Chapter 383 If Xu Qiu didn't come, who would dare to say that the patient would die? !
"really……"
As soon as Xu Qiu came in, he immediately became the absolute core of the operating room. He judged the situation under the operating field, and his face became more solemn.
Pretty much the same as the circulating nurse's report.
The omentum of the abdomen is lumped together with various organs and tissues.
A piece of the left liver area bulged outward, which was an enlarged liver.
At a glance, the intestines are also very bad!
From about 110cm below the Trize ligament, the color of the patient's small intestine was extremely poor, and no physiological peristalsis was seen.
The intestinal wall of a large area of the small intestine was gray-white in color and felt stiff to the touch, as if the nine-turn large intestine had been frozen for several days.
It is these inactivated "zombie intestines" that create the turtle's shell that cannot be cut.
"What's going on? Is there any way?" Wang Ping asked.
Director Xiao also swallowed.
Xu Qiu actually doesn't do many abdominal surgeries. After his first-hand Chen's pancreaticojejunostomy shocked the whole hospital and even alarmed Academician Chen from Tiandu, he rarely performed abdominal surgeries, especially hepatobiliary surgeries.
If this operation is performed on a patient with pneumatosis in the hepatic portal vein, if it can be successful, it may leave a model operation at the level of a medical treasure for the Department of Gastroenterology and Hepatobiliary Surgery!
It's just...this is really weird.
"It's a bit troublesome." Xu Qiu said.
Wang Ping and Director Xiao looked at each other and sighed.
Joseph felt relieved.
I was so scared, I thought Xu Qiu could even master the Death Sign...
This guy is obviously a doctor in the emergency department, but he has established a talent base for brain surgery, performed small blood vessels, and initiated surgeries in the cardiac surgery department. It is simply outrageous!
It would be outrageous to cross the line again to save a patient who has been sentenced to death!
"In that case, then..."
Just when Wang Ping wanted to end with a switch operation, Xu Qiu suddenly picked up the scalpel.
"Change the surgical plan."
Xu Qiu brushed off the fatigue from the previous surgery, her whole face was radiant, and she said forcefully: “Preserve the 110cm of small intestine under the Trize ligament, and simultaneously perform necrotic small intestine + right hemicolectomy + enterostomy + distal transverse colon closure! "
"???"
Wang Ping and others looked shocked.
Is this what you said...a little troublesome?
Just turned around and gave you a solution? !
"Is it really possible?" Joseph was stunned for a long time.
This is unscientific.
But Yang Yuen was very excited: "It can be done, idols can definitely do it!"
…
Xu Qiu spoke, and the center of gravity of the entire operating room immediately adjusted.
Soon, a new surgical plan began.
First is the removal of necrotic small intestine.
Xu Qiu held the knife and directly cut off the "zombie intestines" on the surface of the tortoise shell without any mercy.
It's like a large intestine that was split and frozen together.
A little disgusting, but also a little decompressing.
Large swathes of grey-white, fragile small intestine were stripped away.
Over time, tortoise shells get smaller and smaller.
Wang Ping and others were shocked.
Director Xiao was a little confused: "Why does the abdominal omentum become like this?"
Others also came to their senses.
This question had troubled them for a long time. During the twenty minutes they waited for Xu Qiu to arrive, they discussed it for a long time without an answer.
Logically speaking, this should not happen.
Director Xiao has been undergoing abdominal surgeries for so many years, and this is the first time he has seen a tortoiseshell abdomen that is glued together.
"Peritoneal dialysis."
Xu Qiu peeled off the tortoise shell and gave an explanation.
"Peritoneal dialysis?" Director Xiao and others were stunned.
Peritoneal dialysis, especially long-term dialysis, has many disadvantages, such as intraperitoneal bleeding, organ damage, peritoneal dialysis catheter dysfunction in the acute phase, etc.; complications in the chronic phase include peritonitis, peritoneal hypofunction, hyperlipidemia, etc... …
Turtle shell belly? never heard of that.
“The acute phase leads to omentum encapsulation, and the chronic phase is complicated by peritoneal hypofunction, which coincides with hepatic portal pneumatosis. Under the influence of diffuse inflammation, various tissues all stick together.”
Xu Qiu's answer shocked everyone.
This is something that cannot be learned from textbooks.
Even Director Xiao, a leader in abdominal surgery, only realized this at this moment.
This kind of medical knowledge is like a black box.
No one knows until the box is opened.
But once it was revealed, it became immediately clear.
"That's it!" Yang Yuen also suddenly realized it and nodded in surprise.
As I said, if you have any questions, just ask the magical idol!
…
As Xu Qiu took over, the tense atmosphere in the operating room suddenly relaxed.
Directors Wang Ping and Xiao served as first and second assistants, and they became more and more comfortable.
"It's still nice to be an assistant..." Wang Ping sighed silently.
Being a toolman is so wonderful!
Director Xiao was also smiling.
Who pronounced the death sentence?
Doctor Xu hasn't come yet, who dares to issue a critical illness notice to the patient!
Joseph became increasingly silent.
Didn't he show off his skills at Laihai No.1 Hospital and abduct Xu Qiu along the way?
Why do you feel that your strength is becoming less and less impressive in front of Xu Qiu?
"Cut off."
At this time, Xu Qiu had already dismantled the tortoise shell and removed all the necrotic small intestine.
Then it went straight from the retroperitoneum to the hepatic flexure, and then cut off the right greater omentum along the upper edge of the transverse colon.
This step is a right hemicolectomy.
"Scan."
Xu Qiu's words were concise, but his actions were unambiguous.
He bluntly separated the retroperitoneal fat and lymphatic tissue and carefully explored it.
After confirming that it was correct, he completely cut off the mesentery of the right colon.
Then he used the same method to cut off the right end of the transverse colon.
At this point, the entire right colon was separated from Gao Juan.
At this point, Xu Qiu's Chen's pancreaticojejunostomy came in handy again.
Although it has nothing to do with the pancreas, this suture technique can be used to anastomose the terminal meeting place and the opposite end of the transverse colon.
After integrating various exquisite suture skills, Xu Qiu performed conventional anastomosis again, which was simply like using his arm to a dazzling degree.
When everyone came to their senses, a beautiful intestinal tube had appeared under the surgical field.
"What a waste of natural resources!" Wang Ping envied it.
This kind of suture, taken to the plastic surgery department, is considered a perfect technique for sew double eyelids and make faces for little sisters.
It is actually used in the invisible intestinal cavity!
"Enterostomy."
Xu Qiu thought it was very normal. Without a pause, he started the next step.
Compared with the right colon resection, the enterostomy is much simpler.
But... this is just a routine operation.
Gao Juan's condition is very dangerous. There are a lot of necrotic small intestines. Whether the remaining small intestines can successfully complete the stomy is a big problem.
The only thing to be thankful for is that until this moment, the anesthesiologist did not call the police. Although Gao Juan was weak, she was always stable at a low level that could still be operated on.
Cut off the small intestinal mesenteric blood vessels...
Close the distal end of the small intestine...
Choose the stomy site...
Sew up the serosa and peritoneum of the small intestine, the serosa and the anterior sheath of the rectus abdominis, the entire layer of the small intestine and the skin layer...
Xu Qiu dared not be vague.
Although this step is simple, it is the most important part of the entire operation!
