Brother Yun, look at what you said. This is a normal complication. We didn't do it on purpose. We all hope that the patient will be well. Who would deliberately knock the Kirschner needle out of the bone? "Chief Zhou's face turned pale when he heard Su Yun's words. He explained repeatedly.
"If you have the ability, go out and explain to the patient's family." Su Yun was unwilling to let him go.
"Chief Zheng, do you think Chief Zhou should go up now or later?" Chief Wang came to smooth things over.
He had been in Sea City for a while and had a lot of interaction with the orthopedics department. He knew that Chief Zhou was honest and a little effeminate.
This kind of person would be bullied to death by Brother Yun in a one-on-one battle. It was a one-sided suppression. In the end, Director Zhou was almost in tears.
He did not care about Chief Zhou's life or death, but if he wanted to die, he had to do the surgery first.
"Hmm …" Zheng Ren pondered for a moment. "In a few minutes, the pericardial fibrous tissue will be peeled off. I'll have to trouble Chief Zhou to remove the Kirschner needle."
Only then did Chief Zhou realize that the patient's Kirschner needle was still there …
That was true. If it was not there, it would not be such a big deal.
Usually, before the surgery, the Kirschner needle would be removed half a year later. Even if it was done by himself, Chief Zheng estimated that it had been three years after the surgery. The patient did not come for the second stage of the surgery. This matter should be discussed.
After the shock subsided, Chief Zhou finally figured out the problem.
He was too flustered. Chief Zhou blamed himself in his heart.
While they were chatting, Zheng Ren had already cut the pericardium at the left ventricle. The position was as far back as possible, choosing the non-calcified area.
There were layers under the incision. The pericardial effusion had been sucked clean.
He found the layers outside the epicardium and performed blunt dissection along the layers, gradually expanding the range.
Blunt dissection was Zheng Ren's specialty. At this time, it was also handy to separate the adhesion between the epicardium and the fiberboard.
"Chief Zheng, why are you back?" Chief Zhou looked at Zheng Ren's surgery and suddenly remembered that Chief Zheng had not gone to the Imperial Capital. He did not use his brain and asked in surprise.
As soon as he said this, Chief Zhou immediately realized that something was wrong. He lowered his head to avoid Su Yun's disdainful gaze.
He could lower his head and pretend to watch the surgery, but he could not deliberately block his ears.
"Chief Zhou, did you transmigrate, or did you open the door and see The Truman Show? A Kirschner needle is wandering at the far end, and you're scared to this extent? "Su Yun's voice was filled with infinite contempt.
"It's just a Kirschner needle. If Sea City General Hospital were to carry out cervical spine surgery, wouldn't you have sleepless nights?"
"I missed home, so I came back to take a look," Zheng Ren said with a straight face. "Chief Zhou, please go and wash your hands."
"Ah?" Director Zhou was in a daze and exclaimed absentmindedly.
"The surgery is almost done. Come up to take the Kirschner needle and we'll close the chest." Zheng Ren looked around and had to accept the fact that he had to stay and close the chest.
The 912 was still more convenient. After the surgery was done, he could leave with a wave of his hand. He did not need to think about chest and abdominal closure at all.
Unknowingly, Zheng Ren's thinking had become that of a professor or a department head.
Chest closure, abdominal closure? That's a junior doctor's job, it has nothing to do with me.
He peeled off the pericardium in sequence.
Try to cut it in pieces. If myocardial rupture occurs, use the peeled pericardium to repair and stop the bleeding.
Of course, this was only a preventive measure. Zheng Ren only did it subconsciously. He did not expect that such a problem would occur with his master-level cardiothoracic surgery skills.
The right pericardium was separated from the left atrioventricular sulcus, and the upper boundary was below the thymus. The left pericardium was separated from the upper boundary to the trunk of the main pulmonary artery, and its constriction ring was cut off to prevent serious postoperative right ventricular pressure from being too high.
The lower boundary was to completely dissociate or remove the thickened pericardium outside the diaphragmatic key. The posterior boundary was to completely separate the pericardium that appeared in the left ventricle as much as possible.
When separating the interventricular sulcus, Zheng Ren's hand speed was a little slow. He was especially careful not to damage the coronary artery branches here.
However, the heart was only the size of a fist. According to the order, the blunt separation step by step was completed in the blink of an eye.
After the surgery, Zheng Ren asked for warm saline gauze to cover the incision.
It was best to keep the incision open.
Otherwise, with the bold operation of the orthopedics department, if it was really a blind operation, Zheng Ren was afraid that Chief Zhou would chisel through the patient's aorta.
He changed the incision and paid attention to the sterile area. Zheng Ren glanced at the ECG monitor.
The patient's vital signs were stable. This difficulty should have been overcome.
"Chief Zheng, how can the first symptom of this heart disease be in the abdomen?" Chief Wang recalled the patient's medical history. Although he did not know the details, if he were to receive the patient, he would probably not have thought of chest disease.
Asking Chief Zheng's thoughts would also be a reference in the future.
"Didn't you see how the left phrenic artery was squeezed during the surgery just now?" Su Yun said, "The patient has gradually gotten used to long-term chronic injuries, so he only said there was chest tightness. However, abdominal gastrointestinal ulcers and bleeding, resulting in nausea and vomiting, are more typical symptoms, so it's especially easy to miss the diagnosis. "
"Chief Zheng, Brother Yun, how did the two of you find out?" Chief Wang asked in admiration.
"The patient complained of chest tightness and shortness of breath. Auscultation of breathing sounds is very normal," Zheng Ren said casually. "Chief Wang, it's a normal physical examination. Some simple major items still have to be done, so we can't be sloppy."
Chief Wang was stunned for a moment, then smiled bitterly.
According to the regulations, a physical examination was necessary, and it was a full set of procedures.
However, clinical matters were not that simple.
A full set of examinations was not enough to be done in less than half an hour. The emergency department was so busy, how would they have time to do a detailed examination?
Moreover, the situation was definitely not that simple.
A female patient came in, diagnosed with appendicitis, and insisted on doing a chest and vulva examination. Was that not a hooligan?!
Many doctors who had just entered the clinic fell into this trap.
Chief Wang could only smile bitterly at Zheng Ren's words. However, the patient complained of chest tightness, so he should be able to auscultate. He should be able to.
Chief Zhou led the orthopedic first-line doctors to disinfect, lay out the drapes, and began the surgery.
Removal of the Kirschner needle was one of the smallest orthopedic surgeries, so it should not be difficult for Chief Zhou at all.
However, today's surgery was extremely awkward.
He was careful, almost not daring to use violence.
However, the Kirschner needle had been deeply buried in the callus, so it could not be removed without violence.
In the past, when the scope of orthopedics did not include the cervical and lumbar vertebrae, people called them 'carpenters'.
Adzes, chisels, axes, saws, everything was available.
The surgery was done boldly, and with a series of thuds, thuds, thuds, thuds, thuds.
Seeing that Chief Zhou could not let go of his hands and feet, Zheng Ren sighed.
He had no choice but to give Chief Zhou sufficient protection in the thoracic cavity, using a large layer of gauze to protect it and a large curved iron retractor to block the Kirschner needle. In this way, even if the Kirschner needle moved violently, it would not cause too much damage.
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