medical road high rise

Chapter 15 Goodbye Two-Point Suture

Chapter 15 Goodbye two-point suture

The key point of this operation is whether the patient's bleeding point can be firmly stitched and fixed. As long as the bleeding point is dealt with, the excision operation can be done casually.

This operation does not depend on Lu Ming's surgical level, but on Qin Feng's surgical level.

Qin Feng stared intently at the kidney held in his palm, the suture thread in his hand was running on the two needle threaders, delicate suture lines appeared in the surgical field, crossed and folded together.

"This... is this the two-point intermittent suture method?" The urologist was surprised when he saw the movements of Qin Feng's hands.

"You understand now." Lu Ming stood aside and waited for Qin Feng to finish suturing, and then went up to continue the operation to remove the necrotic kidney parts caused by bleeding, and then let Qin Feng suture them one by one.

The urologist smiled wryly and said, "You said earlier that he knew how to suture at two fixed points. Hemostasis in the section of the kidney is only difficult because of bleeding from multiple blood vessels. In addition, because of the commonality of renal parenchymal blood vessels, embolization of one blood vessel will lead to a second blood vessel." The bleeding volume of the third blood vessel increases, and there is a two-point intermittent suture method, which only needs to find the common point of several blood vessels, and suture the embolism at the same time with the common point as the main point.”

Lu Ming showed a smug smile and didn't answer the urologist's words.

"Director Lu, where did you get this baby?" the urologist asked.

"I said I picked it up at the elevator entrance, do you believe it?" Lu Ming said.

The urologist rolled his eyes, how could such an awesome intern be picked up at the elevator entrance?The elevator entrance has long been a place where the directors of various departments rob people for a long time.

When Lu Ming saw the urologist's eyes, he didn't explain much. Anyway, he did meet Qin Feng from the elevator entrance. As for other people who didn't believe it, he couldn't help it.

Soon, Qin Feng embolized the blood vessels that were bleeding, checked the bleeding point and retreated to the position of the first assistant.

"Director Lu, the operation can continue."

"Okay, I'm here." Director Lu picked up the sterile gauze in his hand, put it on the incision on the left side of the kidney, and began to separate the renal pedicle artery and vein. After the separation was completed, Director Lu directly cut off the blood vessels of the adrenal gland, and The necrotic parts were excised and thrown into the contamination basin.

The severing of the adrenal gland blood vessels caused a trickle of blood to flow out, covering the entire kidney in an instant, making the sterile gloves Qin Feng used to hold the kidney extremely slippery.

"Qin Feng, it's your turn."

Lu Ming stared at the blood vessels of the kidneys trickling out, feeling a little weak in his heart. This was not just a matter of a few blood vessels. Apart from the veins and arteries, there were more than a dozen capillaries that needed to be sutured and embolized. The hemostasis level of the operator is a big test.

Qin Feng hurriedly stepped forward and used an automatic vascular suture cutter to sew and embolize several obviously bleeding capillaries, and then began to focus on the venous and arterial blood vessels. Since the venous blood vessels at the kidneys are like a curved mountain shape, during the suturing process , the surgeon cannot use conventional blood vessel suturing methods to suture.

Moreover, due to the particularity of the patient and the fact that the patient's kidney had been resected twice, the suture field for Qin Feng was not as large as imagined.

If there is not enough space in the surgical field, a certain bleeding point may be missed during embolization to stop bleeding, causing the patient to suffer massive bleeding.

"Can you still do it?" Lu Ming also found out about this and asked proactively.

"Yes." Qin Feng nodded.

"If there is any situation, just tell me, don't worry too much." Lu Ming said.

Qin Feng continued to lower his head and began to block the renal pedicle. First, the renal artery in the inferior vena cava began to appear. At this time, the renal artery was flowing like a stream. Qin Feng inserted the suction device into it to suck out the accumulated blood .

"Needle holder."

Lu Ming took the needle holder from the equipment nurse, and exchanged it with the aspirator in Qin Feng's hand. Qin Feng was in the surgical field opened with normal saline, and the needle holder first processed the renal artery close to the root of the inferior vena cava. place.

"The patient's blood pressure has begun to drop." The anesthesiologist reminded him while staring at the ECG monitor.

These words made everyone who had already raised their hearts even more nervous, and sweat began to drip slightly on everyone's forehead, including Qin Feng.

After treating the root of the patient's renal artery, Qin Feng turned his attention to the duct connecting the renal artery to the left renal artery. Suddenly, a picture flashed in his mind. It was a case that Qin Feng encountered in the training room. Qin Feng performed abdominal surgery. Sometimes, I encountered inferior vena cava bleeding. At this time, the renal artery is a branch of the inferior vena cava.

At that time, Qin Feng followed the method of vein reconstruction, removed sufficient capillary walls from the capillaries around the inferior vena cava, repaired the bleeding inferior vena cava, and sutured it again.

The most important thing in the human body is veins and arteries. Unless the capillaries are in special parts such as the lower body, there are tens of millions of capillaries in other parts. Even if a few capillary walls are damaged, it is harmless, relying on the self-healing of human capillaries ability to regenerate blood vessel walls very quickly.

"Director Lu, do me a favor, take out the capillary wall on the patient's left scalp." Qin Feng said.

"The capillary wall?" Lu Ming was stunned for a moment, then suddenly realized, "Are you going to do blood vessel reconstruction?"

"Even the director of the vascular department of our hospital dare not say that he can do vascular reconstruction, can you do it?" the urologist couldn't help but questioned.

Vascular reconstruction is different from conventional hemostasis. If conventional vascular ligation and hemostasis are the basis of hemostasis surgery, then vascular reconstruction is the soul of hemostasis surgery.

Basically, as long as a vascular doctor can reconstruct blood vessels, no matter which tertiary hospital he goes to, he can earn a lot of money.

What do doctors fear most about surgery?The most fearful thing is excessive blood loss. Most patients die because of excessive blood loss that cannot be rescued.

Why do hospitals now pay attention to non-invasive surgery? It is to prevent patients from excessive blood loss and avoid surgical risks.

Lu Ming had the same doubts as the urologist. The surgical procedure of vascular reconstruction is really beyond the control of ordinary doctors.

"Director Lu, hurry up." Qin Feng urged.

Seeing Qin Feng's skillful hemostasis technique, Lu Ming gritted his teeth and began to prepare equipment for scalp blood vessel wall removal surgery.

"Director Lu, if you do other surgeries without permission, you need to consult with the patient's family and get the patient's family to re-sign before you can perform the surgery." The urologist shouted.

"If something happens, I will take care of it." Lu Ming simply kept yelling at the urologist without doing anything else.

As an excellent emergency surgeon, Lu Ming's knowledge in blood vessels is also not weak. Although he is not as good as the group of specialized angiologists, simple capillary wall separation is still no problem.

Qin Feng used vascular tweezers to clamp the adventitia of the broken end of the blood vessel and pull it outward, and then cut it off. This is the adventitia left at the damaged blood vessel. If it is not treated, direct suture may cause the adventitia to be sutured into the renal vein Among them, it will lead to the formation of thrombus, just like in the sewer, you throw an object that will expand when it absorbs water, and it will gradually cause blockage.

(End of this chapter)