Song Zimo returned to the operating room with the medical records, and various informed consents had been signed.

Xu Zhiliang washed his hands and came back, Yang Ping thought for a while and said: "Don't go on stage, let Tang Fei bring a female trainee to wash his hands and come to the stage, first put his body in a position, and then wash his hands and disinfect the order, Tang Fei!" You come to the stage, send the endoscope to the cecum first, and then inform me that we are going to study the patient's color ultrasound next door. ”

Tang Fei immediately called his regular training girls to get ready, and once the anesthesia was completed, they began to work.

Sending the endoscope from the anus to the cecum is the basic operation of the colonoscopy, and it is not very difficult, as a comprehensive surgeon, Tang Fei is completely fine.

Zhang Lin immediately understood: "Ready to start the operation, everyone goes out, today's surgery sterility requirements are very strict, it is strictly forbidden to visit in the operating room, I repeat, it is strictly forbidden to watch the video in the operating room, and those who are found to stay without permission are permanently forbidden to enter." ”

A group of doctors in the Department of General Surgery had already taken up their respective positions, waiting for the operation to begin, and now Zhang Lin suddenly said that he wanted to clear the scene, everyone, you look at me, I look at you, no one wants to leave.

Director Fang also wanted to stay, and said to Zhang Lin: "Xiao Zhang, let's keep a few less." ”

Originally, endoscopic transcecal appendectomy is a relatively new operation, Director Fang is not carrying out much now, I want to learn and learn, this operation is also accompanied by appendix necrosis perforation, abscess formation, intestinal adhesions, this situation is almost impossible to use endoscope through the cecum to operate, but Yang Ping insisted on using this operation, Director Fang wanted to observe the whole operation.

"No! In addition to the surgical team, all the staff are cleared! Zhang Lin's answer was cold, and there was no room for negotiation.

As soon as Director Fang heard Zhang Lin's tone, he didn't want to say anything, he knew Zhang Lin's temper, this kid was very good now, he would turn his face when he said it, if he didn't listen to his arrangement, he would scold people on the spot.

Rather than waiting for embarrassment and not being able to get off the stage, it is better to take the initiative yourself, Director Fang waved his hand: "Everyone go out, follow the arrangement, and abide by the aseptic system." ”

Reluctantly, the surgeons left the operating room and moved to the classroom.

"Thank you, brothers, for moving, the surgery is sterile, there is no way, I can't be in it." Xiao Wu calmed the emotions of the general surgeon.

In this way, only Liang Fatzi, Tang Fei, Zhou Can, Xiao Su, and the female trainees led by Tang Fei were left in the operating room.

Liang Fatzi wants to be anesthetized, and there is no substitute; Zhou Can is touring and can't leave; Xiao Su is an instrument nurse, how can she not be in the operating room; Tang Fei took the standard Pearson disinfection sheet, and also completed the first step of the operation, which was the participant of the operation.

Kicking everyone out of the operating room, Zhang Lin and Xiao Wu were like door gods, guarding the door of the operating room left and right.

Everyone moved to the demonstration room in the operating room, where there are many seats, which can accommodate many people, and there is a large high-definition screen, which is usually used for surgical observation and teaching.

"I'm sorry, please understand, the sterility of the operation is strict, so I can only observe it here." Song Zimo stood on the stage and apologized again.

Director Fang of the Department of General Surgery was very puzzled, acute appendicitis, three types of incision surgery, typical infectious surgery.

Sterility requirements are so strict? According to this situation, it is stricter than artificial joint replacement surgery, and artificial joint replacement will not be so rushed.

Blatantly bullying!

Surgical procedures can be divided into three categories according to whether the surgical incision is contaminated with bacteria or infected with bacteria:

A type of incision: that is, a clean wound, the most common is thyroid surgery, closed fracture surgery, etc., there is no wound at the surgical site, there is no local infection, and the surface of the body is disinfected by local skin, which can basically meet the requirements of sterility.

The second type of incision: that is, contaminated wound, generally refers to gastrointestinal surgery or biliary surgery in the abdominal cavity, such as: gallbladder, pancreas, small intestine, gastroduodenal surgery, etc.; There are also fresh wounds such as knife cuts, which are contaminated with bacteria, but the bacteria do not multiply rapidly and do not form infections for the time being.

Three types of incisions: infected wounds, generally abscesses or infectious diseases, most of which need to be incision and drainage, so that the purulent discharge can be emptied in time to control the infection, such as: purulent appendicitis, abscess incision, intestinal perforation, acute and chronic osteomyelitis surgery.

In acute appendicitis, the surgical site has been infected and suppurated, so it is an infection surgery.

These types of surgeries, the operating room will also be strictly distinguished, will not be mixed, and the operating room that does not do appendicitis will do closed fracture surgery, which is easy to form cross-infection.

In terms of the sterile management system of the operating room, there are also distinctions, such as appendicitis surgery, the more people who visit, the people in the operating room will not rush people more seriously.

However, if the artificial joint is replaced, the number of visitors exceeds the standard, and the people in the operating room will definitely rush to the people, and the number of people will be strictly limited.

Director Fang was unhappy, but he couldn't show it, as the director, he brought a group of doctors to observe, and he was driven out like a sheep, and he definitely couldn't get over his face, and the reason given by the other party was very far-fetched.

Could it be that Professor Yang still has to keep this operation secret? Don't let us learn.

If you don't let you learn, and you watch the video, the video is all operated under the scope, and the main part of the operation is done under the scope.

Recently, Director Fang is also studying ETA and ERAT, ETA is endoscopic transcecal appendectomy, and ERAT is an endoscopic retrograde appendiceal cavity treatment technique.

The appendix is a "little tail" on the colon, which is a tubular organ between the cecum and the colon of the human body, with a blind tube at the distal end and a communication with the cecum at the proximal end.

Since it is a very narrow cul-de-sac, it is easy to get stuck in traffic for a long time, such as fecal stones, food, foreign bodies or lymphocyte hyperplasia, which are easy to enter this cul-de-sac, and then block and cannot get out, leading to infection and appendicitis.

The incidence of appendicitis is actually quite high, as high as 10% in Western countries, and 4%-8.5% in China, accounting for 20%-30% of patients with acute abdomen.

In ancient times, if you had appendicitis, it was basically a fight for your life, and with good luck, the human body's immunity controlled the infection and survived; If the body's immunity is not strong and the infection cannot be controlled, there is no help.

Later, with the surgery to cut out the appendix, appendicitis is no longer terrible.

The traditional surgical method is to cut out the appendix, also known as appendectomy, which has a history of more than 100 years, and later with the development of laparoscopic minimally invasive technology, laparoscopic appendectomy was introduced.

This way, you don't have to leave a single scar on your abdomen, but you will still have a few small scars, after all, you have to make a hole in your abdomen.

Later, some new surgical methods developed, such as transgastric appendectomy and transvaginal appendectomy, whether it is transgastric or vaginal, it is necessary to make a small incision from the inside of the stomach or the inside of the vagina, as the entrance and exit of the instruments and lenses, through this small opening, the lens and instruments enter the abdominal cavity, and then directly reach the area where the appendix is located, and perform the operation.

These procedures have no scars on the outside, but they do have scars on the inside, which also damage the stomach and vagina.

With the development of surgical technology, a new type of surgery has developed, endoscopic transcecal appendectomy, which does not need to be punched inside and outside, directly from the anus into the lens and instruments, retrograde along the anal canal, through the rectum, into the colon, to the cecum, to find the opening of the appendix, make an incision from around the opening, and then remove the appendix.

This is the miraculous endoscopic transcecal appendectomy, which is suitable for super beauty lovers.

The endoscopic retrograde appendiceal cavity treatment technique is the so-called appendiceal preservation surgery, which is to cure appendicitis without removing the appendix.

In the past, everyone thought that the appendix was a useless organ, and if it was cut out, it would not affect anything.

Modern research believes that the appendix is useful, it is an immune organ, the specific function is similar to the mesenteric lymph node group and tonsils, it can kill some bacteria and microorganisms, and can also transmit its genetic information to lymphocytes, so that the body can develop immunity to this microorganism and improve the body's immune function.

In addition, it can also store a large number of probiotics, which can help prevent intestinal flora imbalance and reduce the incidence of intestinal inflammation; It can also improve digestive function and prevent indigestion.

So once there is a problem with the appendix, it is not a one-size-fits-all approach now, and it is also considered to be kept.

Of course, if the appendix has been necrotic and perforated, there is no way to protect it, if the appendix is not necrotic perforated, you can enter the instrument from the inner opening of the appendix, take out the material that caused the blockage, such as fecal stones, and then rinse the appendix cavity, insert the drainage, pull out the drainage a few days after the operation, and the appendicitis is cured.

Director Fang also likes to delve into business, and now he likes to study new technologies in general surgery, such as da Vinci robotic surgery, which he has carried out more in Sanbo, what ETA and ERAT, this kind of kitkat surgery, how can he not study it.

"Director Fang, let's analyze the color ultrasound, Dr. Song, and call up the color ultrasound image." Yang Ping sat down next to Director Fang, and then called up the color ultrasound image.

The internal systems of Sanbo Hospital are connected, and any image can be called up at any time from the operating room.

Analyzing color ultrasound?

Director Fang was very puzzled, what did he see in color ultrasound, and how could a surgeon look at color ultrasound, he usually read color ultrasound reports.

"In fact, today's surgery is more convenient to do with laparoscopy, but the patient is not even accepted by laparoscopic several small scars because of the scar constitution and high aesthetic requirements, so we are forced to use endoscopic transcecal surgery, which has limited operating space and can only be operated around the appendix, once a large abscess is formed, intestinal adhesions appear, which is very unsuitable for this operation." Yang Ping said to Director Fang.

The more Director Fang listened, the more he didn't understand, since it was not suitable, it was a relative contraindication, why did he still use this method?

What's more, the patient's condition is so serious, what tricks to do, direct surgery to save lives is the best choice, at most laparoscopic operation, which is already a show off.

"This patient, the abscess is so large, there are adhesions in the intestines, and it is very difficult to endoscopy through the cecum, Professor Yang, let's change to laparoscopy."

Director Fang had just heard the reminder from the color ultrasound doctor, and now he reminded again.

Everyone is a colleague, remind each other, avoid stepping on the pit, is an obligation, but also a character, Yang Ping is a high level, godlike, Director Fang knows, but this is an operation, the patient lying on the table is a patient, there is no joke, if you delay time, you will regret it.

I often walk by the river without getting my shoes wet, and if you have the psychology of showing off your skills, it is very dangerous.

"It doesn't matter much, although it is difficult, it is not impossible." Yang Ping was very calm.

——

Waiting area for dependents.

Liao Yiyi's parents are anxious, after all, their children are on the operating table, how can parents not worry.

"Lao Liao, you said Yi Yi should be fine."

"Don't worry, there is Xiaoliang, I didn't hear Yihan say, the Sanbo comprehensive surgery team is world-class, you look at this Xiaoliang, a phone call can be called to a medical helicopter."

The old couple was also very guilty, remorseful, worried, mixed together, at that time they felt sorry for their daughter, and asked everywhere if they could not have surgery, but as a result, they delayed a lot of time, delayed the condition, and now they are in shock, and they heard that their lives will be in danger at any time.

"Xiao Zhang, what did your father's friend say?" Liao Yiyi's mother asked Zhang Zikun.

Zhang Zikun had just called his father's friend, the director of general surgery at a top hospital in the imperial capital, and had heard about acute appendicitis, accompanied by necrotic perforation, the formation of a large number of surrounding abscesses, and intestinal adhesions.

The director was furious on the phone: ", people are in shock, their lives are in danger at any time, or go directly to the surgery, if the laparoscope is proficient, it is okay to use laparoscope, I haven't heard of this kind of surgery with endoscope through the cecum, I think I am a half-immortal, I don't know the depth——"

"People say that they are in shock, people's lives are at stake, saving lives is important, either surgery or punching, what goes in from the anus for surgery, it's pure nonsense, it will kill people." Zhang Zikun said angrily.

Causing a fatality?

"Oops! -——" Liao Yiyi's mother tilted her head, leaned back in the chair, and cried like mud all over her body.

Liao Yiyi's father was much calmer: "Be quiet, what are you crying about, what kind of expert is he, he hasn't even seen a person's face, can you believe a few words on the phone?" Isn't the trabeculae in it? What to worry about. ”

As soon as he heard the word Xiaoliang, Zhang Zikun became angry, and he said: "Can other experts talk nonsense? ”

"Okay, Xiao Zhang, sit down, wait and see, it's only been ten minutes." Liao Yiyi's father was very dissatisfied with Zhang Zikun.

However, he also began to beat the drum in his heart, and when he was attached to the second before, the doctor said that Yiyi had been in shock and needed to be operated on as soon as possible to save his life, and he also suggested that he should operate as soon as possible, and said that he would help cut the line and operate as soon as possible.

However, because there was an emergency helicopter, it might be faster to transfer to this side, so I quickly transferred to the hospital.

"Yihan, look at the time, what time is it?" Liao Yiyi's father also became nervous.

Human lives are at stake, but it's not a joke.

It doesn't matter if the operation is done now, as long as the operation can be done, my daughter will be fine.

"Uncle and aunt, don't worry, there are Dr. Liang and them."

Yu Yihan is not in a hurry, young girl, seeing Dr. Liang's aura, coupled with the roaring helicopter, Yu Yihan has completely believed in Dr. Liang.

It's a really hard time, a minute is like an hour, and it flies very slowly.

"Lao Liao, you said it has been so long, why haven't you come out yet, will there be any chaos?" Liao Yiyi's mother stared at the door of the operating room.

Liao Yiyi's father said: "Don't talk nonsense! ”

"Auntie, it's only been eighteen minutes in." Yu Yihan said.