Doctor: It's Reasonable to Perform Surgery on Yourself.

Chapter 821 Deadly Insect Eggs

Director Lin had a calm face.

Look at how you are making a fuss... We are used to it in neurosurgery.

"Hurry up and operate, don't be dazed." He shouted.

Deputy Director Chen quickly adjusted his state and put his attention back to the operation area.

At Xu Qiu's signal, he used a narrow retractor to bluntly separate subcutaneous fat, tissue, etc. After seeing the linea alba, he clamped both sides of the linea alba with Kocher forceps and lifted it up, while Xu Qiu made a vertical incision.

"Scalpel, No. 15 blade." Xu Qiu spoke and stretched out his hand.

The instrument nurse quickly handed it over.

The sharp blade fell between the two Kocher forceps and cut the peritoneum.

This step is a test of technique. The incision should not be too large, otherwise it is easy to leak gas and increase intraoperative damage; but it should not be too small, otherwise it will not be able to be performed.

And Xu Qiu accurately controlled the incision to about 1cm.

Bo.

There seemed to be a crisp sound, and then the dark and empty abdominal cavity was exposed to everyone's sight. A faint smell of blood spread from the inside, mixed with the smell of hot organs.

This is the smell that causes the most vomiting during the autopsy of corpses, but there is less rotten and smelly smell. However, the people present are all veterans in the operating field and have long been immune to it.

If hygiene is not considered, it is not a problem to suck bone marrow while dissecting.

After entering the abdominal cavity, Xu Qiu inserted his little finger into the incision.

This operation can not only confirm whether the opening can be inserted into the sheath, but also touch the local abdominal cavity.

Under normal circumstances, the peritoneum in this area should be free, but some patients will have omental adhesions, which requires manual pushing.

"Rare good news, no adhesions occurred." Deputy Director Chen couldn't help laughing.

Xu Qiu nodded in approval. He sewed a traction line on both sides of the incision to pull the peritoneum and the linea alba, which is also a small structure to fix the Hassion sheath during the operation.

After all this, the next step is to insert the Hassion tube.

After the sheath enters the abdominal cavity, Xu Qiu uses a No. 0 polyglycolic acid suture to purse-string suture around the defect of the subumbilical fascia at the location of the umbilical cannula, and finally uses a Rommel sheath to finish.

Next, pull out the inner core, connect the gas injection tube, turn on the switch, set the gas flow rate and maximum pressure...

As the peritoneum slowly bulges, the pressure is also displayed: 12mmHg.

Xu Qiu inserts the laparoscope through the subumbilical cannula and begins to explore the abdomen.

This step is mainly to check the liver, small intestine and peritoneal surface.

The next cannula is located in the right lower abdomen, about two centimeters inside the anterior superior iliac spine, and the selected cannula caliber is 12mm.

There is also a 5mm cannula in the left lower abdomen.

Each cannula just avoids the abdominal blood vessels, and the selected puncture points, the path into the abdomen, etc., are all well-thought-out, and almost minimal damage is achieved.

Finally, Xu Qiu casts his eyes on the picture displayed by the laparoscope.

On the screen, small white spots grew on the patient's liver, just like acne popping up on the face, some of which were even wriggling, which was disgusting.

"They are all parasites..."

"Too disgusting, I have also encountered patients with liver flukes before, but none of them were this creepy!"

"The eggs are so dense that I can't even imagine what it looks like inside..."

Everyone felt a little scared.

The surface of the liver has become like this, and the various cavities inside are probably filled with adult roundworms...

If you randomly choose a section to cut, you may cut more than a dozen nematodes into two sections.

Thinking of the half-wriggling nematodes, everyone's scalp tingled.

"Does anyone still eat golden apple snails these days..."

"It seems that many countries in Southeast Asia eat golden apple snails as ordinary field snails."

"I can't eat it at all. Golden apple snails only taste like snails when they are half-cooked. If they are cooked for a little longer, they will feel like chewing rubber. Even strong seasonings can't save them!"

Hearing these conversations, the young instrument nurse showed a resistant expression and said, "Hey, I feel disgusted just looking at them. How can they eat them?"

Deputy Director Chen squinted and said, "What's that? Many African countries still make mosquitoes into meat patties and eat them."

"Mosquito meat patties are just disgusting. From a medical point of view, they are not very harmful to the human body. But golden apple snails are different. If they are infected with roundworms, they are fatal!"

"You make me greedy. Let's have some fried snails tonight?"

"..."

While chatting, the preliminary exploration was completed.

Swish, swish, swish--

The operating table began to adjust and was finally fixed at a position where the left side was about 15 degrees higher than the right side.

This bevel angle can use the effect of gravity to push the small intestine to the right side of the abdomen.

Afterwards, the operating table was fine-tuned again, and the patient was in a head-down-feet-high position.

The intestinal tube reached the upper abdomen.

Next, Xu Qiu inserted two non-destructive intestinal clamps through two cannulas on the right side of the abdomen.

He used them skillfully to reverse the greater omentum above the transverse colon and finally covered it above the stomach body.

For the resection of the sigmoid colon, it is necessary to find the inferior mesenteric vessels, cut them off, and then free the attached tissues on the outside of the sigmoid colon and descending colon.

Xu Qiu extended the non-destructive intestinal clamps to the level of the sacral promontory, which is roughly the midpoint between the intestinal wall and the sacral promontory, and accurately found the mesentery at the junction of the rectum and sigmoid colon, pulling it toward the left lower abdomen.

The inferior mesenteric vessels slowly left the retroperitoneum.

The inferior mesenteric vascular pedicle was exposed, and a clear depression appeared between it and the posterior peritoneum.

Xu Qiu manipulated the electric knife to open the peritoneum along the depression, extending the opening to the root of the inferior mesenteric artery above, and then to the sacral promontory below.

Then the vascular pedicle and the presacral autonomic nerve were bluntly separated.

After this step, the ureter was finally exposed under the surgical field.

"Be careful." Xu Qiu reminded.

Seeing the ureter means that it has reached the deep part of the parietal peritoneum and the inner side of the reproductive blood vessels. If you are not careful, it may cause serious damage.

Zizizizi--

The sound of the electric knife sounded, and Xu Qiu decisively opened an operating window, intending to separate the inferior mesenteric blood vessels from the outside.

In surgical abdominal surgery, for benign inflammatory diseases, low-level ligation is generally performed when the blood vessels are cut off, that is, after the left colic artery is issued.

And malignant surgery, such as tumors and various cachexias, are all performed from a high position.

Xiaojie's situation is quite special.

If it was just parasites, there would be no need for surgery, and the parasites in the intestines could be directly treated with drugs to deworm and eliminate the parasites.

But the number of roundworms in his body was too large, causing the sigmoid colon to be blocked and obstructed.

In this case, the patient's symptoms were very serious, and the roundworm infection itself was quite fatal.

However, Xu Qiu still gave it a "benign" rating.

Therefore, he decided to proceed with the treatment of benign inflammatory diseases - ligation from the bottom.

Chapter 821/1101
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Doctor: It's Reasonable to Perform Surgery on Yourself.Ch.821/1101 [74.57%]