The separation of the hepatoduodenal ligament was complete. Zheng Ren began to dissociate the lesser omental foramen to separate the adhesion between the colonic flexure and the right lobe of the liver.
After that, Zheng Ren pushed the transverse mesocolon down and cut open the retroperitoneum of the duodenum for blunt dissection.
Zheng Ren's surgical technique of blunt dissection had been honed during his appendectomy training. It could be said to be his trump card.
He estimated that this single technique was at least at the Grandmaster level.
However, others had gotten used to it and did not think it was impressive at all. Zheng Ren glanced at Yang Lei and felt a little regretful that he did not notice it.
It seemed like he would have to explain it to him when he was free so that he could understand the key points of the surgery.
After blunt dissection of the retroperitoneum, Zheng Ren separated the second and third segments of the duodenum forward until the duodenum and the head of the pancreas could be lifted to the superficial part of the surgical field. A warm saline gauze pad was placed behind the duodenum and the head of the pancreas.
Normally, when performing sphincteroplasty, the duodenum needed to be positioned.
However, this patient had already undergone a choledochoduodenal lateral incision, so there was no need to worry about that.
Zheng Ren prepared to cut open the duodenum.
He clamped the two sides with a mosquito forceps and made an incision in the middle, clamping one to two times at a time. Then, he used 30 non-invasive sutures to suture the duodenal mucosa and bile duct mucosa, a distance of 20 to 25 centimeters.
Zheng Ren was very careful with this step to avoid duodenal fistula after the surgery.
After the sphincter was cut open, the sutures on both sides of the incision were pulled to check for bleeding.
Then, the opening of the pancreatic duct was examined.
The opening of the pancreatic duct was located below where the duodenum had been cut open. There was pancreatic fluid flowing out in the three o 'clock direction.
A thin catheter was placed into the pancreatic duct to check for obstruction or stenosis.
The upper duodenal incision was sutured in two layers. The suture had to be carefully aligned to prevent duodenal stenosis or duodenal fistula.
Zheng Ren did not suture the incision directly like usual. Instead, he used a transverse and transverse suture to deal with this position to avoid duodenal stenosis and duodenal fistula.
Huh? This suture method was very special.
Someone in Xinglin Garden immediately noticed it.
After countless experiences, the people who watched the live broadcast of the surgery subconsciously believed that the surgeon would not make any mistakes and began to appreciate the benefits of this kind of suture.
There were not many bullet comments and not many people cheering 666.
Everyone was reminiscing and learning.
After suturing the incision on the duodenum, Zheng Ren carefully pulled over the greater omentum and used it to strengthen it. Abdominal drainage was placed in the subhepatic area and the lesser omentum foramen.
The peritoneal cavity was irrigated with warm saline and there was no active bleeding. He applied three doses of antibiotics but did not close the peritoneal cavity immediately.
"B-scan ultrasound machine, sterile sleeve, 50ml syringe," Zheng Ren said.
"Are you really going to do it now?" Su Yun hesitated.
"I'm fine," Zheng Ren said.
Su Yun did not continue to insist. Soon, the circulating nurse pushed the mobile ultrasound machine in the operating theater over. After covering the B-scan ultrasound probe with a sterile sleeve, Zheng Ren began to perform a liver B-scan ultrasound under direct vision.
Without the interference of the skin and subcutaneous tissues, he could see everything clearly!
The 50ml syringe needle was inserted into the abscess cavity of the liver following the guidance of the ultrasound. Tubes of yellowish-green pus were drawn out.
After about 125 ml of pus was extracted, the resistance of the syringe began to increase.
"Two cefoperazone. Dissolve and rinse," Zheng Ren said.
After that, warm saline was rinsed. The circulating nurse opened two more cefoperazone and tazobactam. After dissolving, Zheng Ren injected them into the abscess cavity of the liver.
This time, the surgery was finally completed. Zheng Ren carefully looked at the area that had been operated on. There was no bleeding or inflammatory infection that had not been treated.
"Close the abdomen," Zheng Ren said.
Xie Yiren immediately changed into a pair of gloves and began to use the reserved clean equipment to pass to Zheng Ren.
The entire surgery was fast and slow. When stripping the abscess and forming the sphincter, Zheng Ren's movements were very slow and careful.
When closing the abdominal cavity, his movements were so fast that there were almost afterimages.
Su Yun could keep up with his hand speed. The real person was sure of this.
F * ck, the only step of abdominal closure that I can understand. How can it be done so quickly?!
That's because you're too weak, young man.
It was simply closing the abdomen at the speed of light. The surgeon's stripping of the abscess was slow. Was this what it meant to be fast and slow when it should be?
Not all doctors could understand surgeries.
However, everyone understood the steps of abdominal closure.
The surgeon's hand speed was fast and the first assistant could completely keep up. The two of them closed the abdominal cavity in less than three minutes.
This speed … was simply too skilled. It was like the speed of a rocket.
After the last needle was finished, the patient showed signs of agitation and the surgery live broadcast room was closed.
The doctors watching the surgery still stayed there reluctantly, using it as a chat room. Facing the empty background, everyone began to talk nonsense.
At this moment, things like driving at will were not a problem.
Because abdominal infection was often encountered, this surgery was very valuable as a reference. In particular, stripping the abscess and positioning the ultrasound on the stage, direct puncture to suck out the pus, and then rinse with antibiotics.
The surgeon only had one goal — to try his best to improve the patient's sepsis.
After solving the problem of the source, the rest depended on the results of the bacterial culture and the use of antibiotics.
The surgery was almost perfect. Many doctors were still reluctant to leave the surgery live broadcast room more than an hour after it was closed. They stayed there to chat, talk about their feelings, and see how others felt.
They could refer to each other and improve their skills.
Many doctors thought that it would be great if they could leave behind video and audio materials.
This was an extravagant hope. It was already an extremely lucky thing for someone to be confident in a surgery live broadcast.
There were really not many people who dared to do this. Who could guarantee that the surgery would absolutely not go wrong?
Only someone as amazing as the surgeon would do a live broadcast.
In the surgery live broadcast room, the doctors sighed for a long time. Even if the surgeon did not know, they shouted 666 many times before gradually dispersing.
Zheng Ren finished the last stitch and the patient had already woken up.
Whether it was Chu Yanran or Chu Yanzhi, their level of anesthesia was very high, worthy of being a postgraduate student in intensive care medicine.
Zheng Ren stepped off the stage, tore off the sterile surgical gown, and twisted his neck.
"Not feeling well?" Xie Yiren was a little nervous.
Zheng Ren smiled. "No, just exercising a little."
"Oh."
Xie Yiren began to pack up the surgical equipment, scrub it, and prepare to send it for disinfection.
"Zheng Ren, you're not on duty tonight. I'll treat you to dinner," Xie Yiren said with her back facing Zheng Ren.
Zheng Ren's blood rushed to his heart, and he almost burst out of his closed fontanel.
"You don't have to treat me today. I have a dinner party tonight." Zheng Ren felt a little regretful. Although it was more lively with everyone going together, how good would it be if he could have dinner with Xie Yiren?
After so long, it seemed that the two of them had gone out for a bite of crayfish when she had just arrived and met the Chu sisters.
"Oh, okay," Xie Yiren replied.
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