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"I've been a soldier for so many years, why haven't I eaten?" What is a small operation! ”
This full of words echoed in the ward of The Shaw Hospital affiliated to Zhejiang University School of Medicine, and the mask could not hide the happy face of Grandpa Chen (pseudonym).
Accompanied by medical staff and family members, Grandpa Chen slowly got up from the hospital bed, cautiously and mentally paced the corridor, and carried out postoperative rehabilitation exercises.
Uninformed people may not have imagined that the "small operation" in the mouth of the 90-year-old grandfather removed a whole piece of the left half of the liver of the grandfather, and the day he began to get out of bed and walk was the first day after he finished the operation.
This operation also once again refreshed the record of the oldest patient in the hepatobiliary and pancreatic robot surgery of Zhejiang University Shaw Hospital.
Get out of bed for the first postoperative day
When the family agrees to hospice care
The turnaround has come!
Grandpa Chen is a veteran with more than 60 years of military experience, and his entire life has been dedicated to the party and the country. However, when he should have enjoyed the joy of retirement, the disease quietly entangled the twilight hero. In a physical examination, the tumor marker CA19-9 in Grandpa Chen's blood was significantly elevated, and in the subsequent enhanced magnetic resonance examination of the epigastric region, it was found that there was a mass in the left liver with a significant expansion of the intrahepatic bile duct, considering bile duct cell carcinoma, after preliminary consultation, half of the liver needed to be removed and the hilar lymph nodes were dissected.
The bad news suddenly cast a layer of haze on the heart of Grandpa Chen's family, they were anxious for a long time, considering that the old man was so old, afraid that he could not stand the harm caused by the surgery to remove most of the liver, the family initially decided to find a hospital for conservative treatment after consultation.
Fortunately, there is no end to the road, and at this moment, things have taken a turn for the better. A friend recommended to Grandpa Chen's family the team of Professor Cai Xiujun, a well-known expert in the department of hepatobiliary and pancreatic surgery at Run Shaw Hospital affiliated to Zhejiang University.
At the end of March 2022, Grandpa Chen's family came to the outpatient clinic of Professor Cai Xiujun's team and Chief Physician Liang Xiao, deputy director of general surgery, with the attitude of trying it out.
Director Liang through detailed assessment, that although Grandpa Chen is 90 years old, but fortunately, Grandpa is usually in good physical condition, and the tumor is not spreading at present, there are indications for surgery, at present, this kind of surgery in Zhejiang University Shaw Hospital has been routine surgery, recovery is very fast, according to past experience, the fastest postoperative first day was discharged, so it is recommended to immediately hospitalize to assess the whole body condition, you can perform robotic minimally invasive surgical resection, as far as possible to reduce the risk of surgery.
"Minimally invasive surgery + accelerated rehabilitation" to achieve "winning streak"
Four days after being discharged from the hospital
In the face of a series of questions from Grandpa Chen and his family, Chief Physician Liang Xiao patiently answered them one by one.
Director Liang explained that the current consideration of the old man is suffering from intrahepatic bile duct cell carcinoma (ICC), easy to infiltrate growth and metastasis, late stage is likely to have multiple metastases, timely discovery and standardized treatment is the key to the treatment of the disease, although the old man has been 90 years old, but the usual body is still good, is currently suitable for surgery.
According to the situation of the old man, the robot-assisted left hepatic resection and the dissection of lymph nodes are highly safe, which can achieve accurate resection and rapid recovery.
At present, the minimally invasive da Vinci robotic hepatobiliary and pancreatic surgery of Zhejiang University Shaw Hospital has been very mature and precise. The robot's robotic arm can effectively filter the surgeon's hand vibrations, and the operation is more delicate, even exceeding the flexibility and precision of the human hand. The flexible instrument wrist combined with 10x magnification of 3D HD images allows surgeons to separate blood vessels and tissues more finely and safely, while quickly suturing and knotting.
In anticipation of his family, Grandpa Chen was pushed into the operating room on April 2, 2022. Through the unremitting efforts of about 2 hours, Liang Xiao's team of chief physicians successfully completed the operation. Ten minutes after the operation, Grandpa Chen opened his eyes in the anesthesia awakening room, regained consciousness, and the hanging hearts of the family members finally let go.
At the same time, Liang Xiao's team of chief physicians began another hard battle without stopping - postoperative recovery. Run Run Shaw has been actively promoting the concept of Accelerated Rehabilitation (ERAS), which fully combines the advantages of robotic surgery and postoperative accelerated rehabilitation, and truly brings a good experience of perioperative treatment to patients.
On the first day after the operation, Grandpa Chen resumed his semi-liquid diet and began to get out of bed for postoperative rehabilitation exercises; the next day, due to the relatively normal indicators, the drainage tube was removed; on the fourth day, Grandpa Chen's indicators and physical functions were greatly restored and he was successfully discharged from the hospital.
Constantly climbing the peak of medicine
Addressing the plight of elderly patients
Grandpa Chen regained his new life, which made the main management team very pleased. Chief Physician Liang Xiao admitted that at present, with the advent of the aging era, more and more elderly patients need surgical treatment. However, elderly patients are gradually weakened due to the deterioration of body organ function, and the weakening is aggravated with age, and the incidence of debilitation is reported in the literature to be 4.0% to 27.8% in the elderly over 65 years old, and as high as 20.0% to 45.1% in the elderly over 80 years old. Organ weakening can increase surgical complications and seriously affect the success rate of surgery.
In the past, elderly patients faced with such a large operation were often "turned away". However, with the help of surgical robots with clearer vision and more delicate operation, Zhejiang University Shaw Hospital extends the doctor's "magic hand", breaks through the bottleneck of traditional open surgery and laparoscopic surgery, and widely carries out high-quality and efficient minimally invasive surgery, bringing good news to more and more elderly patients.
It is understood that the Department of Hepatobiliary and Pancreatic Surgery of Shaw Hospital affiliated to Zhejiang University Medical College, under the leadership of Professor Cai Xiujun, a pioneer in internationally renowned minimally invasive surgery, has applied the most advanced technical equipment to the field of minimally invasive surgery, and has routinely carried out robot-assisted pancreatic duodenal resection surgery, robot-assisted liver-assisted liver resection surgery, robot hepatic portal cholangiocarcinoma radical surgery, pancreatic body tail resection, spleen resection surgery, etc. The amount of hepatobiliary and pancreatic robot surgery ranks in the forefront of the country, the first in the province, breaking a number of clinical records.
At the same time, by surgeons, anesthesiologists, surgical nurses, acute pain management team, ward nurses, respiratory therapists, nutritionists, mental health doctors, rehabilitation therapists, etc., the most complete liver ERAS team is formed to carry out individualized assessment and perioperative full-process intervention for the characteristics of the elderly to reduce the stress and trauma caused by surgery and anesthesia to elderly patients, thereby reducing complications, reducing the occurrence of nausea and pain, and escorting elderly patients. Achieve earlier rehabilitation.
"For surgeons, it is necessary to grasp the new technology and new trends at the first time, so that it is possible to continuously climb the peak in the field to which they belong." When patients recover quickly and are discharged from the hospital, we are recognized by patients and families, and all the efforts feel worthwhile. Liang Xiao said.
Source: Department of Hepatobiliary and Pancreatic Surgery, Run Run Shaw Hospital
Original works, reprinted please indicate the source and source
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