"Trauma Surgery."
The nurse who answered the phone first reported to herself......."
Dean Chen and Director Li are here. ”......Dr.
Liu went to the operating room. ”......"
He, Director Liang, and Dr.
Wang went for a laparotomy exploration. ”......
"Good.I immediately told Dean Chen to ask Dr.
Liu to go to the outpatient clinic. ”In the operating room, the patrol nurses walked around the stage, preparing what they might need for a while.Suddenly, the door to the operating room was pushed open, and the head nurse entered."
Where have you been?"
Director Zhou of anesthesia glanced at the probe and replied for the person on the table: "The peritoneum has just been exposed." ”This surgery uses a median incision in the upper abdomen, which is commonly used for acute upper gastrointestinal bleeding.Since the patient had little subcutaneous fat and underdeveloped abdominal muscles, the four of them worked together and the peritoneum was quickly exposed.The head nurse continued: "Director Liang, the outpatient department admitted Dr.
Liu to the orthopedic department, and your Dean Chen told him to go to the outpatient clinic immediately." ”Dr.
Liu's hand paused, and he said very regretfully: "Then, Director Liang, I went to the outpatient clinic first?"
”I haven't entered the abdominal cavity yet.And the peritoneum under him was still a mottled color and character that he had never seen before—he really didn't want to leave.This aggrieved operation!
Director Liang rarely didn't joke with the head nurse.He didn't raise his head and said, "Then you go back, the three of us are almost enough."
Large gauze pads in salt water.Be gentle.Hand washing. ”The instrument nurse had already prepared, and two large gauze pads that met the requirements were handed over.Half a basin of saline was handed over, and the three of them washed their hands in turn.Director Liang and Dr.
Wang grabbed a piece of salt gauze in their hands.Dr.
Wang looked up and smiled apologetically at Dr.
Liu, and then lowered his head to cooperate with Director Liang's progress.Dr.
Liu's departure did not have any impact on the operation."
Big tweezers."
The tweezers were quickly handed to Director Liang's hand."
Two small bends."
Dr.
Wang also asked for equipment."
Suction device, saline gauze.Small bends. ”Li Min has to do what he should do when he is promoted to the position of second assistant.The peritoneum appears slightly hyperemic, edematous under shadowless lamps.Director Liang glanced at Li Min and saw that she had folded several layers of damp gauze, not only wrapped the suction head, but also tied a bow on it.He nodded and said, "Sharp knives." ”The tip of the knife was gently slashed down, and the congested and edematous peritoneum was cut layer by layer under Director Liang's knife tip with a silky thinness.Dr.
Wang and Li Min quickly applied the small curved hemostat to clamp the small bleeding blood vessels.But there was still a small artery that snorted up a thin stream of blood.Doctor Wang turned his face sideways to avoid it for the first time, and Li Min relied on his glasses and immediately leaned over to clamp the bleeding place.Dr.
Wang awkwardly opened the tip of his small curved pliers, a little embarrassed.Li Min's hand speed is too fast, and he can always snatch the bleeding point on the pliers in time.He did his best to pay attention to the field, so as not to be compared to a recent college graduate.But just such a subconscious evasive action was snatched into the head by Li Min.It's so shameless.Director Zhou of anesthesia joked: "This is the advantage of wearing glasses, and I am not afraid that blood will get in my eyes." ”Dr.
Wang thanked Director Zhou for saving the scene, and answered with a smile: "I can't compare to Director Liang and Dr.
Li at this point." ”Li Min is usually silent on the operating table.Director Liang is also very abnormal today, and he doesn't open his mouth to laugh.So Dr.
Wang's words were put aside dryly.Director Zhou saw that Director Liang didn't speak, so he stopped talking.He looked at the display of his own pile of instruments for a while, and then looked at the operation, and he was a little bored.The peritoneum under the tip of Director Liang's knife finally reached the last layer, and Li Min carefully stretched the head of the suction device through the small opening that was stretched, and stepped on his left foot at the same time, and the old-fashioned suction device buzzed and rotated.There was not much fluid in the patient's abdominal cavity, and after three or two minutes, Li Min took out the suction head, untied the gauze stained with the effusion, and lifted it in his hand to find a place.The patrol nurse reached over a dirt basin in time, "Doctor Li, throw it here." ”Li Min half-turned his body and threw the gauze directly into it.The little nurse with the instrument on the stage is very happy that Li Min is careful in his work, if he doesn't stare at her and throws it at her, or if he is nested in the corner of the big order, not to mention polluting the equipment, if he doesn't pay attention to it, he can find it when he counts, and he can kill a few people in a hurry.Li Min threw away the dirty gauze, pinned the suction device head to the list in front of him with a small curved hemostat, and carefully clamped it.She is in charge of the suction device for this operation today.Director Liang stood on tiptoe to see the color of the liquid in the suction device placed behind Li Min, and the nurse immediately lifted the suction device.Director Liang sighed deeply after seeing it.Dr.
Wang began to suck the fluid in the ascites from Li Min, and his complexion changed.- Sure enough, there are no stomach contents!
Not a gastric perforation!!
This color, this shape......
His heart cooled.Looking at the exposed abdominal cavity, what is palpable is the omentum adherent to the peritoneum.Director Liang carefully used wet gauze to slowly push the peritoneum, trying little by little to separate the two.A quarter of an hour passed, and fine sweat appeared on Director Liang's forehead.Wiped again and again.There was no way back for him.The same cold sweat also appeared on Dr.
Wang's back again and again, and he was secretly glad that he had chosen to give up the practitioner in time and decisively.Otherwise, according to what we have seen so far, it is very likely that the difficulty will be even greater in the future.In case you can't do it yourself......
It's not just in case, looking at the firmness of the adhesion in front of him, as the fine beads of sweat on Director Liang's forehead never stopped, he knew that he was more likely to be unable to do it; In the end, I still have to change positions with Director Liang and rely on Director Liang to save the stage.It's really better to hand it over as early as it is now.Actually, he can't blame him for this.He went to the medical university twice for further study: the first time was to study in general surgery, he was only a resident doctor for two years at that time, and he was only a little better than the intern students after major surgery.There aren't many opportunities to get a help.The second time I went to further study, it was when the provincial hospital demolished the inpatient building.In addition to the necessary outpatient on-duty medical care, the provincial hospital sent everyone else to study.This time, he focused most of his energy on fiber gastroscopy, which he advanced, and even fewer opportunities to take the stage in general surgery.I didn't expect to come back and be assigned to the trauma surgery.With Director Liang on the top, he can only do second-level surgery at most.The third-level surgery can get help, and that is also the opportunity left for Director Chen to not want to go on stage, or Director Li doesn't want to do it.If the ascites in front of you is an intra-abdominal malignant tumor, it is appropriate to perform the highest level of surgery.Li Min has a small bend in one hand, and the line scissors are hooked on the ring finger of his left hand.She stared nervously at the field, and as soon as there was a bleeding spot, or a relatively large blood vessel was exposed, she would clamp it.Dr.
Wang held the hook with one hand, and could only use one hand to help stop the bleeding, or help Li Min to help a hemostatic forceps, and watched Li Min use the pliers to do ligation and cut the thread by himself.As for the possible obstruction of Director Liang's vision, Li Min took advantage of those small bends on Director Liang's side after making effective clamps to stop the bleeding.Don't be afraid to do less work on the operating table, blocking the surgeon's vision, that is, adding to the chaos.It's a good way to scold yourself.Time passed little by little, and the peritoneum and omentum, which were adhered together, were finally peeled off without much damage.The surgical field is barely clean, and the amount of bleeding from the patient is less than that of the abdominal adhesions.Director Zhou has already hung up 200CC of whole blood."
Damn, it's good that it's not so inseparable."
Director Liang sighed, full of luck."
Director Liang is lucky."
Dr.
Wang then praised it from the bottom of his heart."
That's it.I've had a lot of luck lately.Otherwise, I wouldn't dare to stand in the position of a sorcerer today. ”Damn, is this a matter of good luck?
This is Lao Tzu, how many years of practice at the grassroots level is good enough.Director Liang's tone is not quite right!
How can there be a feeling of a horse's fart slapping on the horse's feet.Dr.
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Wang was deeply annoyed, and pondered the meaning of his words and sarcasm.His face tensed.I secretly said in my heart: My luck is not satisfactory for a while, isn't it that you are going to be the director of the general foreign department?
Seeing that Director Liang's step was successfully completed, the instrument nurse finally dared to speak: "Director Liang, give me back your big tweezers and sharp knife if you don't use it." ”Something is pressed against the patient's chest and thrown at it.Director Liang returned the big tweezers to the nurse and asked, "Wash your hands with salt water." ”The instrument nurse handed over half a basin of salt water, and the three of them washed their hands in turn."
Lao Liang, where could it be?"
Director Zhou asked."
The liver, gallbladder, spleen, pancreas, esophagus, stomach, duodenum are all possible.Xiao Li, where do you say it is?
”Director Liang was about to reach in and investigate, and he could see the banter in his eyes through the lenses of his glasses."
It's not guts."
Li Min smiled and responded to Director Liang who was amusing him."
Why?"
Director Zhou stared at Li Min and asked."
He's had a cholecystectomy before.""
Then the people who don't want to grow another gallbladder?"
Director Zhou has read the medical records, and he just wants to make a joke after being nervous and make the atmosphere in the operating room a little more relaxed.Li Min's attention followed Director Liang's hand, and he didn't even raise his eyelids at Director Zhou's question.Director Liang touched his liver and said, "Old Zhou, have you seen whose gallbladder has been cut off and then grown?"
Yes?
You should cut leeks.After cutting a stubble, it grows again.The king, exposing the esophagus, pulled the left lobe of the liver. ”"The surface of the liver is smooth, Xiao Li, you reach out and touch it."
The first step went smoothly, and Director Liang was willing to ease the atmosphere.Li Min reached over according to Director Liang's gesture and gently stroked the surface of the liver to feel the hardness of his hand."
Is this the tip of the nose?"
Li Min touched the liver for the first time and asked suspiciously.Dr.
Liang lifted the wet gauze and asked calmly, "What should normal look like?"
”"Soft as lips.""
What's the next hardness?""
First the tip of the nose and then the forehead.Does he have mild cirrhosis?
”Director Liang nodded."
We don't have time to care about whether he has cirrhosis at this time.We have to find out the cause of bloody ascites and acute abdomen.There was no damage or abnormality on the surface of the right lobe of the liver. ”Dr.
Wang used gauze to pad the big retractor hook and carefully pulled the left lobe of the liver to the right upper abdomen, and his body posture was a little awkward.Director Liang pushed the stomach cardiax to the lower left, wanting to reveal the cardia, and then stretched out his finger to go in to investigate.() The distance is a bit far