Zheng Ren didn't hesitate, the scalpel reflected a cold light and cut straight away.
He did not choose a conventional incision, but chose a large incision on the left side of the rectus abdominis, with the upper end tilted to the right. The entire incision was about 25cm long.
This was completely different from his usual surgical style. Xie Yiren was startled for a moment, then put the automatic retractor at his hand and stared at Zheng Ren's movements.
Chu Yanran sat next to the ventilator, staring closely at the ventilator values and the values on the monitor. She held a pen in her right hand and kept running it between her fingers.
Chu Yanzhi stood opposite Zheng Ren and asked, "Mr. Zheng, can I be your assistant?"
"No, the operation will be completed after you finish brushing your hands." Zheng Ren replied indifferently. Without raising her eyelids or even glancing at Chu Yan, she reached out for the middle-curved pliers, then reached for the sheathed suction device, and immediately opened her abdominal cavity and inserted the suction device.
The dark red blood was sucked out quickly. After a few seconds, Zheng Ren said in a deep voice: "Chu Yanzhi, go and stimulate the blood."
Chu Yanzhi ran out as fast as a rabbit.
In Xinglin Garden, there were not many people in the live broadcast room.
It's the time when I first get to work. Between ward rounds, condition reports, and surgeries, the morning is always the busiest.
There are only "a handful" of more than a thousand people online.
The bleeding was so severe that at least one spleen was diagnosed as ruptured.
My blood pressure is already 60...
What I hate the most is emergency surgery, especially this kind of rescue. Every time I come down, my whole body is sore and I have to wait for two days.
Seeing the surging dark red blood being sucked out of the transparent tube of the suction device, the doctors in the live broadcast room naturally felt the same.
The tense and suffocating feeling at the rescue moment has entered everyone's emotions unconsciously.
There are not many barrages, most of them are chatty people.
The more nervous this kind of doctor is, the more willing he is to talk to relieve stress.
After suctioning for about ten seconds, the amount of dark red blood decreased. Zheng Ren did not wait to completely draw out the blood, directly opened the peritoneum and inserted his left hand.
Xie Yiren immediately put the pollution basin in Zheng Ren's hand.
Zheng Ren took out several large blood clots and threw them into the pollution basin.
"Latex tube." Zheng Ren said to Xie Yiren rarely.
Xie Yiren responded, then handed the prepared latex tube to Zheng Ren, and then took away the pollution basin.
The coordination is almost perfect.
Zheng Ren put his hand in and didn't know what he was touching.
Wow, is this meant to block the porta hepatis? Is the liver ruptured
It looked like the surgeon was also anxious and wanted to hurry up and stop the bleeding. However, I think it is better to expose the surgical field first, as this is too risky.
Sitting back and waiting to be slapped in the face upstairs is my experience these days.
In the live broadcast room, after just exchanging a few words, Zheng Ren put the latex tube in.
If the surgical field is good, you should be able to see the latex tube passing through the omental foramen and passing through the hepatoduodenal ligament to control the first porta hepatis. But at this time, Zheng Ren had no vision at all, and everything was done blindly.
Afterwards, Zheng Ren quickly protected the peritoneum, and then used a large retractor to open the abdominal cavity.
Under direct inspection with the naked eye, it can be seen that there is a 4cm wound in the spleen, with irregular and jagged edges, and blood flowing out of it like a river overflowing a dam.
Because the patient's blood pressure is already very low, the flow rate is not very fast.
But both the people in the operating room and the doctors in the live broadcast room knew that if the bleeding was allowed to continue, the patient would die in about ten minutes.
Zheng Ren said in a deep voice: "Appendix retractor."
He used the appendix retractor to pull the edge of the incision on the side close to the Shay, and after arranging the position, he handed it to the Shay to help him expand his field of vision to the limit.
Then he reached out again, and a pair of separation pliers was slapped into his hand.
The spleen-gastric ligament is cut off by first separating the clamps and ligating, and the short gastric blood vessels are processed very quickly to avoid damaging the gastric wall.
It's so fast...
The surgeon's understanding of the anatomy is really very high. I feel like he knew where the short gastric artery was without even looking at it.
You know it after doing it too much. Young people, doing more surgeries and thinking more are the key to growth.
After several bullets flew by, the splenic artery was freed and exposed in the surgical field. Zheng Ren saw that the spleen shrank significantly after ligating it with 3# silk thread.
Then the spleen was lifted out of the splenic fossa, the splephrenic ligament and splenocolic ligament were processed, the splenic pedicle was cut off with clamps and ligated, and the proximal section was ligated in two ways.
And all this took less than five minutes.
It's so fast. I seem to know why the surgeon blocked the first portal of liver first.
People are confident that they should first block the portal of liver to minimize bleeding. The first porta hepatis can be blocked for up to 10 minutes.
15 minutes, but here we usually loosen it after 10 minutes to avoid ischemic necrosis of the liver.
The doctor in the live broadcast room saw the trick. Although he was surprised to remove a spleen in 5 minutes, it was not a difficult operation. It just showed that the surgeon had a deep understanding of the anatomy.
Well, that's all really.
So far, the operation is the simplest and most straightforward operation except for blindly blocking the blood supply to the first porta hepatis. But how many people can do it so quickly
Everyone knows this truth, so there are only a few scattered barrages flying by. Everyone is waiting to see what the surgeon does with the liver.
Dealing with the liver is ten times more difficult than cutting out the spleen.
After simply suturing the rough surface of the diaphragm and spleen pedicle with 2# silk thread to stop bleeding, Zheng Ren began to extend the surgical incision along the mouth to the reserved right corner.
There is no blood flowing out of the patient's subcutaneous tissue, which is a sign of hemorrhagic shock. Due to insufficient blood volume, almost all peripheral small blood vessels are closed, and the limited blood volume first ensures the blood supply to the body's large blood vessels.
But Zheng Ren did not let down his guard because there was no bleeding. He quickly performed blunt separation and tried to avoid causing too much damage.
He opened the peritoneum and protected it with a large sterile gauze pad. He repositioned the appendix retractor and asked Mr. Xie to help him pull it open.
At this moment, Chu Yanzhi and the traveling nurse ran back quickly.
"Blood transfusion!" Zheng Ren ordered while exploring.
At this time, there is no need for false politeness, everything is focused on rescue.
The circulating nurse and Chu Yanzhi each took out a bag of fresh frozen red blood cells from their arms and hung them on the infusion pole.
Because fresh frozen red blood cells are cold, they try to raise the temperature a little during transfusion, so the two of them used their body temperature to raise the temperature of the blood on the way back.
After checking the blood type and code on the red blood cells, the circulating nurse put the fresh frozen red blood cells into the pressurized transfusion device, then picked up a bag of red blood cells and put it in her arms.
"Give me a bag." Zhu Yanran, who was looking at the values of the ventilator and monitor attentively, said.
Several people divided the blood bags and kept changing positions, seizing the time to make the temperature of the frozen red blood cells higher.
The bag of red blood cells in the pressurized transfusion machine quickly deflated and was replaced with another bag.
At this moment, seeing the dark red red blood cells flowing into the patient's blood vessels along the deep vein puncture makes people feel a little calmer.