Auto chess in the operating room

Chapter 261 Which department's chief is this?
When Liu Jinjin and Yang Min were sensitive, Guo Caier came over.

"Doctor Guo, why are you here?"

When meeting Guo Cai'er, Dr. Wang Chuan's confidant physician, who also came from a Peking Union Medical College background, Liu Jinjin and Yang Minmin were of course very polite.

Guo Caier's eyes lit up when he saw Liu Jinjin and he said, "Dr. Liu, do you have time now? Dr. Wang has a partial liver resection and needs an assistant. You can either come with me. "

Liu Jinjin nodded immediately. He was very happy to be able to serve as Dr. Wang Chuan's assistant. After thinking about it: "Although partial liver resection is difficult, an assistant should be able to do it. And Dr. Wang is the surgeon. It must be all right."

"Well, then follow me to the pre-operative preparation, this operation should take quite a long time."

Guo Cai'er said a word, then turned around and led the way.

And Tang Lou also entered the operating room at this moment.

The resident doctor, Dr. Wu, was obviously a bit unexpected when he saw Tang Lou coming in, and he was not the attending physician he was familiar with.

"Doctor Wu, this Dr. Tang, the chief surgeon arranged by the inpatient department."

The intern saw Dr. Wu's doubts and immediately introduced him.

When he heard Dr. Tang, Dr. Wu became even more stunned. After all, he belonged to Shen Bingbing, so usually his surgical partners were from Director Shen's family. He didn't seem to remember that the attending physician's surname was Tang.

However, Tang Lou didn't give him too much time to think. After the diagnostic technique, he issued an order directly, and the chief surgeon's aura was fully activated:

"The patient's physical condition is poor. Have you taken preoperative antibiotics and gastrointestinal decompression? Has the water and electrolyte balance been corrected? Can the blood volume be replenished?"

Hearing Tang Lou's professional and meticulous three-time questioning and strong aura, Dr. Wu's uneasiness was completely suppressed. It seems that the person who came was a big boss, maybe the attending physician of other departments, maybe the director level.

After all, the First City Hospital is still very large, with many departments, and it is normal to have some that he is not familiar with. He feels anxious, but he must not show his timidity.

"Report to Dr. Tang that a nasogastric tube has been placed in advance, gastrointestinal decompression has been continued, simultaneous infusions have been made to correct water loss and electrolyte imbalance, anti-shock treatment has been completed, and blood transfusions have been carried out."

Dr. Wu was as obedient as a little white rabbit in front of Tanglou's aura. After all, before you know the temper of a big-shot doctor, being cautious, obedient and sensible is the only magic weapon.

"Apply broad-spectrum antibiotics and administer analgesics as appropriate."

Tanglou continued to issue orders, and at the same time signaled the anesthesiologist to start working.

Due to the patient's older age and poor physical condition, intensive plus local anesthesia was used.

"Scalpel"

Tang Lou walked to position C very naturally, and reached out to take the scalpel from the equipment nurse.

"Yizhu, after I make a midline incision in the upper abdomen, I enter the abdomen in time and suck up the fluid and gastric overflow in the abdomen."

After hearing what Tang Lou said, Dr. Wu didn't pay too much attention. After all, in his opinion, Tang Lou definitely needed to mark the incision and make an incision. The time was enough for him to prepare, and he did not prepare the instruments simultaneously.

While Dr. Wu was in a daze, Tang Lou chose the classic bow-holding style, under the three-star incision technique, one knife, one knife, one knife.

After three movements with the same frequency, the same distance, and different strengths, the abdominal surgical field is directly exposed.

"What are you still doing?"

Tang Lou frowned.

"Damn, how could it be so fast."

Dr. Wu was startled, and immediately lifted his spirits, and hurriedly performed the operation: "Right away, right away!"

Dr. Wu hurriedly followed Tang Lou's incision, penetrated into the abdomen, and cleaned up the internal fluid and gastric overflow.

"Explore to find the location of the lesion."

Under Tang Lou's command, Dr. Wu carefully began to expose the stomach and the front wall of the duodenum, not daring to be careless.

"Intraoperative findings: perforation of the stomach and anterior duodenal wall. It can be seen that the tissue around the perforation is obviously congested, edematous and hard, and there is overflow of gastric or duodenal juice."

After Dr. Wu finished his report, under Tang Lou's instructions, he continued the exploration. After careful inspection, he completed the exploration and determined the perforation sites. There were three in total.

"so serious!"

Compared to Tanglou's calmness, Dr. Wu's face was solemn.

"Nonabsorbable Thread Fillet Needle. Microscope"

Tang Lou directly gave the order to start the suture operation. Since the small perforation in the stomach wall and the surrounding hard area were not large, he was going to do intermittent suture of the seromuscular layer.

Because Tang Lou chose the thinnest thread, the operation difficulty is very high, and if the strength of the seromuscular suture is not well controlled, it is very easy to tear the tissue.

Seeing that Tang Lou was suturing with such a high level of difficulty, Dr. Wu broke into a cold sweat. He is really a brave man with high skills!

On the display screen, Dr. Wu watched Tang Lou operate the needle-holding forceps, covering and perforating the seromuscular layer very quickly and steadily.

After that, the greater omentum is covered and fixed with the abdominal wall. The tissue structure of the greater omentum is very easy to tear. If the strength and angle are not well grasped, it is very easy to tear, but if it is worn too fast, because the silk thread is very thin, it is easy to break.

Dr. Wu held his breath and watched Tang Lou's operation until Tang Lou punctured several times in a row before he was sure. This Dr. Tang's suture level is the top in the entire general surgery department.

"Strange, why haven't you met such a powerful boss before?"

While Dr. Wu was pondering, Tang Lou had already completed the first perforation site and was directly suturing the second perforation.

The second perforation is located deeper, and the perforation is larger, and the inflammation and edema are heavier, so it is not suitable to suture directly.

"Doctor Tang, how to suture this situation?"

Doctor Wu now completely regards Tanglou as a highly respected old doctor, so he asks for advice very humbly.

"If this kind of edema is more serious, if it is directly sutured, it will cause stenosis and passage obstacles. Therefore, we can directly block the perforation with the omentum, and then use non-absorbable suture to fix the omentum and the intestinal wall around the perforation. .”

What Tang Lou said didn't affect his operation at all.

"understood."

Dr. Wu nodded in admiration. He was indeed a boss. Dr. Tang must have practiced hundreds of surgeries with just one suturing hand.

Three minutes later, Tang Lou completed the textbook-level stitching and entered the third stitching without stopping.

"Doctor Tang, you don't need to rest."

Dr. Wu was a little worried. He was afraid that Tang Lou's continuous sutures would cause him to lack concentration and energy. Dr. Tang hadn't stopped the operation until now.

After all, in his previous sutures, every stitch had to be done carefully, and the whole person was probably going to collapse after suturing.

Moreover, the third perforation involves duodenal ulcer perforation. For a resident doctor like him, it is like a sailor who hears the Cape of Good Hope and fears death in his heart. It is full of desire to conquer.

Huge setbacks and supreme achievements coexist!It is the obsession of every surgeon.

"continue."

Tang Lou didn't talk nonsense, and he had already started suturing. He directly chose the edge of the perforation that was very bold in Dr. Wu's opinion to do interrupted sutures. Moreover, if you look carefully, you can find that the direction of the suture in Tang Lou is consistent with the direction of the twelve fingers. The longitudinal axis of the intestine is vertical.

"When suturing the duodenum, remember not to use too much force when ligating the sutures. Just bring the edges of the two sides of the perforation together closely."

Sensing Dr. Wu who was nervous and excited beside him, Tang Lou taught it very naturally. Under the aura of the chief surgeon and the talent of the academic leader, Dr. Wu nodded. Unknowingly settled down.

"This kind of suture can prevent the surrounding edema and inflammation from being strangled. After suturing, the omentum is used to cover the surface, and then non-absorbable suture is used to suture the surface of the intestinal wall to fix it."

Tang Lou demonstrated while talking, a very difficult gastrointestinal perforation repair was completely made into a teaching demonstration.

Another 5 minutes later, after counting the equipment, Tang Lou stopped, and rewarded Dr. Wu with the right to close the abdomen in a very ceremonial manner.

"One help, shut down."

"Thank you, Doctor Tang."

Dr. Wu was very happy to stand on the operating table, and it was a great honor to be recognized by a great doctor, even though he had done it countless times.

"Continue gastrointestinal decompression to prevent gastric distension after operation. Generally, continuous decompression is required for 2 to 3 days until intestinal function is restored."

"Daily infusion during fasting to maintain nutrition, water and electrolyte balance, and blood transfusion when necessary."

"Apply broad-spectrum antibiotics."

Tang Lou was the first to leave the operating room after giving the final postoperative doctor's order.

Listening to Dr. Tang's leaving footsteps, Dr. Wu sighed enviously: "When can I become such a chic chief surgeon?"

Continuing to perform abdominal intubation safely, Dr. Wu asked the intern beside him:
"By the way, Dr. Tang, which department's director is he? His level is better than Dr. Wang Chuan's. It's too good."

(End of this chapter)