What are some of the things that might prolong a 10-10 operation?

Zhang Tianyang meditated hard, and finally chose to give up.

It's not that there are too many possibilities, but that this surgery is really simple.

The previous kidney cutting and adrenal glands were done very smoothly, this surgery is no different from a simple cystoscopy, and the devil knows what will go wrong!

If he could have thought of it in advance and stopped it in time, it is estimated that the operation would not have been prolonged.

The sixth sense probably won't be bouncing back and forth.

Brother Li Yueban's heart rate and blood pressure have dropped, and all the items on the anesthesiologist's side have been found.

"Come, move yourself, change your position. ”

Li Yueban's surgery does not require general anesthesia, but it still requires anesthesia.

Zhang Tianyang has seen Li Yueban's surgical schedule, and the anesthesia method marked on it is, "combined spinal-epidural anesthesia".

As the name suggests, it is a combination of epidural anesthesia and spinal anesthesia (subarachnoid anesthesia).

It is usually used for surgeries from the waist down.

In urology, it is a commonly used anesthetic method.

There is no way to anesthetize lying down, you must turn sideways, hug your knees, and arch your lower back.

It's the same as the posture of the waist wear.

Therefore, under the command of the anesthesiologist, Li Yueban's little brother fiddled with his posture for a while, and finally arched his back correctly according to the requirements.

Brother Li Yueban's skin is white, white and fat, and there is a lot of fat.

After the whole back was arched, I still couldn't see the bulge of the spine clearly, and when I pressed my hand, I could clearly feel a thick layer of flesh pads.

"Dude, it's time to lose weight!"

The anesthesiologist set the puncture site and patted Li Yueban's waist with his hand.

These two slaps went down, and the flesh trembled suddenly.

The anesthesiologist's face was a shade darker.

"This guy is not easy to wear!"

Turning his head with a sad face, a pair of sterile gloves were handed in front of him.

With his eyes running down his arm, the anesthesiologist found that it was Zhang Tianyang who came over.

"Huh?"

He took the sterile gloves, but did not rush to unpack them, and expressed his doubts in a nasal voice.

"I'm here to give the teacher a hand. ”

Zhang Tianyang blinked, and his tone was sincere.

"I see that your intern is off work and you don't have an assistant anymore, so I came over to see if there was anything I needed help with. ”

Anesthesiologists do not rest at noon, so the free labor who rotates in the anesthesiology department can leave work at four o'clock every day.

Of course, anesthesiologists who are already regular workers can only "fall straight" bitterly and stick to their posts until all the operations in this operating room are over.

Just before the fourth patient arrived, the anesthesiologist's "little coolie" had already sneaked away, and now he was really "alone".

Zhang Tianyang took the initiative to help at this time, and the anesthesiologist was instantly moved.

Not to mention anything else, just looking at Zhang Tianyang, I feel a lot more pleasing to the eye!

"Shall we get started?"

Zhang Tianyang asked with a smile on his face, but he had already pushed the treatment table full of instruments over in his hand.

He came up, of course, just to help.

His ultimate goal is actually to get his hands on it.

Strangled all possible accidents in the cradle!

After all, anesthesia is also quite prone to accidents.

"Will you, just rush forward. ”

The instrument nurse, who had been silent for a long time, didn't know why she suddenly jumped out again, and her mouth was full of mockery.

Zhang Tianyang's movements paused slightly, he didn't even look at her, and he had already opened the outermost package of the puncture bag by himself.

"Huh!"

"What the hell!"

This time, the anesthesiologist couldn't stand it.

The instrument nurse scolded Zhang Tianyang before, so it was scolding, anyway, it was not his student.

But now Zhang Tianyang is here to help himself, and you are still in a hurry.

Isn't that looking down on me!

So he was angry on the spot.

"You little girl, if you are in a bad mood, you can lie to your boyfriend, or lie to your little nurse, what are you doing to embarrass our doctor's intern!"

"I ......"

"What are you!"

When it's not about me, hang it high, and when it's about myself, I'm willing to be a "big troll"!

The fourth operation itself was cystoscopic and did not require the presence of an instrumental nurse.

After being angry by the anesthesiologist, the instrument nurse stomped her feet a few times, found a scene without success, and finally turned around and walked away.

"This little girl, usually not like this, today I don't know why I ate gunpowder. ”

The anesthesiologist smiled again, explained a few words to Zhang Tianyang, and felt that something slapped on his hand again.

When I looked down, I saw that it was still the same pair of sterile gloves that had been unpacked and the paper bag packaging inside had not been opened.

He subconsciously shook his head.

"I'm not busy with sterile gloves, there's still a lot of stuff I haven't prepared. ”

"Well, is there anything else you need to prepare?"

Hearing Zhang Tianyang's rhetorical question, the anesthesiologist subconsciously lowered his head to look at the operating table.

"And ...... Eh, when are you ready???

The dazzling array of items flashed the anesthesiologist's eyes for a while.

The process of combined spinal-epidural anesthesia is like a strengthened version of lumbar puncture, and the richness of the equipment is also like a strengthened version of lumbar puncture.

In addition to the preparation for lumbar puncture, the combined spinal-epidural anesthesia also requires the preparation of a series of items corresponding to the epidural.

Various pipes, syringes, various types of local anesthetics, and assembly of different instruments.

Strictly speaking, it's still a bit complicated.

The anesthesiologist still remembers the first time he took his intern to the combined spinal-epidural anesthesia yesterday, and it took ten minutes to prepare the items and explain everything.

And now, how long has it been?

It's just a matter of two sentences!

Is this little intern so fast???

The anesthesiologist was a little messy, and Zhang Tianyang pulled him back to reality with a gentle smile.

"Teacher, can't you wear gloves yet?"

"Oh, oh!

It was rare to be disrupted, and the anesthesiologist's face was a little hot.

But he quickly calmed down with the process of putting on gloves, trying to use his rich experience to occupy the dominant position again.

However, when he turned his head and subconsciously touched the disinfectant items in the operation bag, something had already been stuffed into his hand.

When I looked down, I saw that it was the handle that was connected to the sponge soaked in disinfectant!

Just after the detoxification, the bucket with the yellow garbage bag was kicked under his feet.

As soon as he turned his head, the syringe containing the local anesthetic lidocaine, which had been drawn and drained of air, was handed over.

As soon as he took the syringe, Zhang Tianyang had already begun to calm the patient very humanly and automatically.

"We're going to anesthetize you, it's going to hurt a little, bear with it?"

"Uh-huh. ”

Little Brother Li Yueban tried to nod, "I believe in you, Doctor Zhang!"

Under Zhang Tianyang's guidance, the patient's back was shown wider, and the bony protrusion in the marked area seemed to be a little more obvious.

The anesthesiologist pinched the somewhat trembling needle tip, looked at the patient, and then looked at Zhang Tianyang.

Obviously, now is the best scene for patients to trust and assistants to give strength.

But why, a little uncomfortable?

Inexplicably, there is a nervousness when parents check homework when they are young.

Wait, why do parents check homework?

Why do I feel like an intern like a parent???

Fine sweat broke out on his forehead at some point, and the anesthesiologist's complicated eyes wandered around, then retracted, and then took a deep breath.

Manually.

Zhang Tianyang paid attention to the anesthesiologist's hands.

Watch him hit a raised pichu under the skin with local anesthetic, and watch him go deeper and deeper along the skin, injecting fluids all the way.

Watching him poke in all directions with the needle in the shape of a "pin", a small amount of liquid was left in a large area under the skin.

Then, at the moment when he pulled out the needle, he handed over the gauze to press and stop the bleeding, and the puncture needle needed for the next operation.

The anesthesiologist, who had just regained a trace of his rhythm, couldn't help but breathe again.

Here it is again, and that feeling is here again!

It's like when I was a child, I worked hard to complete a big event that I thought was great, and then when I looked back, my parents followed me all the way, and they gave applause and hugs in a very timely manner, and didn't forget to add a sentence "Baby, you're awesome!"

In such a moment, what I thought was great just now seemed to have become a small case that was insignificant in the eyes of parents and was in their hands.

And then all the swelling is like poking a hole in the ball, and it is deflated in minutes.

Handing Zhang Tianyang a somewhat "resentful" look, the anesthesiologist sighed, handed out the deflated needle in his hand, and took the new long puncture needle.

There's an old saying.

If life deceives you, don't be sad, don't be sad.

When you can't resist, it's better to lie down and get ready to enjoy.

When the anesthesiologist put down his resistance and accepted Zhang Tianyang's "service" wholeheartedly.

Hey, pretty cool?

Clothes come to reach out, food comes to open your mouth, and the needle is pulled out and helps you wipe and clean up.

Hiss –

Whew-

Zhang Tianyang also vaguely felt the changes in the anesthesiologist, but he didn't care about these.

He was concerned about the course of the anesthesia itself.

The whole process of combined spinal-epidural anesthesia is still very simple.

The whole process is equivalent to a "lumbar puncture" to inject a small amount of anesthetic into the subarachnoid space, while leaving a spare tube in the epidural space.

In case the anesthetic effect is not enough and the operation time is too long, the anesthetic can be supplemented through this tube to continue to maintain the anesthetic effect.

However, the simple principle does not mean that the operation is not complicated.

After lumbar skin and subcutaneous local anesthesia, an epidural puncture needle is also required.

After reaching the epidural space, a spinal anesthetic needle is inserted.

At this point, it is necessary to withdraw the cerebrospinal fluid back to unobstructed like a lumbar puncture, and then give an appropriate amount of local anesthetic.

Finally, the spinal anesthesia needle is pulled out, and the epidural tube is inserted into the epidural space through the epidural puncture needle and fixed.

With every step here, there is the possibility of mistakes.

For example, if spinal anesthesia fails, you can't wear cerebrospinal fluid......

For another example, the epidural catheter failed, and even the tube poked directly into the blood vessel......

Fortunately, under the "supervision" of Zhang Tianyang's single-handed feeding technique, the whole process was successfully completed.

Although because of Li Yueban's figure problem, the steps of waist piercing were delayed for a while.

But after all, the anesthesiologist is an experienced and familiar hand, and Zhang Tianyang didn't have a chance to say that, "Or I'll try", and the whole anesthesia came to an end.

The last needle was withdrawn, the wound and the indwelling tube were sealed and fixed with gauze and adhesive tape, and the anesthesia was finally declared.

The anesthesiologist dropped the instrument and looked around, a little stunned, and still unsatisfied.

How did it end so quickly?

How long has it been?

It's hard to have a good time, but can't I experience it more?

On the other side, Zhang Tianyang breathed a sigh of relief.

It's amazing that the difficulty of anesthesia has finally passed, and nothing has happened.

He looked at the anesthesiologist and subconsciously praised him, "No......"

As soon as he opened his mouth, Zhang Tianyang realized something, and forcibly swallowed the sentence "not bad" and replaced it with:

"It's not a loss to the anesthesia teacher!

The anesthesia teacher who was held by Zhang Tianyang felt ashamed of such a compliment, and praised Zhang Tianyang with a smile.

"Dr. Zhang is also very skilled! If you get started, you should be faster than me. ”

This opening is equivalent to putting Zhang Tianyang as a doctor of the same level.

The anesthesiologist had a smile on his face and shock in his heart.

For a moment, he even thought that the other party was going to say "good", and he felt that the other party should say so!

It's just horrible.

Operate this kind of thing, whoever does it knows.

For a long time, he was urging those clumsy interns to rush forward, but he didn't expect to be the one who was driven forward today.

I don't know where this little classmate practiced, and he was even more skilled than him, an old anesthesiologist.

Could it be that the family has opened a hospital?

After a little cranky thought in his head, the anesthesiologist quickly denied the idea.

How could it be!

Even if there is a hospital, it is impossible to use patients to practice!

......

After getting through the anesthesia, Zhang Tianyang really couldn't think of a cystoscopic operation, where would there be moths.

Therefore, he could only give up the struggle, step aside, and be a low-key bystander like the first three surgeries.

Perhaps it is because I feel that this level of surgery does not require the chief physician to perform the surgery at all.

Therefore, the chief surgeon of this operation is the bald head of the deputy chief physician.

"Okay, then get ready. ”

Senior Brother Meng was the role of an assistant as always, and he also greeted the two little white cats before taking the stage.

"Senior brother and sister, the last operation is over, hold on. ”

The bald head led Brother Yang also looked at this side for a few seconds, and then nodded lightly at Sun Yu.

I don't know why, Zhang Tianyang always felt that he seemed to deliberately ignore himself.

Compared to before, it seems a little cold.

"I've accidentally offended people again???"

Tianyang fell into a brief contemplation, and then quickly gave up because he couldn't figure it out.

And over there, the bald head and the bladder have successfully entered Li Yue's body.

On the screen, a camera view of the inside of the bladder is displayed.

The camera turned around a few times, and soon captured a large piece of peach pit-like things.

"This is the big rock. ”

Senior Brother Meng was still preparing the laser knife on the instrument table, and took the time to explain a few sentences to the two little white cats.

"Our next job is to use a laser knife to slowly break the stone, and then wash the rubble out with a stream of water. ”

It sounds simple, but it looks really simple to do.

The bald head instructor manipulated the laser knife, and the "peach pit" was quickly beaten into two "small peach pits".

"This stone is a bit hard, come on, it is estimated that it is water grinding kung fu. ”

Urology is a department that is happy to give the opportunity to the little doctors below.

The bald head led the teacher just a few symbolic blows, and then handed over the operation to Senior Brother Meng.

And Senior Brother Meng did not do badly.

Although it is a laparoscope, it is also very proficient in use.

At this point, the operation enters the most boring mechanical repetition period.

What Senior Brother Meng has to do is to keep finding a large stone, hold it down, and then use a laser knife to hit it with a "da-da-da" to make it more broken.

Find a stone, hold it down, hit him.

Find a stone, hold it down, hit him.

Ten minutes after finding it, the bald instructor yawned.

"I'll go to the side to rest for a while, you help Xiao Meng watch, and come to me if you have something." ”

Then, the sturdy figure twisted a few times, passed through the instrument "forest" in the back of the operating room, pushed open the innermost door, and disappeared outside the door.

In the operating room, for a while, only Senior Brother Meng, who was "da-da-da", and two helpless, weak, and poor little white cats.

"Da Da Da

The laser knife continued to make a sound under Senior Brother Meng's operation, and it actually had a hypnotic effect.

After another five minutes, Sun Yu was a little dizzy and drowsy, so he had to take out his mobile phone to refresh himself.

Zhang Tianyang frowned, forcing himself to keep his attention.

That sixth sense still lingers.

Nine times out of ten, there's something waiting for us.

But the boring repetitive work is really exhausting, and he can't help but rub his eyes.

When he looked at the screen again, he was slightly stunned.

In the screen, he is still looking for stones, holding down, and hitting his rhythm.

But......

"I always feel like there's something wrong with me?"