Zheng Ren silently glanced at the patient's state, the general anesthesia had been completed, and he could use it at any time. The familiar sound of good luck was automatically blocked by him, and he brushed his hands silently.

People who sing out of tune have no concept of all music.

Clear water flowed out of the stainless steel faucet, and Zheng Ren entered the system space.

At the same time, a tinkling sound was heard.

[Urgent Mission: Transform a Cocoon into a Butterfly.]

Mission: Treat 1 patient with abdominal callouse.

Rewards: 3,000 skill points, 100,000 experience points, and × energy potion.

Mission duration: 15 hours. 】

Huh? Big pig's trotters have given you a task?

This is a bonus, but the quest reward cannot be claimed until it is completed, so it is not needed at this time.

Only the whole language proficiency is given in advance, and this big pig's trotters are still very kind, and Zheng Ren has nothing to blame.

There was a sound of footsteps outside, and Zheng Ren estimated that it should be Director Wei.

Open the menu in the system shop and click to purchase surgery time. The system operating room rose from the ground, and Zheng Ren entered directly without hesitation.

The test subject was lying on the operating table, Zheng Ren had nothing to hesitate, although there was a task of [turning a cocoon into a butterfly] as a supplement, but Zheng Ren, who had experienced a surgical training time and dried up, was now like a miser tightly saving every minute and every second.

On the operating table of the system, the subject was in the supine position, the iodophor alcohol routinely disinfected the skin, spread sterile towels and surgical sheets layer by layer, and made an incision on the right side through the rectus abdominis muscle, the incision was about 18cm long, and the peritoneum was incised layer by layer, lifted and incised.

This set of regular sequences also wasted nearly 3 minutes of Zheng Ren's time.

Slightly distressed, Zheng Ren resisted the urge to dissect the test subject directly. He was still afraid that he would get used to dissecting himself and that he would have symptoms of a split personality.

He is a doctor, not a butcher.

After cutting the peritoneum, there is a piece of white flowers inside. It was dense like a layer of oilcloth, and no other tissues could be seen.

Is it really so heavy to have a cocoon abdomen? Zheng Ren was a little unconvinced.

Zheng Ren held a hemostatic pliers in his left hand, clamped a piece of tissue, and carefully cut it with blunt scissors in his right hand.

Below...... Not the intestines, but a large omentum.

How many layers are densely wrapped, Zheng Ren doesn't understand. It is said that the omentum is a barrier to protect the abdominal cavity, but the omentum of the test subject loses this function and is wrapped in layers of cocoons.

Like a silkworm baby, it adds countless variables to the operation.

As you can imagine, the space inside must also be connective tissue wrapping the intestines, and there are connective tissues outside the intestines, layer by layer, and it feels a headache to think about.

Anyway, it is an experimental subject, although Zheng Ren controls the desire to dissect, but it is still okay to make a slightly larger incision.

On upward exploration, the gallbladder was large, the gallbladder wall was not congested and edema, and there were no obvious abnormalities in the liver and spleen.

It's okay up there, that's good, that's good. If it is combined with diseases such as a ruptured gallbladder, Zheng Ren will be helpless.

In that case, it is estimated that there will be no time left for surgical training.

Zheng Ren carefully opened the dense connective tissue under the omentum, and there was about 30ml of clear light yellow liquid in the sac cavity, and the suction device sucked up the liquid. I don't know how many such cavities there are, Zheng Ren didn't think about other positions first, and hurried to deal with the front one.

Exploration of the bowel reveals adhesions between the intestinal wall and surrounding connective tissue. Blunt scissors are placed on with hemostatic forceps and loosened little by little, carefully detached.

Even at the level of Jeong-in-in's surgery, it is difficult to treat it non-destructively. But every time he makes a mistake, Jung in remembers the difficulty. How much force should be used, whether by hand or with blunt scissors.

The damaged position was also stitched by Zheng Ren.

At a distance of 25cm from the ileocecal part, the intestinal tube was tightly adhered to, and Zheng Ren was slightly forced, and the intestine was torn and a 2-3cm opening was torn.

This section of the intestine is so swollen that it cannot be sutured at all.

Zheng Ren sighed, this operation should have failed.

He had no choice but to manipulate it roughly, and began to dissect the test subject. While dissecting, I warned myself that this was the operating training room, and it was an experimental subject provided by the big pig's trotters. If you're outside, you can't do it so casually.

This is something that Zheng Ren has been careful to avoid.

I'm really afraid that on a whim, I will cause irreparable mistakes outside.

After the autopsy, Zheng Ren found that the patient's intestine was wrapped in countless layers, not only on the outside, but also on the inside.

The cocoon does not only surround the peritoneum and wrap all the intestines, but also wraps the entire intestines.

After a section of the intestine is loosened, connective tissue remains.

In the face of this situation, the best way is to do intestinal resection, which is a simple and brutal removal of all the parts with severe adhesions.

But...... Almost all of the subject's intestines were wrapped, leaving no room for Zheng Ren to remove them.

Total intestinal resection, even if you survive the surgery, you will need to undergo intravenous hypernutrition for the rest of your life.

The most important thing is that the patient is 72 years old and cannot withstand such severe surgical trauma.

Let's honestly peel it off little by little, although the operation is difficult to do, but this is the only way that Zheng Ren can think of to succeed.

Zheng Ren is quite confident in his level of blunt separation, coupled with Dr. Charles's surgical box and surgical tools. If you can't do it yourself, there are few people in the world who can.

After the dissection, Zheng Ren had a certain understanding of the anatomy of the experimental subject, and the second operation was much faster.

After the location of the last intestinal rupture, Zheng Ren added twelve points of caution, peeling off the connective tissue little by little, and adapting to the strength that different intestinal walls can accept.

The intestinal tissue of the subject is very stressed, and even simple actions such as clamping and lifting upwards with hemostatic forceps may cause intestinal damage.

There is no way, Zheng Ren can only sum up the lessons from one failure after another. How much force is applied to the intestinal wall and what equipment is needed.

Fortunately, Zheng Ren's memory has always been good, and with the invisible blessing of the big pig's trotters, he can still barely remember it.

Nineteen failures in a row, and finally Zheng Ren finally completely peeled off the layers of cocoon.

However, Zheng Ren, who was about to swing his intestines, suddenly saw that the patient's ovaries were seriously infected and had dense packages.

So that's it!

Zheng Ren remembers mentioning the source of cocoon syndrome in a literature, which is divided into two conditions: primary and secondary.

Primary cocoonism, also known as idiopathic cocoonism, occurs more often in young women in the tropics or subtropics and may be related to gynaecological infections and autoimmune reactions due to fallopian tube infections or retrograde menstruation.

The patient's age is already menopause. But the infection still comes from the ovaries and pelvis, which are the causative agents.

What should I do? Zheng Renleng froze.

Is it going to be a gynecological surgery next? He looked at the pelvic part and wondered.

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