Chapter 28 Appendiceal Surgery (please ask for monthly votes)
Thinking of this, Wu Xiaofu was also a little sad. They all said that it was the fault of the father to not raise him, but how should he deal with this situation?
"Teacher Liu!"
"There is a patient with appendicitis during the day. He will need an operation soon. I will go over right away. You can come on stage with me. You can rush to the hospital as soon as possible."
"Okay teacher, I will wait for you at the hospital."
Appendicitis patient during the day? Wu Xiaofu couldn't help but think of that old bookworm, couldn't it be that one?
Looking at the medical records, it seems to be true.
The person on duty in the observation room at night was a teacher from the emergency medicine team. Wu Xiaofu took a look at the patient.
During the day, the patient was very willing to undergo surgery and remove the appendix as soon as possible. But when his wife came and heard that her husband had removed the appendix, she treated him as if it would not affect his drinking. When I get angry, I directly tell him to treat conservatively first and see how the effect is. If possible, it is best not to cut.
The doctor had no choice but to wait, but while waiting, he actually waited for the appendix to perforate.
At this time, there were two brothers of the patient in front of the patient's bed.
I originally came here to stay with you. After all, they are real friends. Even if you are sick, they are willing to accompany you. The patient took medicine in the afternoon and the symptoms have been relieved. At least there is no pain, so the patient Feeling that he was doing well again, he called his two brothers and got some wine. These two brothers were also drunkards, so they dared to accompany the patient when he said he wanted to drink.
No, the patient who was supposed to be fasting was actually given two ounces of wine.
It wasn’t that the patient didn’t want to drink more, but that the appendix didn’t allow it and the pain was excruciating. He shouted anxiously, and upon examination, it was found that it was perforated.
I heard that the daughter-in-law was so angry that she also lay down at this time. The two brothers looked at each other with blurred eyes, and they also felt scared at this time.
Wu Xiaofu was also speechless.
It is said that you should guard against fire, guard against theft, and guard against best friends. Today, there is another saying to guard against alcohol, meat, and brothers.
Liu Wenyin came very quickly. It seemed that she also had a home next to the hospital. When the patient was sent to the operating room, the two brothers were still there. The patient still pulled the two brothers and talked, "Wait a minute." Hold me, an hour later, I am a good man again, let’s continue drinking.”
If the doctors and nurses hadn’t pulled him, he would have been slapped by his wife before entering the operating room.
Today's appendicitis surgery is basically performed laparoscopically. The cost is definitely higher, but the scars left are relatively small.
Although this patient had a perforated appendix, he could still undergo laparoscopy.
But the patient was unwilling to use it, not because of the high cost, but because he heard that laparoscopy was inserted through the navel, and he refused a little. In addition, he actually always felt that men should leave some space. He still had a scar, but if he really wanted to prick himself, he couldn't bear the cruelty. This time it was cured, and the scar was increased under anesthesia. When drinking in the future, he would leak out his stomach to show that he had also been in trouble.
Among the people at the stall, who could tell whether it was a surgical scar or a scar from a fight?
Liu Wenyin doesn't care about this. Patients can choose whatever they want. For appendix surgery, it is not always clear whether it is better to do incision or laparoscopy.
Appendix surgery, even if it is done through incision, the incision is very small. In fact, it is not much larger than the three eyes of laparoscopy, or even smaller. Moreover, if it is done through incision, you can choose the local area. Anesthesia, usually epidural anesthesia, is different for laparoscopy, which basically requires general anesthesia.
These two types of anesthesia are also issues that many patients have to consider. They always feel that general anesthesia will make people stupid.
Of course, this is nonsense, but you can’t help spreading rumors and many patients believe it.
So, patients are more willing to choose this kind of local anesthesia than general anesthesia.
Qu Ying and Wu Xiaofu both entered the operating room together. Qu Ying was also very grateful for this. After all, Liu Wenyin had not planned to bring her in. It was Wu Xiaofu who suggested that she be brought in together, even though she worked overtime. However, after getting the opportunity to participate in the operation, Qu Ying no longer complained as before, and her mood was much better.
However, Qu Ying had never had surgery before, so she began to feel nervous at this time.
The anesthesiologist was not the Liu Wengui I met during the day. She was a female anesthesiologist, and her movements were also very agile.
The first step in the operation is to choose the incision.
"Qu Ying, how to choose the incision for appendicitis?"
This is naturally difficult for Qu Ying. After all, it is the basic knowledge in the textbook, "Mai's point." "Come on, draw. ”
Hearing Liu Wenyin's words, Qu Ying was immediately stunned. It was her first time to have an operation, and she could answer questions just fine, but it was a bit awkward to do it.
However, Qu Ying was not a shy person and took over the drawing pen.
McFarland's point is actually the middle and outer third of the line connecting the belly button and the right iliac ridge. The iliac ridge is the highest point on the pelvis. It is easy to find. You can find it by touching it from left to right. It is still symmetrical. .
Qu Ying quickly found this point based on the textbook knowledge.
It's just that it's easy to find the dots, but difficult to draw the lines. After all, Liu Wenyin didn't ask her to find the dots, she asked him to draw the incisions.
"What are the different types of appendiceal incisions?"
"Oblique incision on the right lower abdomen and transverse oblique incision on the right lower abdomen."
"Then which one should we choose?"
< br>"MC!"
These two questions were answered by Wu Xiaofu. Liu Wenyin rolled her eyes at Wu Xiaofu. She had not been working for long, and she was like an old doctor. She was MC!
In fact, it is a McBurney incision, an oblique incision in the right lower abdomen.
Wu Xiaofu took the line drawing pen from Qu Ying's hand and drew it lightly.
Liu Wenyin didn't say anything and went to wash her hands directly, but Qu Ying breathed a sigh of relief and was somewhat grateful to Wu Xiaofu for rescuing her.
When Qu Ying washed her hands, she washed them very carefully. She followed the surgical procedures completely. However, she was a little dumbfounded when she saw Wu Xiaofu’s neatness. The teacher was watching, could you not act like this? Casual?
However, the teacher didn't scold him yet. It wasn't fair. She had been scolded all day. At least he scolded Wu Xiaofu to let her balance.
Wu Xiaofu took the initiative to take over the task of disinfecting and laying out the sheets.
Of course, when Wu Xiaofu was about to seize the title, Liu Wenyin couldn't bear it anymore. Wu Xiaofu also reacted quickly and turned the switch into a gift and presented it to Liu Wenyin. Damn it, I had done too many surgeries in my dream. This They all acted subconsciously, forgetting that they were assistants today.
Liu Wenyin gave Wu Xiaofu a look that made people beside him laugh.
Appendix and cholecystectomy are probably the two smallest operations in general surgery, and they are also the operations that emergency doctors are best at.
Although Liu Wenyin is only thirty-two, she has done a lot of this kind of surgery. The gauze pad pushes the small intestine inward. After finding the cecum, she traces it along the three colon belts to the top of the cecum. The appendix was soon found.
Um! Surgeons vividly call this method the intestinal palpation method.
It’s like following the clues without making any mistakes. This is one of the reasons why appendectomy is simple.
The appendix is clamped by the appendix forceps, and the mesoappendix is clamped by the hemostatic forceps. Once the position is fixed, most of the operation is actually completed.
Pull the appendix out of the incision.
Hmm! So ugly!
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(End of this chapter)