Zhang Fan's original plan to accompany his sister to Bayinbuluke failed. Shao Hua and Jing Shu signed up for a two-day tour group and happily went to Bayinbuluke.
Bayinbulak is an intermountain basin in the middle section of the Tianshan Mountains, surrounded by snow-capped mountains, with an altitude of about 2,500 meters and an area of 23,835 square kilometers, second only to the NMG Ordos Grassland. Bayinbuluk means "rich spring" in Mongolian. The grassland has flat terrain and abundant water and grass. It is a typical grass meadow grassland and one of the most important animal husbandry bases in the border areas. There is not only a paradise surrounded by snow-capped mountains, the Kaidu River with "nine twists and turns", but also the elegant and charming Swan Lake.
During the Ming Dynasty and the early Qing Dynasty, the Yuledus River Basin was mainly the nomadic zone of the Huite tribe in Mongolia, the desert. In the 39th year of Qianlong's reign in the Qing Dynasty (1774), the Torgut Mongolian tribe led by Wobasi who returned to the east was settled.
Saturday, surgery. The patient was young and had good vital signs. Hela bought Zhang Fan breakfast in the morning. This patient belonged to him. She pulled Zhang Fan to come for the operation on the weekend. Although it was the director's order, as the doctor in charge, he bought it specially. Thank you Zhang Fan for breakfast. He also specifically told Zhang Fan not to eat breakfast. The three of them finished the steamed buns in several mouthfuls and prepared to enter the operating room. The patient's family had some local connections, and Li Jianguo even gave a few words of comfort to the family members in the morning. Normally, this kind of thing is done by the doctor in charge, and the director does not come forward.
In the operating room, position yourself, anesthesia and disinfection begin. The incision and exposure steps vary depending on the location and lesions of the kidneys. Li Jianguo chooses a conventional surgical incision, incises the perirenal fascia, uses various waist incisions to reach the perirenal fascia, and then cuts it. The back is divided, a small incision is made, and the incision is expanded upward and downward. At this time, care must be taken to avoid damaging the peritoneum.
Hela was one assistant and Zhang Fan was the second assistant. This kind of surgery was not difficult for Li Jianguo and Zhang Fan was fine, but it was a little difficult for Hela. However, kidney removal surgery is considered a major urological surgery, and it was impossible for Zhang Fan to do it. Anyone who is the chief surgeon.
Slowly separate the kidneys and use your fingers to separate the perirenal fascia, starting from the convex surface and back of the kidney, then to the upper and lower poles and front, and finally along the upper part of the ureter to the renal hilum, separating it from the renal pedicle.
Li Jianguo has a good level of experience. His many years of experience and cautious personality make his surgery look very clean. He does not rush the surgery and is very solid step by step. No matter how big or small the bleeding is, he must be ligated to stop the bleeding, and he must be very careful.
Zhang Fan also learned a lot from watching Li Jianguo's surgery. Li Jianguo is the most careful surgeon he has ever seen, and he also performed the surgery very meticulously.
Start processing the ureter by separating the waist segment of the ureter, surrounding it with a gauze strip and lifting it up to separate it as downward as possible. Use two hemostatic forceps to clamp the ureter at the lowest part of the separation section, cut it off between the two forceps, and sterilize the two broken ends with a small cotton ball dipped in pure carbolic acid, 75% alcohol and physiological saline. The distal ureter is then ligated and sutured.
The surgery has entered the second half. The initial work is to free the kidneys, and the rest is to deal with the renal blood vessels, carefully separate the fatty tissue at the renal hilum, and expose the renal arteries and veins. Use renal pedicle forceps or large curved hemostatic forceps to clamp the renal blood vessels. Cut off the blood vessel between the two forceps at the distal end and remove the diseased kidney.
Something happened at this moment!
Because the family members were very anxious and even went to the superior supervisor to say hello, Lao Li had no choice but to rush the patient into the operating room and failed to do many examinations.
During the operation, Lao Li was extremely careful, fearing that something might go wrong. As a result, I was careful and something happened.
The patient's kidney has mutated a redundant renal blood vessel, which is also an artery. Although it is not thick, it is not thin either. Because it was a mutated blood vessel and it was on the side of the renal fossa, Lao Li didn't pay attention. He went down with the scissors and cut off the ligated renal pedicle, preparing to remove the affected kidney.
As a result, after a stab, blood spurted out, and the blood vessel opening happened to be facing HeLa. The pressure on the renal blood vessels was not small, and it sprayed directly on HeLa's face. Hela was confused at that time. The blood vessels had been tied. Where did the arterial blood come from? Moreover, when it spurted out, Hela closed her eyes subconsciously and forgot to assist Lao Li.
Lao Li still held the hemostat in his hand to clamp the blood vessel, and he had no extra hands to stop the bleeding. He suddenly broke out in a cold sweat, and a voice in his heart was shocked: "It's over! It's a big one today!"
This kind of moment is the best moment to show off your assistant, but Hela has been covered by the blood mystery! The viscosity of the blood increased as it cooled, and it was difficult for Hela to open his eyes. Lao Li was anxious, but there was no other way. He did not dare to relax the hemostatic forceps in his hands, and shouted: "Zhang Fan, Zhang Fan. Quickly." Look, where are the blood vessels.”
The suction device cannot absorb the bleeding at this time. The bleeding pressure in the renal arterioles is high and the amount is large. In just a few seconds, the bleeding has flooded the renal fossa.
Just when Lao Li shouted Zhang Fan's name, Zhang Fan didn't delay at all and blocked the kidney socket with his fist. "Wipe Hela's face quickly." Zhang Fan pressed down on the kidney socket and said to Xianyou. He was in a bad position, so he could only do this one step, and he had to rely on Ichisuke for the rest.
Then he said to the anesthesiologist: "Quickly lower the blood pressure." Zhang Fan suppressed the bleeding. At this time, Lao Li's nerves were already stretched to the maximum and said to the anesthesiologist: "Yes! Yes! Yes! Quickly lower the blood pressure."
The moment Hela's eyes were blinded by blood, he was really desperate. Fortunately, today's second assistant is Zhang Fan. If it were another transfer doctor, it would probably be in trouble. Zhang Fan reacted so quickly that he had already dealt with it accordingly without his having to direct him.
Fast, stable and accurate. Zhang Fan punched down and immediately stopped the bleeding. After wiping off the blood, Hela was still confused, and finally said something without thinking, "Didn't you clamp the renal pedicle properly?"
Lao Li went crazy. At this moment, if you don't look for the blood vessel quickly, you will still stare in confusion, "Stop talking nonsense, are you blind? The hemostatic forceps are not clamped properly. This is a mutated blood vessel. Quick!"
Lao Li's tone was very serious. Hela, who was not frightened by the bleeding, told Lao Li that he was scared. He was stunned and knew that he had said the wrong thing. This means that Lao Li did not do a good job in surgery! Not done carefully. Patients with incomplete examinations are afraid of this kind of thing. The doctor can't say anything about it. If the examination is incomplete, he will go for surgery. The mistake must be the doctor's. At this time, there is no such thing as a call from the leader.
"Transfuse blood, correct shock, increase fluid velocity." Zhang Fan ignored the two people's emotions and began to give verbal medical instructions to the circulating nurse. Blood not only sprayed on Hela's face, but also sprayed blood on the walls of the operating room.
The circulating nurse was in a hurry. As soon as Zhang Fan gave the verbal doctor's orders, she knew what to do. If you know what to do, you won't be in a hurry.
The blood pressure dropped and the bleeding was less. Hela quickly started to tie the knot. The atmosphere in the operating room was tense. Old Li had a livid face and spoke in a cold voice. Hela regretfully wanted to slap herself.
