Zheng Ren silently took a look at the patient's status. General anesthesia was completed and he could be treated at any time. The familiar sound of good luck music was automatically blocked by him, and he went to wash his hands in silence.
People who sing out of tune have no idea about all music.
Clear water flowed out of the stainless steel faucet, and Zheng Ren entered the system space.
At the same time, a ding-dong sound came.
Urgent Mission: Transform Cocoon into Butterfly
Mission content: Treat a patient with abdominal cocoon.
Mission reward: 3000 skill points, experience value: 100000 points, energy potion x2.
Mission time: 15 hours.
Um? Has Big Pig Hoof given a mission
This is an unexpected surprise, but the reward cannot be received until the mission is completed, so it is not needed at this time.
Only the proficiency in all languages was given in advance. In this regard, Big Pig Hoof was very kind, and Zheng Ren had nothing to complain about.
There were footsteps outside, and Zheng Ren estimated that it should be Director Wei.
Open the system store menu and click Purchase Surgery Time. The system operating room rose from the ground, and Zheng Ren entered directly without hesitation.
The experimental subject was lying on the operating table. Zheng Ren had nothing to hesitate. Although he had the task of turning a cocoon into a butterfly as a supplement, Zheng Ren, who had experienced a depletion of surgical training time, was now saving every minute like a miser. ,every second.
On the operating table of the system, the subject is placed in a supine position. The skin is routinely disinfected with iodophor and alcohol. Sterile drapes and large surgical sheets are laid out layer by layer. An exploratory incision is made through the rectus abdominis on the right side into the abdomen. The incision is about 18cm long and is incised layer by layer. Lift and incise the peritoneum.
This routine sequence also wasted nearly 3 minutes of Zheng Ren's time.
Feeling a little distressed, Zheng Ren resisted the urge to directly dissect the experimental subject. He is still afraid that if he is used to dissection, he will develop symptoms of split personality.
I am a doctor, not a butcher.
After cutting open the peritoneum, there was a piece of white flowers inside. It was as dense as a layer of oilcloth, and no other tissue could be seen.
Is cocoon really that serious? Zheng Ren didn't believe it.
Zheng Ren held the hemostatic forceps in his left hand, clamped a piece of tissue, and carefully cut it with the blunt scissors in his right hand.
Down there...is not the intestines, but a layer of the omentum.
Zheng Ren didn't understand how many layers it was densely packed. It is said that the greater omentum is a barrier that protects the abdominal cavity, but the greater omentum of the experimental subject lost this role and was wrapped in layers of cocoons.
Like silkworms, it adds countless variables to the surgery.
It can be imagined that the internal space must be connected to the intestines by connective tissue, and there are also connective tissues outside the intestines, layer by layer. Just thinking about it gives me a headache.
It was an experimental subject anyway. Although Zheng Ren controlled his desire to dissect, it would still be okay if the incision was slightly larger.
Upon upward exploration, the gallbladder was large, the gallbladder wall was not congested and edematous, and no obvious abnormalities were found in the liver and spleen.
It's okay up there, that's good, that's good. If combined with a disease such as gallbladder rupture, Zheng Ren would be helpless.
If that were the case, there would probably be no surgical training time left at all.
Zheng Ren carefully opened the dense connective tissue under the omentum. There was about 30ml of clear and light yellow liquid in the cyst cavity, and the suction device sucked out the liquid. There are countless such gaps. Zheng Ren doesn't think about other positions and seizes the time to deal with the situation in front of him.
Exploration of the intestinal tract revealed adhesion between the intestinal wall and surrounding connective tissue. Use blunt scissors and hemostatic forceps together to separate and release bit by bit and carefully.
Even with Master Zheng Ren’s surgical skills, it is difficult to perform non-destructive treatment. But every time he makes a mistake, Zheng Ren will remember the difficulty here. How much force should be used, and should it be done by hand or with blunt scissors.
Zheng Ren also sutured the damaged area.
At a position 25cm away from the ileocecal part, the intestinal tube was tightly adherent. Zheng Ren exerted a little force and the intestinal tract was torn open, resulting in a 2-3cm opening.
This section of the intestine was severely edematous and could not be sutured.
Zheng Ren sighed. This operation should have failed.
He had no choice but to operate roughly and began to dissect the experimental subjects. While dissecting, he reminded himself that this was a surgical training room and an experimental subject provided by Big Pig Hoof. If you are outside, you must not operate so casually.
This is something Zheng Ren has been careful to avoid.
I'm really afraid that on a whim, I might cause irreparable mistakes outside.
After an autopsy, Zheng Ren found that the patient's intestines were wrapped in countless layers, not only on the outside, but also on the inside.
The cocoon not only surrounds the peritoneum and wraps all the intestines, but also wraps all the intestines.
After a section of the intestine is released, there is still connective tissue underneath.
Faced with this situation, the best way is to perform intestinal resection, simply and crudely cutting off all the severely adhesions.
But... almost all of the experimental subject's intestines were wrapped, leaving no room for Zheng Ren to remove them.
After total intestinal resection, even if you survive the operation, you will have to undergo intravenous high nutrition for the rest of your life.
The most important thing is that the patient is 72 years old and cannot bear such severe surgical trauma.
Let's just peel it off bit by bit. Although the operation is difficult to perform, this is the only successful way Zheng Ren can think of.
Zheng Ren is quite confident in his blunt dissection skills, coupled with Dr. Charles's surgical box and handy surgical tools. If you can't do it yourself, not many people in the world can do it.
After the dissection was completed, Zheng Ren had a certain understanding of the anatomical structure of the experimental subject, and the second operation was much faster.
After passing the location of the last intestinal rupture, Zheng Ren was extra careful, peeling off the connective tissue bit by bit, adapting bit by bit to the strength that different intestinal walls could accept.
The intestinal tissue of the experimental subject is subject to very little force, and even simple actions such as clamping with hemostatic forceps and pulling upwards may cause intestinal damage.
There is no way, Zheng Ren can only sum up experience and lessons from failure after failure. Depending on how much force the intestinal wall bears, what equipment is needed.
Fortunately, Zheng Ren has always had a good memory, and with the invisible blessing of the big pig's hooves, he can still remember it.
After nineteen consecutive failures, Zheng Ren finally peeled off the layers of cocoon.
But Zheng Ren, who was about to place the intestines, suddenly saw that the patient's bilateral ovaries were seriously infected and had dense wrappings.
So that’s it!
Zheng Ren remembered that he mentioned the origin of abdominal cocoon syndrome in a document, which was divided into two types: primary and secondary.
Primary abdominal cocoon, also known as idiopathic abdominal cocoon, occurs mostly in young women in tropical or subtropical regions. The cause may be related to gynecological infection and autoimmune reaction caused by fallopian tube infection or retrograde menstruation.
The patient was already past menopause. But the infection still comes from the ovaries and pelvic cavity, where the pathogen is.
What to do? Zheng Ren was stunned.
Should I switch to gynecological surgery next? He looked at the pelvic area and felt a little confused.