The hepatoduodenal ligament had been separated, and Zheng Ren began to dissociate the lesser omental foramen and separate the adhesions between the hepatic flexure of the colon and the right lobe of the liver.
Zheng Ren then pushed down the transverse mesocolon, cut the lateral retroperitoneum of the duodenum, and bluntly separated it.
Zheng Ren's blunt dissection surgical skills were developed when he first trained in appendectomy. It can be said to be a special skill.
He himself estimated that any single skill could reach the master level.
But when others see it too much, they become accustomed to it and don’t think it’s so amazing at all. Zheng Ren glanced at Yang Lei and felt a little regretful that he didn't notice this.
Only by talking to him when it seems like everything is fine can he understand the key points of the surgery.
Zheng Ren bluntly separated the retroperitoneum, and then separated the second and third segments of the duodenum forward until the duodenum and pancreatic head could be lifted to the shallow part of the surgical field, and the duodenum and pancreatic head were temporarily placed behind Warm salt water gauze pad.
Normally when performing ODD sphincteroplasty, it is necessary to find the positioning point of the duodenum.
But this patient has already had a common bile duct and duodenum lateral anastomosis, so there is no need to worry about it anymore.
Zheng Ren began to prepare to cut the duodenum.
Use mosquito-type vascular forceps to clamp both sides, cut from the middle of the two forceps, clamp 1 to 2 mm each time, and then use 3#0 non-damaging sutures to suture the duodenal mucosa and bile duct mucosa to 2.0 to 2.5 cm. distance.
Zheng Ren did this step very carefully to prevent the patient from developing duodenal fistula after surgery.
After the sphincterotomy is made, the sutures on both edges of the incision are pulled and checked for bleeding.
The opening of the pancreatic duct is then examined.
The opening of the pancreatic duct is located inside and below the position where Zheng Ren incised the duodenum. At the 3 o'clock direction, pancreatic juice can be seen flowing out.
A thin catheter is placed into the pancreatic duct to check for obstruction or stricture.
The upper duodenal incision is sutured in two layers, which must be carefully aligned to prevent duodenal lumen stenosis or duodenal fistula.
Instead of directly suturing the incision as usual, Zheng Ren treated this location with a transverse suture to try to avoid complications such as duodenal lumen stenosis and duodenal fistula.
Huh? This stitching method is very special.
In the Xinglin Garden, someone immediately noticed this.
After countless experiences, people who watched the live broadcast of the surgery subconsciously believed that the surgeon would make no mistakes, and began to appreciate the benefits of this kind of suturing.
There were not many barrages, and not many people shouted 666.
Everyone is reminiscing and learning.
After the incision on the duodenum was sutured, Zheng Ren carefully pulled over the greater omentum, covered it with the greater omentum to strengthen it, and placed abdominal drainage in the subhepatic area and the lesser omentum hole.
The abdominal cavity was flushed with warm salt water and no active bleeding was found. Three local antibiotics were used. Zheng Ren did not directly close the abdominal cavity.
"B-ultrasound machine, sterile sleeve, 50ml syringe." Zheng Ren said.
"Are you really ready to do it now?" Su Yun hesitated.
"It's okay." Zheng Ren said.
Su Yun did not persist, and soon the circulating nurse pushed the mobile B-ultrasound machine from the operating room. The sterile sleeve covered the B-ultrasound probe and the connecting cable, and Zheng Ren began to perform a direct vision B-ultrasound of the liver.
There is no interference from skin or subcutaneous tissue, and it looks translucent!
The 50ml syringe needle entered the abscess cavity of the liver along the B-ultrasound guidance, and tube after tube of yellow-green pus was extracted.
After about 125ml of pus has been extracted, the resistance of the syringe begins to increase.
"Two sticks of cefoperazone, dissolve and rinse." Zheng Ren said.
Immediately, after rinsing with warm salt water, the circulating nurse on the other side opened two more bottles of cefoperazone and tazobactam. After dissolving, Zheng Ren injected them into the abscess cavity of the liver.
This time the operation was finally completed. Zheng Ren carefully looked at the area where it had been done. No bleeding or untreated inflammatory infection lesions were found.
"Close the abdomen." Zheng Ren said.
Xie Yiren immediately changed into a pair of gloves and began to hand the reserved clean instruments to Zheng Ren.
The entire operation was fast and slow. When peeling off the abscess and shaping the sphincter, Zheng Ren moved very slowly and carefully.
When closing the abdominal cavity, the movement was almost like flying, so fast that it almost left an afterimage.
Su Yun can keep up with his hand speed, Zhenren is sure of this.
Let me go, the only step of closing the abdomen that I can understand, how can you do it so fast? !
That's because you are too weak, young man.
It's like closing the abdomen at the speed of light. The surgeon is so slow when peeling off the pus. Does this mean that we should go as fast as we should and go as slow as we should
Not all doctors can understand surgery.
But everyone understands the steps of closing the belly.
The surgeon's hand speed is at full speed, and one assistant can keep up with it. The two people close the abdominal cavity, and it takes no more than 3 minutes.
This speed... is so proficient, it can be called rocket speed.
As the last injection ended, the patient became agitated and the live surgery room was closed.
The doctors who were performing the surgery still stayed here reluctantly, treating this place as a chat room, and everyone started talking nonsense against the empty background.
At this point, things like driving casually aren't a problem.
Because abdominal infections are often encountered, this surgery has great reference value. In particular, the pus should be peeled off and B-ultrasound positioned on the table, the pus should be directly punctured and pus extracted, and then rinsed with antibiotics.
The surgeon's only goal is to make the patient's sepsis better as much as possible.
Once the source problem is solved, the rest depends on the results of bacterial culture and the application of antibiotics.
The operation was almost perfect. Many doctors were still reluctant to leave the surgery live broadcast room for more than an hour after it was closed. They stayed here to chat, talk about their own feelings, and see how other people felt.
Cross-reference and improve technical level.
It would be great if audio and video data could be left behind, many doctors thought about it.
These are all extravagant hopes. It is already an extremely lucky thing for someone to be able to post a live broadcast of surgery with confidence.
There are not many people who dare to do this. Who can guarantee that there will be no problems with the operation
Only someone with such a defiant attitude as a magician would be able to do live broadcasts.
In the live broadcast room of the surgery, the doctors lamented for a long time. Even if the surgeon didn't know it, they shouted 666 many times before they gradually dispersed.
Zheng Ren finished the last stitch and the patient had regained consciousness.
Both Chu Yanran and Chu Yanzhi have very high anesthesia standards and are worthy of being graduate students in critical care medicine.
Zheng Ren stepped down, tore off the sterile surgical gown and twisted his neck.
"Uncomfortable?" Xie Yi was a little nervous.
Zheng Ren smiled, "No, just doing some exercise."
"oh."
Xie Yi began to pack up the surgical instruments, scrub them, and prepare them for sterilization.
"Zheng Ren, you won't be on duty tonight. I'll treat you to dinner." Xie Yiren said with his back to Zheng Ren.
Zheng Ren's blood surged into his heart, and he almost couldn't get out of the closed fontanelle.
"No need to treat today, there is a dinner party tonight." Zheng Ren was a little regretful. Although it would be more lively if we all go together, how great would it be if we could have dinner with the Xie Yi people
After so long, it seems that only when she first arrived, the two of them went out to have a bite of crayfish and met the Chu sisters.
"Oh, okay." Xie Yi replied.
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