Zheng Ren did not hesitate. The scalpel reflected a cold glint and made a direct incision.
Instead of a conventional incision, he chose a large incision beside the left rectus abdominis with the upper end slightly to the right. The incision was about 25 centimeters long.
This was completely different from his usual surgical style. Xie Yiren was stunned for a moment. Then, she placed the retractor beside her hand and watched Zheng Ren's movements closely.
Chu Yanran sat beside the ventilator and stared at the numbers on the ventilator and monitor. She held a pen in her right hand and moved it between her fingers.
Chu Yanzhi stood opposite Zheng Ren and asked, "Chief Zheng, can I scrub in and be your assistant?"
"No need. The surgery will be done by the time you're done," Zheng Ren replied coldly. Without looking at Chu Yanzhi, he reached out for a pair of curved forceps and an aspirator. He immediately opened the abdominal cavity and inserted the aspirator into the abdomen.
Dark red blood was rapidly sucked out. A few seconds later, Zheng Ren said in a low voice, "Chu Yanzhi, accelerate the blood flow."
Chu Yanzhi responded and ran out like a rabbit.
Xinglin Garden. There were not many viewers in the live broadcast room.
It was the busiest time for ward rounds, patient reports, and surgeries.
Only a "handful" of viewers were online.
[The bleeding is intense. It's at least a splenic rupture.]
[Blood pressure is already at 60 …]
[I hate emergency surgeries the most, especially this kind of rescue. My whole body aches every time and I need to rest for two days.]
The doctors in the live broadcast room felt the same way as they watched the surging dark red blood being sucked out of the transparent tube of the aspirator.
The tension and suffocation of a rescue had unknowingly seeped into everyone's emotions.
There were not many comments on the screen. Most of them were chatterboxes.
The more nervous they were, the more willing they were to talk to relieve their stress.
After about ten seconds of aspiration, the amount of dark red blood decreased. Zheng Ren did not wait for the blood to be completely sucked out. He opened the peritoneum and reached in with his left hand.
Xie Yiren placed the urinal beside Zheng Ren's hand.
A few large blood clots were dug out and tossed into the urinal.
"Latex tube," Zheng Ren said to Xie Yiren, which was rare.
Xie Yiren nodded and passed the latex tube to Zheng Ren before taking the urinal away.
Their teamwork was almost perfect.
Zheng Ren reached his hand in, searching for something.
[Wow, is he going to block the hepatic portal? Did his liver rupture?]
[It looks like it. The host surgeon is also anxious and wants to stop the bleeding as soon as possible. But I think it's better to expose the surgical field first. It's too risky.]
[I'm waiting for the person above to be slapped in the face. This is my experience over the past few days.]
In the live broadcast room, they had just exchanged a few words when Zheng Ren inserted the latex tube.
If the operative view was good, the latex tube should be seen passing through the omental foramen, passing through the hepatoduodenal ligament to control the first hepatic portal. However, at this time, Zheng Ren had no vision at all. Everything was done blindly.
After that, he quickly protected the peritoneum and used a large retractor to open the abdominal cavity.
Looking at it with the naked eye, one could see that there was a 4cm wound on the spleen. The edges were irregular and jagged, and blood flowed out of it like a river overflowing a dam.
Because the patient's blood pressure was already very low, the blood flow rate was not very fast.
However, regardless of whether it was the people in the operating theater or the doctors in the live broadcast room, they all knew that if the bleeding continued like this, the patient would die in about ten minutes.
Zheng Ren said in a low voice, "Retractor for the appendix."
He used the appendix retractor to pull the edge of the incision near Xie Yiren's side and placed it in position before handing it to Xie Yiren to help him expand his field of vision to the limit.
Then, he reached out and a pair of dissociative forceps appeared in his hand.
First, he ligated the spleen and stomach ligaments with the dissociative forceps and quickly treated the short gastric vessels to avoid damaging the gastric wall.
[That's f * cking fast …]
[The host surgeon's understanding of the anatomical structure is very high. Why do I feel like he knows where the short gastric artery is without even looking?]
[You'll know after doing this many times. Young people, more surgery and more thinking are the keys to growth.]
After a few comments, the splenic artery was separated and exposed in the operative view. Zheng Ren used a # 3 silk suture and saw that the spleen had shrunk significantly.
Then, the spleen was pushed out of the splenic fossa and treated the spleen-phrenic ligament and spleen-colon ligament. Then, the splenic pedicle was cut with the dissociative forceps and the proximal double ligament was ligated.
All of this took less than five minutes.
[That's fast. I think I know why the host surgeon blocked the first hepatic portal first.]
[He's confident. He blocked the hepatic portal first to minimize the bleeding. The first hepatic portal can be blocked for up to ten minutes.]
[Fifteen minutes, but we usually release it every ten minutes to prevent ischemic necrosis of the liver.]
The doctors in the live broadcast room understood the trick. Although they were surprised that a spleen could be removed in five minutes, it was not a difficult surgery. It only showed that the host surgeon had a deep understanding of the anatomical structure.
Yes, that was it.
Up until now, other than the blind operation to block the blood supply to the first hepatic portal, the other procedures had been the simplest and most straightforward. However, how many people could do it so quickly?
Everyone understood this logic, so there were only a few scattered comments on the bullet screen. Everyone was waiting to see how the host surgeon would deal with the liver.
Dealing with the liver was ten times more difficult than removing the spleen.
After a simple suture of the diaphragm and the rough surface of the splenic pedicle with the # 2 silk suture, Zheng Ren started to extend the incision to the right corner.
The patient's subcutaneous tissues were no longer bleeding, a sign of hemorrhagic shock. Due to insufficient blood volume, almost all the peripheral blood vessels were closed. The limited blood volume was used to ensure blood supply to the body's large blood vessels.
However, Zheng Ren did not let his guard down just because there was no bleeding. He quickly performed blunt dissection to avoid excessive damage.
He opened the peritoneum and protected it with a large piece of sterile gauze. He repositioned the appendix retractor and asked Xie Yiren to pull it open.
At that moment, Chu Yanzhi and the circulating nurse rushed back.
"Blood transfusion!" Zheng Ren ordered as he examined the patient.
There was no need for false pleasantries. Rescue was the priority.
The circulating nurse and Chu Yanzhi each took out a bag of fresh frozen red blood cells and hung them on the infusion rack.
Since the fresh red blood cells were cold, it was necessary to increase the temperature of the transfusion. On the way back, they used their body heat to increase the temperature of the blood.
After verifying the blood type and code on the red blood cells, the circulating nurse put the fresh red blood cells into the pressurized transfusion device and put another bag into her pocket.
"Give me a bag," said Zhu Yanran, who was focused on looking at the numbers on the ventilator and monitor.
The few of them divided the blood bags and kept changing their positions, seizing the time to raise the temperature of the frozen red blood cells.
The bag of red blood cells in the pressurized transfusion device quickly deflated and was replaced with another bag.
You've already exceeded your reading limit for today. If you want to read more, please log in.
Login
Select text and click 'Report' to let us know about any bad translation.
