Auto chess in the operating room

Chapter 112 Endo-GIA Cutting Closer?
[Ding, new task: Complete the first laparoscopic appendicectomy by the chief surgeon within 60 minutes, reward 4 gold coins, and refresh the card library once]

"Routine laparoscopic appendectomy usually takes 90-150 minutes. Is this too demanding?"

[The host's three-star appendectomy is within the reach of the whole country, you can do it, the host. 】

"It's too pretty, isn't it?"

Tang Lou really didn't want to be too high-profile, after all, it was his first laparoscopic appendectomy.

[Isn't it normal for the first time to be quick? 】

Tang Lou: ╭(╯ε╰)╮

After communicating with the patient before the operation, the family members signed the signature, and soon the operation was arranged.

It's just that this time there was more noise in the operating room. In addition to Qingping, Song Yang also became very interested in Tanglou and also chose to watch.

When he heard that Tang Lou was going to perform the first laparoscopic appendectomy, Cheng Jian took the time to rush to the operating room.

In front of the operating table, Tang Lou was naturally standing in the position of the chief surgeon, Ma En was in the position of the mirror assistant, and the equipment nurse was on the other side.

Chen Wenhao had seen Tang Lou's surgery before, but this time he was still very surprised.

First, of course, this guy was the first assist last time, so he directly started to take the lead.

Second, when he saw a bunch of bosses in the operating room, he was a little skeptical. This time, he thought he was smart and prepared three stools.

And then, once again all requisitioned
Standing in front of the operating table, watching his bench being divided up by several bosses, Qing Ping still had a sensible look in his eyes.

Chen Wenhao's face darkened.

This feeling is like playing on a basketball court, watching my mineral water bottle being picked up by the old aunt who picked it up and shaking the pitiful little bit of water, and the wrinkles on my face read, young man, you are always embarrassed to let me wait Let's go, don't you want this little water?Then I'll take it!

And you wanted to wait until the ball was dead, when your throat was at its dryest, and drink it all in one gulp.

Then, the old aunt rushed to say thank you before you made a decision, stomped on it nimbly, stuffed it into the bag, and walked away quickly.

Chen Wenhao suddenly felt that the rest of the anesthesia process was boring, and numbly completed the routine tracheal intubation anesthesia.

After that, it was handed over to Tang Lou.

"Doctor Ma, follow my instructions later, we will try our best to complete the operation within an hour."

Tang Lou didn't want to either, but the bosses of the system have issued tasks, and for four gold coins, they can only force Marne.

"Within an hour?"

Ma En looked at Tang Lou with an exaggerated expression: "This is impossible, even Doctor Qing can't do it so quickly."

"Prepare for three-hole puncture!"

Tang Lou didn't have time to explain, so he raced against time and gave the order directly. Since the patient had a dislocated appendix, Tang Lou slightly changed the position of the puncture on the basis of the traditional three holes.

“..脐上缘10mm常规建立CO2气腹，置10mm套管，压力维持在9～13mm Hg”

".5mm and 10mm incisions were made at the midpoint of the connecting line between the umbilical cord and the pubic symphysis, and 5mm and 10mm trocars were inserted to place endoscopic instruments to treat the appendix."

Tang Lou directed the first assistant and the equipment nurse precisely and calmly.

"Is there something wrong with the opening position?"

Since he had not participated in the consultation before, Cheng Jian was a little puzzled.

"Director Cheng's patient's appendix is ​​ectopic, so the puncture position is a bit different. We have demonstrated Tang Lou's surgical plan."

Qingping hurriedly explained.

Only then did Cheng Jian nod his head. After all, Tang Lou was the main surgeon in this operation, but it was still recorded on Qingping in name and supervised by him, so Cheng Jian was still very relieved.

After Tang Lou marked the spot, Ma En assisted in the puncture.

Ma En was also very surprised and didn't know why. Every time he cooperated with Tang Lou, his mentality was very stable, and his movements were much smoother and more proficient.

The piercing was completed perfectly, but before Ma En could appreciate his masterpiece, an order came from Tanglou.

"Laparoscopy."

For ectopic appendix, it is difficult to find the appendix with conventional McBurney incision. However, laparoscopy is different. The field of view is wide and clear under laparoscopy, and the subsequent washing is more accurate.

This is also the reason why Tang Lou suggested laparoscopic surgery before.

Sure enough, under the laparoscope, although Ma En's mirror holding technique was not as perfect as Tang Lou's, it was solid enough. Under Tang Lou's precise command, he quickly found the cecum under the liver.

"Intraoperative exploration found that the ileocecal area was tightly adhered to the liver, and the appendix was wrapped in a mass by the omentum."

Ma En fully adapted to the role of Isuke and began to report the investigation results.

"Zoom out the camera and prepare to free the appendix."

Tang Lou gave orders unhurriedly, and Ma En responded quickly. Under the aura of Tang Lou's main knife, he felt very at ease, and only Tang Lou's voice was in his mind.

"Free appendix found during the operation: 1cmX1cm fecal stone at the root of the appendix, highly dilated distal appendix, dark gray, smelly, a little dark gray turbid exudate around"

"Intraoperative confirmation: the patient had gangrenous appendicitis, and fecal stones at the root of the appendix."

After Ma En told the result, although Qing Ping and Song Yang beside him were somewhat prepared, they still had some shocking aftermath.

"Sure enough, it is exactly as Tang Lou speculated. This kid is really talented in diagnosis."

Qingping praised without hesitation.

Song Yang didn't speak, but he was a little convinced in his heart.

To be able to put aside the interference of such classic appendicitis symptoms, peel off cocoons, and even relate to the right oophorectomy 20 years ago and the history of repeated gastric diseases in the past two years, so that the ability to reason about the disease systematically, this ability can only be called a talent.

It really has nothing to do with experience qualifications.

"Tang Lou is not only talented in diagnosis, the operating room is where he can really display his talent."

Cheng Jian said softly at the side.

Only then did Qingping and Song Yang realize that, indeed, on the operating table, Tang Lou had shown a maturity that did not match his age, and they could even feel the aura of a senior surgeon.

That is the calm demeanor that can only be obtained after hundreds of surgeries.

"Absorb the abdominal pus, separate the forceps, and prepare the electrocoagulation hook"

"Mesoappendix 1-0 Silk Suture Ligation"

The only sound left in the operating room was Tang Lou's commanding voice, and Ma En and the equipment nurse were already a little bit powerless, and they were desperately cooperating.

"Do you feel that there is basically no time for adjustment and preparation between the steps of the Tanglou?"

"It's true, it feels like I'm in a hurry."

Qingping frowned slightly. Some surgeons in the operating room are accustomed to quick operations, but they are generally veterans who have done no less than a hundred operations, so they can form muscle memory-like operations.

Could it be that Tang Lou deliberately wanted to show off because they were watching from the sidelines.

"Tang Lou, think carefully about every step, don't go too fast."

Qingping still reminded, if you leave troubles too soon, the loss outweighs the gain.

When Ma En and the equipment nurse heard this, they couldn't agree more, and they waited for Tang Lou to let them rest for a while.

Especially the equipment nurses frowned, and Dr. Tang was too ignorant of compassion.

"Prepare a small piece of saline gauze"

However, what answered her was Tang Lou's impersonal order. With his talent, concentration and tenacity, Tang Lou was actually very restrained. If it wasn't for Ma En's limited level, he even wanted to speed up his steps.

"Marne, when separating the adhesions and dealing with the mesentery and the root of the appendix, sometimes intestinal damage may be caused, and a small piece of saline gauze can be placed for proper compression. In the future, you must know how to observe yourself, and prepare the saline gauze before performing the surgery."

Tang Lou taught it seriously, and then added: "You are still not proficient in laparoscopic appendicitis surgery, so you have to hurry up next time."

Ma En still felt quite rewarded for the first half of the sentence, but when he heard the second half, his whole face collapsed. Do you think everyone is a monster like you?
The first case of laparoscopic surgery, as skilled as an old attending for decades.

I'm a dignified resident doctor, and I'm a helper for your intern, but I'm still dismissed as slow?
Ma En really felt that he was too difficult.

And when Ma En had just completed this step, Tang Lou had already completed the separation.

"Endo-GIA Cut Closer Ready!"

Tang Lou issued another order.

"Endo-GIA Cutting Closer???"

Hearing Tang Lou's order, the bosses beside him were also surprised. Did this really come from the mouth of a rookie who had laparoscopic appendectomy for the first time?
(End of this chapter)