Removing the uterus is too easy. This operation is much simpler than major gastrectomy or liver resection. After all, the uterus is just a pocket. If Zhang Fan had not chosen surgery, he would have chosen gynecology.
If a gastric perforation requires major incision, he will never be able to do it. No matter how bad his liver was, Zhang Fan would never be able to undergo major general surgery in just two years.
I chose surgery and worked in various departments for a long time, and gynecology is also called minor surgery. Therefore, uterine removal is really not a problem for Zhang Fan.
Separation, precise separation, and ligation of blood vessels in advance. To put it bluntly, Zhang Fan felt like he was dissecting a corpse, because there was no bleeding at all.
The uterus is connected to the vagina (a), these two structures are very strange. The unpregnant uterus is like a flask, and the vaginal canal is like a tube that fits around the flask. Once pregnant, at this time, the uterus is like a big watermelon with a pedicle.
As early as ancient times, Chinese medicine believed that kidneys are related to reproduction. The predecessors back then did not have the equipment of today, and I don’t know how they confirmed it. Their ideas were really awesome.
According to modern embryology, the testicles, vaginal sperm, uterus, and vaginal canal are actually all formed by the mesonephric duct, because the amount of male hormones determines what it will grow into. .
In human terms, the body is actually treated with the kidneys first, and then the remaining materials are used to treat the reproductive system. The strange thing is that the vagina and the uterus are originally one cell, but this thing changes as it grows.
The cells of the uterus become cells that are more flexible and can shed, while the cells of the vagina (a) become wear-resistant squamous cells. They were originally twins, but in the end they looked nothing alike.
At the junction of the vaginal canal and the uterus, the cervix is difficult to do. The side close to the vaginal canal is squamous epithelium, but the side close to the uterus is not squamous epithelium.
Conventional cancers in the human body mostly occur at the junction of these two tissues. And they are particularly susceptible to disease, so the free two-gland and one-gland screening in China every year is really great. Once a woman is over 30 years old, it is necessary to check her body once a year.
Ligation, the ligament thing is opaque. Just like beef tendons, which are creamy or bright yellow, human ligaments are not as tough as cow's, but they are also opaque. And the ligaments of the uterus are like a fan covering the left and right sides of the uterus, and where the arteries and veins travel, they thicken into tubes.
The uterus is like a hanging mermaid. The left and right hands are the ovaries, the left and right arms are the arteries and veins on both sides, the body of the uterus is the body of the mermaid, and the cervix and vagina are the mermaid's tail.
Really, if you think about it carefully, this thing is very vivid.
Now, what Zhang Fan is doing is to cut off the mermaid's arm first, sew the two ends with thick threads and ligate them, then click the scissors in the middle to break the arm. "Yeah!" Doctor Xiang originally wanted to remind Zhang Fan.
But after Zhang Fan cut off the artery very neatly, no liquid came out, and there was no more gnawing sound. Because it is very dangerous here, 2cm below the artery is the ureter, which is also called water under the bridge!
After cutting off the artery, Zhang Fan gently pressed the uterus with his hand and asked the anesthesiologist: "How are you doing, Lao Cheng?"
Of course the anesthesiologist knew what Zhang Fan was asking, "The blood pressure started to rise slowly. But, just after I listened, there was a large area of moist rales in the lungs."
"It's swollen, hey!" Zhang Fan sighed helplessly.
"That's good, Zhang Yuan. If we hadn't cooperated so smoothly today, she might have been on the stage. Now it depends on her life. She may be able to survive." Doctor Xiang comforted Zhang Fan.
This kind of thing is really helpless, embolism, so terrible. Although Zhang Fan and the others stopped the progression of the disease early, the few minutes of lack of oxygen may have caused irreparable damage.
"Big curved forceps!" Zhang Fan took the large curved forceps handed over by the nurse and clamped it directly on the free lower body (a) of the uterus. If the cervix does not bleed, there is no need to cut the cervix. To be honest, it is too troublesome to cut the cervix. Since the patient is not old, I can keep it if I can. Woof woof woof knows Mao!
If you don’t talk about the cellular components of the uterus, to the naked eye, it is just a larger bladder. The inner layer is mucous membrane, the middle layer is muscle, which is much thicker than the bladder, and the outer layer is an anti-friction coat.
Anyone who has ever eaten a small belly should know this.
The hand raised and lowered the knife, a cold light flashed, and the uterus fell off along the upper part of the large curved forceps.
The stitching here needs to be particular, it must be stitched tightly, otherwise it will be troublesome if there are gaps. "Absorbable thread!" Zhang Fan took the absorbable thread and began to sew it up.
Unabsorbable lines are all black, while absorbable lines are generally blue. Figure-eight suture, the advantage of this kind of suture is that the suture is more precise.
What is a figure-of-eight suture? It is very simple. For example, if someone talks a lot, sew his lips together and use a figure-of-eight suture.
The curved needle goes in from the left side of the lower lip first, and then comes out from the left side of the upper lip. Then pull it across the lips, enter directly on the lower right side of the lower lip, and come out from the upper right side. Then, pull it across and tie a knot and cut it at the lower edge of the left side.
Then an X was marked on the surface of the lips. This is called a figure eight suture.
Zhang Fan sutured, tied knots, and cut the threads to the doctor. The two of them cooperated very smoothly. I really have to thank Ouyang for his transfer rules. Otherwise, today, Zhang Fan would just dip his fingers in chili peppers and get nowhere.
Sew bit by bit and close bit by bit. In the end, only what looked like a flesh tunnel could be seen sitting alone in the pelvic cavity.
If you didn’t look carefully, you would think that a man’s thing was stuffed into his stomach!
The surgery is done. However, the woman was only pulled half of her body out of the hands of the King of Hell. The other half is still in the hands of the King of Hell. Life and death are still pending!
As for whether he will survive or not, Zhang Fan is really not sure. He can only say now that the patient will not die due to massive bleeding.
In normal surgeries, doctors usually don't have much adrenaline surge, but with this kind of massive obstetric hemorrhage and amniotic fluid embolism, the adrenaline surge is almost exhausted.
When Zhang Fan completed the operation and sutured the abdominal cavity, the doctors sat on the ground of the operating cart. They were so tired and their bodies were shaking slightly after the adrenaline faded.
The head nurse looked at these doctors with envy. She couldn't rest yet. She also had to change fluids and adjust monitors.
"How is it? Is there still hope for her?" Suddenly the white doctor squatting in the corner of the corner asked, like a motherless orphan.
Zhang Fan had forgotten about him. As the translator spoke, Zhang Fan and the others looked at the white doctor. In the past two hours, this doctor seemed to have spent more than ten years, and suddenly he seemed to be old. many.
"The massive bleeding has been stopped and the uterus has been removed. However, it is not yet known whether the amniotic fluid embolism has caused her irreversible symptoms."
"Hu Da! Thank you, thank you!" He trembled with trembling lips and tears circled in his eyes. Guilt, unspeakable guilt. Although he couldn't understand his words, Zhang Fan understood him.
If he were a gynecologist today and an amniotic fluid embolism occurred, he would not feel guilty even if the patient failed to be rescued. Because he tried his best, but he was not a gynecologist, he felt that it was his fault that caused the patient to have an embolism.
