Surgeons dressed as poor people in the Republic of China

"Who can tell me what's going on? Where's Mr. Wilson?" Dr. Anthony had no image at the moment, and he was called back by the hospital almost as soon as he got home.

The car at home ran out of gas at night, and there were few rickshaws in the concession at night, so he had no choice but to run over. At the age of 50, he ran for a full two kilometers. He ran almost to death, and he finally ran. Tell me People have already entered the operating room?

No, Bonn and Robert are with him, so who is in the operating room?Alan or Richard? ?

The little nurse at the operation door was yelled at by Anthony and trembled all over, "Mr. Wilson has already entered the operating room. Dr. Ye said that the doctors can change clothes and enter the operating room directly when they arrive."

"Ye?" Anthony repeated this strange pronunciation, and then looked at Bonn and Robert with a confused expression.

The tense expression on Robert's face calmed down a bit, but Professor Born still frowned. He turned and walked upstairs without saying a word.

"Where is he going?" Dr. Anthony asked curiously.

"Go back and change into the operating room. Are you so relieved of those brats inside? Why don't you go in and have a look?" Robert laughed.

Only then did Dr. Anthony come to his senses, "Yes, yes, go back to the office and change your clothes first."

in the operating room

"High blood pressure, diabetes, and hernia sac compressing the heart and lungs, all the elements of anesthesia for high-risk groups are taken."

Dr. Ye raised his palms inwards in front of his chest, "I'll do the anesthesia myself, Richard, go check the surgical instruments and get ready for the surgery."

Richard nodded immediately. He was afraid that Ye Yibai would give him anesthesia just now. With Mr. Wilson's body size, he couldn't control the dosage of the medicine well.

"Mr. Wilson, do you have any dentures in your mouth, do you have loose teeth, do you have cervical spine problems, and have you had any head, neck and facial surgery."

Ye Yibai took the list from the nurse and looked at it, "Add it to 4%, and then prepare a small 2F catheter."

The flesh on Mr. Wilson's body trembled slightly because of the master's sobbing. Hearing Ye Yibai's question, he replied softly: "I installed a few false teeth...does this have something to do with my illness?"

Ye Yibai raised his head, "How many?"

Mr. Wilson had a look of embarrassment on his face, and the question "Should I also say this?" was clearly displayed on his face.

"Mr. Wilson, your current situation is not optimistic. Please answer my question clearly." Doctor Ye's tone became serious.

Justice Wilson had the illusion that he had returned to the court where he had worked for more than 20 years, but in this court, he became a defendant sitting in the audience, and the young man in a white coat in front of him became a A judge sitting at the bench.

"Eight...eight." Wilson hesitated to say his answer.

There was a chuckle immediately in the operating room, Ye Yibai immediately looked over with stern eyes, a young nurse immediately stopped smiling, and at the same time showed a nervous look on her face.

"Mr. Wilson, after the anesthesia is finished, we need to intubate you to help you breathe. There is a risk of choking if you have dentures in your mouth, so please take them off."

Mr. Wilson had a sad look on his face when he heard this, but he still started to take out his dentures cooperatively.

The treatment tray jingled eight times. After Mr. Wilson took it out, Ms. Jona checked it again politely and seriously, and then nodded to Ye Yibai.

At the same time, Ye Yibai's sedative, analgesic and muscle relaxants have also been prepared, "Mr. Wilson, we are starting anesthesia now, please relax."

When it was about to start, Mr. Wilson calmed down a lot. He took a deep breath and said in leaky English, "Come on, I'm ready."

Ye Yibai nodded.

The anesthetic slowly entered Mr. Wilson's vein along the needle hole, and Ye Yibai's nerves gradually tensed up.

"Doctor Ye, the patient stopped breathing spontaneously."

"understood."

Endotracheal intubation after general anesthesia is a great test for both doctors and patients.

Muscle relaxants cause the muscles of the patient's whole body to relax, including the diaphragm we use to breathe. In other words, after the muscle relaxants take effect, the patient's breathing will stop.

Therefore, the time left for the anesthesiologist to operate is only two to three minutes. The doctor must quickly and accurately perform endotracheal intubation within these two to three minutes. Insert the endotracheal tube into the trachea together with the ventilator to meet the oxygen supply during the operation. .

Remove the pillow on Mr. Wilson's head, make his head tilted back and his mouth open, Ye Yibai took the laryngoscope and entered Wilson's mouth from the right, pushed his tongue to the left, and then continued to push it slowly, Reveal the uvula.

At the same time, the right hand lifts Mr. Welsh's lower jaw, and the laryngoscope continues to advance. When it is advanced to a certain extent, the laryngoscope is lifted upwards.

At this time, Ye Yibai's nerves collapsed to a limit, 30 seconds, the next action must be completed within 30 seconds, otherwise artificial oxygen must be given again, and then re-intubated.

Ye Yibai took the endotracheal tube from Qiao Na with his right hand, and without any hesitation, the endotracheal tube passed Mr. Wilson's glottis and entered his trachea smoothly.

Quickly unplug the metal guide, and inflate the air bag in one go.

Ye Yibai breathed a sigh of relief and took out the laryngoscope at the same time.

The number of times of intubation increased, and the surgeon knew whether the intubation was successful. Ye Yibai knew it was done the moment the endotracheal tube passed through Mr. Wilson's glottis.

But the feel is the feel, and there are no missing steps.

Place the tooth pad, record the depth of intubation, and at the same time use a simple respirator to blow air at a large flow rate, and listen to the lungs and stomach with a stethoscope to see if there are obvious breathing sounds and water passing sounds.

"After anesthesia, prepare for surgery."

Sac and Brande had seen Ye Yibai's appearance during the free clinic. Although they were still surprised at this time, they would not be frightened, but Alan...

Brande patted Allen on the shoulder, and comforted him in the tone of a person who has experienced it: "Just get used to it, go in, although you are in internal medicine, Mr. Wilson is a patient in your department, you have to watch."

Allen moved his stiff neck, looked at Brande, and asked in an erratic tone: "Your surgery threshold is so high? I used to think that Richard was an embroidered pillow, but now look at the interns he brought. They are all better than me... So I am the embroidered pillow."

Allen said, exuding a decadent atmosphere of doubting self-doubting life all over his body.

Brande was silent for a while, looked at Richard who was busy running around, and swallowed the words "You are right, he is just an embroidered pillow".

"Brande, you pay attention to the patient's heart rate and blood pressure, and remind me if there is any change."

"Okay!" Hearing Ye Yibai's voice, Brande immediately forgot about the decadent Alan, and happily joined the "busy around" team.

"The patient's condition is special, and the fat layer is very thick, so Richard will ask Sac to replace you as soon as you can't stand it." Such a thick fat layer is also a huge challenge for Lagouman.

"Ok."

"Ok."

Ye Yibai changed into a pair of sterile gloves and stood on the operating table, "The repair of esophageal hiatus hernia can be done through the chest or the abdomen, because according to the X-ray, Mr. Wilson's stomach is higher and closer to the chest cavity, so In this operation, we opened the chest cavity."

"Knife." Ye Yibai stretched out his hand.

Richard looked at Mr. Wilson's fat that was completely anesthetized and trembling from time to time due to mechanical ventilation. He was in pain and joy. The pain was the challenge he was about to face. The fat layer was two or three times thicker than ordinary people, and his thin arms actually Isn't it painful to fight them head-on.

But thoracotomy, in the 30s, out of awe of the heart, thoracotomy in surgery was rare, and the special disease of diaphragmatic hernia was very rare, which surgeon resisted one The temptation of new diseases and new surgeries.

Look at that Allen from the Department of Gastroenterology, an internal medicine doctor, quietly stood in a position with a good view. Thinking of this, Richard puffed out his chest again, isn't it just the layer of fat several times thicker? , he is not afraid!

"For this kind of transthoracic esophageal hiatal hernia repair, the left posterolateral incision is usually made, and the seventh or eighth intercostal space is inserted into the chest." Dr. Ye touched Mr. Wilson's sternum as he spoke.

however……

Sure enough, this fat layer is not only a test for Lagou Man, but also a test for the chief surgeon. Where are the ribs... Where are you?

Dr. Ye's usually calm face finally had some cracks. After the second press, he still couldn't get it right, "Richard, help me take off the glove on my left hand."

Richard said hello, and helped Ye Yibai take off the left glove that he stretched out.

"Iodophor, disinfect my left hand again."

Half a bottle of povidone iodine was washed down without distress, and wiped with a sterile cloth.

Although the rubber gloves are thin, they still affect the doctor's sense of touch to some extent. Ye Yibai felt it again carefully with his hands without gloves, and finally identified Mr. Wilson's eighth intercostal space.

The scalpel cut a line of blood smoothly, down, and down.

Cut off the inferior pulmonary ligament, locate the esophagus, and incise the mediastinal pleura behind the lower end of the esophagus.

"Richard!"

"Received." Richard took out his hook with an attitude of "the wind is rustling, the water is cold, and the strong man will never return once he is gone", and fixed it.

Free the esophagus to the cardia, "gauze belt!"

"Okay." Qiao Na quickly handed over the gauze, and Ye Yibai gently wrapped it around the esophagus.

"Change knives."

Qiao Na immediately took the knife from Ye Yibai's hand and replaced it with a smaller scalpel.

Mr. Wilson's fat is really thick, which makes the gastroesophageal junction very thick. Dr. Ye unceremoniously cut off the excess fat after dissecting the hernia sac and the edge of the diaphragmatic hiatus. This weight is probably worth selling in the market A lot of money.

"There are vagus nerves here. Be careful when you peel them out, or you may damage them when you suture them."

At this stage of the operation, Ye Yibai has gradually adapted to Mr. Wilson's thick fat layer, and he has time to explain the key points of the operation to his little stars.

"Tissue forceps!"

"Yes." Qiao Na is always the best helper in the operating room, as soon as Ye Yibai moves, she will know what the doctor will do next.

"Zack." Ye Yibai raised his head and called the orthopedic doctor over.

"Tighten the diaphragmatic tendon."

"Okay." Sark nodded vigorously.

The tendon of the diaphragm was tensed, and the edge of the esophageal hiatus and the left and right wings of the right diaphragmatic horn were exposed behind the esophageal cardia. When the esophageal hiatus was exposed, there was a burst of exclamation in the operating room.

It's like opening a hole between the upstairs and the downstairs of your house that allows people to fall directly, but you haven't noticed it. When outsiders find out, their reaction is similar to that of everyone in the operating room.

"No wonder the stomach can come up..." The only physician at the scene said what all the surgeons wanted to say.

Such a big hole is so bright and open, I am a stomach, and I also want to climb up to see a different scenery.

Ye Yibai sewed six stitches on the pterosaur column with interrupted sutures without ligation.

"There will be two more stitches inside later, and the hole will be stitched up and ligated at the end." Ye Yibai handed the needle holder to Qiao Na and explained.

"Okay, now I have to send the stomach back to its own home." The operation was getting smoother, and Dr. Ye also joked with interest.

In an operating room, the chief surgeon often determines the atmosphere of the operating room. Some chief surgeons like to be serious and tense, but the little doctors can only tremble and breathe.

Some doctors like to chat and talk, so gossip is everywhere in the operating room. When it comes to the dean’s wife, he likes to check the dean’s mobile phone. When he goes to the hospital, the cleaning aunt buys a few more suites. After one operation, the young doctors immediately mastered it. The latest developments in the whole hospital.

Ye Yibai is somewhere in the middle of the two. His operating room is relatively serious, but Dr. Ye likes to entertain and educate. The vivid operation explanations are good for these little boys to remember them deeply.

"Oh, yes, dear Stomach, you have also seen the scenery on the high place, and for the sake of our Mr. Wilson's health, please go back to your own home now." Brande, who was the most leisurely in the audience, took a look After Mr. Wilson's heart rate and blood pressure, he happily followed Ye Yibai's words.

As for Richard and Sack and... Allen.

Richard: My hand, my hand, oh, my hand is not mine anymore, I can't talk, I get angry when I talk.

Sack: My strength should be just right. All I touch are bones every day. The diaphragmatic tendon is soft and slippery. It seems that I can break it with a little force. I have to be careful, be careful, Be careful again.

Allen: The stomach in the chest... sighing

Ye Yibai carefully pulled the stomach to the front of the lower end of the esophagus.

"Needle holder."

"In order to prevent the stomach from wandering around in the future, we need to suture here. Between the front wall of the stomach and the esophagus, folded mattress sutures are used to suture through the seromuscular layer but not to the mucous membrane." Go through both ends.

"Usually leave two centimeters on this side, then fold back and make a diagonal seam." Ye Yibai pointed to the junction between the stomach and the esophagus.

"It's the same at 12 o'clock, 9 o'clock, and 3 o'clock." Ye Yibai noticed Richard's pale face and stopped moving, "Brand, you come to replace Richard."

Brande quickly stood up from the chair and pulled himself together. Although it is important to pay attention to the patient's blood pressure and heart rate to protect the patient's life, he is a surgeon, not an anesthesiologist. He is boring.

In the case of boredom, the retractor also looks extraordinarily beautiful, isn't it just a thicker layer of fat, "Richard, I'll change it with you."

Richard took a deep breath, reluctantly exchanged places with Brande, the best observation point for the surgery... gone.

"Then let's continue."

After suturing at 12 o'clock, 9 o'clock, and 3 o'clock, Dr. Ye ligated them respectively, and at the same time carefully wrapped the bottom of the stomach up to about two-thirds of the circumference of the esophagus, and then performed the second layer of suture.

"The location is two centimeters from each part of the first layer of suture, which is about the distance of a thumbnail." Ye Yibai explained.

Everyone in the surgery department listened and nodded again and again. Only Alan from the internal medicine department wrote like a god, and Richard, who was staring at the data, secretly... sneaked a look at it, and then his eyes widened.

Gan!Actually steal the teacher!And draw so well!

Gently return the cardia to the abdominal cavity.

Everyone in the operating room heard a "boo", and Mr. Stomach, under the action of external force, gently walked through the hole and returned to his home.

There was a burst of applause in the operating room.

Ye Yibai looked up, Richard looked up, Brande looked up, Sac looked up, and all the nurses turned their heads.

Alan:  …

Allen's applause became lighter and lighter, and then he put down his hand embarrassingly.

"Thank you." Ye Yibai said suddenly.

Allen was shocked, he raised his head abruptly, and looked at Ye Yibai, his eyes seemed to be shining, "Doctor Ye, you are awesome."

Ye Yibai smiled gently at him.

Whoa whoa whoa...Richard's alarm radar sounded, and his arm immediately stopped being sore, "Ye Ben is great, we know it even if you don't tell me, you don't need an internal medicine doctor to boast!"

Allen glanced at Richard, disdaining to talk to him, but kept looking at Ye Yibai with shining eyes, and kept releasing rainbow farts.

"Doctor Ye, I have never seen such a neat operation."

"That's because you don't have a chance to see surgery as an internal medicine doctor."

"You mean that Dr. Ye's operation is not smooth?"

"Me! I didn't say that!"

There were only two idle people in the operating room who were talking to each other, making the operating room full of "fireworks", and even the smell of disinfectant seemed to be a little lighter.

Ye Yibai gently ligated the second layer of sutures, "The esophagus is very fragile, and the second layer of sutures is very close to the esophagus, so we must be very careful not to damage the esophagus."

Ignoring those two childish ghosts, Dr. Ye continued to explain.

Orthopedic Sac nodded vigorously: It really is very fragile!

After the second layer of suture was sutured, Ye Yibai ligated the suture of the hole, "leave a hole that can pass through a little finger, and it cannot be sutured completely. If the suture is too tight, the patient will have difficulty swallowing."

"Drainage tube." Ye Yibai said.

Jonah handed it over quickly.

After placing the closed drainage tube, Ye Yibai shook his hands lightly, "Richard, the chest wall is sutured next, do you want to try it?"

The soreness in his arm came and went quickly. Richard had almost rested a long time ago. When he heard that he could sew, he jumped up immediately, then glanced at Alan with disdain, and walked briskly towards Ye Walk in the direction of Yibai.

Only halfway through, he paused.

"That kid can't do it, let me do the stitches." A slightly majestic voice came from the door of the operating room, and everyone looked around, only to see Professor Bonn, Dr. Robert, and Dr. Anthony standing by the door of the operating room in full armor.

The two giants of surgery and the head of gastroenterology are all here?

So here comes the question, when did they come in, how long did they watch and listen to?