Auto chess in the operating room

Chapter 164 Chapter 164

In the operating room, the staff was fully prepared, Qing Ping personally helped Tang Lou, while Yan Ruoyun and Fang Qing also watched from the sidelines.

At the request of Tang Lou, the nurse adjusted the patient to the supine position, and at the same time raised the right hand and placed it behind the pillow.

"Color ultrasound to determine the safe puncture path."

Qingping personally assisted Tang Lou, and soon determined the puncture path.

Tang Lou took a marker pen and marked the patient's 6th to 8th intercostal space near the junction of the midaxillary line.

"anesthetist"

Chen Wenhao rushed over immediately and performed local anesthesia on the patient's puncture site, using 1% lidocaine as the anesthesia drug.

"Chiba needles."

Chiba needle, also known as Chiba needle, is a suction biopsy needle, which can be used for injecting drugs, inserting guide wire, taking liquid cell tissue fluid, etc. It is a commonly used tool in puncture. There is a slender silver needle on the upper body, and a small cap on the tail.

Tang Lou used his thumb, index finger and middle finger to push the puncture needle into the predetermined puncture point, keeping the needle body parallel to the bed surface.

Watching his operation, Qingping was a little surprised, Tang Lou's hand was very stable, and his strength was well controlled.

In just a moment, the long Chiba needle was inserted into the patient's xiphoid-process root to 11 cm from the right edge of the 2th thoracic vertebra, and stopped.

"So fast."

Yan Ruoyun on the side also gave a sigh of admiration. After the Chiba needle pierced in, when there was a breakthrough of resistance, it meant that it had been pierced.

The subtle force feedback here is a test of a physician's ability to judge.Some doctors are slow to react, and they will penetrate too deeply. Some doctors are cautious, but they will be very hesitant.

But Tang Lou's movements were done in one go. Once he broke through, he stopped immediately. This feeling was like reining in his horse and whistling on the edge of a cliff, exhilarating.

"syringe"

Tang Lou pulled out the needle core decisively, replaced it with a syringe, and started to suck.

"Aspiration of the existing bile, the needle tip has successfully entered the gallbladder cavity."

When Tanglou made his judgment, the needle tip was visible in the gallbladder cavity under ultrasound.

"Guide wire, dilation catheter preparation."

Hearing that Tang Lou had successfully entered the next step, Qing Ping was also shocked. It was really amazing. For ordinary doctors, when puncturing, it is very rare for a doctor to succeed once, and it is very common to puncture three to four times.

The next step is to use the seldinger method to sequentially feed the guide wire and dilation catheter.

Seldingerr operation is a blood vessel puncture technique proposed by Sven Ivar Seldinger in 1953.

This method is very classic, but it also requires a high level of proficiency and judgment for the operator.

Since there is a certain distance between the skin incision and the blood vessel puncture point, the angle and thickness must be calculated very accurately.

I saw that Tang Lou fixed both sides of the puncture point with one hand and two fingers to prevent the puncture point from slipping, and controlled the guide wire with one hand, retracted deeply and advanced shallowly, and inserted the guide wire along the puncture path.

Even Dr. Fang Qing, who doesn't know much about surgical procedures, admires Tang Lou's solid foundation. The entire operation process is clear and the movements are pleasing to the eye.

He sighed inwardly, no wonder he has such a powerful voice in general surgery at such a young age, even senior attending surgeons are willing to listen to his advice and even cooperate with him as the surgeon.

"6/8F PTCD Catheter"

After that, the PTCD catheter was placed, and the tip of the catheter was confirmed to be in the gallbladder lumen by ultrasound, and there was no exudate around the gallbladder.

"needle pliers, silk thread, tape"

Tang Lou proceeded to the next step very smoothly, fixing the catheter.

"Sterile Drainage Bag"

And at this point, the operation is basically declared complete, and the rest is to ensure the smooth drainage.

As for the anti-inflammatory treatment after the puncture, the nurses and interns will follow up later.

"The extracted bile is sent to the laboratory for bacterial culture and drug susceptibility testing."

After Qingping finished speaking, the whole operation came to an end.

Transhepatic gallbladder puncture and drainage can avoid acute infection and control cholecystitis, but of course it is not a cure.

Wait until the patient's physical condition is stable, and then choose an appropriate period for laparoscopic cholecystectomy treatment. At least so far, the goal has been fully achieved, and the patient is waiting for the critical period.

Soon, Tang Lou Qingping and others pushed the flat car out of the operating room.

The patient's daughter waited early, and when she saw her father being pushed out, she rushed to meet him.

"Doctor, how is my father?"

"Dr. Tang's operation was very successful, and the acute cholecystitis has been relieved now. We will re-evaluate and perform cholecystectomy after your father's physical condition stabilizes and he passes through this dangerous period."

Qingping and his family explained carefully.

"That's great, thank you doctor."

The heart of the patient's family finally fell to the ground. After all, his father had a serious heart problem. Now as long as the acute cholecystitis is under control, it is just another "chronic disease" that can be controlled.

As for chronic diseases, family members have a high degree of acceptance. After all, there is a long list of chronic diseases in the body.

After sending the patient to the ward, everyone felt relieved. After Qingping gave some instructions, everyone returned to their respective jobs.

While Tang Lou's interns and Lin Dong's residents were busy with their work, the director of the general surgery department of the city's No. [-] hospital and the attending physician started to turmoil because of a piece of news.

Especially Hang Cuishan, he is one of Cheng Jian's confidants. He is very knowledgeable about external abdominal hernia. He is also one of the main doctors who established the provincial acute abdomen discipline point in the first hospital of the city.

But in the past few days, he had trouble sleeping and eating, and finally came to Cheng Jian's office to discuss.

In Director Cheng's office.

Cheng Jian looked at a case file, and Hang Cuishan made a cup of coffee for Cheng Jian.

"Director Cheng, as far as I know, Wang Chuan will be returning to the City No. [-] Hospital in another week."

Hangcui Mountain naturally did not hide from Cheng Jian, and went straight to the point.

After taking the coffee from Hangcui Mountain, Cheng Jian took a sip and frowned: "Why is it so bitter, add some sugar."

"Can't add it."

Hangcui Mountain rascally sat opposite Cheng Jian, with a look of anxiety on his face: "I'm in the same mood as this coffee."

Cheng Jian put down his coffee and looked at Hangcui Mountain for a few seconds. He naturally understood what Hangcui Mountain meant.

"I said Director Cheng, this time Wang Chuan came back from Xiehe advanced training, a deputy chief physician will not be able to escape. With his ability and his arrogant temperament, I'm afraid we will have a hard time for a few days."

Hang Cuishan was a little helpless and depressed: "As far as I know, Wang Chuan will not only implement a lot of new techniques when he comes back this time, but also prepare to do a project on external abdominal hernia to show his skills."

Cheng Jian knew it and asked: "So."

"He, Wang Chuanxie, came back from advanced studies and is the deputy chief physician. The patients with abdominal external hernia are still selected by him. In the future, when the city's first hospital mentions abdominal external hernia, he is the only one, Wang Chuan, and there are no others."

Hangcui Mountain was originally specialized in the study of abdominal external hernia, if Wang Chuan made a horizontal shot, wouldn't the previous efforts of their medical team be in vain.

As a prefecture-level city hospital, the source of disease is limited. If Wang Chuan sorts out the best quality patients and picks up the rest to give to their medical team, Hangcui Mountain will know the miserable situation after that.

The amount of surgery is equal to a doctor's fame and money, not to mention the added value that those patients with unusual status can generate.

Cheng Jian took a sip of bitter coffee and stared at Hangcui Mountain: "Then how do you want to deal with it?"

(End of this chapter)