The holiday was short-lived and Iris Clinic was back to business as usual again.
Many customers who came to visit expressed their appreciation for the new look of Iris Clinic!
After asking Zhou Qiao, Rachel transferred a patient to Murphy, a 25-year-old nursing mother who was diagnosed with acute appendicitis.
If it is chronic, simple or mild suppuration, not too serious, and does not recur, she, as a physician, can prescribe some medicine and just give it a squeeze. But now it is acute, causing fever and nausea. Vomiting and severe pain in the lower abdomen, surgery is the fastest and most stable solution!
Rachel's admiration for Zhou Qiao is natural. She has never seen the 23-year-old visiting professor at the University of California in her life.
As for Murphy, after the last congenital diaphragmatic hernia surgery, Rachel also sincerely appreciates it!
She often feels lucky that she is a physician with relatively senior qualifications. She has been a surgeon for many years. If she were a surgeon and competed with Murphy on the same stage, she would probably be very stressed. She would worry about being overtaken by her while sleeping!
Murphy had short hair, natural chestnut hair that didn’t require highlights, like satin, and with a fair face and delicate facial features, Elena nicknamed her “Iceberg Little Hepburn.”
"Iceberg" means that she has a cold temperament, and her lonely look of being outside the world always drives others away.
Needless to say, "Little Hepburn" is so beautiful that even Elena likes it and can't help but want to reach out and pinch it!
Even when Murphy wasn't paying attention, Elena secretly kissed her, which made the expressionless Murphy rarely show a bit of embarrassment!
Murphy rarely had this kind of intimacy with people.
Every time Elena teases Murphy, Zhou Qiao gets excited!
The patient was given an analgesic injection, and then an order was made for the patient to undergo a preoperative examination. At the same time, the patient was told to strictly eat and drink.
The mother was accompanied by her husband, but the child was not brought with her and was sent to her grandmother to take care of her.
Because I needed to undergo surgery and take a lot of medicines, I stopped breast-feeding and asked my grandma to feed me milk powder.
Zhou Qiao also often pays attention to the price of infant milk powder in the United States. It is indeed cheap. A can of more than ten dollars can cost hundreds in China, and what you buy in China may not be genuine.
It's not that he wants to eat it himself, but it's been a long time now. Everyone knows that he is in the United States, and they always use various methods, including sending him messages directly, conveying them through his old father, and communicating with children in the same village. , ask him to mail milk powder!
Zhou Qiao was helpless because these things took up a lot of his time, so he declined the ones he was not familiar with directly. But for the ones he really couldn't push, he had to work hard on his own. It didn't matter what price he bought, plus shipping costs. How much money does the other party make?
The profits of his current clinic are very generous, so he doesn't like the middleman's price difference on milk powder. Moreover, they are relatives, so the old father’s face will not look good if he has too many people.
After Murphy formulated the surgical plan, he came to Zhou Qiao and asked him to help take a look.
"Single-port transumbilical laparoscopic surgery... scar constitution..." Zhou Qiao read through it carefully and nodded.
Just looking at the surgical plan, I can’t find any major faults.
As for the single-hole surgery, it was because the patient actively requested it. She has a scarred constitution. As soon as she heard that she was going to have surgery, she immediately lost her guard and begged Murphy if the incision could be smaller because she still had the scar from her last caesarean section. Extremely big and ugly!
She didn't want to get a few more hideous scars! A multi-hole laparoscope requires 3-5 holes, which she couldn't accept at all!
Murphy told her that she only needed to make a small hole of about 1.5 cm in her belly button, because there were already wrinkles there, and if she used cosmetic sutures afterwards, it would basically be impossible to tell that a knife had been used!
Since Murphy had never performed an appendectomy before, Zhou Qiao took her and practiced it several times with the clay figurine while he had time. He did not give up until Murphy reached the expert level.
When it was time for the operation, the group came to the community hospital.
Single-port laparoscopy is also a third-level surgery and requires general anesthesia. The operating room conditions of Iris Clinic are not enough, so it is still carried out by community hospitals.
Compared with the University of California Medical Center, operating room rental costs in community hospitals are much cheaper. For minor illnesses such as appendicitis, community hospitals are naturally the first choice.
The anesthetist made an appointment for Andre, with the patient in a supine position and combined intravenous and inhalational anesthesia.
After time out, the surgery officially begins.
The first song Ai Wa chose this time was "Rolling Waters of the Yangtze River East". It must be said that Ai Wa can surprise Zhou Qiao every time.
Andre gave a thumbs up, this song is great! Even though he doesn’t understand! But he likes the majestic and tragic style of music!
Murphy turned a deaf ear and turned his blue eyes. The virtual 3D modeling started instantly, the holographic three-dimensional image was displayed, and he moved under the knife!
The surgical instruments are laparoscopes, multifunctional laparoscopic puncture sheaths produced by the American company Stryker, and Cambridge single-hole laparoscopic instrument kits (including a series of disposable rotatable wrist instruments, which are inserted into the puncture sheath and into the body cavity in an extended state After that, it can be rotated and bent to different angles or arcs as needed, and then locked. There are 7 degrees of freedom of operation that can be switched at will).
An arc-shaped incision of about 1.5 cm is made on the right side of the umbilicus, a multifunctional puncture sheath is inserted, and a pneumoperitoneum tube is passed through the puncture sheath to establish pneumoperitoneum.
Pneumoperitoneum, simply understood, means inflating the stomach, usually with carbon dioxide, to make room inside.
Carbon dioxide is an inert gas. If oxygen is used, there may be sparks and explosion during surgery~
In addition, if carbon dioxide is used, the human body can absorb it, it can be easily excreted through the lungs, and hypercapnia is less likely to occur.
If oxygen or nitrogen is used, it is difficult to absorb and discharge. If the pressure is too high, the gas will enter the severed blood vessels and there is a risk of gas embolism!
Zhou Qiao can operate a five-port laparoscope with one hand with the help of a mirror support. Although Murphy is not as advanced as Zhou Qiao, it is no problem for one person to operate this single-port laparoscope with both hands.
Zhou Qiao is not so much an assistant as he is here to provide guidance and prevent unexpected situations from happening.
Murphy adjusted the pneumoperitoneum pressure to about 12mmHg with his hands, maintained it, inserted the laparoscopic lens through the 10mm hole (this is not an incision, but a hole on the multifunctional puncture sheath), explored the circumference, and changed the head down, right Side elevation position.
The appendix is a very special part. Some people have it big, some people have it small, some people have weird shapes, and some people have double appendix.
Murphy followed the colon, found the confluence of the three colonic bands of the cecum, and then gently lifted the cecum!
"Eh~" Murphy couldn't help but chuckle.
Because, according to what she has learned and Zhou Qiao's teachings, it is usually at this time that the appendix will appear!
Now, everything is ready, and with the ultrasonic knife in hand, we have reached the lair of the "Appendix Monster", but the "Appendix Monster" is not in the "lair"!
Murphy probed and searched again, but after searching several times, there was no appendix.
She couldn't help but wonder, had she been misdiagnosed? After all, this patient was referred to her by Rachel.
However, she read the patient's examination report and confirmed that it was acute appendicitis.
"Could it be that the other party has a medical history and the appendix has been removed? But if it was removed, how could it be diagnosed as appendicitis?"
"Or, could it be congenital absence of the appendix?"
Even a genius like Murphy can't help but be confused.
Zhou Qiao patted his thigh slightly. This was his negligence, because this situation was rare, and he did not expect that the patient would be in this situation, so he forgot to tell Murphy.
"Feifei, the appendix is wrapped inside." Zhou Qiao reminded softly.
Murphy was stunned: "What the hell is Feifei? Is it my new nickname?"
Somehow, she felt a little sweet in her heart and nodded. She controlled the ultrasonic scalpel and made a light stroke on the serous membrane!
Suddenly, an inflamed and swollen appendix hidden inside popped out weakly and helplessly!
Not only Murphy breathed a sigh of relief, but Elena and Ava also breathed a sigh of relief.
The three little ones looked over with admiring eyes.
System: "Murphy's favorability +1, Murphy's current favorability is 89!"
Ava curled her lips and said to herself that although Murphy is powerful, he still needs Joe's guidance from time to time! Huh, without Qiao, she is nothing.
She has been very dissatisfied with Murphy recently because Murphy cut his hair short and became more and more beautiful after being dressed up by his sister. The number of times Zhou Qiao peeked at Murphy increased significantly. But what made Ava depressed was that her sister But he didn't realize at all that he was so familiar with Murphy all day long.
In fact, even if she leaves Zhou Qiao, if Murphy is given a good platform and given a few years to grow, her achievements will definitely be amazing! It's just that she doesn't have a better platform now. It’s impossible to have a better platform than Zhou Qiao’s!
There are so many surgeries, and he can also perform the surgery, and he has master-level or ceiling-level technical guidance!
Once you find the "appendix monster", the next step will be much easier!
The biggest advantage of this "appendix monster" is hiding. If Xingzang is discovered, he will be nothing!
Murphy's expert level is more than enough to deal with it!
The appendix is carefully peeled off, its adhesion to the surrounding tissue is completely separated, the avascular zone of the appendiceal root is penetrated, the appendix root is clamped with a ligating nail, the appendiceal artery is isolated, and the appendix is ligated with a ligating nail.
After that, the knife is raised and lowered, the appendix is cut and taken out, the hole is sutured, and the operation is completed.
Murphy thinks this ultrasonic scalpel is quite easy to use!
In fact, in the previous traditional laparoscopic surgery, high-frequency electrosurgical scalpels were used for separation, cutting, hemostasis, etc., but ultrasonic scalpels obviously have more advantages, so they are now more and more widely used, and the surgical efficiency has also been greatly improved.
The entire operation process, although there was a delay in the middle, did not last more than twenty minutes. It's fast.
Generally, novices do this for the first time after observing it many times. Because they are not proficient, it will take at least forty minutes. Some people with clumsy hands may even need more than sixty minutes. Murphy has never observed it on the spot before. For the first time, he can control it. Within twenty minutes, it can be considered a gift.
Thanks to "Guizi Yizhu" for sending Luo Ya the chicken legs and blades.
(End of chapter)
