so the skill is still there.

The entire process of removing this outermost rectal polyp with an endoscope is textbook‑perfect.

Although there is still no textbook for Endoscopic Submucosal Dissection, in Lei Yinghua's imagination the operation just witnessed was perfect. If one must nitpick, the only faults are a slightly slower speed later on and some unnecessary maneuvers.

Young people, you know, they add those maneuvers just to show off their technique. At my age, I couldn't do that.

"Director Lei, what do you think of Zheng Lao Ban's surgery?" Peng Jia asked nervously.