(Today's three watches, ask for recommendation votes, collect, reward!)

This process is very important!

Because you need to observe the patient's specific condition before proceeding to the next step of surgery.

This is because if the following conditions are found during laparoscopic cholecystectomy, continued laparoscopic cholecystectomy is prone to complications such as bile duct injury, and it should be transferred to laparotomy on a case-by-case basis.

For example, if you find that the common bile duct, cystic duct, and common liver duct in the gallbladder triangle have adhesions that are difficult to separate, and the anatomy is difficult to distinguish. and the cystic duct opening is too high close to the hilum of the liver, making it difficult to separate the cystic duct. or the cystic duct is too short by 5 mm) to be clamped. There are also cystic duct parallel to common hepatic duct or common bile duct and gallbladder artery variations.

In addition, if it is found that there is already vascular damage during the operation, resulting in active bleeding, bile duct injury, bile duct wall electrical burn, duodenal and other organ injury, it should also be transferred to laparotomy in time to deal with these injuries!

Ruan Bin quickly checked and found no of the above situations. This patient can be operated on laparoscopically!

"How's the situation?" Jiang Yurong asked.

"The gallbladder is adherent to the internal organs of the abdominal cavity!" Ruan Bin said, using a sponge rod to blunt separation.

After the separation, it is possible to distinguish the common bile duct, common hepatic duct, and cystic duct, and then carefully cut the serous muscle layer at the ampulla of the gallbladder with an electrocoagulation hook. As a result, blunt separation is performed in the direction of the common bile duct, and the common bile duct, cystic duct, and common hepatic duct are fully exposed.

A series of operations were as fast as lightning, and Jiang Yurong, who could see it, was numb in her scalp!

"Ruan Bin, do you want to be so fast? I'm worried that if you are too fast, it will be bad if you make a mistake. Jiang Yurong said worriedly. Because when it comes to surgery, the faster you go, the more likely you are to make mistakes. The probability of mistakes will definitely increase!

"Don't worry, believe in my 25 years of single hand speed!" Ruan Bin smiled slightly.

After confirming the above anatomical relationship, he separated the tissue around the cystic duct!

To this part, care should be taken not to burn the common bile duct.

Ruan Bin has world-class experience and standards for this, and of course he knows it by heart, and uses titanium clamps to clamp the cystic duct 3mm away from the common bile duct and cut it. The gallbladder artery was sought by blunt separation on the medial side of the gallbladder triangle, and after the gallbladder artery was revealed, the gallbladder artery was cut by clamping.

Jiang Yurong next to her looked at Ruan Bin's dazzling operation, and she muttered in her heart: "Is this person really a genius in surgery? After the operation, he didn't even sweat a drop, and there was not the slightest nervousness on his face at all, but he was extremely calm, how did he do it?"

To be honest, she will be nervous about this kind of risky surgery! Once she concentrates, her body will definitely sweat involuntarily.

But this guy ...... Freak!

At this point, the surgery has been carried out to remove the part of the gallbladder. Jiang Yurong looked at her watch, only 13 minutes had passed, and it was terrifying!

At this rate, it can really be done in 20 minutes!

Ruan Bin lifted the neck of the gallbladder and gradually cut the gallbladder from the gallbladder bed about 5mm away from the liver. Adequate electrocoagulation to treat bleeding from the gallbladder bed. After careful exploration to confirm that there is no active bleeding in the abdominal cavity, no bile duct and other organ damage in the abdominal cavity, the gallbladder is placed in the specimen bag, and then the laparoscope is moved under the xiphoid process, and the gallbladder is taken out of the body through the umbilical incision!

At this critical moment, it is still a dog-like operation.

Nothing happened.

However, when the gallbladder was removed, the pregnant woman had a slight contraction, but Director Du next to her prompted: "The problem is not big, the contractions are not violent, and the operation should be fine." ”

Hearing Director Du's words, Ruan Bin was even more relieved, if a pregnant woman had violent contractions, it would be really dangerous. Because at any time, pregnant women can be born prematurely, and even pregnant women and babies will die.

After observing for another half a minute, after confirming that there is no problem, CO2 is released to eliminate the pneumoperitoneum, and the anterior sheath of the rectus abdominis muscle is sutured for the incision under the umbilicus and xiphoid process, and the wound is closed with a band-aid.

The surgery is complete!

"How long will it take?" Ruan Bin asked with a relieved sigh of relief.

"I'll see. ”

"It took 19 minutes and 38 seconds! Oh my God, you really did it. Jiang Yurong was shocked again.

"Hey...... Live up to expectations!" Ruan Bin smiled. At the same time, the sound of completing the task sounded in his head.

"The contractions of the pregnant woman did not continue to increase, but calmed down, I think this operation was really successful, Dr. Ruan, you are really amazing!" Even Director Du gave Ruan Bin a thumbs up.

They have such a master of cholecystectomy in their hospital, and they are not worried about the pregnant women who will be sent to their gynecology department in the future.

"Ruan Bin, I think your surgery can be recorded as a textbook teaching video in our hospital, and it can even be posted on our vast surgical forum for people to watch. I'm sure this surgery will definitely surprise a lot of people's jaws. Jiang Yurong said with a smile.

"Did I record this operation?" Ruan Bin wondered.

"Recorded. Jiang Yurong nodded.

"But I'm just a resident doctor for further study, so let my operation video be recorded in the First Affiliated Hospital of Modu, isn't it?" Ruan Bin touched his nose.

Generally speaking, the teaching and operation videos recorded by the chief surgeon of the hospital are recorded by the chief surgeon of the hospital and used to watch and communicate with the doctors who are studying at that time.

Now he is not a doctor at this hospital, but a doctor who is training.

"What's this? This surgery of yours is so representative, what's not so good? I'll help you get it!" Jiang Yurong made a decision directly.

"Okay!" Ruan Bin didn't care.

At noon.

Office.

"At noon, I'll have a small meeting, Huang Hongwen, you call Deputy Director Liu and several attending physicians over. Jiang Yurong said coquettishly. Director Qian is resting today, so he didn't mention it.

Soon, Deputy Director Liu and several attending physicians of the hospital came in.

"Deputy Director Jiang, what kind of meeting are you having? I'm busy. Deputy Director Liu said nonchalantly.

He's getting ready to eat.

"This morning, Ruan Bin performed a laparoscopic cholecystectomy, and he did a very good job in this operation! I plan to let him put this operation video into our hospital's teaching video database, which can not only allow more doctors to learn and watch in the future, but also let our doctors in our hospital watch and exchange. Jiang Yurong said.

As soon as this sentence came out, everyone looked at Jiang Yurong and Ruan Bin in surprise.

Even if a cholecystectomy performed by a trainee doctor is a good performer, it is not eligible to be included in our hospital's teaching video database, right?