Mr. Jiang carefully looked at the bloodstained metal ball.

"Don't take the hemostats off, if it's not enough, make another cut-out bag. Zheng Ren admonished.

Who knows what this thing is, there is no connective tissue entanglement, if the hemostatic pliers are released and the metal blade is retracted, it will be terrible if there is any weird change in this thing.

Mr. Jiang responded cautiously, and asked the instrument nurse to cover it with a layer of cotton pad, and then put it far away, so as not to really collapse and hurt people.

Unknown dark lightning was ruled out, but the operation had only just begun.

Zheng Ren sucked blood with a suction device and observed the patient's abdominal cavity, and there were no other metal objects.

After confirming this, Zheng Ren was also a little bolder, reached in, dragged the spleen, and began to cut the spleen.

Free, clamped, cut, sutured, the broken spleen was quickly cut off.

Putting it in the basin, Zheng Ren did not rush to move on to the next operation, but began to study the spleen.

"Mr. Jiang, where is your home?" Zheng Ren suddenly asked.

"I'm from the Imperial Capital. Mr. Jiang replied with some doubts.

"Have you ever seen a hunt?"

"......" Mr. Jiang was stunned for a moment, hunting? What the hell is this?

"What do I think of this wound and the metal ball that has just been taken out, like something for a big animal. ”

"What?" Mr. Jiang still didn't understand, but when Zheng Ren said this, he made up his brain.

The metal ball is wrapped in meat and flour mixed with sesame oil, sprayed with incense, and thrown into the field where large animals are infested.

The so-called large livestock generally refers to wild boars. Now bears are all protected animals, and their numbers are small, and there are not many people who hunt them. Although wild boars are also protected animals, this thing reproduces much faster than bears, and it is close to becoming a disaster.

After eating, the metal ball unfolded, shattering the stomach, and the wild boar and other large animals died because of the bleeding.

Although the metal blade on one side of the metal ball was spread out and the other side was not, Zheng Ren still felt that his guess was right.

It's just that this kind of thing has been updated, but the principle is still the same.

Mr. Jiang's brain supplement, and he also understood.

"Is this child fed by others or eaten by himself?

"I don't know. Zheng Ren put the spleen, which had stirred up a huge wound, into the pathological basin and began to look for the wound on the liver.

There are several scratches on the liver, which are relatively deep, and because the hepatic hilum is entangled, there is very little bleeding.

Absorbable sutures suture the liver, untie the liver portal blockage, Zheng Ren observed for 30 seconds, and saw that there was no continuous bleeding, so he was relieved.

The hepatosplenic hemorrhage is solved, and the rest is to the point.

The stomach has been cut open, and the stomach and intestines have been damaged due to gastric bypass surgery. It's a big job, and you have to deal with it little by little.

"Boss Zheng, is this after gastric bypass surgery?" Mr. Jiang asked in surprise when he saw the patient's situation so far.

"Yes. ”

"Open surgery? I thought the patient had had other surgeries before, what happened?"

What Mr. Jiang said was not very clear, but Zheng Ren knew what he meant.

Gastric bypass surgery is now done laparoscopically, and the operation is relatively simple and less traumatic. The patient in front of me had an open surgery.

Since 2000, gastric bypass surgery has replaced gastric reduction surgery as the most popular bariatric surgery in the United States, with about 100,000 cases performed each year.

In 2004, the National Institutes of Health included gastric bypass surgery in the U.S. National Health Insurance, officially recognizing gastric bypass surgery as the most effective bariatric surgery.

More than ten years have passed, and now it is minimally invasive laparoscopic gastric bypass surgery. And this child turned out to be a knife, no wonder Mr. Jiang was surprised.

Jeong-in didn't explain, but proceeded with the operation.

Several bleeding points of solid organs have been removed or sutured, and the patient's bleeding has basically stopped.

With the transfusion of fresh frozen red blood cells and plasma, the patient's blood pressure gradually increases.

Surgery, not so urgent.

Gastric bypass surgery, the principle is to cut the greater curvature of the stomach to reduce the volume of the stomach and then rearrange the intestines.

The surgery divides the stomach into two parts, the upper part of the smaller part and the lower part of the larger part, and then amputates the small intestine, rearranges the position of the small intestine to change the route of food through the digestive tract, slows down the rate of gastric emptying, shortens the small intestine, and reduces absorption.

In this kind of surgery, the probability of intestinal adhesion and intestinal obstruction is relatively high, after all, the intestines must be re-examined.

The operation done by the underground black clinic in Xiangjiang is also regular, but the open surgery is more traumatic and the adhesion is more serious.

The operation preserved the pylorus of the stomach and measured the upper jejunum 25 cm distally, where the jejunum should have been transected using a laparoscopic linear cutting stapler, but the surgeon cut it directly.

After suturing, the adhesion in this area is more severe.

When Mr. Jiang saw this degree of adhesion, his eyebrows wrinkled directly.

What is the most feared thing about gastrointestinal surgery? It must be adhesions.

Gastroduodenectomy is not the most troublesome gastrointestinal and hepatobiliary surgery. It can be said that the "most" surgery is only intestinal adhesion and intestinal obstruction.

In addition, regardless of the level of the surgeon, the length of the operation cannot be determined before the operation.

Because the adhesions are too heavy, you have to be careful not to tear the intestines when decomposing.

Mr. Jiang suddenly became afraid of difficulties.

Zheng Ren didn't think much about it, and asked for hemostats and blunt scissors. With hemostats, blunt scissors are either free or cut, and sometimes even blunt scissors are held in the hand, and fingers are used to free and loosen the adhesions.

Mr. Jiang was able to cooperate at first, but he soon couldn't keep up with Zheng Ren's speed and thinking. However, Zheng Ren was used to operating alone, so he didn't delay anything.

"Boss Zheng, you are so skilled in general surgery. While doing the operation, Mr. Jiang sighed: "I heard Brother Wang say that half a year ago, you helped him do an operation to cut and remove polyps for P-J syndrome. I thought your level was high, but I didn't expect it to be so high. ”

"It's fine. Zheng Ren released the intestinal tube and said casually.

He didn't care much about Mr. Jiang's words, but was more thinking about what to do with the patient's duodenal bulb tumor.

After freeing the adhesions of the duodenum and jejunum cutoff, Jung in found several scratches. Sew it with your hands so that you don't miss it for a while.

The surgery in the Xiangjiang underground black clinic is also standardized, but it is not minimally invasive.

After free release, the anatomy gradually became clear.

The surgeon of Heung Kong measured 150 cm from the distal end of the jejunum to the distal side, and positioned it with a silk thread.

The proximal and distal ends of the jejunum are fixed with silk sutures at a position of 150 cm distal, and all the mouths are made at the mesangial margin of the two intestinal segments, and the jejunojejunal lateral anastomosis is performed, and the anastomosis is about 6 cm.

Finally, a small incision was made at the base of the mesangium under the colon, the sleeve stomach was passed under the colon, and the distal end of the jejunum and the sleeve stomach were fixed with silk sutures at the subpyloric end of the broken end, and the end of the line was anastomosed.

It doesn't matter if the open intestine is scratched, this part of the intestine has lost its original digestive function.

After examining the intestinal rupture, Zheng Ren looked at the duodenal bulb and pondered.

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