Medical road

Zhang Fan and the surgeons began to change their gloves.In general surgery, surgery is rarely changed, but for this kind of contamination surgery, gloves must be changed.

This kind of operation is said to be complicated. It is not as complicated as a tumor resection. It is simple. It has a flower-like intestine inside and can save your life. The surgeon is already very powerful. The action is a little slower, and the life is probably gone.

Now that hemostasis is complete, the remaining intestines and anus have been removed, and the rest is self-evident, and the digestive system has to find a way.

As the saying goes, water and fire are ruthless, and as ruthlessly, it will be uncomfortable to die if you hold back for a while.So this channel of reconstruction is also very important.

The life-saving is now done, and the rest is about the quality of life of the patient.More than three hours have passed since the operation, and Zhang Fan is already considered to have exercised, and it is not considered long to stand for less than six hours.

Anxiety, the anxiety before the operation has slowly subsided, and the rest is suffering, "No news is good news." Ms. Jiang said with a cold face, leaning on the plastic bench outside the operating room, talking to herself. .

The assistants and secretaries stood far away and dared to surround themselves.They know that at this time, they must not be troubled by trouble.But the eye contact between a few people is not a kind of misfortune, but also a kind of helplessness that is hard to tell.

The parents of the silly boy have already set off from their hometown in Jiangsu and Zhejiang.People who are concerned, or because of politeness and interest, come in one by one, and Ms. Jiang really wants to smash the phone.It's annoying enough, and I have to perfuse some people.

Several transferred doctors in the emergency department looked at the book-thick disclaimer, and quietly stuck their tongues out, "Director Xue is really good, and almost everything is done. How courageous!"

"Do you know what a shit, this is called timid? He didn't do the operation, the hospital is not his family, what is his fear, this is called responsibility, don't understand, don't know how to learn!" The female doctor of babbled a few words and another male transfer doctor who always harassed him.

Whether it is timid or responsible, Ouyang is satisfied anyway.

"I didn't see it, this kid is so brilliant. I'm still worried that he didn't understand it, yes!" Ouyang looked at the signed disclaimer. Although he didn't say anything, he was satisfied with Xue Fei. It is estimated that she has entered her pocketbook.

Changed the gloves and washed away the talcum powder on the gloves.Zhang Fan and the others continued the operation. They were originally the patients who received the operation when they were about to get off work at noon.At this time, the meal was already past, and the anesthesiologist and itinerant nurse had already changed their meal.

The surgeon and instrument nurse can only endure it, and the operation is not so urgent at this time.Zhao Pingquan, the director of General Foreign Affairs Department, also has the thought to speak.

"Lao Chen, what's the meal in the cafeteria today? Why did I ask the smell of tofu." The long operation, coupled with Zhang Fan's weird operating habits, made Lao Zhao forbearing too hard.Forget it if you don't let you eat, you don't even let you talk!

"Unfaded braised pork and boiled tofu, hey! I was able to endure eating meat before, but today I completely lose my appetite. Your surgeon is better. You can go outside to eat after the operation. We are beaten to death. Ah, it's terrible."

"You're pursuing this point!" Old Zhao mocked. He was also hungry. During the operation, he became nauseated, and then stimulated the gastric mucosa to secrete a lot of stomach acid. At this time, his old stomach disease came again.

Most surgeons have stomach problems. They don't eat regularly all the year round, and stomach ulcers are caused by a hungry meal, and they start to feel pain when they skip meals.

"Gauze, Director Zhao forbearance, the operation is almost over." Zhang Fan knew that Old Zhao had a stomach ulcer, so he speeded up under his hands.

"It's okay, I can't die after eating later. It's this child, I don't know if he can accept it after the operation." Before the operation, Zhao had a black face to help his life, but after he really saved his life, he felt a bit cruel.

"Generally, for this kind of reconstructive surgery, psychological counseling must be given to the patient before the operation, so that the patient can receive it in advance, but there is no way for emergency surgery. Although the quality of life has dropped a lot in the future, people will always survive!" Zhang Fan In turn, he began to persuade Lao Zhao.

From this point, you can see the difference between the personality of Lao Zhao and Zhang Fan. Zhang Fan hesitated before doing it, and Lao Zhao hesitated after doing it. It is kind to say that it sounds good, and it is the benevolence of women to say that it sounds bad. There is a lot of smoke in the department. It has nothing to do with his character.

The flushing in the abdomen, the ligation of the ligation, the lower abdomen is cleaned up, and the operation has truly entered the final step, fistula and abdominal closure.

The fistula of the intestine is very troublesome. Although the intestines are spread out, it seems to be more than ten meters, but there are ligaments hanging around this thing, and the blood vessels around it are like spider webs, which make the intestines fixed. In other words, the intestinal tract is not much movable.

If he could move a little bit, Zhang Fan really wanted to do an artificial anus for this stupid child.Now it can only be rebuilt near the fracture.Open at the remaining upper end of the sigmoid colon.

This place is projected on the abdomen, which is actually on the upper left side of the navel. In technical terms, it opens at the midpoint of the connection between the navel and the left anterior superior iliac spine.

Ostomy is simple and very simple, and general surgeons with a little experience can do it, but this kind of permanent ostomy is not something that ordinary doctors can do.

The first thing to consider is the stability and applicability of the external anal bag. This is not a trivial matter. It doesn’t matter if you hang a bag on the patient’s body for a day or two, but this permanent thing, once the design is unreasonable, will bring the patient It is endless trouble.

Because the cecum and anus have strong contraction ability, the mucous membrane inside is smooth, and has a certain degree of self-cleaning ability. Except for people who don't pay attention to hygiene, the general human body will not smell.

But this permanent anal bag will not work.First of all, the tightness of this thing cannot be compared with the anus, and the closure of the orbicularis muscle is less.Therefore, a permanent smell will accompany it.

"For such patients abroad, there will be a psychologist to intervene during their stay in the hospital, and the rehabilitation doctor will give him some future life training. We are still short of doctors!" The anesthesiologist looked at Zhang Fan and began to prepare for the hole, as if thinking of something. Same, I started to hiccup as I spoke.

"That's because their clinicians can't do it. Our clinicians are doing it all." Old Zhao didn't want to listen to this. The old man and Ouyang are a generation, and their generation is the strangest generation.He often said that it was okay when he was okay, but he was immediately unhappy when he heard others say it.

For the fistula, Zhang Fan prepared a fistula on the outside of the belly button."Sharp knife!" The nurse handed Zhang Fan a sharp knife. Zhang Fan put one hand in the abdominal cavity and the other opened a two-finger-wide incision on the patient's belly with the sharp knife, which penetrated directly into the abdomen.

Then use the babcock forceps to clamp the colon and slowly pull it outward.The most feared thing in the intestines is ischemia. Although the intestines are tough and flexible, this thing won't work even if it is folded, not to mention the intestinal ischemia.

After pulling out the colon, Zhang Fan began to stitch.This stitching is very particular.It is necessary to suture the colon to the opening of the abdominal wall without puncturing the intestine.

This suture is not to repair clothes. Regardless of the small needles, as long as they penetrate the intestines, as time goes on, the intestines, this precious thing, will grow bigger and bigger with this small mouth, and finally necrosis.

You can only use a small needle and thin thread on the film outside the intestine to slowly hang on the opening. The suture is actually an auxiliary function, which is to let the two tissues contact and then fuse.

After a round, Zhang Fan carefully stitched together a round, and took a long sigh of relief. It was a long sigh of relief. If this thing is a little careless, there will be problems, and it is not small. problem.After all, the intestines are just a little bit, not leeks, it won't grow anymore after cutting.

After stitching up the intestine and the interface, Zhang Fan began to trim the skin opening.The opening of the two fingers is for better stitching, but if the opening is left, the opening is a bit too big.

The reconstruction is the anus, so it is best to choose the size of the original device.For example, a finger is inserted into the anus of a normal adult. Note that this is a normal person.

Therefore, when trimming this skin, it can fit in the size of a finger. Because there is no orbicularis muscle, the suture should be slightly smaller. When a finger must be inserted, it should be a little tighter.

"Um! Director, are your fingers a bit thicker!" Old Zhao had done physical work in his early years, and his fingers could be half as thick as Zhang Fan's.

"Is it thick? Not thick! Without the levator ani muscle, without the sphincter, it's better to be thicker."

"Haha!" Zhang Fan thought for a while, and smiled helplessly, directly with a wry smile, although it was a re-creation, it was just the same thing, and it was missing a lot of things.

In the end, Zhang Fan still didn't use the fingers of the General Foreign Affairs Director, and put his own fingers in.Then gather sutures from both ends of the incision.A little bit of recycling.When it feels a little tight, it is considered the end of the rebuilding.

This stitching is no simpler than Zhang Fan's stitching blood vessels.The feces, especially the feces of omnivorous animals, contain a lot of bacteria and viruses. As long as there is a little gap to let it remain, it would be a very terrible thing.

Infection and death are both possible. Even if there is no infection, this thing will corrode as long as there are gaps and will slowly form a fistula. Therefore, when Zhang Fan sutured, he was very careful not to suture too tightly to cause ischemic necrosis. , There can be no gaps, the operation is not fast at all.

Pressing on the anal bag, Zhang Fan looked at it, "Yes! There should be no major problems. Ready to close the belly!"

Just like the cattle and sheep returning home, after Zhang Fan closed his stomach, the nurses and anesthesiologists started to work. With the last stitch cut, the operation was over!

The operation that took more than four hours was finally over.