Often, many surgeons would rather go for tertiary surgery than perform first-degree appendicitis resection for a pregnant woman in the third trimester of pregnancy! Because the risk is too high, if you don't get it right, you will have two lives, and this is no joke.

Therefore, pregnant women are definitely blacklisted in the list of many surgeons.

Although appendicitis during pregnancy can be surgically removed. Appendicitis during pregnancy can be divided into appendicitis in the first trimester, appendicitis in the second trimester and appendicitis in the third trimester according to the number of weeks of gestation. Regardless of the trimester, surgery can be performed when acute appendicitis occurs. However, the complications of appendicitis surgery vary from pregnancy to pregnancy, and the degree of risk is somewhat different. For example, the younger the gestational age, the more likely it is to cause miscarriage or preterm birth, and the third trimester is closer to delivery. However, the complications of appendicitis surgery in the second trimester of pregnancy are relatively rare and the safety is greater.

In other words, if Ruan Bin, a pregnant woman who is nine months pregnant, performs surgery on her, it is very likely to cause premature birth! Why is it premature? For example, violent contractions during the operation, or heavy bleeding, etc., will cause premature birth.

After all, it is the same sentence, the operation should be fast, don't make mistakes, and it will be basically stable. The advantage of laparoscopic surgery is that the wound is small and the pain is light, which reduces the possibility of causing contractions. There is also a fast recovery, short hospitalization, less bleeding, and you can be discharged in three or four days.

"Let's upgrade my surgical skills first!" Before Ruan Bin entered the operating room, he began to upgrade his surgical skills for appendectomy.

"System!"

"Krypton Divine Doctor System"

[Host: Ruan Bin]

【Occupation: Doctor】

【Vocational Skills】:

1: Debridement and suturing of superficial trauma: world-class+

...

4: Appendectomy: not entry+ (traditional laparotomy, laparoscopy.) ）

...

... (Don't write so many surgical skills, to prevent you from saying that I have a water word count~ hum!)

15: Cholecystectomy: World Class + (Traditional, Small Incision, Laparoscopic)

Points: 3500 (Friendly reminder: You can get points by completing system tasks, and you can also get points by charging money.) ）

System tasks: 1: Persist in not being deducted points for one week (not completed).

"Escalate appendicitis resection!" Ruan Bin thought silently.

"Ding-dong...... Deduct 200 points, Appendectomy: Getting Started+. ”

"Keep upgrading!" He knew that this first-level appendectomy included two surgical methods, so it required more points than other first-level operations, and even comparable to second-level surgery!

"Ding-dong...... Deduct 400 points - proficient +!"

"Ding-dong...... Deduct 800 points - Director level +!"

"Ding-dong...... Deduct 1200 points - Expert +!"

"If you don't have enough points, please top up ......"

Ruan Bin gritted his teeth: "Charge 700!"

"Ding-dong...... Deduct 1600 points - world-class+!"

With the appendectomy upgraded to a world-class level, Ruan Bin not only got 700 yuan, but the points of the system were also cleared, which was really cool for a while.

Yang Tian's assistant for this operation was Huang Hongwen.

This guy was even more excited than Ruan Bin at the moment! He felt that he would definitely learn something by following this genius for surgery!

After all, everyone is about the same age, and they are also here for further study, so they are easier to speak.

The anesthesiologist has begun general anesthesia, and Huang Hongwen has been preparing surgical instruments, such as CO2 pneumoperitoneum device, ultrasonic knife host and ultrasonic knife head, laparoscopic irrigation system, needle holder, cloth towel forceps, curved hemostat, tissue forceps, wire scissors, No. 11 sharp knife, toothed short forceps, knot pushing rod, etc......

I have to say that there are indeed more things to prepare for laparoscopic surgery than for traditional laparotomy.

Everything is ready, the surgery begins.

"Lao Huang, the incision of general laparoscopic appendectomy is at the inner and lower edge of the umbilical foramen, the lower left of the lower abdominal umbilicus, and the lower right abdomen at the lower three points of the Mai point, right?" Ruan Bin asked while making an incision.

"That's right!" Huang Hongwen nodded, although he is a good cook, he has a good textbook memory!

"But the incision I made for laparoscopic appendicitis resection is different from the textbook, I like to use the reverse McLean's point as the observation hole, and the umbilical hole as the main operation hole can reduce the chopstick effect!" Ruan Bin said with a slight smile. That's what he gained as a result of his world-class appendicitis resection. The most suitable is the best, and the textbook is not necessarily the best!

The so-called chopsticks effect is that the laparoscopy is made with a single incision and a single orifice, the operation space is narrow, and the instruments cross and interfere with each other, which is easy to fight!

"It turns out that it can be like this!" Huang Hongwen nodded after hearing this, Lao Tzu finally learned something useful!

Just when Huang Hongwen was still recalling Ruan Bin's words, Ruan Bin had already made all the incisions, handed over the pneumoperitoneal needle and the empty needle filled with water (to remove the needle) for the abdominal drip test!

In addition, the umbilical incision is 10 mm, which is the main operation hole, which is convenient for removing the specimen. ”

"I've been taught!" Huang Hongwen nodded violently while handing over the surgical instruments, he felt that what Ruan Bin explained was to the point, one step in place, and it was relatively in place.

At this time, Ruan Bin's drip test was completed, and there was no problem. The pneumoperitoneum needle was withdrawn, the abdominal cavity was punctured with an introducer, the inner core was extracted, and the laparoscope was inserted, and no abnormalities were found on the surface of the abdominal cavity.

Then place a 10mm Trocar, put the pre-warmed lens into the Trocar, and look around the abdominal cavity to detect any collateral injuries and periappendiceal conditions.

Ruan Bin's movements are very fast, because these are the usual surgical steps before the removal of the appendix, just to explore the situation, whether there is any abnormality, and whether the operation can be continued.

So these steps can be as fast as possible, just know the bottom of your heart!

That's experience.

Two more trocars were punctured under laparoscopic vision, and a 10mm trocar was inserted into the laparoscopic direct view of the outer edge of the rectus abdominis muscle on the right side of the umbilicus, and forceps were placed on the left side. A 5 mm Trocar (C incision) is inserted under laparoscopic direct vision at 5 cm above the pubic symphysis, and a separator forceps is placed in this hole, ultrasound!

Change the head to lie on the left side with high feet and low feet, lift the appendix with forceps, separate and dissect the mesoappendium with ultrasound, and then electrocoagulate and truncate the appendix artery after leaving the appendix artery......

The action is done in one go!

Lightning-fast!

At this point, the operation is almost half complete.

At this moment, there are no contractions in the pregnant woman, and other data are relatively normal, so the operation is considered a success!

Originally, laparoscopic appendicitis resection was much easier than laparoscopic cholecystectomy, so this time Ruan Bin's speed was faster.

The surgery was over in 13 minutes!

Generally speaking, appendicitis surgery can be completed in 30 minutes if it is fast, unless there are special circumstances, it is more difficult to remove or something, and it takes one or two hours.

But now Ruan Bin encountered a difficult patient, it was still completed in 13 minutes, far beyond the conventional time, he sighed in his heart, worthy of the world-class level!

If you start the operation yourself, you are afraid!