This is a laparoscopic minimally invasive surgery, and the highlight is the single port!
Because Billie is young, only 15 years old, and still has a long life ahead of her, Zhou Qiao chose this technique.
Utilizing the natural scar of the umbilical hole, surgical instruments are inserted "single-handedly", and then cleverly sutured after surgery, the surgical scar can be perfectly "hidden", thereby reducing the patient's physical and psychological trauma.
In general gynecological laparoscopic surgery, the conventional method is to make 3 to 4 surgical incisions of about 0.5 to 1 cm in the patient's abdomen, insert a cannula in each, and all operations are performed through these channels.
However, single-port laparoscopic surgery reduces multiple incisions to one, and has many advantages that traditional laparoscopy does not have, such as patients experiencing less pain, being able to get out of bed one day after surgery, and preventing postoperative intestinal adhesions, etc. The incidence of complications is reduced; the single incision is in the umbilicus, and the postoperative appearance is good; it is less prone to infection and the postoperative recovery is faster.
Anesthesia method: tracheal intubation plus intravenous inhalation combined general anesthesia, opening large peripheral veins, and routine monitoring of NIBP, SPO2, HR, RR, etc.
The mask provides oxygen and nitrogen removal for several minutes, and rapid intravenous induction (0.3 mg of Changtonin, 2 mg of Liyuexi, 25 μg of sufentanil, 20 mg of etomidate emulsion, and 14 mg of cisbenzene)...
After success, the tracheal tube is inserted through the mouth under clear vision. After confirming that it is in the trachea (the inner diameter of the tube is 7mm and the depth of the incisors is 22cm), the tube and dental pad are properly fixed, and the anesthesia machine is connected to control breathing.
After anesthesia is completed, routine time out...
Anesthetist, circulating nurse, instrument nurse, surgical assistant, chief surgeon... one by one.
Although Murphy has always been taciturn, at this time, with Zhou Qiao's encouragement, he had to speak up, otherwise, the process would not go forward.
Murphy is just autistic, not stupid. At this time, she would not insist on saying anything.
Once everything is verified, the operation begins.
Maintenance was with inhaled sevoflurane and intravenous pump propofol and remifentanil. The operation was uneventful, with small-dose pump injection of Deximetin and monitoring of muscle relaxation.
…
It has to be said that Murphy is indeed a medical genius. Although it was his first time to perform the actual operation, his technique was extremely skillful. He controlled the instrument with dexterous hands. He first made a 1.5cm incision in the middle of the patient's umbilicus and then inserted it. A single-port laparoscopic puncture device is inserted into the laparoscope.
At this time, it can be clearly observed on the electronic display that the patient has a large left mesosalpinx cyst and a right ovarian cyst with a smooth surface, and the left appendage has been twisted for 3 weeks.
Due to the intuitive imaging, Murphy does not have to waste brainpower to simulate holographic three-dimensional images. However, on the electronic display screen, one after another annotation boxes appear according to her thoughts. This is the virtual construction that she is good at. The annotated image is combined with the image on the electronic display!
A condensation of pure imagination, visible only to her and invisible to everyone else.
Murphy first performed a left mesosalpinx cyst dissection, electrocoagulating the mesangium on the surface of the cyst, opening the mesangium on the surface of the cyst, and using bipolar electrocoagulation of the blood vessels between the mesentery and the cyst to gradually separate...
Complete removal of cyst…
Place it in the specimen bag and take it out...
Use 3-0 Vicryl (Vicryl) interrupted sutures to restore the mesangial structure...
During this process, Zhou Qiao naturally had some pointers, such as paying attention to hemostasis during the operation, not removing the cyst too quickly, gradually separating the cyst and mesangial space, and electrocoagulating the blood vessels between them to reduce bleeding and the mesangial surface after removal of the cyst. Bleeding.
When suturing the mesosalpinx, Murphy is advised to use interrupted sutures, which will help restore the normal structure of the mesosalpinx and effectively stop bleeding. Pay attention to the shape of the fallopian tube during the suturing process.
These key points, as Zhou Qiao explained, all appeared in Murphy's "note box" one by one.
After being condensed by her imagination, it is equivalent to being imprinted in her mind and difficult to forget easily.
Delicate, sophisticated, and effortless, the drum does not need a heavy hammer. Sometimes Murphy hesitates a little, but Zhou Qiao just gives a little hint, and Murphy immediately understands.
I have to say that teaching such talented students is really very worry-free.
If you teach stupid students, you will probably get angry and curse them!
Subsequently, the right ovarian cyst was removed...
Ovarian formation…
The entire operation lasted about forty-five minutes, and the pelvic mass in Billie's body was successfully removed.
After the operation, the medication was stopped, and Billie was pushed to the recovery room and gradually regained consciousness.
After waking up, the anesthesiologist Caroline asked some questions. Billie was conscious, answered the questions to the point, and clenched her fists forcefully.
Aspirate the tracheal tube and oral secretions. After resistance, remove the tracheal tube and observe for 10 minutes without oxygen inhalation. SPO2 is maintained above 95%.
Connect to PCIA, use an oxygen bag to maintain oxygen supply, and send the patient out of the resuscitation room.
Ariel was naturally extremely happy when she heard the news that the operation was successful. She put away the bullet and immediately helped push him back to the Iris Clinic ward. There was no need for an oxygen bag. The Iris Clinic ward had a dedicated oxygen pipeline.
Continue to monitor vital signs.
The sample tissue taken out is sent to the testing center for pathology.
When the report came out and showed that the lesion was benign, Zhou Qiao, Murphy, Ariel and Billie all breathed a sigh of relief!
Billie was lying on the bed at Iris Clinic and said to Ariel: "Sister, the operation actually didn't hurt at all. It's so magical. I felt like I had a dream, a very strange and strange dream."
Zhou Qiao brought Murphy in for ward rounds. Ariel expressed her gratitude, and then hugged Murphy heavily. Murphy did not resist, but did not respond.
"Murphy, thank you so much! You will definitely become a great doctor in the future!" Ariel sincerely admired him.
I thought that Murphy was only 4 years older than my cousin, but his medical skills were already so superb, and he was worthy of being a disciple trained by Dr. Zhou!
I don’t know where Dr. Zhou abducted such a medical genius. His eyes are really like an eagle and like a torch in the dark!
After Zhou Qiao checked Billie's physical condition, he smiled slightly and said, "Billie will need to stay here for about five days. Ariel, if you have anything to do, you can go and get busy. Don't worry, we will take good care of her."
"Only five days?" Ariel was shocked, and Billie was also very happy. They thought they would stay in the hospital for a long time.
"Dr. Zhou, how much is the approximate cost of this operation? I paid it in advance!" Originally, the bill had to wait until discharge, but Ariel thought it was better to pay it first. After all, the clinic had helped her a lot.
If you give it early, the clinic's funds can be turned around. It's not good to let people advance money.
Zhou Qiao asked Ava to bring the bill, turned it over carefully, and said, "Just give me 15,000 dollars."
Ariel said: "Let's round up the number and give it 20,000."
After saying that, he happily took out 20,000 in cash and said that Zhou Qiao must accept it!
She knew the market. Billie had this disease and had no medical insurance. If she went to other clinics or large hospitals, it would cost less than fifty thousand dollars. If she met some shady people, it might cost one hundred thousand, eighty thousand, or even more.
