Mr. Jiang carefully looked at the blood-stained metal ball.
"Don't take off the hemostatic forceps. If it's not enough, use another incision bag." Zheng Ren warned.
Who the hell knows what this thing is? There is no entanglement of connective tissue. If the hemostatic forceps are released and the metal blade retracts, it will be terrible if this thing undergoes some weird changes.
Mr. Jiang responded cautiously and asked the equipment nurse to cover it with a layer of cotton pad and then put it far away to prevent it from falling out and hurting anyone.
The unknown hidden mine has been ruled out, but the operation has only just begun.
Zheng Ren used a suction device to suck blood and observed the patient's abdominal cavity. There were no other metal objects.
After confirming this, Zheng Ren became more courageous. He reached in, grabbed the spleen pedicle, and began to cut the spleen.
After freeing, clamping, cutting, and suturing, the broken spleen was quickly removed.
After placing it in the basin, Zheng Ren did not rush to continue the next step of the operation, but began to study the spleen.
"Mr. Jiang, where do you live from?" Zheng Ren suddenly asked.
"I'm from the Imperial Capital." Mr. Jiang replied with some confusion.
"Have you ever seen hunting?"
"..." Mr. Jiang was stunned for a moment, hunting? What the hell is this
"How do I look at this wound and the metal ball that was just taken out? They look like something for big animals to eat."
"What?" Mr. Jiang still didn't understand, but when Zheng Ren said this, he made up his mind.
The metal ball is wrapped with meat and noodles mixed with sesame oil, fragrant, and thrown into the wild where large animals are.
The so-called large livestock generally refers to wild boars. Nowadays, bears are protected animals, their numbers are small, and not many people hunt them. Although wild boars are also protected animals, they reproduce much faster than bears, and are on the verge of becoming a disaster.
After being eaten, the metal ball expands and crushes the stomach. Large animals such as wild boars bleed to death.
Although the metal blade on one side of the metal ball was unfolded and not on the other side, Zheng Ren still felt that his guess was correct.
It's just that this kind of thing has been updated, but the principle is still the same.
Mr. Jiang thought about it and understood.
"Was this child fed by others or ate by himself? Why is he so brave?!" Mr. Jiang sighed with emotion.
"I don't know." Zheng Ren put the spleen with a huge wound into the pathology basin and began to look for the wound on the liver.
There were several scratches on the liver, which were relatively deep. Because the porta hepatis was wrapped around, there was very little bleeding.
Absorbable sutures were used to sew the liver and unblock the porta hepatis. Zheng Ren observed for 30 seconds and was relieved when he saw that there was no continuous bleeding.
After liver and spleen bleeding is resolved, the rest comes to the point.
The stomach had been cut open, and the stomach and intestines were damaged due to gastric bypass surgery. This is a big job and needs to be handled bit by bit.
"Boss Zheng, is this after gastric bypass surgery?" Mr. Jiang now understood the patient's condition and asked in surprise.
"yes."
"Operation? I thought the patient had had other surgeries before. What's going on?"
What Mr. Jiang said was not very clear, but Zheng Ren knew what he meant.
Gastric bypass surgery is now performed laparoscopically, and the procedure is relatively simple and less invasive. The patient in front of him underwent surgery.
After 2000, gastric bypass surgery has replaced gastrectomy surgery and has become the most popular weight loss surgery in the United States, with about 100,000 cases performed every year.
In 2004, the National Institutes of Health included gastric bypass surgery in the US National Health Insurance, officially recognizing gastric bypass surgery as the most effective weight loss surgery.
More than ten years have passed, and gastric bypass surgery is now performed minimally invasive laparoscopically. And this child was actually treated by surgery. No wonder Mr. Jiang was surprised.
Zheng Ren did not explain, but continued the operation.
The bleeding points of several solid organs were either removed or sutured, and the patient's bleeding had basically stopped.
With the transfusion of fresh frozen red blood cells and plasma, the patient's blood pressure gradually increased.
Surgery is not so urgent.
The principle of gastric bypass surgery is to cut the greater curvature of the stomach, reduce the volume of the stomach, and then rearrange the intestines.
The surgery divides the stomach into two parts, a smaller upper part and a larger lower part, and then cuts off the small intestine and rearranges the position of the small intestine to change the path of food through the digestive tract, slow down gastric emptying, shorten the small intestine, and reduce absorption.
After this kind of surgery, the probability of intestinal adhesions and intestinal obstruction is relatively high. After all, the intestines have to be straightened again.
The surgeries performed at Xiangjiang's underground clinics were quite orderly, but the trauma was relatively large and the adhesions were severe during the surgery.
The operation preserved the pylorus of the stomach, and the upper jejunum was measured 25cm distally. The jejunum should have been transected here using a laparoscopic linear cutting stapler, but the surgeon cut it off directly.
After suturing, the adhesions at this location were severe.
Mr. Jiang frowned when he saw this level of adhesion.
What are you most afraid of about gastrointestinal surgery? It must be adhesions.
Gastroduodenectomy is not the most troublesome among gastrointestinal and hepatobiliary surgeries. What can be said to be the "most" surgery is only for intestinal adhesion and intestinal obstruction.
And no matter how good the surgeon is, the length of the operation cannot be determined before surgery.
Because the adhesions are too heavy, you have to be careful not to tear the intestines when breaking them down, especially the surgical techniques.
Mr. Jiang suddenly became frightened.
Zheng Ren didn't think much and asked for hemostatic forceps and blunt scissors. Use hemostatic forceps to pull and blunt scissors to either free or cut. Sometimes you even hold the blunt scissors in your hand and use your fingers to free and loosen the adhesions.
Mr. Jiang could cooperate at first, but soon he couldn't keep up with Zheng Ren's speed and thinking. However, Zheng Ren was used to operating alone, so it didn't delay anything.
"Boss Zheng, you are so skilled in general surgery." While performing the operation, Mr. Jiang sighed: "I heard from Brother Wang that you helped him perform an incision to remove polyps for PJ syndrome half a year ago. I thought your level was high, but I didn’t expect it to be so high.”
"It's okay." Zheng Ren loosened the intestines and said casually.
He didn't pay much attention to Mr. Jiang's words. He was more thinking about what to do about the tumor in the patient's duodenal bulb.
After freeing the adhesions where the duodenum and jejunum were cut, Zheng Ren found several scratches. Sew it on smoothly to avoid missing it later.
The surgeries performed at the underground clinics in Xiangjiang are quite standard, but they are not minimally invasive surgeries.
After free release, the anatomical structure gradually becomes clear.
The surgeon in Xiangjiang measured 150cm from the distal end of the jejunum to the distal side and positioned it with silk thread.
The proximal and distal ends of the jejunum were fixed with silk sutures at a distance of 150 cm. An incision was made at the mesenteric edge of the two intestinal segments, and a side-to-side anastomosis of the jejunum and jejunum was performed. The anastomosis was about 6 cm.
Finally, a small incision is made at the root of the mesentery under the colon, and the sleeve gastric sleeve is passed under the colon. The distal side of the jejunal stump and the broken end of the sleeve gastric sleeve under the pylorus are fixed with silk thread, and an end-to-side anastomosis is performed.
It doesn't matter if the left intestine is scratched. This section of intestine has lost its original digestive function.
After checking the intestinal tear, Zheng Ren looked at the duodenal bulb and pondered.