In fact, it is not a last resort, and doctors rarely perform abdominal decompression surgery on patients. Because the patient had already undergone one operation, it is not said that opening the abdomen again now will cause secondary surgery damage to the patient. The risk of complications after abdominal decompression is also greatly increased.

However, if abdominal decompression is not performed, kidney failure, kidney necrosis and infection will occur to the patient. If it's serious, it's going to be fatal!

Therefore, abdominal space syndrome is a very serious condition, and it will hang up if you are not careful.

Since you have to have surgery, you must first light up your surgical skills.

"System!"

A few days ago, Ruan Bin watched all the teaching videos of the first and second level of general surgery, and even some of the third level surgeries.

It just so happens that this abdominal decompression is also among them!

[System Points]: 900

[Abdominal decompression]: no entry+ (laparoscopic decompression, open abdominal laparotomy decompression, abdominal stomy decompression. ）

"Level up!"

"Ding-dong...... After deducting 500 points, [Abdominal Decompression] is upgraded to - Beginner!"

"It's over, it's going to be krypton gold again!" Ruan Bin saw this and knew that if he wanted to be promoted to the director level, he would definitely have to charge the money.

"Recharge 6,000 from your bank card!"

"The recharge was successful. ”

"Keep upgrading. "At this time, the deposit of Ruan Bin's bank card is only about 23,000, and he is really getting poorer and poorer~

"Ding-dong...... After deducting 1500 points, [Abdominal Decompression] will be upgraded to - proficiency level!"

"Ding-dong...... After deducting 4,500 points, [Abdominal Decompression] will be upgraded to - Director level!"

At this time, he still has 400 system points left.

At the same time, I have to say that this [abdominal decompression] is quite expensive, in fact, it is not a small difficulty to operate, and even the most difficult secondary surgery is not necessarily as difficult as it.

Because when decompressing the abdominal cavity, there are many things involved in it, five abdomen and six organs, if there is a problem with those wounds of the five abdomen and six organs, it must be treated, or even repaired and removed. But this surgery also involves three surgical skills, so it's not cheap.

To be honest, now Ruan Bin regrets a little bit and says that he knows how to deal with this coeloperitoneal space syndrome, you see, he lost another 6,000 to go out.

I still operated on a fake qigong master who seemed to be cheating money everywhere, but when I thought that I was a doctor, doctors should save lives, so I endured it!

"Let's earn it back on those plastic surgery patients in the future~" Ruan Bin comforted himself in his heart.

General anesthesia, surgery begins.

Zhang Haoyu worked as an assistant for him.

The first step in surgery is to open the abdominal wall, which is to remove the sutures from the original surgical incision.

After removing the original sutures, Ruan Bin picked up the scalpel and compared the two ends of the wound on the bald qigong master's abdomen, and cut it horizontally!

Enlarge the cutouts on both sides!

The original incision was 15 centimeters, and Ruan Bin went directly to the 20 centimeter side.

Zhang Haoyu next to him saw that his scalp was numb: "Doctor Ruan, should this incision be so big? The original 15 cm incision should be enough, right?"

Isn't it your own stomach, and you are more ruthless?

Generally, a 15 cm incision is already very large, you pour well, directly 20 cm!

"Abdominal decompression is different from other surgeries, the incision must be large, although it looks more penetrating, just get used to it. Nguyen Bin Ba pulled the incision. Begin to look inside the abdomen.

The first thing to judge is whether there is necrosis in the intestines and kidneys!

Ruan Bin investigated and found that the intestines, omentum, and parietal peritoneum were moderately edema, and the intestines and effusions gushed out of the incision.

The peritoneum was then separated and incised, and a large amount of fluid gushed out.

"Medical scissors, tweezers!" Ruan Bin said.

Zhang Haoyu quickly handed over the two things to Ruan Bin's hands.

"Hold it for me, I'll bandage it. ”

...

There are two methods of open decompression, the first is to continue to close the abdomen after the open treatment of decompression surgery. The other is particularly serious, and the abdominal incision is exposed if the abdomen is not closed after the decompression surgery. Although ACS can be avoided by opening the abdominal cavity on the outside, complications such as intestinal fistula, abdominal viscera bulging and abdominal wall hernia, and even wound tearing and opening are prone to occur after surgery.

And only severe patients need this kind of non-abdominal operation, such as when the intra-abdominal air pressure reaches 87pxH2O!

At this time, Ruan Bin began to drain the peritoneum of the intestine and reduce the intra-abdominal pressure......

The method of drainage is to surgically drain and decompress the intestines, peritoneum, omentum, and kidneys, which are organs with hydrops.

Ruan Bin's movements are very fast, although they can't be called swords and swords, but they are also galloping.

Half an hour later, the operation was completed, and the abdomen was closed!

"Okay, no problem, right?" Zhang Haoyu asked with some concern. After all, he is half a bucket of water, and the operation is done, but who knows if the effect will work?

"The air pressure in the abdomen has decreased, but it will be an hour before we know if it will work. Ruan Bin pointed to the monitor and said with a smile. The upper intra-abdominal air pressure shows that it is close to normal.

However, after laparotomy and decompression, the symptoms caused by it, especially the renal and intestinal dysfunction, can generally be improved in 1~2 h.

That is to say, after one or two hours, see if the patient's kidney function and intestinal function are still disordered, if there is still an obstacle and no improvement, then the operation is equivalent to a failure.

"Okay, then I'll call a nurse here and watch. Zhang Haoyu said.

"Yes, yes. Ruan Bin nodded.

Together, the two walked out of the operating room.

It was already past 3 p.m. at this time.

The number of patients is still not decreasing.

"Is there any resident doctor or attending doctor who is available?" Zhao Yaxin asked in the emergency department hall, rushing into some operating rooms.

Still, nothing was found, everyone was busy!

"Nurse Zhao, what's wrong?" Ruan Bin greeted him in confusion.

"Alas~ Director Liu wants to change an assistant, the intern who went in before was clumsy, and he asked for at least a resident doctor!" Zhao Yaxin said busily.

"I see. Ruan Bin could only observe a three-second silence for the intern. It is estimated that he was sprayed by Liu Junchi in the operating room just now, and even deducted a lot of internship points.

However, it is indeed more difficult for an intern to do a fourth-level operation for Liu Junchi as an assistant. After all, it is a fourth-level surgery, and the new interns are definitely not good enough!

Well, if you want to blame it, there are too many patients today and there are not enough people!

"By the way, Dr. Ruan, are you free now?" Zhao Yaxin asked.

"I guess I have, I just finished an operation. Ruan Bin nodded.

"Then you're going to be Director Liu's assistant?"

"Okay, no problem, I'll go. Ruan Bin nodded. If he doesn't go, who will? No one is free now!

......

In the operating room.

When Liu Junchi saw Ruan Bin, the person who came in, he was stunned for a moment, could this kid be on a rocket? The operation over there was completed so quickly?