Zheng Ren silently looked at the patient's condition. The general anesthesia had been completed and he could go on at any time. The familiar music of good luck was automatically blocked by him as he silently went to scrub his hands.
People who sang out of tune had no concept of all music.
Water flowed out of the stainless steel faucet as Zheng Ren entered the System space.
At the same time, a crisp ding came.
[Urgent Mission: Cocoon Transformation
Mission Content: Treat a patient with abdominal cocoon disease.
Mission Reward: 3000 skill points, 100,000 experience points, Energy Medicine x2.
Mission Time: 15 hours.]
Huh? The System gave him a mission?
This was a pleasant surprise. However, the mission reward could only be received after completion, so it was not used at the moment.
Only the full language proficiency was given in advance. The System was very kind to do this, so Zheng Ren had nothing to complain about.
Footsteps came from outside. Zheng Ren guessed that it should be Chief Wei.
He opened the menu of the System store and clicked to buy surgery time. The System's operating theater rose from the ground, and Zheng Ren entered without hesitation.
The simulation mannequin was lying on the operating table. Zheng Ren did not hesitate. Although he had the [Cocoon Transformation] mission as a supplement, Zheng Ren, who had experienced a surgery training and had run out of time, was now like a miser, saving every minute and every second.
On the operating table, the simulation mannequin was in a supine position. Iodophor alcohol was routinely disinfected the skin. Sterile towels and surgical sheets were placed layer by layer. An exploratory incision was made on the right side of the rectus abdominis. The incision was about 18cm long. It was cut layer by layer, lifted and cut open the peritoneum.
This routine sequence also wasted nearly three minutes of Zheng Ren's time.
With a slight heartache, Zheng Ren resisted the urge to dissect the simulation mannequin directly. He was still afraid that if he got used to dissecting, he would have symptoms of schizophrenia.
He was a doctor, not a butcher.
After cutting open the peritoneum, there was a white patch inside. It was as dense as a layer of oilcloth, and no other tissue could be seen.
Was the cocoon disease really that serious? Zheng Ren was in disbelief.
Zheng Ren held hemostatic forceps in his left hand and picked up a piece of tissue. His right hand carefully cut it with a blunt pair of scissors.
Below … was not the intestine, but a layer of greater omentum.
Zheng Ren did not understand how many layers were they densely packed together. Logically speaking, the greater omentum was a barrier to protect the abdominal cavity, but the greater omentum of the simulation mannequin had lost this function and was wrapped in layers of cocoon.
Like silkworms, they added countless variables to the surgery.
It was conceivable that the internal space must also be made of connective tissue that wrapped around the intestines. There were layers upon layers of connective tissue outside the intestines. Just thinking about it gave him a headache.
It was a test subject anyway. Although Zheng Ren controlled his desire to dissect it, it was not a problem for him to make a slightly larger incision.
The gallbladder was large, and the gallbladder wall was not hyperemia or edema. There were no obvious abnormalities in the liver and spleen.
Everything was fine up there. That was good, that was good. If it was combined with diseases such as gallbladder rupture, Zheng Ren would be helpless.
If that was the case, he probably wouldn't have any surgical training time left.
Zheng Ren carefully opened the connective tissue under the greater omentum. There was about 30 ml of clear, pale yellow liquid in the sac, which was sucked clean with an aspirator. He did not know how many such voids there were. Zheng Ren did not think about other positions for now and seized the time to deal with the things in front of him.
When the intestines were probed, the wall of the intestine was adhered to the surrounding connective tissue. The blunt scissors and hemostatic forceps were applied together. Bit by bit, they were carefully dissected and loosened.
Even with Zheng Ren's Legendary-level surgical skills, it was very difficult for him to deal with it without any damage. However, every time he made a mistake, he would remember the difficulty. How much strength should he use? Should he use his hands or blunt scissors?
Zheng Ren also sutured the damaged part.
At a position 25 cm away from the ileocecal region, the intestines were tightly adhered. Zheng Ren used a little force and tore open a 2-3cm hole in the intestine.
This section of the intestine was so edematous that it could not be sutured at all.
Zheng Ren sighed. The surgery was probably a failure.
He could only operate roughly and begin to dissect the simulation mannequin. As he dissected, he warned himself that this was the surgical training room and the simulation mannequin provided by the System. If it was outside, he would definitely not be able to operate so casually.
This was something Zheng Ren had always been careful to avoid.
He was really afraid that on a whim, he would cause an irreparable mistake outside.
After dissecting, Zheng Ren found that the patient's intestines were wrapped in countless layers. Not only the outside but also the inside.
The cocoon not only surrounded the peritoneum and wrapped around all the intestines, but it also wrapped all the intestines.
After loosening a section of the intestines, there was still connective tissue below.
In the face of this situation, the best way was to do a bowel resection. It was simple and crude to cut off all the parts with serious adhesion.
However … almost all of the intestines of the simulation mannequin were wrapped, leaving no room for Zheng Ren to remove them.
Even if he could survive after the total bowel resection, he would have to undergo intravenous hypernutrition for the rest of his life.
Most importantly, the patient was already 72 years old and could not withstand such a serious surgical trauma.
It was better to just peel it off bit by bit. Although the surgery was difficult, it was the only successful way Zheng Ren could think of.
Zheng Ren was quite confident in his level of blunt dissection. In addition, Dr. Charles's operating box and handy surgical tools. If he could not do it, there were not many people in the world who could do it.
After the dissection, Zheng Ren had a certain understanding of the anatomical structure of the simulation mannequin. The second surgery was much faster.
After passing through the previous location of the intestinal rupture, Zheng Ren was extra careful. He peeled off the connective tissue bit by bit and slowly adapted to the different forces that the intestinal wall could accept.
The simulation mannequin's intestinal tissue was very small. Even simple movements such as clamping and pulling with hemostatic forceps could cause intestinal damage.
Zheng Ren had no choice but to summarize his experience and lessons from each failure. How much force was applied to different intestinal walls and what instruments were needed.
Fortunately, Zheng Ren's memory had always been good. In addition to the System's invisible blessing, he could still barely remember.
After nineteen consecutive failures, Zheng Ren finally completely peeled off the layers of cocoon membrane.
However, just as he was about to put out the intestines, Zheng Ren suddenly saw that the patient's ovaries were seriously infected and tightly wrapped.
So that was it!
Zheng Ren remembered that the source of abdominal cocoon was mentioned in a document. It was divided into two types: primary and secondary.
Primary abdominal cocoon was also known as idiopathic abdominal cocoon. It mostly occurred in young women in tropical or subtropical regions. The cause might be related to fallopian tube infection or gynecological infection caused by menstrual retrograde and autoimmune reactions.
The patient's age had long since reached menopause. However, the infection still came from the ovaries and pelvic cavity. These were the pathogens.
What should he do? Zheng Ren was stunned.
Should he change to gynecological surgery next? He looked at the pelvic cavity and felt a little conflicted.
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