Start From Emergency Doctor

Chapter 215

“Intraoperative bleeding!”

He Jing raised his hand, blood stains on his gloves.

This scene is so familiar, it looks exactly like the pregnant woman who was bleeding that night.

It’s just that the last time the pregnant woman had a severe bleeding from the Yin Dao, this time the uterus was opened, and the bleeding was directly in the uterus.

Zhou Yuan immediately walked up to check the situation.

“Immediately prepare absorbent absorbent gelatin sponge gauze strips, prepare gauze after soaking with thrombin!”

The master-level thrombin hemostasis method immediately judges the best hemostasis method.

Generally speaking, the usage and dosage of thrombin is difficult to be unified, and can only be roughly divided into massive bleeding and ordinary bleeding.

Ordinary bleeding is to dissolve thrombin into a solution spray of 50~2000U/ml, spray it directly on the bleeding site, and quickly exert the coagulation mechanism to complete hemostasis.

At present, He Lili suffers from heavy bleeding, so Zhou Yuan gave up spray hemostasis and directly chose to use gauze or sea surface to treat the wound.

“Prepare the external drainage tube and start the infusion immediately!”

The venous channel opened earlier is working.

Zhou Yuan took the gelatin sponge from the equipment nurse and started to stop the bleeding.

Under the action of thrombin, the soluble fibrin in the plasma undergoes a chemical change and turns into insoluble fibrin, which directly blocks the bleeding port and completes quick hemostasis.

Moreover, thrombin is also promoting the mitosis of epithelial cells at the wound, and wound healing becomes faster.

“Give thrombin every twenty minutes.” Zhou Yuan said to He Jing.

He Jing nodded blankly.

Obviously I’ve encountered such a thing, why can’t I solve it by myself…

Is it just because there is a tumor next to it? Just because of a tumor, the brain suddenly went blank when he saw a massive hemorrhage!

He Jing lowered his head and blamed herself.

Zhou Yuan saw that He Jing was a little depressed, and said, “Hurry up and strip the placenta. Your uterine tamponade and compressions are done well, otherwise the fetus won’t be taken out so easily.

He Jing was taken aback, but he didn’t expect Zhou Yuan to praise herself.

“it is good!”

He Jing became energetic again, and soon completed the removal of the placenta.

Wei Lili and He Jing retreated to the side, and Dean Fang and Lu Shao got together.

Now… the highlight begins!

“After the cesarean section is completed, the uterine myomectomy will begin!” Zhou Yuan said.

“Scalpel.”

The first step is to eliminate the tumor in the intermural muscle.

Because the tumor is too large, it is attached to various parts of the uterine cavity. The adhesion sites between the tumor and the uterus must be separated sequentially before the tumor can be removed.

He Jianyi is a good assistant. With his help, Zhou Yuan’s surgical field is particularly good, he can directly observe several important blood vessels of the tumor, and it is very convenient to choose the incision.

“That’s it.” Zhou Yuan’s eyes lit up.

The scalpel dropped and cut just at the place with the least blood vessels on the tumor surface.

This will have the least impact on He Lili and the least risk of surgery.

Following the direction of the tumor’s blood vessels, Zhou Yuan made an arc-shaped incision, extending the incision to the tumor envelope, and then bluntly separated along the surface of the envelope.

The reason why sharp separation is not chosen is because of the fear of damaging blood vessels.(Read more @ wuxiax.com)

Vascular bleeding during surgery is always not a good thing, not to mention that this is still a tumor with tumor cells.

Tumors in the intermural muscles have more blood vessels at the base, so Zhou Yuan cannot be incised directly.

“Vascular clamp.”

After blocking the blood flow, Zhou Yuan carefully cut along the contact surface between the tumor and the intermural muscle.

Onlookers were instrument nurses, oncologists, obstetrics and gynecology oncologists, President Fang, Lu Shao, and two female doctors in the obstetrics and gynecology department.

Looking at Zhou Yuan’s separation operation, several people held their breaths, their eyes widened, and they didn’t want to miss any details.

“Fuck, what a dick…”

“Awesome.”

“Amazing.”

“This is not a person.”

“It’s really a god and a man!”

Words of appreciation came from everyone’s heart.

Until Zhou Yuan’s scalpel came out from the other end and the tumor separated from the intermural muscle, everyone came back to their senses.

“This is over?”

“How is it like cutting a watermelon?”

“…”

“So fast.”

Zhou Yuan’s attention is focused on surgery.

“Needle holder.”

Zhou Yuan sutures the excised stump.

Without stitching, blood will spray out from here after the blood circulation is restored, just like a fountain, internal bleeding will occur at that time.

“Absorbable thread.”

After finishing the suture, Zhou Yuan began to suture the muscle layer.

Continuous suture method, suture two layers, this can ensure that the uterine intermural muscle can withstand the pressure of uterine contraction, otherwise it is easy to break.

The seromuscular layer is sutured intermittently with No. 0 absorbable thread…….. Dead space is prone to appear here, so Zhou Yuan’s speed is relatively slow.

“All right.”

Slowly Zhou Yuan completed the stitching.

“It’s only eight minutes?!” The director of the oncology department was not calm.

Lu Shao was silent, looking at Zhou Yuan, who was at the position of the chief sword.

He felt that he saw the god man descend to the earth, this god man was here to save the medical world…

Without strabismus, Zhou Yuan continued: “To perform subserosal tumor resection.”

Because of the morphological characteristics of the subserosal layer, the tumor attached here is often pedicled. Once the pedicle is damaged, it will also cause He Lili to become infected.

“Vascular clamp.”

Zhou Yuan clamped the tumor pedicle close to the uterine wall.

“Scalpel.”

The hand lifted the knife down, and a fusiform incision appeared at the base of the subserous membrane of the uterus.

Because this part is not suitable for the scalpel, Zhou Yuan changed the tissue forceps, opened the tissues on both sides, and then cut and separated the tumor.

“finished.”

The tumor has one less attachment point to the uterus.

“Removal of the submucosal tumor.”

He Jian came to his senses once, and looked at the tumor that had been cut with two attachment points, a little blinded.

too fast.

Zhou Yuan is the fastest man He Jianyi has ever met.

“Tissue forceps.” Zhou Yuan said.

The tumor is too big, and the tumor has obviously protruded into the uterine cavity, so you need to enter the uterine cavity to clear the tumor.

In this step, the previous uterine incision needs to be made larger.

Without a good surgical vision, it is impossible to finely separate the tumor and the uterine mucosa.

Zhou Yuan suddenly thought that since the perfect compression hemostasis method can let the fingers feel the movement of blood vessels, and then hemostatic.

So, can the perfect-level hysteromyomectomy be able to let the fingers find the fibroids and remove them by themselves without the need for a surgical field? !

Zhou Yuan silently incised the muscle layer, completed the excision of the tumor, and then sutured it.

This step needs to be careful, and the mucosal layer should be avoided to prevent the endometrium from implanting in the muscle layer, artificially causing endometriosis.

When Zhou Yuanzi carefully sutured the muscle layer, He Jing suddenly walked over and stood at the end of the patient’s operating table.

Dean Fang turned his head and took a look, just in time to see He Jing squatting down and reaching directly into He Lili’s sound channel…

“What are you doing!!” Dean Fang was stunned. .