The Surgeon’s Studio

Chapter 145: 0142 Don’t use the knife when a couple is fighting (Part 1)

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Asking Xie Yiren to notify the group of arrogant and lustful guys playing mahjong to work overtime, Zheng Ren stuffed the remaining meat into his mouth in three mouthfuls.

In the emergency department on the first floor, a woman stood helplessly in the emergency room, covered in blood and looking panicked.

Zheng Ren quickly came to the emergency department again and glanced at the patient on the bed. A light red diagnosis of splenic rupture and hemorrhagic shock appeared on the system panel in the upper right corner of his field of vision.

"The patient is a male, forty-five years old. He was stabbed in the left upper abdomen an hour ago. His blood pressure was 80/60 mmHg when he was sent to our hospital." The doctor on duty at the emergency surgery department reported the medical history: "Emergency B-ultrasound report, splenic fossa. Fluid was visible, with a depth of 3.5cm, and no effusion was found in the pleural cavity."

Because the spleen is under the left diaphragm, when it is injured, it is necessary to determine whether there is a combined thoracoabdominal injury.

Once there is a pneumothorax and the patient is sent to the operating table and blown by the ventilator... it can be fatal.

Although the system did not diagnose lung stab wounds or traumatic pneumothorax, Zheng Ren still listened carefully with a stethoscope. The breath sounds in both lungs were clear, and no wet or dry sounds were heard.

Trauma should be simple.

"Where are the family members?" Zheng Ren asked.

"That's it." The surgeon on duty secretly pointed at the woman who was stunned in the emergency room. "It is said that the couple had a quarrel, and she stabbed her directly."

“…”

So tough

However, Zheng Ren was not in the habit of filing household lawsuits. He called his family members and took the patient for another chest and abdominal CT scan. After confirming that there was indeed no pneumothorax, he came to the emergency operating room.

Su Yun was already waiting at the door of the operating room, and one of the Chu sisters pushed the patient in, and Zheng Ren went to change clothes.

The patient is in good condition and the injury is not serious, which can be seen from the blood pressure.

Maybe there is no need for splenectomy, Zheng Ren has a basic assessment of the condition in his mind.

Change clothes, brush hands, and put on surgical gown.

After the Chu sisters finished anesthesia, Su Yun had done the preliminary work, disinfecting and laying out surgical drapes. Under the shadowless lights, everyone was waiting for Zheng Ren to take the stage.

It really felt like a professor, but Zheng Ren still couldn't adapt to this situation. When he was in the first department of general surgery, Su Yun did all the work by himself. Sometimes he couldn't even get on the operating table, so he would be kicked off after laying out the sheets.

He had been thinking about the patient's condition all the way, and Zheng Ren already had a case.

Reaching out, the handle of the scalpel was slapped into his hand.

Zheng Ren did not choose a small incision, but made a 20cm long incision along the left costal margin.

In the Xinglin Garden, the live broadcast begins.

The master hasn’t broadcast live for a long time.

What is it this time? Huh? Spleen rupture is rare.

It seems that there is no difficulty. It is just a simple splenic rupture and the blood pressure is not very low. It can be cut off and the patient can be discharged from the hospital in one week.

According to the custom in Xinglin Garden of skin peeling before examination, the first doctors who entered were chatting miscellaneously.

For surgeons, simple resection is indeed not difficult.

It is always easier to destroy than to build.

It was such a big opening, so spacious. I judged that it was not the same person as the previous practitioner.

Who knows, the techniques are similar.

They all move very quickly, right? It's just a splenectomy, so even if you want to be slow, it won't be much slower.

During the live broadcast, the moment the peritoneum was opened, the suction device wearing a condom was inserted. Thick, dark red blood gurgled out.

Soon, all the blood near the incision was sucked away, the suction device was pushed in, and the surgeon began to open the peritoneum and protect it.

Surgery with an assistant looks so easy.

Inevitable, otherwise how could there be a saying that surgery is not done by one person.

If you look at other surgeries performed by the podcaster, many of them were successfully completed by one person. Adding one more person can shorten the operation by just a few minutes.

The doctors watching the live broadcast had inexplicable confidence in the surgeons. This confidence was built up by dozens or hundreds of previous surgeries.

After peritoneal protection, it enters the abdominal cavity.

Su Yun took the suction device and sucked out the remaining blood in his abdominal cavity. At the same time, Zheng Ren quickly checked his spleen and saw that there was an incision of about 2cm on the upper pole of the spleen, and blood was gurgling out.

Using gauze to compress to minimize bleeding, Zheng Ren quickly checked the liver, pancreas, stomach, retroperitoneal blood vessels, nearby intestines, duodenum and other organs.

Fortunately, it was just a simple splenic rupture, which was the same as the systematic diagnosis.

Due to splenic rupture and massive bleeding, the spleen shrinks and has no adhesion to surrounding tissues. Zheng Ren held the spleen out of the incision and carefully handed it to Su Yun.

Wow, what is the warlock going to do? Could it be spleen repair

Probably, this patient is very suitable for spleen repair.

We have repaired everything except the broken spleen which cannot be sewn back. Splenectomy is not difficult at all.

Can you die if you don’t blow? In splenoplasty, if one is not careful, the possibility of a second stage of surgery is extremely high.

Many doctors watching the video have their own judgments on whether splenic rupture should be repaired or violently removed.

Hospitals or doctors with weaker standards rarely dare to perform repair surgeries.

Just like the patient who suffered bleeding after segmental nephrectomy performed by Zheng Ren a few days ago, the spleen also has such risks.

Both the spleen and the kidneys are very fragile. When suturing with needles and threads, the wounds cannot be sutured if they are too gentle. If it is severe, it will tear immediately, causing secondary damage during the operation.

After Zheng Ren handed the spleen to Su Yun, he began to fill the spleen bed with a large gauze pad.

The whole process seems to be very fast, but it is very careful and does not cause any side injuries caused by violent operations.

While Zheng Ren was filling the spleen bed, Su Yun had already discovered the direction and depth of the spleen crack.

The wound was located at the upper pole of the spleen and was about 3cm deep.

After Zheng Ren filled and compressed the spleen bed, he stretched out his hand and found a needle and thread.

Medium needle, standard 3# suture needle.

Thin, 1-0 absorbable suture.

Su Yun fixed the spleen, and Zheng Ren began to perform mattress sutures.

Uh... why so fast? Aren't the practitioners afraid of tearing

It should be because I know the reason well in my mind. The more I do it, I can’t slow down even if I don’t think fast.

It was really scary to see. I had my spleen sewn up once and it tore when I applied too much force.

This kind of operation is not routine. Some surgeons in lower-level hospitals have never performed a spleen repair operation in their lives. Generally, if the spleen is found to be ruptured, it can be cut off directly to avoid the risk of a second surgery after surgery.

After suturing, Zheng Ren patted the needle holder on the side of the patient's leg. Xie Yiren then picked it up and placed it on the instrument table. While wiping the blood on the needle holder, he watched Zheng Ren's movements.

After tying the knot, Xie Yiren slapped the scissors on Zheng Ren's outstretched hand.

Cut, wire, and prepare to rinse with warm salt water.

Step by step, neither slow nor fast.