Auto chess in the operating room

Chapter 151
In the operating room, Tang Lou is the surgeon and Lin Dong is the assistant.

After the anesthesiologist finished, he gave up the position to Tang Lou.

ERCP+EST+LC combined operation, the first step is to perform ERCP first.

"Duodenoscope"

With talent and concentration, Tang Lou quickly entered the rhythm, and steadily controlled the camera to enter the duodenum.

"Guide wire, contrast catheter preparation."

Tang Lou calmly gave instructions while controlling the equipment in his hand.

Since dozens of ERATs have been made, it is natural for the ERCP Tanglou of the same origin to be easily grasped.

Cooperating with Tang Lou's operation, Lin Dong was very shocked. Since the last cholecystectomy, he obviously felt Tang Lou's progress again.

The organizational structure and anatomy of the gallbladder and common bile duct have become more and more accurate.

Lin Dong is well aware that although more than 80% of the bile duct and pancreatic duct have a common channel anatomically, the length of the common channel, the angle with the opening of the RT, and the angle at which the bile-pancreatic duct joins are different. It is difficult to achieve selective contrast imaging, and only continuous practice can be mastered.

At Tang Lou's age, it is obvious that there are only a handful of surgeries he has performed. One of the reasons for being able to do this is that he spends a lot of time studying anatomy knowledge, watching surgical videos, and even learning the experience and skills of Dr. Niu.On the other hand, it is pure talent.

In particular, he had just experienced Tang Lou's first laparoscopic cholecystectomy. The last time Tang Lou gave him the same feeling as himself, but this time, his operation and proficiency increased by more than one dimension.

"This kind of learning ability is amazing."

Lin Dong had to admire.

"Diagnosed during ERCP: One of the common bile duct stones of the patient is more than 20mm, and mechanical lithotripsy is required under endoscopy. Five stones are less than 10mm, and the stones can be removed through the basket after incision by EST."

Under ERCP, the situation in the patient's common bile duct is naturally invisible, which also avoids inaccurate preoperative physical examination and lays a solid foundation for subsequent stone removal.

The next step is naturally EST+LC. Compared with conventional laparotomy, the incision in laparotomy is too large. Lithotomy forceps are usually used during the operation, which often leads to Oddi sphincter injury.

The use of LC combined with EST is very suitable for Hu Jie’s stenosis of the end of the common bile duct, and this program can cure gallbladder and small common bile duct stone lesions with one operation, and can also preserve the function of Oddi’s sphincter to the greatest extent.

"Shockwave Lithotripsy Preparation"

Tang Lou issued an order non-stop, even the well-informed Lin Dong was slightly under pressure.

This kind of high-speed efficiency can only be found with a partner at the chief physician level.

"Get the stone basket ready."

Under the combined operation method, because the number and size of the stones are precisely located by the contrast in the first step, not only the stones in the common bile duct are removed, but also the incarcerated stones in the ampulla are also cleaned up.

As an expert, Lin Dong naturally paid close attention to Tang Lou's operations.

When pulling out the stone, it was obvious that he controlled the strength precisely. Lin Dong once encountered a low-level resident doctor who used too much force when pulling out the stone, which caused the ampulla of the patient to tear. What a pity.

Moreover, Tang Lou's movements were very rhythmic, and the more he looked at Lin Dong, the more frightened he became.

I saw that Tang Lou inserted the mirror, turned right, and turned downward. The direction of the joint action was always consistent with the axis of the bile duct.

This kind of operation is naturally very conducive to the removal of stones, and in the order of stone removal, Tang Lou also follows the principle of "down first, then up, first small and then large", very calm and rigorous.

In Lin Dong's memory, the first time he took stones, he was too nervous and forgot this principle, which led to the removal of too many stones at one time, which caused the stone extraction basket to get stuck in the RT.

A surgery has been completed here, and most of it has been successful. The next step is the regular LC, which naturally has no difficulty for Tang Lou.

In the subsequent operation, it was as expected by Tang Lou. Due to the combination method, the patient's blood loss during the operation was very small.

Moreover, since there is no need to use a T-tube for drainage, negative effects such as bile duct bleeding, damage, electrolyte and bile loss caused by the T-tube are avoided.

As a result, Hu Jie, who had just been rescued, barely survived the operation, and the rest was recovery after the operation.

"Tang Lou, congratulations."

Lin Dong, as an assistant, of course monitored the patient's vital signs at all times, but if the amount of bleeding was larger, the patient might go into a second shock, which shows how accurate Tang Lou's previous prediction was.

If he were to perform the surgery and use conventional LC, the consequences would be unimaginable due to the excessive amount of bleeding and Hu Jie's current physical condition.

When Lin Dong pushed the flat trolley out of the operating room, Hu Jie's husband was still communicating with Fa Xiao. For this complicated operation, according to Fa Xiao's prediction, at least at the level of the city's first hospital It will take two and a half hours.

Hu Jie's husband checked the time within a few minutes, and it was only an hour and a half later, feeling restless and apprehensive.

While he was suffering, Lin Dong and Tang Lou pushed the flat cart out.

Hu Jie's husband confirmed the time again, his mind went blank, and he was so panicked that he didn't see the patient on the flat car behind Lin Dong:
"Doctor, why did you come out so soon? You are not doing surgery inside, what are you doing out here?"

Lin Dong turned his head, pointed to Hu Jie on the flat car, and motioned to him: "The operation is complete, very successful."

"What did you say! It worked, really!"

Following Lin Dong's guidance, Hu Jie's husband saw Hu Jie still recovering from anesthesia on the flat car.

"Come over and help me, and send the patient to the ward."

"Oh, oh, good."

Hu Jie's husband hurried over, holding the car with one hand, and holding Hu Jie's hand with the other: "It's okay, it's okay."

Hu Jie was lying on the flat car, the corners of his mouth moved slightly, and he blinked his eyes.

"Doctor Tang, I was an asshole before, because I had a bad attitude and still questioned you. You are like Hua Tuo alive, with a wonderful hand rejuvenated."

After Hu Jie's husband finished comforting his wife, he finally saw the tenement building at the back. At the moment, he was ashamed, ashamed, and full of gratitude.

His childhood friend told him about the difficulty of this joint operation, even the most powerful attending in his department would take at least two hours to complete. They are from the provincial capital hospital, so Dr. Tang only used one Half an hour, it's not much better than the experts in the provincial capital hospital.

"It's so lucky."

Recalling what happened that day, Hu Jie's husband became more and more afraid. Fortunately, he met Dr. Tang, otherwise his wife might really not survive.

[Ding, new mission: The dictatorship has been completed.The patients and their families are sincerely convinced.Reward 2 gold coins, refresh the card library once. 】

Tang Lou glanced at Hu Jie's husband, who nodded his thanks and scolded himself a few words.

After Lin Dong and Tang Lou sent the patient to the ward, they gave a few more instructions.

This time, Hu Jie and her husband were naturally respectful of what Tang Lou said, and took it down seriously.

Before Tang Lou and Lin Dong left, Hu Jie got up slightly and said to Tang Lou:
"Thank you, Doctor Tang."

Tang Lou and Lin Dong didn't look back, and quickly walked out of the ward, especially Lin Dong had seen too much of this kind of condescending patient.

For gratitude, accept it with peace of mind, and will not forgive the previous meanness.

Seeing the two doctors walk out of the ward without looking back, Hu Jie was slightly taken aback.

Interns will naturally assist with the rest.All Tang Lou and Lin Dong have to do is check the house regularly.

The next day, Tang Lou received a call from Tang Qichen early in the morning. Professor Huang from the provincial capital was already on his way to the First Hospital of Hecheng City.

Professor Huang said that he was very satisfied with their previous physical examination, enhanced CT and contrast-enhanced ultrasound.

After he arrives, he will personally see the patient and communicate with him. If there is no problem, the operation can be carried out and Tang Lou and the others will prepare.

　Is the big guy fattening up? I feel that follow-up subscriptions are not very powerful~ there is another chapter tonight

　　
　
(End of this chapter)