In addition, Liu Zewei was also interested in hearing about intracavity appendix before.
Although I am not a surgical person, I still understand a little bit when I drink and eat and listen to people bragging.
That kind of appendix surgery that belongs to the heavenly level, Boss Zheng actually succeeded in saving Taiwan.
"I felt it, and there was no mass in the ileocecal part, but after checking everything, I asked Director Luo to come on stage for a colonoscopy."
"..." Liu Zewei was stunned for a moment.
Boss Zheng, you are cheating.
Cutting out the appendix with one knife is really awesome, right? You...
However, Boss Zheng's approach seems to be a way to achieve long-term peace and stability.
In the future, if you encounter a similar situation where the appendix cannot be found, push up the colonoscopy machine to see if it is an intraluminal appendix.
This kind of operation is not coquettish or cool at all, but it is very practical.
"Boring." Su Yun scolded: "Have you already figured it out?"
"Absolutely." Zheng Ren said with a smile, "I've thought about it, but if it doesn't work, I'll just use a gastrointestinal tract imaging if the endoscope can't see it. Anyway, there are many ways."
"Where did you find it later?"
"Director Wei almost touched the position about 12cm above the ileocecal part. However, I estimate that I touched it, but I am not sure. I will be very cautious even when operating the knife."
"What a pity. Next time, remember to bring the entire treatment team with you." Su Yun warned again, "No matter where I am, I will fly there within 10 minutes."
"Stop talking nonsense, are you really going to fly back with your underwear on on the street?"
“If you have an intraluminal appendix that can be viewed, that is also an option.”
Just joking and coming to the endoscopic room. After changing their clothes, the three of them walked in.
"Boss Zheng, what's going on today? I heard it's hyperemesis gravidarum?" Liu Zewei asked.
"Well, the vomiting is too severe, and the pregnant woman still doesn't agree to induction of labor, so we can only try this method." Zheng Ren said: "But it's very troublesome. I won't talk about the surgical process. The jejunal feeding tube is blocked after the operation and needs to be replaced. , I need to inject nutrient solution along the jejunal feeding tube every day. I also have to check various things regularly, which is really troublesome."
"But there is a way after all."
"Well, it's just a trial. There aren't many related surgeries around the world, but there are some successful cases." Zheng Rendao.
Is that so? Liu Zewei mentally sketched out the technique that Zheng Ren wanted to perform. Although it was not difficult, it was more commendable to have this idea.
Sometimes, a wild idea turns into a commonly used clinical technique, saving countless lives.
The patient has been sent, Director Du from the Gynecology Department has come with him, and Director Luo is also here.
The directors of 912 are still very interested in a relatively new technique and want to see it with their own eyes.
Zheng Ren suddenly remembered whether he would be angry if he didn't report this new technique to Director Kong.
well.
It's difficult to do surgery.
It is difficult to perform difficult surgeries.
It is even more difficult to perform a difficult surgery that no one else has done.
I encountered a case of intracavity appendix today, and I didn't call anyone else. I was given a "serious" warning by Xiao Yiren.
Although he wasn't holding a rolling pin or his ears, Zheng Ren could feel the murderous aura.
This is seeking death, Zheng Ren knows.
Next time, I must call and inform everyone.
Would it be too conspicuous and jealous to bring the entire medical team to the rescue? Zheng Ren was a little sad.
Just imagine that Director Wei wanted to save the stage by himself. As soon as he walked in, there were seven or eight people. Regardless of whether they were surgeons, assistants, equipment nurses or even anesthesiologists, they were all kicked out...
So arrogant.
Arrogance is arrogance. If you can't undergo the operation, is it still reasonable
Forget it, don't think about these troublesome things, let's do the surgery first.
"Boss Zheng, the preoperative explanation you wrote is so detailed." Director Du said with a wry smile: "I was shocked when I explained it to the patient's family."
"Many of them are extremely rare complications, and there is nothing we can do about them." Zheng Ren said: "In order to avoid future disputes, this is still the right thing to do."
"You do it, it will open my eyes." Director Du smiled and said: "I have considered giving the patient a transesophageal jejunal feeding tube. What surgery method are you going to choose?"
"The kind you mentioned is less invasive, but there is a tube passing through the oropharynx, which is very irritating to the patient. The specific pathogenesis of patients with hyperemesis gravidarum has not been studied yet, but the method of tube insertion through the oropharynx is not suitable. .”
Zheng Ren began to explain seriously why he chose the technique, and all the previous worries were gone.
The only solution to the problem is surgery.
"There are two remaining types. The first is a domestic percutaneous gastric puncture for patients with ALS to leave a nutrition tube; the second is a way to puncture the jejunum from the inside out and leave a nutrition tube."
"Each has its own advantages. The first advantage is that the possible side effects during the operation are relatively small, and bleeding and the like can be avoided as much as possible. But the disadvantage is that pregnant women may react to the jejunal nutrition tube passing through the pylorus. This is Very head-scratching.”
"The second advantage is that there is no pylorus stimulation. However, the tube directly enters the jejunum and is punctured from the inside to the outside. It cannot be punctured under CT guidance. I am worried that there will be problems during the operation. In addition, there may be infection and other problems after the operation. A series of troublesome events.”
Director Du didn't expect that Zheng Ren could say one, two, three, four, five for this "simple" technique.
"What technique are you going to choose?"
Zheng Ren smiled slightly, said nothing, and came to the surgery room.
The gastroscopy is ready, and Director Luo is ready to operate it himself.
Zheng Ren came to the patient, pretended to do a physical examination, directly entered the system space, and clicked to purchase surgical training time.
…
"I want to choose percutaneous endoscopic gastric puncture, where the gastroscope guides the jejunal nutrition tube into the jejunum through the pylorus." Zheng Ren finally made the decision.
Disinfect, lay sterile drape, and start the surgery.
This surgery is quite special and can be regarded as a technique for double surgeons.
One of the magicians is Zheng Ren, and the other one is Director Luo.
Su Yun, who came to the stage with a brush, was just an assistant holding the guide wire, and was completely ignored.
The gastroscope gently enters the pregnant woman's stomach. Because there is local anesthesia, there are some side effects, but they are slightly milder.
Director Du personally talked to the pregnant woman before the operation. This should be the only chance to save the child.
Although it was very uncomfortable, the pregnant woman held back her tears and tried not to cause any trouble to the operation.
The balloon expands and pushes up the stomach.
The pregnant woman began to vomit violently, although she could not vomit anything.
This is a neurological reflex and cannot be tolerated if you want to.
Zheng Ren did not wait for the pregnant woman to stop vomiting and struggling, and directly performed the puncture. Under direct vision of the gastroscope, the puncture kit's abdomen and gastric wall umbrella were opened, and the puncture needle was fixed.
"Director Luo, relax." After this step was completed, Zheng Ren breathed a sigh of relief.
All that's left is to send the jejunal tube inside.
Director Luo nodded, but his hand was grabbed by a pale hand full of cold sweat.