Examinations, especially preoperative examinations, seem to be of little use. Once the doctors get them in their hands, they just look at them casually. That's it, they still have to make patients line up for examinations.
In fact, every time there is a leap forward in Western medicine, most of the time, corresponding examinations or corresponding materials are invented or improved. Surgery is an invasive treatment. If possible, the doctor would like to give the patient all the examinations he can do.
Because traumatic treatments are so unpredictable, and because patients are either old or frail, the chances of things going wrong are even greater.
But today, not to mention X-rays, there was not even a color Doppler ultrasound, because there was no time, and if he moved a little, this stupid child would surge like a chrysanthemum spring, and there was no way to check it.
"What to do!" the director of general surgery said subconsciously. It's not that he doesn't know what he wants to do, and he doesn't know whether it will succeed or whether it can be rescued.
Zhang Fan really wanted to say: "Cold salad!" But he couldn't. "Let's do a laparotomy, what else can we do?"
"Am I coming? Or you are coming." The current Director of General Surgery has put Zhang Fan on the same level as himself, perhaps a little bit above him.
"I'll do it." Although the operation was difficult, Zhang Fan didn't want to miss it.
Since he had to decide to have surgery, Zhang Fan performed the surgery as quickly as possible. This kind of surgery was very troublesome, and no one was sure of it.
"It is estimated that the damage to the intestines will be disastrous, and subsequent recovery will be troublesome." The director of general surgery seemed to have great confidence in Zhang Fan.
"Look at the present first. We can't even talk about life or death." Zhang Fan rolled his eyes. Sometimes he felt happy to be relied on, but sometimes he felt like he was being cheated.
Why is this operation difficult? Let’s first talk about the digestive structure.
To eat meat, you first chew it in the mouth, then pass through the pharynx, esophagus, and enter the duodenum, vacuum, and ileum (these three components are the small intestine), then the cecum, colon, and rectum (these three components are the large intestine), anus.
After food is taken into the mouth, it is not swallowed by gravity. If you eat the meat while standing upside down, it will not return from the intestines to the mouth. It's because of the peristalsis of the muscles, it's like pinching a ball, and it feels like you can't go back after pinching it.
Just like when you eat a popsicle and you can't eat the last piece, you squeeze it with your hands until it reaches your mouth from the bottom. The principle is the same.
Muscle peristalsis starts from the esophagus and squeezes, and finally reaches the anus.
Because of the need for peristalsis, the entire digestive system does not have so many fixed systems. Ordinary water means that there are few ligaments, which are fixed and the intestines cannot move.
But you can't let it move randomly, otherwise if it squirms and doesn't squirm, the long thing may become knotted and blocked by itself.
So there is a peritoneum hanging in the belly, like a mosquito net, hanging in the belly, from high to low, these intestines, like snakes, pass through the gauze for a while, to the belly, and then pass through the gauze to the lumbar spine. side.
Therefore, the basic position is still fixed, but this thing is very thin. With such a large suction force, it happily sucks on the anus. The vacuum formed after the water flows away, let alone sucking through his large intestine, even if his esophagus is passed through the anus It's not strange at all to suck it out.
"What's wrong with playing? Let's just play this! Haha." The director of general surgery said with a smile.
"It's really confusing." Zhang Fan was a little hesitant while holding the scalpel. If the incision was made too big, the damage would be serious. It's not necessarily whether the stupid kid can resist it. If the incision was made small, the damage wouldn't be handled well.
"Cut it!" the director of general surgery said. Suddenly, Zhang Fan seemed to have figured it out, yes, now we don't care about recovery after surgery, let's save our lives first!
No matter how good or beautiful the surgery is, if the person dies, the hair will be of no use. This operation is very troublesome. What is known now is rectal damage and shock. The rest are unknown.
Make an incision, cut through the skin, peel off the subcutaneous fat, open the various aponeuroses wrapping the muscles, and enter the transversalis fascia, external abdominal fascia, and finally the peritoneum.
These tissues are roughly the structure of an abdomen from the outside to the inside. Especially the fascia that wraps muscles. These tissues are the toughest except bones.
When the peritoneum was opened, Zhang Fan almost vomited. To be honest, for the first time during the operation, I almost vomited because it was so sudden.
When the peritoneum is opened, bleeding, especially at the end of the mesentery, is slightly black in color, and is mixed with yellow, mushy stool that is not fully absorbed.
There are also various kinds of feces that are as big as walnuts and have absorbed water. What's even more disgusting is that the rectum and sigmoid colon have been sucked to pieces by the huge suction force. It was broken like small pieces of paper torn into pieces.
Fat particles the size of yellow cherries and flaky intestinal tissue float on the mushy, chyle-like coffee- or soy-sauce-colored liquid, with the fishy smell of blood and the stench of semi-fermented intestinal tracts.
It's like adding too much soy sauce to the spicy soup, and then adding meatballs, sliced meat, and yellow lumps of fat. Because the bleeding continues, Gulu! Gulu, slowly, it's like boiling spicy soup in an iron pot over low heat.
Really, Zhang Fan directly squirted out the lunch meal from his esophagus. Fortunately, he was able to forcefully shut his mouth in time, and then forcefully swallowed it again. The stomach acid directly scratched his esophagus like a knife. After the scratching was over, another handful of salt was thrown on the scar!
Zhang Fan's body almost buckled in pain as his stomach suddenly felt strong. "Ha!" Despite this, tears of pain welled up in Zhang Fan's eyes, and he didn't dare to delay with his hands, because at this time, no ink could be written.
Once the abdominal cavity is opened, the pressure suddenly decreases. If the bleeding point is not found in time, the bleeding speed accelerates, and the person will die without even thinking about it. The stinging pain in the esophagus and the pulling pain in the stomach were relieved immediately.
"The rectum and sigmoid colon can no longer be seen. Use pliers to clamp the stump of the intestine." Zhang Fan said to the director of general surgery with a sour smell in his nose like the roar of white wine.
The director of general surgery also felt uncomfortable and just nodded without saying a word. It is estimated that he is also trying hard to suppress this disgusting feeling. This smell coupled with this super explosive visual stimulation is really anti-human. If you don't spit it out, it's because your portal sphincter is powerful.
"Gauze! Count it carefully and give a few more. Just unfold it and don't close it." Zhang Fan said to the operating nurse. Because the gauze is all folded up.
The surgical field of view was not light, and the bleeding point and intestinal stump could not be found at all. The suction device is as thick as an ordinary chopstick and cannot suck out the various things inside.
The soy sauce-colored chylous liquid was sucked into the transparent plastic pipe, and the rest could only be taken out with hands and gauze. It is not without reason that general surgery is looked down upon by doctors from other departments.
The white gauze entered the abdominal cavity, and then Zhang Fan endured the suffocating gas and dug out lump after lump! The gauze was white when it went in, but it was soy sauce color when it came out, and it was still tangled.
"It's such a training exercise." Zhang Fan complained in a nasal voice while holding his breath. As the air conditioning temperature in the operating room increases, the smell becomes even more compelling!
Sweat, the sweat on the neck flows down the body towards the lower part of the stomach. It is not from tiredness, but from the sweat on my head that I have worked hard to hold in.
