313 Invite You To Eat (1/4)

Chapter 313 Invite you to dinner (14)

The hepatoduodenal ligament had been separated, and Zheng Ren began to free the lesser omentum foramen, separating the hepatic flexure of the colon and the adhesion of the right lobe of the liver.

Then Zheng Ren pushed down the transverse mesocolon, cut open the retroperitoneum outside the duodenum, and bluntly separated it.

Zheng Ren's blunt dissection technique was developed when he first trained in appendectomy, and it can be said to be a housekeeping skill.

He himself estimated that the individual skills have reached the level of a master no matter what.

But others have seen it too much, so they get used to it, and don't think it's so powerful at all. Zheng Ren glanced at Yang Lei, regretting that he hadn't noticed this.

It seemed that he had to talk to him when he was fine, so that he could understand the essentials of the operation.

Zheng Ren bluntly dissected the retroperitoneum, and then separated the second and third segments of the duodenum forward until the duodenum and the head of the pancreas could be lifted to the shallow part of the surgical field, and the duodenum and the head of the pancreas were temporarily placed behind Warm saline gauze pad.

When performing Oddi's sphincteroplasty, it is necessary to find the anchor point of the duodenum.

However, this patient has already undergone anastomosis of the common bile duct and duodenum, so there is no need to worry about it.

Zheng Ren began to prepare to cut the duodenum.

Clamp both sides with mosquito-style vascular forceps, incise from the middle of the two forceps, clamp 1-2 mm each time, and then suture the duodenal mucosa and bile duct mucosa with 3#0 non-invasive suture to reach 2.0-2.5 cm distance.

Zheng Ren took this step very carefully to avoid duodenal fistula in the patient after surgery.

After the sphincter is cut, the sutures on both sides of the cut are pulled to check for bleeding.

The opening of the pancreatic duct is then checked.

The opening of the pancreatic duct is located on the inside and below where Zheng Ren cut the duodenum. At the 3 o'clock direction, pancreatic juice can be seen flowing out.

A thin catheter is placed into the pancreatic duct and checked for blockages or strictures.

The upper duodenal incision was sutured in two layers, and the sutures must be closed carefully to prevent duodenal lumen stenosis or duodenal fistula.

Zheng Ren did not directly sew up the incision as usual, but treated this position with a transverse suture to avoid complications such as duodenal lumen stenosis and duodenal fistula.

【Huh? This stitching method is very special. 】

In the Xinglin Garden, someone immediately noticed this.

After countless times of experience, those who watched the live broadcast of the operation subconsciously believed that the surgeon would not make mistakes, and began to appreciate the benefits of this kind of suture.

There are not many bullet screens, and there are not many people calling 666.

Everyone is reminiscing and learning.

After the incision on the duodenum was sutured, Zheng Ren carefully pulled the greater omentum over, covered and strengthened it with the greater omentum, and placed abdominal drainage in the subhepatic area and the hole in the lesser omentum.

The abdominal cavity was flushed with warm saline, no active bleeding was found, and 3 antibiotics were used locally, but Zheng Ren did not directly close the abdominal cavity.

"B-ultrasound machine, sterile mantle, 50ml syringe." Zheng Ren said.

"Are you really going to do it now?" Su Yun hesitated.

"It's okay." Zheng Ren said.

Su Yun didn't continue to insist, and soon the roving nurse pushed the mobile B-ultrasound machine in the operating room over. With the sterile mantle covering the ultrasound probe and connection wires, Zheng Ren began to perform B-ultrasound on the liver under direct vision.

Without the interference of skin and subcutaneous tissue, it looks translucent!

The needle of the 50ml syringe entered the abscess cavity of the liver along the guidance of the B-ultrasound, and tube after tube of yellow-green pus was drawn out.

After pumping out about 125ml of pus, the resistance of the syringe began to increase.

"Two cefoperazone, dissolve and rinse," Zheng Ren said.

Immediately, it was rinsed with warm salt water, and the itinerant nurse opened two more cefoperazone and tazobactam, which were dissolved and injected into the abscess cavity of the liver by Zheng Ren.

This time the surgery was finally done, and Zheng Ren carefully looked over the area that had been done, and found no bleeding or untreated inflammatory infection lesions.

"Shut up." Zheng Ren said.

Xie Yiren immediately changed a pair of gloves, and began to pass the reserved clean equipment to Zheng Ren.

The whole operation was fast and slow. Zheng Ren moved very slowly and carefully when peeling off the pus moss and shaping the sphincter.

When closing the abdominal cavity, the movement is almost like flying, so fast that it almost has an afterimage.

Su Yun can keep up with his hand speed, the real person is sure of this.

[I'm going, the only step of closing the abdomen that I can understand, how do you do it so quickly? ! 】

[That's because you are too weak, boy. 】

[It's like closing the abdomen at the speed of light. When the surgeon peels off the pus moss, it's so slow. Is this what should be fast and fast, should it be slow? 】

Surgery, not all doctors can understand.

But everyone understands the steps of closing the abdomen.

The operator's hand speed was at full speed, and the first assistant was able to keep up with it. The two of them closed the abdominal cavity, and it took no more than 3 minutes.

This speed... is simply too proficient, it can be called rocket speed.

With the end of the last injection, the patient became restless, and the live broadcast room of the operation was closed.

The doctors who were undergoing surgery still stayed here reluctantly, using this place as a chat room, facing the empty background, everyone started talking nonsense.

Things like driving casually are not a problem at the moment.

Because abdominal infection is often encountered, the reference value of this operation is very great. Especially stripping the pus moss and B-ultrasound positioning on the table, directly puncture to suck the pus, and then rinse with antibiotics.

The purpose of the surgeon is only one—to make the patient's sepsis better as much as possible.

After solving the source problem, the rest depends on the results of bacterial culture and the application of antibiotics.

The operation was almost perfect. Many doctors were still reluctant to part with the live broadcast room for more than an hour after it was closed. They stayed here to chat, talk about their own feelings, and see the feelings of others.

Cross-reference to improve the technical level.

It would be great if audio-visual materials could be left behind. Many doctors thought about it.

This is an extravagant hope. Someone who can confidently broadcast the live broadcast of the operation is already an extremely lucky thing.

There are not many people who dare to do this. Who can guarantee that there will be no problems with the operation?

Only a person who is so against the sky as a surgeon will do a live broadcast.

In the live broadcast room of the operation, the doctors sighed for a long time. Even if the surgeon didn't know, they called 666 many times, and then gradually dispersed.

After Zheng Ren finished the last stitch, the patient had come to life.

Whether it is Chu Yanran or Chu Yanzhi, the level of anesthesia is very high, as expected of a graduate student in intensive care medicine.

Zheng Ren stepped off the stage, tore off the sterile surgical gown, and twisted his neck.

"Uncomfortable?" The Xie Yi was a little nervous.

Zheng Ren smiled, "No, just move around."

"oh."

The Shays began to pack up the surgical instruments, scrub them, and prepare to send them for disinfection.

"Zheng Ren, you won't be on duty tonight, please have dinner." Xie Yiren said with his back to Zheng Ren.

A surge of hot blood surged into Zheng Ren's heart, and he almost couldn't let it out from the closed fontanelle.

"We don't need to treat guests today, we have dinner tonight." Zheng Ren felt a little regretful. Although it would be more lively if everyone went together, how great would it be if he could have dinner with Xie Yiren?

It's been so long, it seems that only when she first came, the two went out to eat a bite of crayfish and met the sisters of the Chu family.

"Oh, yes." The Shay replied.