Start From Emergency Doctor

Chapter 124

After the skin tissue is exposed, the lower abdominal external oblique muscle aponeurosis also appears in the surgical field.

Zhu Gaoyang was a little surprised: “You can still see that I am a jungler?”

Zhou Yuan did not reply.

“Tissue shears.”

Zhou Yuan took the tissue scissors and asked the ocean to lift the aponeurosis on both sides, and slowly sneak under the aponeurosis with scissors. Then, he cut the aponeurosis upward and the outer ring downward.

“This step easily damages the iliac-inguinal nerve of the nearby iliac hypogastric nerve.” Zhou Yuan reminded.

Zhu Gaoyang: “Be careful! The following are all my treasures!”

He shook his head to see what Zhou Yuan was doing, but there was a cloth on the shelf in front of him, blocking his vision.

At this time, his oxygen mask suddenly fell off.

Zhu Gaoyang paled with fright: “Doctor! Doctor! My oxygen mask is off!”

Zhou Yuan frowned and took a look: “It’s okay.”

“What’s okay! I want to take oxygen!”

The ocean said helplessly: “Then do you feel any different from just now?”

Zhu Gaoyang froze for a moment, calmed down, and sniffed: “No…”

Zhou Yuan calmly dissociated the inferior iliac-abdominal nerve and the iliac-inguinal nerve, and said: “It was originally just pretending to be, and if you add an oxygen mask to you, you will not be so nervous, but you dumped it.”

Zhu Gaoyang:? ? ?

The anesthesiologist came over, picked up the oxygen mask silently, and put it on Zhu Gaoyang again, “Is it comfortable now?”

Zhu Gaoyang:…

“I feel a little bored…”

“You all found that this oxygen mask is useless, isn’t it stuffy?” The anesthesiologist sighed.

Zhu Gaoyang sighed, then took another look. Zhou Yuan, Haiyang and others are all working hard.

“Why do I get this disease? It suddenly bulged up, and I was almost scared to death.” Zhu Gaoyang asked curiously.

“Life is not good.” Zhou Yuan said succinctly.

After saying this, he quieted down.

“Scalpel.”

“Vascular clamp.”

Zhou Yuan once again separated the cremaster, the levator testis muscle and the transverse abdominal fascia fibers, revealing the hernia sac.

This is an off-white thing, which is not easy to identify.

Zhou Yuan glanced at Zhu Gaoyang who was in a daze, and said, “Cough.”

“Okay, brew for a while…cough cough!”

With coughing, one part protrudes with the spermatic cord, the hernia sac.

“The next step is to cut the wall of the hernia sac.” Zhou Yuan said.

Ocean rubbed his hands next to him, “Junior Brother Zhou Yuan, can I have a cut?”

Zhou Yuan nodded.

This operation can be done by residents, and it is not a key link now, and it is no problem to let the ocean practice hands.

Ocean happily picked up the scalpel.(Read more @ wuxiax.com)

Zhou Yuan paused and said, “Don’t cut the wall of the hernia sac directly. You can’t control it well. First make a small cut in the wall of the hernia sac, and then use scissors to slowly expand the incision.”

This is a technique to avoid damaging the contents of the hernia.

Ocean nodded excitedly.

Zhou Yuan frowned, “Your hands are a little trembling…”

The ocean smiled: “It’s the first time… I’m a little excited.”

The equipment nurse took a look, “Like a lucky cat.”

Zhou Yuan shook his head: “The Lucky Cat only has one hand shaking. This is the auntie in the cafeteria.”

Zhu Gaoyang was stunned when he heard the conversation.

“An anesthesiologist, can you give me general anesthesia?”

The anesthesiologist nodded, took a needle with thick fingers and walked over: “Are you sure?”

“Forget it.” Zhu Gaoyang closed his eyes and looked at Zhou Yuan and others who were struggling under him in fear.

Except for the ocean swaying for a while when holding the knife at the beginning, after the actual operation, the ocean’s hand was still very stable.

Soon, the wall of the hernia sac was cut open by the ocean.

“Put your index finger into the abdominal cavity and feel the position of the inferior abdominal artery to avoid injury. Also, carefully check if there is a second hernia.” Zhou Yuan said.

Ocean happily reached in, touched it, closed his eyes intoxicated, and said after a while, “No.”

With that, he was ready to push the contents of the hernia back into the abdominal cavity.

Zhou Yuan stopped him: “Not yet, check whether the contents of the intestinal tube that fell from the hernia are necrotic.”

The ocean was taken aback.

Zhou Yuan explained: “Once intestinal necrosis occurs, if you push it back, it will cause abdominal inflammatory disease, which will become more serious at that time.”

“Okay, okay.”

Haihai carefully checked the color of the intestines and the pulsation of the blood vessels. They were all normal, and then pushed back.

“Come on, Junior Brother!” Ocean retreated.

He was too addicted to his hands, and he was not sure about the next procedure.

Zhou Yuan nodded.

Zhu Gaoyang also breathed a sigh of relief.

“Scalpel.”

Zhou Yuan cut off the hernia sac in the middle quickly, using “hemostats.”

After hemostasis was completed, Zhou Yuan left the distal hernia sac in the scrotum.

“Don’t you close the hernia sac?” Haiyang asked.

“No. It will cause fluid or blood accumulation in the hernia sac.”

Zhou Yuan continued his operations.

“Have you cut my vas deferens?” Zhu Gaoyang seemed a little expectant.

Zhou Yuan:…

“Lift the proximal hernia sac with hemostatic forceps.” Zhou Yuan said.

After the ocean was lifted up, Zhou Yuan stretched his left index finger in and slowly dragged the inner surface of the proximal hernia sac, while the right index finger was wrapped with gauze and turned, peeling the proximal hernia sac to the neck The location of the department.

“See the spermatic cord and vas deferens here?” Zhou Yuan motioned his eyes.

Ocean nodded: “Do you want to cut it?”

“…”

Zhou Yuan: “I want you to pay attention, don’t damage it. This thing will be over if it breaks.”

Zhu Gaoyang was dumbfounded: “You didn’t say that before going to the operating table!”

Zhou Yuan smiled and continued to operate.

“You can put it down, and then retract the arcuate lower edge of the internal oblique and transversus abdominis to the outside and upwards.”

The ocean does.

Zhou Yuan found a good location for the surgical field and prepared to suture the neck of the mountain sac.

After the suture was completed, Zhou Yuan cut off the excess wall of the hernia sac, then used a needle thread to pass through the transversus abdominis and internal oblique muscles from front to back, and ligated there to fix the neck of the hernia sac.

Next, as long as the hernia is repaired, the internal organs in the abdominal cavity, small intestine and large intestine will not flow down from this hole.

Zhou Yuan lifted the spermatic cord, passed a strip of gauze underneath it for traction, and then separated the levator testis muscle and the transverse abdominal fascia around the spermatic cord.

“The defect in the inner ring is large, and the transverse abdominal fascia in the inner ring must be sutured before repairing.” Zhou Yuan said.

Soon, this step of stitching was also completed.

The ocean swallowed its saliva: “It’s fast. It’s dazzling.”

Some yawning Zhu Gaoyang looked at Zhou Yuan and Haiyang helplessly.

“Doctor, I want to give you a suggestion.” Zhu Gaoyang said suddenly.

“what?”

“Don’t you think the operating room is too boring?” Zhu Gaoyang said.

Zhou Yuan looked up and said, “Then what do you want? Cut your sperm live?”.