Medical road

If this operation is combined with lymph node dissection, it is directly a combined abdominal perineal resection.

In other words, everything in the patient's lower abdomen must be cut off.Ms. Jiang’s staff is so strong that it can be pulled out in time. If it is slower and the damage is greater, there is no need to rescue it.

Zhang Fan used toothless forceps to clamp the remaining sigmoid colon. The forceps in the operation are divided into toothed and toothless ones.The tip of the tooth tweezers has tooth-like protrusions like mouse teeth, which makes it more stable when clamped, but this thing cannot be used to clamp organs, especially the intestines. One clamp has three small holes.

Intestinal bleeding can be regarded as closed by all the clamps. This is the first step. There is still a lot to do. First, we must explore the ureter and vas deferens, and because it is not a dissection, we must also explore the pelvic autonomic plexus. There is a sacral nerve. It can be said that this operation is similar to a dissection.

If it ruptures and cannot be repaired, these things must be removed. For example, one side of the ureter is ruptured so that it cannot be repaired. There is no way, and the corresponding kidney must also be removed!

It is estimated that the drainage port is not very big, if it is bigger, it will be troublesome.Fortunately, the bleeding has been stopped, and there is no obvious damage to the ureter, vas deferens, and other organs. The life of the stupid child is currently saved.

"The abdominal cavity and other organs of the pelvic cavity are intact!" After exploring, Zhang Fan said to the director of General Foreign Affairs, and then asked: "How much bleeding is there now. How much solution is in the aspirator."

"3000ml of liquid, it is not easy to estimate the bleeding now." The itinerant nurse said to Zhang Fan after taking a look at the liquid bottle on the floor.

"It is estimated that it is at least about 2000ml. I was in shock when I came here, plus we had bleeding during the operation, no matter what."

"Well, the amount of fluid has increased. Now we are ready to remove the necrotic tissue." After Zhang Fan spoke to the anesthesiologist and nurse, he began to remove the intestine remaining in his stomach.

The sucked intestines spread out in the abdominal cavity like a piece of rags. Because of the blood ligation, the color has turned white, and the original ruddy has long gone.The intestines in the pelvic cavity have been destroyed, and only the remaining rectum and sigmoid colon can be removed.

The sigmoid colon is easy to say, after closing the mesenteric artery, it is OK to cut the stump directly with tissue scissors."Give me two sterile tissue bags." After Zhang Fan cut off the stump of the sigmoid colon, the cut pieces should be put into the tissue bag, which will be seen by the family members later.

The other end was first ligated with a tissue bag. The soup contained a large amount of E. coli. This thing is a normal flora in the intestine, and once it escapes, it becomes a pathogenic bacteria.So first wrap the other mouth.

"This cut, the young man will be sad from now on!" Zhang Fan looked at the sigmoid colon in the tissue bag and said to the General Surgery Director with emotion.

"It's better than lifeless. It's better to die than to live. Besides, in a rich family, you don't have to worry about eating or drinking, and you don't need to move bricks to work. It's a lifetime of eating and drinking."

"People should do something!" Eat and drink for a lifetime, and it won't be a waste. Zhang Fan didn't feel embarrassed to say the latter sentence.

"Don't use your poor thinking to think about people's future. I want to eat and drink for a lifetime, but the conditions can't be met. Hey!" The general director estimated that the several deputy directors under his hand were tired of manipulation.

Finished the sigmoid colon, then the rectum and anus.The rectum and anus are not as easy to handle as the sigmoid colon.Zhang Fan started with two-finger Zen, using his middle finger and index finger to enter the anterior space, which is the surrounding tissues of the rectum and buttocks, and slowly separate first to identify the levator ani muscles.

"Vascular forceps!" The nurse handed Zhang Fan two forceps.The blood vessels of this human body are very smart. It knows that its body is thin, so it usually finds a big brother, either bones or muscles, and then hides inside or next to the big brother.Therefore, to cut the muscle, you must first clamp the two ends, and then tie the knot to let go.

In the past, when there was no electrocautery, after the muscle was severed, the stump had to be sutured firmly with sutures, because after the muscle was severed, it retracted, and bleeding was not found.

Now that I have an electric knife, I walked it like baking pigskin on the wound, and it directly closed the blood vessel.Then, after all the rectum and surrounding tissues are freed, the anus is processed.

"Our hospital does not have a plastic surgery department, otherwise, like this kind of people, the plastic surgery department must come for consultation." After Zhang Fan and the general surgery director looked at the solitary anus after treating the rectum, the general surgery director sighed. One sentence.

"What?" Zhang Fan didn't understand.

"Being a good-looking thing, you don't have everything lost."

"It's not a kid, and he doesn't wear open crotch pants, who cares!" Zhang Fan said in surprise.

"Hey, don't tell me, there are patients who really have this need. No matter who doesn't see it, it's an organ."

"Haha!" Zhang Fan had no intention of holding up with the old man.

The rectum is separated and the anus is left.In fact, the anus is very simple, except for the levator ani muscle, the rest is surrounded by fat.

This is why people in the early years liked to eat chicken buttocks and pig buttocks, because they were all yellow fat, with a little orbicularis muscle, a fatty fragrance, and chewy.Take one bite, and you can be full and relieve your hunger.

The patient's position is a stone cutting position, that is, the legs are spread out and the chrysanthemum is flat against the ground."Sharp knife!" Zhang Fan said to the nurse.

"You make it more beautiful. It's an organ anyway." The general secretary of foreign affairs specially reminded.

Zhang Fan rolled his eyes and said nothing.How can this thing be beautiful!You can't get a personal eyebrow tattoo anymore.

The size of the anus is as big as a dollar coin. Because of the orbicularis muscle, this thing is contracted, and it looks small.Zhang Fan followed the anus with the tip of the knife, gently drew an arc downward, and then also drew an arc on the opposite side.

It is equivalent to drawing a rugby line around the anus.Then, following the line drawn by the tip of the knife, start to cut the skin.

The yellow fat is crystal clear. The fat on the buttocks is denser because of the long-term sitting posture. The knife is cut on the fat, it is really crystal clear, and the fat particles are like yellow rice grains.

Alice clamped the anus gently in advance, the tooth forceps pulled the skin apart, and Zhang Fan used his fingers to gently free the fat near the anus and the levator ani muscle.

"Sutures! Salt water, gauze, iodophor, alcohol." The freeing is over, and at this time the anus is directly attached to the fat with a little rectum.Because the anus is no longer useful.

Washing, a large amount of salt water washes the free anus, like a rubber tube hung on the wall, the anus droops poorly on the buttocks.

After washing with a large amount of salt water, start to wipe with gauze. After wiping with gauze, wipe with iodophor. After wiping with iodophor, use alcohol.

"Come on, give more saline and gauze. You must wash it a few more times here." Zhang Fan said to the nurse. This cleaning is definitely cleaner than the restaurant chef cleaning the gourd head.

After cleaning, Zhang Fan followed the anus with a needle to go in and out, go in and out, sew a circle around the anus, and finally pull the thread and tail to completely close the anus.This is the so-called purse string suture, which is generally used for stump sutures, such as appendix.

The stump was closed, and then gently pulled in the abdominal cavity, and the rectal stump and anus were pulled out.

"Tissue bag!" The equipment nurse handed the tissue bag to the itinerant nurse. The itinerant nurse opened it up and Zhang Fan put the rectum and anus into the transparent tissue bag.

This thing does not look big when it is in the body, but when it is put into the tissue bag, it is directly filled with a tissue bag, the whitish anus, and the bloody rectum.

The rectum and anus are very important organs. It is not something that can be cut off and thrown away. If cancer is suspected, pathology is needed.

If there is no doubt, you must let your family members go over it. Some people who are particular about this important organ are required to deal with it by themselves.

The place where the anus used to stay is now empty, like a black hole. The rest is sutures, from the inside to the outside, and finally the skin. After the oval incision is sutured, it looks like a person's closed eyes.The chrysanthemum was gone, completely lost, replaced by a suture scar.

Light a cigarette, sit on the toilet, and play with his mobile phone. He will not be able to enjoy this kind of pleasant enjoyment in the future.

After stitching up, Zhang Fan looked at it, um, yes, it's almost a stubborn willow eyebrow!

"Change gloves!"