Chapter 317: The first laparoscopic surgery for obturator hernia!
Wu Man’s voice came from the other side of the phone.
Well, at this moment, Wu Xiaofu had no other worries. This was the confidence given by his elder sister. Work hard and leave the rest to her. Wu Xiaofu suddenly felt that the beatings he had received over the years were nothing. It hurts so much.
"Sister, thank you."
"I'm so stupid, I'm starting to be polite to you."
In the law firm, Wu Xiaofu finished signing, thanked him, and was told. However, Wu Man never said anything to tell Wu Xiaofu to pay attention to next time. She knew that Wu Xiaofu had his own code of conduct. Since Wu Xiaofu did it, it must be right.
Since it is correct, why should we pay attention to it.
The beloved younger brother with strength must be Wuman.
After Yu Shifu saw Wu Man filing a lawsuit for Wu Xiaofu, he felt relieved. To litigate a lawsuit, a lawyer must be professional, not to mention that she is Wu Xiaofu’s biological sister. Wu Xiaofu helped.
This matter must not affect Wu Xiaofu's working status.
The awards are over here, and Wu Xiaofu will return to Donghai. Now Wu Xiaofu is the signature of Donghai General Surgery. Wu Xiaofu still registers for the outpatient clinic the day after tomorrow. I don’t know how many people will come to seek medical treatment.
However, after returning, Wu Xiaofu received a call from Jiang Ruonan.
"Dr. Wu, sorry to bother you, I'm calling you this time because..."
Listening to the very serious and programmed voice on the phone, Wu Xiaofu knew that Jiang Ruonan was There is official business.
Sure enough, it was because of offer2.
offer2 is still in the audition stage, but it is about to end. My sister and grandma want Wu Xiaofu, as the winner of the previous session, to make a video for the students who will participate in the show in the next session.
The purpose is to inspire them and share some experiences.
As for the connection between the front and back, it was naturally difficult for Wu Xiaofu to refuse such a thing, so he just nodded and agreed.
Wu Xiaofu is still looking forward to it when he thinks that Offer2 will participate in the program as a mentor this time. It is like a graduate returning to campus and giving a speech to other students. This feeling is difficult to understand. Expression.
Jiang Ruonan also understands Wu Xiaofu’s character, so this time the video recording is much simpler. Of course, Jiang Ruonan feels that Wu Xiaofu no longer needs too many bells and whistles. Sitting there, It’s a living sign.
Of course, there was another reason for recording the video, which Jiang Ruonan didn't mention.
As Donghai Satellite TV announced that it would host Offer 2, many other satellite TVs have also begun to organize similar programs.
The Imperial City finally changed its name to "Youth in Dreams."
Well, I don’t know who named it, it’s very abstract. Those who don’t know what it is might think it is. As for the youth idol drama, however, it has changed its name. Other satellite TV stations are much simpler. They are directly Offer2 Jinling Station, Offer2 Xijing Station, etc.
Don’t mention it, I was really sucked in a lot.
Many people feel that Donghai Satellite TV is too popular and there is not much chance, so they settle for other satellite TVs, and there are also those who apply for multiple projects with one resume. The main thing is to cast a wide net, catch as many fish as possible, and choose the best. .
He will go to whichever TV station allows him to pass the audition. If multiple TV stations give him a chance, he will choose the best one.
Well, it made the students very distressed.
It’s hard to imagine that when we met on campus, they were all asking: Hey, which satellite TV program did you sign up for? I signed up...
Furthermore, because Wu Xiaofu participated in the World Because of the surgical competition, a lot more people are paying attention to this type of program. Therefore, the attention of Medical Road Offer 2 has suddenly increased a lot.
After unexpectedly opening the webpage, you can see a lot of discussion programs.
There are even many people who are giving suggestions to the program team, saying that a certain student is famous and should pass the audition.
Of course, I don’t know if the students themselves are involved in the navy.
When making a video, he starts with some big talk, and then talks about his inner thoughts. He can’t talk too thoroughly. For half an hour of video, Wu Xiaofu can be said to have complete freedom of expression.
"Dr. Wu, thank you for your cooperation. I didn't expect that you had prepared so much for this video, but it was so smooth and passed in one go."
Jiang Ruonan thought that Wu Xiaofu had prepared in advance, memorized the manuscript, and practiced it many times, and it was just a one-time recording. But the fact is that Wu Xiaofu now has many awards for various acceptance speeches. These words are really Open your mouth and come.
In the hospital.
Patients with endometriosis have already been examined, and as Wu Xiaofu expected, the result is that the endometriosis is really located in the liver.
Compared with ectopic ectopic to other parts of the body, the risk and complication rate of ectopic ectopic to the liver are obviously much higher, and the effect of medication will be greatly reduced. In this case, Surgery is almost the only treatment.
This is what Wu Xiaofu told the patient after seeing him.
When he heard that he needed surgery, the patient was depressed, but he still agreed. At this time, the patient’s family members had also arrived, and it was the patient’s husband. When he heard that his wife was suffering from a rare disease that may only have a dozen cases in the world, he felt very sad. Startled.
While chatting with the patient’s husband, Wu Xiaofu also received two messages.
One is that the patient grew up in an orphanage, and they did not know the condition of the patient's mother. This is why when Wu Xiaofu asked the patient about her genetic status, the patient shook his head and said he did not know.
The other thing is that these two people actually had sex during their menstrual period, not just once. This situation is not a small situation.
However, it is also the result of poor publicity and guidance.
Having sex during the menstrual period, that is, the menstrual period, has many hazards, such as irregular menstruation, gynecological infections, endometriosis, formation of anti-sperm antibodies, and infertility.
If you have sex during menstruation, vaginal secretions are more likely to go up into the urethra than usual, leading to the onset of urinary system diseases such as urethritis.
Furthermore, women’s immunity is low during menstruation. Once the male genitals are not thoroughly cleaned and contain bacteria, women can be infected with vaginal inflammation through sexual intercourse, and even cause diseases of the reproductive system, such as the uterus. Endonitis, salpingitis, pelvic inflammatory disease, etc., affect women's reproductive health.
Sex during menstruation can cause congestion in the female genitals, leading to irregular menstruation such as increased menstrual flow and prolonged menstrual periods. During this period, it may also induce the production of anti-sperm antibodies, leading to Immune infertility, infertility.
Furthermore, sexual intercourse during menstruation will cause a woman's uterus to contract, so it is possible that endometrial fragments will be squeezed into the pelvic cavity, causing endometriosis and leading to female infertility.
This may be the direct cause of endometriosis in patients, and it is also related to the ectopic location in the liver.
Wu Xiaofu didn’t shy away from anything, and directly talked about this matter with the patient’s husband. Although he was a young man with strong firepower, he still had to exercise moderation when it was time to exercise control, which only lasted for a few days. , can't you bear it?
When Wu Xiaofu said this, the patient’s husband was ashamed and also very regretful.
He really didn’t know this. If he knew this, he would never do anything reckless. Now that his wife has to suffer from surgery, he blames himself even more. However, Wu Xiaofu did not He continued to say more, and even gave him a few words of comfort, saying that it would be good if he realized the seriousness of this problem. Maybe that was not the reason. The most important thing now was to treat the patient.
With the agreement of the patient and the patient’s husband, Wu Xiaofu asked Chen Zhendong to start the arrangements before the operation.
Preparations are scheduled for Monday.
However, there is a small episode in the middle, that is, the director of the gynecology department believes that endometriosis is a gynecological disease, and patients should go to their department for surgery. Well, this is a rare case. .
The dispute was left to Chen Zhendong. Although endometriosis is a gynecological disease, if it is ectopic to the liver, it is a disease of hepatobiliary surgery. Moreover, we came to the hepatobiliary surgery clinic. As the first-diagnosing doctor, they have a greater right to choose.
It’s just that Wu Xiaofu saw that the gynecology department was so entangled that he simply let the patient make a choice.
The director of gynecology was embarrassed but agreed.
However, the patient came here for Wu Xiaofu, especially after hearing Wu Xiaofu's admonishment, he trusted Wu Xiaofu even more. How could he give up Wu Xiaofu and choose gynecology at this time, so he firmly rejected the director of gynecology.
The patients had to be treated here by Wu Xiaofu, and the director of gynecology had no choice but to nod and leave.
It’s already Thursday. If you want to have surgery, you need to undergo some necessary pre-operative examinations and pre-operative preparations. Friday is Wu Xiaofu’s outpatient clinic, so the surgery can only be scheduled for next week. . "Let's arrange it on Monday."
The next day was Wu Xiaofu's outpatient clinic again.
Granny Wang was the first patient Wu Xiaofu received in the morning.
"Dr. Wu, my mother has been suffering for more than half a month. I said she should come to the emergency room first. She insisted on calling you because she was afraid of spending money. No, I have endured it for half a month, but now it feels worse than before.
Before, it was just a stomachache, but now it hurts even my legs.”
The patient’s son was speaking, Wu Xiaofu looked at it. After looking at the registration information, Granny Wang was already seventy-five years old, which is quite a lot. At this time, if you have stomachache, you have to consider many diseases.
Cholecystitis, gallstones and the like are minor problems.
"Come, let me take a look."
On the diagnosis and treatment bed, Wu Xiaofu found that the patient mainly suffered from distension and pain in the lower abdomen and pain in hip flexion of the right thigh. Since in addition to abdominal distension and pain, there was also pain in the thigh, if If that's the case, it doesn't look like some tumor-related disease.
Human organs actually have time validity. As age increases, various organs may have some problems. This is also the reason why the probability of cancer increases as age increases.
Especially the liver and gastrointestinal tract are most prone to problems.
Nowadays, patients say they have stomach pain or persistent pain, which inevitably makes people think of the worst. However, tumors generally do not spread to the legs unless it is more serious.
However, the probability is much smaller.
“How does it feel here?”
“It hurts.”
“Here it is.”
“It’s okay here.”
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"Mummy."
"Mummy."
Fortunately, although Granny Wang is old, she is deaf, otherwise, it would be difficult to proceed with the consultation.
Finally, Wu Xiaofu also determined that the main symptoms were still in the abdomen, but in addition to the abdomen, there was also numbness, pain, paresthesia, and radiating pain in the groin and inner thighs, which seemed like neurological symptoms.
And it only occurs after the sciatic nerve is compressed and injured.
If that's the case, is it a hernia?
As for the condition of the abdomen, the patient has not eaten much in the past half month, because whenever he eats, he will have stomach pain. Moreover, when sleeping, he will wake up because of colic, and his bowel movements are also bad. not good.
This shows that abdominal problems are mainly in the intestines and stomach.
If this is the case, it is consistent with a hernia.
Having an idea, Wu Xiaofu just followed this investigation. Modern medical practice is different from ancient medical practice. Modern medical practice first makes a preliminary diagnosis, and then conducts examinations based on this diagnosis. After the diagnosis, Treat again.
But in ancient medicine, because there were no modern methods, it was almost impossible to make a diagnosis. Treatment could only be carried out based on preliminary diagnosis. This is why doctors are good and bad.
Good doctor, the initial diagnosis is right, and the treatment is done in one step.
A poor doctor will have a poor initial diagnosis, and it is easy to delay treatment. If the condition is serious, the patient may die as a result.
So, no matter how you say it, this modern examination method is good and can reduce a lot of misdiagnosis.
Based on the patient’s condition, just perform a CT examination of the lower abdomen.
Grandma Wang’s CT scan came out in the afternoon.
Examination report: The right obturator hernia is incarcerated, and the content of the hernia is part of the small intestine.
It was indeed a hernia.
However, this hernia is different from the hernias commonly seen. It is an obturator hernia.
The obturator foramen refers to the hole from the pelvic cavity to the thigh, a round hole formed by the pubic bone and the ischial part of the hip bone. It is located above the obturator membrane and can generally accommodate the passage of fingertips.
Obturator hernia refers to an external abdominal hernia in which the abdominal organs protrude through the obturator foramen of the hip bone toward the femoral triangle.
This type of obturator hernia is very rare in clinical practice. Its incidence rate among all hernias is less than 1%, and it is more common in women.
Because the symptoms are mild at the onset and it is difficult to feel a clear mass, it is difficult to make an early diagnosis.
Only when symptoms of obturator nerve compression and intestinal obstruction appear, such as numbness in the groin and inner thigh, pain, paresthesias, radiating pain, etc., will active examination and diagnosis be initiated.
Just like Granny Wang, the symptoms are almost the same. Moreover, obturator hernia is more common in elderly, frail, emaciated, and multiple-birth women, because in such patients, the obturator structure Changes can easily lead to incarceration and intestinal necrosis.
Grandma Wang only waited for half a month, but she did not suffer from intestinal necrosis, but she did have intestinal obstruction. This was the reason for her abdominal symptoms.
Once obturator hernia occurs, manual reduction cannot be attempted, as this will only cause greater damage.
Generally, surgery is required to solve the problem.
And because of the structure, the difficulty of the operation is not low. The main difficulty lies in the need to pay great attention to avoid damaging the obturator blood vessels and obturator nerve when releasing and freeing the hernia sac and surrounding peritoneum during the operation.
Once injured, it will be difficult to stop bleeding and cause sensory nerve dysfunction in the lower limbs after surgery.
Grandma Wang's obturator hernia was incarcerated for a relatively short period of time, and there was no intestinal necrosis. Wu Xiaofu planned to use a biological hernia patch to cover the obturator during the operation to avoid recurrence of hernia surgery to the greatest extent.
However, this type of surgery was previously a traditional open surgery, which was also an incisional surgery. This time Wu Xiaofu had other ideas and challenged himself to do it laparoscopically.
Although both are hernia surgeries, laparoscopic surgery for obturator hernia and laparoscopic surgery for conventional hernia are not at the same level of difficulty. After all, obturator hernia involves too many nerves and blood vessels and is not ordinary at all. Hernias are comparable.
Obturator hernia is also rare, which does not give many major hospitals the opportunity to try laparoscopic surgery.
So, in the world now, laparoscopy is not performed for obturator hernia.
If Wu Xiaofu succeeds, it will be the first in the world.
Although the incidence of obturator hernia is not high, there are a lot of them around the world. If laparoscopy can really be performed, it will undoubtedly be great news for these patients.
After all, laparoscopic surgery has the characteristics of small trauma, fast recovery, short hospitalization time, clear surgical field, and thorough surgery. Compared with traditional surgery, laparoscopic surgery has many advantages.
Obturator hernia surgery should not be delayed, so Wu Xiaofu directly arranged the surgery early in the evening after the outpatient clinic was over.
The outpatient clinic didn’t end until evening approached.
Wu Xiaofu did not delay and went directly into the operating room. When he saw the last few patients, Granny Wang had already been sent to the operating room. When Wu Xiaofu entered the operating room, Peng Xia had already started disinfection.
(End of this chapter)