When a doctor opened a plug-in

"Really not?"

"Really not..."

"Oh! It's fine, come on, I'll teach you!"

After repeated confirmations, Lao Ma felt that he should not face being beaten, so he calmly started the next operation.

And Zhou He, an anesthesiologist on the side, couldn't help but smile.

Even the little nurses feel a little bit more distressed and wronged.

How could a male god not?

They felt that Ma Yuehui was bullying us Chen Ouba.

The difficulty of the next operation is not low at all.

Because it has the cause of suppurative appendicitis, and the exudation of bloody fluid, the adhesion and infection in the entire abdominal cavity are very serious.

Have to use antibiotics during surgery for anti-inflammatory and anti-infection.

A large group of black, red, black and red intestines is still bulging, and the memory is not small. Before surgical removal of excess intestinal tissue, the adhesion of the intestine in the abdominal cavity must be completed.

This process is very delicate.

And Lao Ma seems to be a rugged man, but in fact there are fine things in the rough. Well, when Chen Cang and Lao Ma go to the bathroom together, they often talk about life trivial matters...

During the operation of the old horse, he has a good grasp of details.

Colon obstruction exists, so the ileocecal colon swells, causing the intestinal wall to thin!

Therefore, it is very easy to damage the intestines in the following free process!

As a very flavorful operation, once the intestinal wall is cut, the feces will contaminate the abdominal cavity!

So before that, decompression is given first, and then the bowel is freed.

At this time, Lao Ma looked at Chen Cang: "Push the small intestine and greater omentum to the left and protect them with warm saline gauze pads. This can reduce the risk of surgery."

For Chen Cang's education, Lao Ma is still very attentive, and he will tell Chen Cang some details very well. This is all experience and dry goods, not those things in the books.

A joke is a joke, but Lao Ma is dedicated to teaching Chen Cang without reservation.

"When ligating, remember to bring a cloth strip, otherwise it will easily damage the mesentery and blood vessels."

"The end of the blood vessel must be ligated in two ways"

...

The surgery is performed step by step.

Although bowel surgery is simple to say, it is nothing more than cutting off the obstruction and necrosis, and then the two ends are anastomosed.

However, there are many surgical details that need attention.

At this time, the old horse said: "You take this colon up with your hands."

Chen Cang nodded. At this time, Lao Ma took the stripper and began to separate the fat and lymph tissues behind the peritoneum, directly reaching the mesangial roots.

During the whole process, Lao Ma’s hand was very stable, because at this step, you must be careful during the separation process!

There are blood vessels in the ureter and ovary, of course, for men, they are the blood vessels in the spermatic cord.

Chen Cang remembered that there was a patient from the people of the province who had a spermatic cord blood vessel accidentally cut because of an operation. He only learned a year later that the hospital had compensated more than 2 million yuan...

When everything is done, the disconnected intestine is completely free, and it only needs to be removed.

Each port needs two bowel forceps to control to prevent content from flowing out.

Lao Ma glanced at Chen Cang: "Be careful when cutting, and lean slightly!"

Chen Cang was taken aback: "Why?"

Old Ma grinned and said: "Private work, I will tell you if I invite me to dinner tonight."

The operation has not been difficult, and the most dangerous link has passed.

The little nurse on the side couldn't help but complain: "This kind of smelly operation, Mr. Ma, you have a good appetite!"

That's right!

Chen Cang was also convinced...

This old horse is really rough, and doesn't care about these rough details.

Lao Ma couldn't help shaking his head: "Have you seen? When cutting down diagonally, the port diameter of the stump of the ileum can be increased. When stitching up for a while, the choice is better!"

As soon as he said this, Chen Cang suddenly realized.

The next same operation completes the other end.

Thanks to the length of the intestines, the intestines are crooked, and the anastomosis is still not difficult after the intestinal tube, which is about one meter long, is cut.

"3-0 chrome gut!"

Lao Ma took the needle holder and glanced at Chen Cang, "Will it?"

Chen Cang nodded: "Well, I know a little bit."

Lao Ma feels relieved: "Come on, try it, I will point you."

Chen Cang nodded, his intestinal anastomosis is a master, although not so good, but it is also good.

Lao Ma looked at Chen Cang: "Do you know the process?"

Chen Cang nodded: "Yeah."

Seeing Chen Cang nodded, Lao Ma simply said, "Then be careful and don't worry."

This can't blame the old horse, because this intestinal anastomosis is not the same as an ordinary broken anastomosis.

The whole process is cumbersome.

First, the posterior wall needs to be anastomosed to make a full-layer continuous suture, which is not small.

Next, use catgut to make a full-thickness continuous inversion suture on the front wall of the anastomosis!

Afterwards, a row of intermittent sutures on the seromuscular layer of the anastomosis are made with thin non-absorbable thread.

After the anastomosis is completed, the ileum and the transverse mesocolon are sutured with a thin non-absorbable thread.

In the whole process, the difficulty of each process is not small, and because it is relatively cumbersome, the operation of layer by layer is a test of the basic skills of the surgeon in gastrointestinal surgery.

Lao Ma asked Chen Cang to do it, with a bit of consideration and a bit of training.

Chen Cang took a deep breath. It was the first time he did such an anastomosis, because the intestines at both ends are not the same at all, and the calibers are different, so the difficulty coefficient will inevitably be much larger.

But when Chen Cang pulled both ends over, he was suddenly taken aback!

Because he found that this inclined caliber fits better with one end and the other end!

Chen Cang suddenly realized!

No wonder it had to cut diagonally.

Lao Ma glanced at Chen Cang, then smiled, "Do you know why?"

Chen Cang nodded!

"The diameter of the broken port of the transverse colon and the ileum are different, so the suture is better for the intestinal anastomosis!"

The old horse couldn't help but smiled and said, "Yes!"

"I'm calling this end-to-side anastomosis! Exclusive secrets, not passed on from inside to outside, should you consider calling a godfather? I still have many unique skills!"

Chen Cang rolled his eyes, ignored this Tie Hanhan, and quickly started his work.

When Chen Cang started like this, Lao Ma was stunned, this kid...what's wrong?

Could it be... pretending to be a pig and eating a tiger?

indeed!

Not only the old horse, but even Zhou He was stunned. Is this a person who can't get an intestinal anastomosis?

I saw that the suture needle was in Chen Cang's hands as if he had a soul. The so-called one method can pass all the methods, Chen Cang's tendon suture is perfect, and the blood vessel anastomosis is perfect!

Chen Cang's intestinal anastomosis had a master at the beginning, and with the blessing of these two insights, he also understood a little more.

After all, medicine is a connected discipline, and does not exist in isolation.

When Chen Cang stitched together, he felt very much. He felt that his stitching skills could cross boundaries!

Waiting tonight to try the silk stockings that Qin Xiaoli tore off last night, maybe it can restore the stockings to look like!

Thinking of this, Chen Cang suddenly felt that the surgeon was not so boring...

Sewing and mending is actually quite interesting?