This step is originally one of the difficulties of this operation.
The routine operation is: the second assistant pulls the distal stomach, pancreatic head, duodenum and upper jejunum to the right, and the third assistant guides the superior mesenteric vein to the left, thereby revealing the three branches of the superior mesenteric vein that drain from the pancreas into the superior mesenteric vein. to four small veins.
The first assistant cooperated with the surgeon to ligate and cut these small veins one by one, and then performed the next step of uncinate process resection.
But there was a little problem in the process.
As the chief resident of gastrointestinal surgery, third assistant Guo Xiaolin participated in a pancreaticoduodenectomy for the first time.
Even if you have done a lot of homework before the operation and are familiar with the work you have to do, if you want to know how to do it, you must practice it with real swords and guns.
At this time, when he used the retractor to tract the superior mesenteric vein, he used a little more force.
The blood vessels of the human body are delicate, and for middle-aged and elderly women in their fifties, they are even more fragile.
The vein ruptured, and blood suddenly surged from the lower end of the retractor, quickly flooding the entire surgical field.
Dave reacted very quickly. He immediately removed the retractor and took out a large gauze to press it down. Director Shen also quickly used a suction device to suck out the accumulated blood.
The first important thing at this time is to find the bleeding point and stop it.
However, the blood flow was so turbulent that it was impossible to see the location of the bleeding point clearly. Dave tried clamping and suturing several times to stop the bleeding, so he could only use gauze to compress it again and signaled Director Shen to help him apply pressure to stop the bleeding.
At this time Tao Le took action. Three filiform needles were inserted near the bleeding site, forming a "pin" shape.
She did not use gold fingers to repair it, because then, after the bleeding was stopped, it would be discovered that there was no wound at all, which would turn a good operation into a suspenseful event.
It's okay once, but if it happens too many times in the future, people will definitely be suspicious of you.
She couldn't use gold finger treatment in the space, but the mask man taught her a new acupuncture method.
Acupuncture and pulse control to stop bleeding. Although it is not as fast as direct repair, the effect is immediate.
The rate of bleeding slowed down visibly, turning from a spring to a stream.
This change naturally caught everyone's attention, and they became more convinced of Tao Le's acupuncture skills.
Director Shen sucked up the accumulated blood, and Dave also saw the location of the bleeding point.
First use non-abrasive vascular forceps to clamp the break, and then use non-atraumatic sutures to repair and suture.
After that, everyone calmed down and focused their attention on Tao Le.
Tao Le didn't want to be the center of attention, and now was not the time to relax at all.
She pointed to the monitoring equipment, which showed that the patient's heart rate had risen to 120 and her blood pressure had dropped to 80/50.
The people present were all experienced clinicians, and they immediately understood what she meant.
During the massive bleeding just now, too much blood was sucked out with the suction device. The blood sucked out alone reached 1000ML, and the patient's actual blood loss was even greater.
If the blood is not replenished as soon as possible, the patient's life will be in danger, let alone the operation.
"Use a blood recovery machine to purify the sucked blood and then infuse it back into the patient," Dave said.
"Well, we have indeed been applying for the introduction of this equipment, but not yet." Director Shen explained.
This equipment really should be available, and every operating room should be equipped with one. But I don’t know why, but applications submitted are always rejected because of insufficient funds.
"First transfuse 5U of red blood cells." Dave didn't expect that the first hospital didn't even have this common equipment, so he had to settle for the next best thing.
The first circuit nurse took the doctor's order and ran all the way to the transfusion department to get red blood cells.
As soon as she left, Tao Le asked, "Do you want some more fluid?"
She had learned a hard lesson. The patient has high blood sugar, poor coagulation function, and will continue to lose blood for a while. Just replenishing this red blood cell is not enough. At least 3000ML of fluid must be replenished to ensure that the patient can get off the stage normally.
Tao Le said something, but Dave didn't think much about it and immediately agreed.
"Prepare 2000ML of crystals and 1000ML of colloids," he said.
The first circuit nurse is not available, so Yang Ruixue, as a field worker, naturally has to fill in.
Song Mei handed the doctor's order into her hand: "Go and come back quickly."
"Where should I get this?" Yang Ruixue hesitated for a moment, then asked.
She had never picked up anything by herself before. Aren't these things all the nurse's responsibility?
Even though she is wearing a nurse uniform, she is still a doctor at heart!
Although her voice was not loud, it reached the ears of everyone on the stage.
Most of the people present recognized Yang Ruixue and knew the reason why she was here, so that was all.
The most surprising person was Dave. This was the first time he had seen such a nurse, whether at home or abroad.
As a circulating nurse, she doesn't know where to get the medicine. How can such a person blend into the operating room and squeeze into her own team?
He was warm and affectionate towards Tao Le, but he was not like this towards others.
Meticulous, conscientious, and almost demanding, these are his true requirements for his team assistants.
"Please get out. Don't show up in my surgery again." Dave's voice was low, but his words were very serious.
"Why? I'm here to experience your surgery. Please give me a chance." Yang Ruixue almost cried.
She didn't expect that she would be kicked out by Professor Dave just for asking a question.
"I've already told the hospital leaders that we only need the highest level of medical care." Dave frowned.
"Now, I don't think you can shoulder your responsibilities and are not qualified to participate in my surgical team. So please get out and don't let me say it a third time."
He has said this. Even if Yang Ruixue is not thin-skinned, she can't hold it anymore.
But if she just left like this, where would she put her face?
"She, Tao Le, is also a trained doctor. If I can't stay in the operating room, why can she?"
Tao Le never thought that his silence would cause him to get burned.
She was about to say something when Dave spoke first.
"You can't compare with her, and you don't deserve to compare with her."
As soon as these words were said, not only Yang Ruixue, but also everyone else was stunned.
Why does this foreign expert have such a high opinion of Tao Le?
Not worthy? Am I not worthy to compare with Tao Le? Yang Ruixue couldn't understand Dave's words at all.
She and Tao Le are indeed incomparable in any place. Whether it is family or academics, the other party is not qualified to compare with her.
"I'm not worthy? How is she better than me? Just your mouth? That's not fair!" Yang Ruixue could no longer hold back and shouted directly.
Dave spread his hands and had no intention of continuing to explain to her.
He directly asked Sun Mei, the head nurse: "Are all the nurses in your hospital so rude and ignorant of the rules?"
