Chapter 92 It's Just Faster, That's All
Zheng Ren didn't hesitate, the scalpel reflected a hint of coldness and cut it straight.
He did not choose a conventional incision, but chose a large incision next to the rectus abdominis on the left side, and the upper end was shifted to the right, and the entire incision was about 25cm long.
This was decidedly different from his usual surgical style. Xie Yiren was stunned for a moment, then put the automatic retractor by his hand and stared at Zheng Ren's movements.
Chu Yanran sat next to the ventilator, staring at the values on the ventilator and the monitor, holding a pen in her right hand, constantly wandering between her fingers.
Chu Yanzhi stood opposite Zheng Ren and asked, "Mr. Zheng, can I be your assistant?"
"No, when you finish brushing your hands, the operation will be done." Zheng Ren replied indifferently. Without raising his eyelids and without looking at Chu Yanyi, he reached out for the middle-bending pliers, and then for the suction device with the sleeve on, and immediately opened the abdominal cavity and inserted the suction device into it.
The dark red blood was quickly sucked out, and after a few seconds, Zheng Ren said solemnly, "Chu Yanzhi, go and stimulate the blood."
Chu Yanzhi ran out in response, as fast as a rabbit.
In Xinglinyuan, there were not many people in the live broadcast room.
It is the time just to go to work, ward rounds, reporting of illnesses, and operations. The morning is always the busiest.
Only "little" more than 1,000 people are online.
[The bleeding is fierce, at least one spleen rupture is diagnosed. 】
[Blood pressure is already 60...]
[I hate doing emergency surgery the most, especially this kind of rescue. Every time I come down, my whole body is sore and I have to wait two days. 】
Watching the surging dark red blood being sucked out of the transparent tube of the suction device, the doctors in the live broadcast room naturally felt the same way.
The tension and suffocation at the time of rescue have unknowingly entered everyone's emotions.
There are not many barrages, and most of them are people who talk the same way.
The more nervous this kind of doctor is, the more willing he is to talk and relieve stress by talking.
After about ten seconds of suction, the amount of dark red blood had decreased. Zheng Ren did not wait until the blood was completely drawn, and opened the peritoneum directly and put his left hand in.
The Xie Yi people immediately put the polluted basin in Zheng Ren's hand.
Zheng Ren pulled out several large blood clots and threw them into the polluted basin.
"Latex tube." Zheng Ren rarely said to Xie Yi people.
Xie Yi responded, then handed the prepared latex tube to Zheng Ren, and then took the pollution pot away.
The tacit cooperation is almost perfect.
Zheng Ren put his hand in, not knowing what he was touching.
[Wow, this is to block the portal of liver? Is the liver ruptured? 】
[It seems that the surgeon is also in a hurry and wants to seize the time to stop the bleeding. But I think it's better to expose the surgical field first, because it's too risky to do so. 】
[Sit and wait upstairs to be slapped in the face, this is my experience these days. 】
In the live broadcast room, just after a few exchanges, Zheng Ren put the latex tube in.
If the surgical field is good, the latex tube should be able to see through the omental foramen and pass through the hepatoduodenal ligament to control the first porta hepatis. But at this time, Zheng Ren had no vision at all, and everything was doing blind exercises.
Afterwards, Zheng Ren quickly performed peritoneal protection, and then opened the abdominal cavity with a large retractor.
Under the naked eye, it can be seen that there is a 4cm wound in the spleen with an irregular edge and a zigzag shape.
Because the patient's blood pressure is already very low, the flow rate is not very fast.
But both the people in the operating room and the doctors in the live broadcast room know that if you let the bleeding go like this, the patient will die in about ten minutes.
Zheng Ren said solemnly, "Appendix retractor."
He used the appendix retractor to pull the edge of the incision on the side close to the Shea, and then handed it over to the Shea to help him expand his field of vision to the limit.
Then he stretched out his hand again, and a split pliers slapped his hand.
The splenogastric ligament was first separated and clamped and ligated to cut off the gastrosplenic ligament, so that the short gastric blood vessels could be handled very quickly to avoid damage to the gastric wall.
【The speed is really fast... 】
[The surgeon's understanding of the anatomical structure is really high, how do I feel that he knows where the short gastric artery is without even looking at it. 】
[If you do more, you also know that young people, doing more surgery and thinking more is the key to growth. 】
After several barrages flew by, the splenic artery had been dissociated and exposed in the surgical field. After Zheng Ren ligated with 3# silk thread, the spleen was obviously shrunk.
Then the spleen was lifted out of the spleen fossa, and the spleen-phrenic ligament and splenocolic ligament were treated, and the spleen pedicle was cut off with forceps and ligation.
And it all took less than five minutes.
[How fast, I seem to know why the surgeon blocked the first hepatic portal first. 】
[People are sure, block the hepatic portal first to reduce bleeding as much as possible. The first hepatic portal can be blocked for up to 10 minutes. 】
[15 minutes, but we generally release it in 10 minutes to avoid ischemic necrosis of the liver. 】
The doctor in the live broadcast room saw the doorway. Although he was surprised that a spleen was cut in 5 minutes, it was not a difficult operation, but it just showed that the surgeon had a deep understanding of the anatomical structure.
Well, it really is.
So far, the operation is the simplest and most common operation except for the blind operation to block the blood supply to the first hepatic portal. But how many people can do it so quickly?
Everyone knows this principle, so there are only a few scattered barrages flying by. Everyone is waiting and watching, wanting to see the treatment of the liver by the surgeon.
Handling the liver is ten times more difficult than cutting the spleen.
2# silk thread was simply sutured to the rough surface of the diaphragm and spleen pedicle to stop the bleeding, Zheng Ren started along the mouth and extended the surgical incision to the reserved right corner.
There is no blood flow out of the subcutaneous tissue of the patient, which is a manifestation of hemorrhagic shock. Due to insufficient blood volume, the peripheral small blood vessels are almost completely closed, and the limited blood volume first ensures the blood supply of the body's large blood vessels.
But Zheng Ren didn't let his guard down because he didn't bleed. He quickly and bluntly dissected to avoid causing too much damage.
Open the peritoneum, protect it with a large piece of sterile gauze pad, reposition the appendix retractor, and let the Shei people pull it open for him.
At this moment, Chu Yanzhi and the traveling nurse ran back quickly.
"Blood transfusion!" Zheng Ren ordered while investigating.
At this time, there is no need for false courtesy, and everything is mainly about rescue.
The itinerant nurse and Chu Yanzhi each took out a bag of fresh frozen red blood cells from their arms and hung them on the infusion stand.
Because fresh frozen red blood cells are cold, try to raise the temperature a little when inputting, so the two of them used their body temperature to raise the temperature of the blood on the way back.
After checking the blood type and code on the red blood cells, the itinerant nurse put fresh frozen red blood cells into the pressurized blood transfusion device, and then picked up a bag of red blood cells and put them in her arms.
"Give me a bag." Chu Yanran, who was concentrating on watching the values of the ventilator and monitor, said.
Several people divided the blood bags, kept changing positions, and seized the time to make the temperature of the frozen red blood cells warmer.
The bag of red blood cells in the pressurized blood transfusion device shrunk quickly, and then another bag was replaced.
At this moment, seeing the dark red red blood cells slid into the patient's blood vessels along the deep vein puncture, makes people feel a little more anxious.
Thanks to book friend 160104135804205 for the reward.