Chapter 877 A Game of Patchwork

"Really not?"

"Really not..."

"Oh! It's fine, come on, I'll teach you!"

After confirming again and again, Lao Ma felt that he should not face being slapped in the face, so he calmly started the next operation.

The anesthesiologist Zhou He on the side couldn't help but laugh.

Even the little nurses felt a little more distressed and aggrieved.

How could the male god not?

They felt that Ma Yuehui was bullying us Chen Ouba.

The next surgery is not difficult at all.

Because of its own cause of suppurative appendicitis, plus bloody fluid exudation, the adhesion infection in the entire abdominal cavity is very serious.

Anti-inflammatory and anti-infective antibiotics had to be used intraoperatively.

A large mass of black, red, black and red intestines is still bulging inside, and the memory is not small. Before surgical removal of excess intestinal tissue, the adhesion of the intestinal tract in the abdominal cavity must be completed.

This process is very delicate.

And Lao Ma seems to be a rough man, but he is actually rough and fine. Well, when Chen Cang and Lao Ma go to the toilet together, they often talk about some trivial things in life...

When the old horse operated, he had a good grasp of the details.

There is a colonic obstruction, so the ileocecal colon swells, resulting in a thinning of the bowel wall!

Therefore, it is very easy to damage the bowel during the following dissociation process!

As a very flavorful operation, once the intestinal wall is scratched, the feces contaminate the abdominal cavity!

So before this, decompression is given first, and then the bowel is freed.

At this time, the old horse looked at Chen Cang: "Push the small intestine and the omentum to the left and protect it with a warm saline gauze pad, which can reduce the risk of surgery."

For Chen Cang's education, the old horse is still very attentive, and he can tell Chen Cang about some details. These are all experience and dry goods, not those things in books.

A joke is a joke, but the old horse is also conscientious and unreserved in teaching Chen Cang.

"When ligating, remember to bring a cloth strip, otherwise it will easily damage the mesentery and blood vessels."

"The broken end of the blood vessel must be ligated twice"

...

The surgery proceeds step by step.

Although intestinal surgery sounds simple, it is nothing more than cutting off the obstructed and necrotic area, and then the two ends are anastomosed.

However, there are many details of the operation that need to be paid attention to.

At this time, the old horse said: "You pick up this colon, with both hands."

Chen Cang nodded. At this time, Lao Ma took the peeler and began to separate the retroperitoneal fat and lymphoid tissue, directly reaching the root of the mesentery.

During the whole process, the old horse's hand is very stable, because of this step, in the process of separation, you must be careful!

There are ureters, ovarian blood vessels, and, of course, the spermatic cord blood vessels for men.

Chen Cang remembered that there was a patient in the province who had a spermatic blood vessel cut due to an accident. It was only after a year that he learned that the hospital had compensated more than 2 million...

When everything is done, the broken intestine has been completely freed and only needs to be removed.

For each port, two intestinal forceps are required to control and prevent the contents from flowing out.

The old horse glanced at Chen Cang: "Be careful when cutting, and tilt it a little bit!"

Chen Cang was taken aback: "Why?"

The old horse said with a smile: "I'll tell you about my private work, if you invite me to dinner tonight."

The operation is not too difficult now, and the most dangerous part has passed.

The little nurse on the side couldn't help but complain: "This kind of tasteful operation, Team Leader Ma, you have a good appetite!"

That's right!

Chen Cang is also convinced...

This old horse is really rough and doesn't care about these rough details.

The old horse couldn't help shaking his head: "See? When you cut it diagonally, it can increase the port diameter of the stump of the ileum, and when it is sutured later, you have a better chance of choosing!"

As soon as these words came out, Chen Cang suddenly realized.

Then the same operation completes the other end.

Thanks to the long enough length of the intestines and the tortuous ones, the anastomosis is not too difficult after the intestines, which are almost a meter long, are cut out.

"3-0 Chrome Gut!"

The old horse took the needle pliers and glanced at Chen Cang: "Will you do it?"

Chen Cang nodded: "Well, a little bit."

The old horse was very relieved: "Come on, try it out, I'll give you some pointers."

Chen Cang nodded. His intestinal anastomosis was a master. Although it wasn't that good, he was able to do it well.

The old horse looked at Chen Cang: "Do you know the process?"

Chen Cang nodded: "Yes."

When the old horse saw Chen Cang nod, he simply said, "Then 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 rather cumbersome.

First of all, it is necessary to do a full-thickness continuous suture on the posterior wall of the anastomosis, which is not small.

Next, use catgut to do full-thickness continuous inversion suture on the anterior wall of the anastomosis!

Afterwards, a row of seromuscular discontinuous sutures were made on the front and rear walls of the anastomosis with thin non-absorbable sutures.

After the anastomosis, the ileum and transverse mesocolon were sutured intermittently with thin non-absorbable sutures.

The whole process, each process is not small, and because it is relatively cumbersome, layer by layer operations, it is a test of the operator's basic skills in gastrointestinal surgery.

The old horse asked Chen Cang to do it, which was both a bit of consideration and a bit of training.

Chen Cang took a deep breath. It was the first time for him to perform such an anastomosis. Because the two ends of the intestinal canal are fundamentally different, the caliber is different, and the difficulty factor will inevitably be much greater.

But when Chen Cang pulled the two ends over, he was suddenly stunned!

Because he found that the oblique caliber fits better with one end and the other!

Chen Cang suddenly realized!

No wonder it was cut diagonally.

The old horse glanced at Chen Cang and smiled: "Do you know why?"

Chen Cang nodded!

"The diameter of the stump of the transverse colon and ileum is different, so the suture is better for intestinal anastomosis!"

The old horse couldn't help but smile and said, "Yes!"

"I call this end-to-side anastomosis! Exclusive secrets, whether it's inside or outside, should you consider calling it a godfather? I still have a lot of unique skills!"

Chen Cang rolled his eyes, ignored this Tie Hanhan, and quickly started the work in his hand.

As soon as Chen Cang started like this, the old horse was stunned, this kid... is something wrong?

Could it be... pretending to be a pig and eating a tiger?

indeed!

Not only the old horse, but even Zhou He was stunned. Is this a person who can't have intestinal anastomosis?

I saw that the suture needle was in Chen Cang's hands as if it had a soul. The so-called one method can be used for all 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, and with the blessing of these two kinds of insights, he also understood a little more.

Medicine, after all, is a related discipline, not an isolated one.

Chen Cang felt a lot when he sutured. He felt that his suture skills could cross the border!

Try it out tonight with Qin Xiaolick's stockings that she ripped off last night, maybe you can restore the stockings to what they should look like!

Thinking of this, Chen Cang suddenly felt that the surgeon was not so boring anymore...

It's actually quite interesting to sew and mend, right?