"Really not?"
"I can''t..."
"Oh! It won''t be good. Come on, I''ll teach you!"
After repeated confirmation, Ma felt that he should not face being beaten, so he calmly began the next operation.
The anesthesiologist Zhou he couldn''t help laughing.
Even the little nurses feel a little more distressed and wronged.
How can a male god not?
They think Ma Yuehui is bullying us, Chen ouba.
Next, the difficulty coefficient is not low.
Because itself has the cause of suppurative appendicitis, coupled with bloody liquid exudation, the adhesion infection in the whole abdominal cavity is very serious.
Antibiotics have to be used intraoperatively for anti-inflammatory and anti infection.
A large mass of black and red intestines is still bulging, and the memory is not small. Before surgical resection of excess intestinal tissue, the adhesion of intestines in the abdominal cavity must be completed.
This process is very delicate.
The old horse looks like a rough man. In fact, there are details in the rough. Well, when Chen Cang and the old horse go to the bathroom together, they often talk about some trivial things in life
When the old horse was operated on, he had a good grasp of the details.
Colon obstruction exists, so ileocecal colon swells, resulting in intestinal wall thinning!
Therefore, it is very easy to damage the intestines in the next dissociation process!
As a very delicious operation, once the intestinal wall is cut, feces will pollute the abdominal cavity!
Therefore, before this, decompression is given first, and then the intestinal canal is free.
At this time, the old horse looked at Chen Cang: "push the small intestine and greater omentum to the left and protect it with warm saline gauze pad, which can reduce the risk of surgery."
For Chen Cang''s education, Lao Ma is still very attentive. He is good at telling Chen Cang some details. These are some experience and dry goods, not those things in books.
Joking is joking, but Lao Ma is also conscientious and unreserved in Teaching Chen Cang.
"When ligating, remember to bring a cloth strip, otherwise it is easy to damage the mesentery and blood vessels."
"The broken end of the blood vessel must be ligated twice"
……
The operation was carried out step by step.
Although intestinal surgery is simple, it is just to cut off the obstruction and necrosis, and then anastomose the two ends.
But there are many surgical details that need to be paid attention to.
At this time, the old horse said, "pick up this colon and use both hands."
Chen Cang nodded. At this time, the old horse took the stripping ion and began to separate the retroperitoneal fat and lymphoid tissue, directly reaching the root of the mesangium.
The whole process, the old horse''s hand is very stable, because this step, in the process of separation, we must be careful!
There are ureteral and ovarian vessels. Of course, in the case of men, they are spermatic cord vessels.
Chen Cang remembered that there was a patient who accidentally cut the spermatic cord and blood vessels because of surgery. He didn''t know until a year later. At that time, the hospital compensated more than 2 million
When all was done, the broken intestine was completely free and only needed to be removed.
Each port requires two intestinal forceps to control to prevent content from flowing out.
The old horse took a look at Chen Cang: "pay attention when cutting, tilt a little!"
Chen Cang was stunned: "why?"
The old horse smiled and said, "private work. I''ll tell you if you invite me to dinner in the evening."
The operation is not difficult now, and the most dangerous link has passed.
The little nurse on the side could not help but Tucao: "this kind of operation make complaints about the appetite."
you ''re right!
Chen Cang is convinced
The old horse is really a rough man. He doesn''t care about these rough details at all.
The old horse couldn''t help shaking his head: "see? When cutting obliquely, it can increase the port diameter of the broken end of the ileum. When suturing later, it has a greater chance!"
As soon as he said this, Chen Cang suddenly realized it.
Next, the same operation completes the other end.
Thanks to the length of the intestines, it is not difficult to anastomose after the intestines, which are almost one meter long, are cut off.
"3-0 chrome catgut!"
The old horse took the needle holder and looked at Chen Cang: "will you?"
Chen Cang nodded: "well, a little."
The old horse was relieved: "come on, you try and I''ll give you some advice."
Chen Cang nodded. His intestinal anastomosis is a master. Although it is not so excellent, it can also be taken.
Old ma looked at Chen Cang and said, "do you know the process?"
Chen Cang nodded, "yes."
Seeing Chen Cang nodding, the old horse simply said, "be careful, don''t worry."
This can''t blame the old horse, because this intestinal anastomosis is different from the ordinary broken anastomosis.
The whole process is cumbersome.
First, it is necessary to do full-thickness continuous suture on the anastomotic posterior wall, which is not easy.
Next, make a full-layer continuous varus suture on the front wall of the anastomosis with intestinal suture!
Then, a row of plasmomyometrial discontinuous suture should be made on the front and rear walls of the anastomosis with fine non absorbable suture.
After anastomosis, the ileum and transverse mesocolon were sutured intermittently with a fine non absorbable thread.
In the whole process, the difficulty of each process is not small, and because it is cumbersome, the operation layer by layer is a great test of the operator''s basic skills of gastrointestinal surgery.
Lao Ma asked Chen Cang to do it, with both consideration and cultivation.
Chen Cang took a deep breath. This is the first time he has done such anastomosis, because the intestines at both ends are fundamentally different and the caliber is different, so the difficulty coefficient will inevitably be much larger.
But when Chen Cang pulled both ends over, he was suddenly stunned!
Because he found that one end of the inclined caliber fits better with the other end!
Chen Cang suddenly realized!
No wonder it cuts obliquely.
The old horse looked at Chen Cang and smiled, "do you know why?"
Chen Cang nodded!
"The diameter of the broken end of the transverse colon and ileum is different, so the suture is better for the anastomosis of the intestine!"
The old horse couldn''t help laughing and said, "right!"
"I''ll call it end to side anastomosis! It''s an exclusive secret. It''s passed inside but not outside. Do you want to consider calling godfather? I still have a lot of unique skills!"
Chen Cang rolled his eyes, ignored the iron Han Han and quickly began his work.
Chen Cang was stunned at the beginning. This boy... What''s wrong?
Is it... Pretending to be a pig and eating a tiger?
you bet!
Not only the old horse, but also Zhou he was stunned. Is this a person who can''t match his intestines?
I saw the suture needle in Chen Cang''s hand as if he had a soul. The so-called one method leads to one hundred methods. Chen Cang''s tendon suture is perfect and the blood vessel anastomosis is perfect!
Chen Cang''s intestinal anastomosis had a master at the beginning. With the blessing of these two kinds of feelings, he also had a little more understanding.
Medicine, after all, is an interlinked discipline, not isolated.
Chen Cang felt very much when sewing. He felt that his sewing skills could cross the border!
Try the silk stockings that Qin xiaolicked last night tonight, and maybe you can restore the appearance of the silk stockings!
Thinking of this, Chen Cang suddenly felt that the surgeon was not so boring
Sewing and mending is actually very interesting?