쉐도잉 연습: Splenectomy: step-by-step - 영상으로 영어 말하기 배우기
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54 문장
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Hello and welcome to the GYO surgery series.
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This will be the first of several different explanations of individual surgeries that we perform in Gynonk,
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including some photos that I'll have referenced, as well as some handmade drawings.
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the first surgery that we'll be going over is the splenectomy
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and I only own the drawings other pictures will be referenced on individual slides
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and at the end this is for educational purposes only this is not intended to be medical advice
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so reference this lovely picture on the right the removal of
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the spleen is occasionally required to achieve optimal surgical cytoreduction in ovarian cancer
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and so knowing the relevant anatomy is important and
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so we'll go over the ligaments attaching to the spleen as well as the blood supply to the spleen
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so there are approximately five ligaments the splenophrenic ligament the splenorenal the pancreaticosplenic,
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the splenocolic, and the gastrosplenic ligaments.
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They are labeled here, 1 through 4.
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We have 1, 2, 3, 4, splenofrenic, which you can't see,
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but the diaphragm would be up here, the splenorenal, the pancreaticosplenic, the splenocolic, and then over here we have the gastrosplenic.
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Each of these ligaments are transected during a splenectomy.
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And then as far as our blood supply goes, it's a little bit easier.
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You just have the splenic artery and the splenic vein.
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As you can see here, these come off the celiac trunk.
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The artery comes off the celiac trunk, and the celiac trunk, as you may remember, is the splenic artery, the left gastric,
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and the common hepatic, and then the splenic vein coming back into the portal vein.
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the basic steps of a splenectomy are entering the lesser sac mobilizing the spleen
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and then ligating the vessels
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which sounds very easy however in practice is definitely scary for gynonks there is an anterior
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or posterior approach
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and the choice depends on the distribution of disease whatever approach would be easier based on disease
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and i will be going over the anterior your approach in this short lecture.
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So first entering the lesser sac of the omentum, you want to identify the gastrocolic ligament.
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This lies between the stomach's greater curvature and the transverse colon.
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The anterior leaf of the omentum attaches to the greater curvature of the stomach via the gastrocolic ligament, and the posterior leaf attaches to the margin of the transverse colon.
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And the lesser sac is kind of between these two leaves.
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So identifying the ligament and then transecting this in order to open the lesser sac.
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The dissection, then this is another depiction of opening the lesser sac, but the omentum is no longer there.
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And as you can see here, this is the gastrocolic ligament here.
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The dissection continues along the transverse colon with mobilization of the
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entire splenic flexure of the colon to eventually reach the splenocolic ligament,
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highlighted here, and then you're also dissecting upward to the greater curvature of the stomach towards the gastrosplenic ligament.
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That's here.
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once mobilized you can grasp the spleen
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and elevate it medially this will expose the splenophrenic ligament here
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and you can continue to dissect the spleen from the gastrosplenic ligament as well as the splenocolic ligament
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so you can see the gastrosplenic ligament in this picture as well as the splenocolic ligament here you'll continue dissecting
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that and then also the splenofrenic ligament, with this being the diaphragm.
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The gastrosplenic ligament is the most vascular and contains those short gastric arteries, so we are very careful in ligating and dividing these.
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And then finally, the spleen is elevated to the incision.
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You do some blunt dissection in order to identify the splenic artery and the splenic vein.
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Each one of these vessels are individually ligated and the artery is ligated first in order to prevent engorgement of the spleen.
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You can use, as depicted here, a right angle placed underneath the artery or individual
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vein artery or vascular pedicle
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and you can use a 2 -0 silk you will then place a second 2 -0 silk
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and then on the proximal end you can either tie
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or clip this end and then divide the artery vein
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or other vascular pedicle and then
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if you're done with the artery you do the vein and that is the end of the splinectomy.
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이 레슨의 어휘와 말하기 포인트
이 말하기 레슨은 영상 “Splenectomy: step-by-step”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: ligament, artery, spleen, splenic, vein. 이 영상에는 섀도잉할 문장 54개와 단어 709개가 있습니다. 말하는 구간의 길이는 5:25입니다. 화자는 분당 약 131단어의 일정한 속도로 말해서 섀도잉하기에 편한 속도입니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 72%뿐이라 어휘가 어려운 편입니다.
이 영상의 핵심 어휘
영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.
| 단어 | 발음 | 뜻 |
|---|---|---|
| artery 명사 | /ˈɑɹ.təɹ.i/ | 동맥 |
| vein 명사 | /veɪn/ | 정맥 |
| colon 명사 | /ˈkoʊ.lən/ | 쌍점, 콜론 |
| leaf 명사 | /lif/ | 잎 |
| trunk 명사 | /tɹʌŋk/ | 그루 |
| attach 동사 | /əˈtæt͡ʃ/ | 첨부하다, 붙이다 |
| stomach 명사 | /ˈstʌmək/ | 위, 위장 |
| vessel 명사 | /ˈvɛsəl/ | 배, 선박 |
| divide 동사 | /dɪˈvaɪd/ | 나누다, 가르다 |
| silk 명사 | /sɪlk/ | 명주, 비단 |
| explanation 명사 | /ˌɛkspləˈneɪʃən/ | 설명 |
| label 명사 | /ˈleɪ.bəl/ | 라벨, 레이블 |
| occasionally 부사 | /əˈkeɪʒənəli/ | 가끔 |
| angle 명사 | /ˈæŋ.ɡəl/ | 각, 각도 |
| scary 형용사 | /ˈskɛə.ɹi/ | 공포의, 무섭다 |
주의할 발음
화자는 we'll, you're, can't 같은 축약형과 약화된 형태를 7번 사용합니다. 들리는 대로 짧게 발음하세요.
- “sh”와 “zh” 소리: explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, dissection /dɪˈsɛkʃən/, depiction /dɪˈpɪkʃən/, flexure /ˈflɛkʃə(ɹ)/
- 긴 단어 — 강세 위치에 주의: anterior /ænˈtɪɹ.i.ɚ/, explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, anatomy /əˈnætəmi/, individually /ˌɪndɪˈvɪd͡ʒ(u)əli/
한국어 화자가 어려워하는 소리:
- /f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: leaf /lif/, diaphragm /ˈdaɪəˌfɹæm/, flexure /ˈflɛkʃə(ɹ)/
- /v/ — ㅂ(/b/)과 구별하기: vein /veɪn/, vascular /ˈvæskjələ/, vessel /ˈvɛsəl/, divide /dɪˈvaɪd/, removal /ɹɪˈmuː.vəl/
- /z/ — ㅈ이 아니라 성대를 울리는 /s/: expose /ɪkˈspoʊz/, mobilize /ˈməʊbɪlʌɪz/
이 영상으로 연습하는 방법
- 먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
- 보통 속도로 한 문장씩 섀도잉하고, 화자의 리듬과 맞을 때까지 반복합니다.
- 자신의 목소리를 녹음해 원본과 비교하고, artery, vein, colon 같은 단어에 특히 주의합니다.
쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법
쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.