When he came out of the ward, Dr. Ye also came. Wei'er prepares to take the patient up to the operating room on the fourth floor.

"Wei'er! The operating room has been checked, right? Li Qi asked.

Before any surgery, it is necessary to check the sterilization status and date of instrument packs, cloth bags, and clothing bags. Operating table equipment, lighting, etc.! These are more cumbersome than teaching, but they must be in place!

It's the devil in the details, and it's especially true in surgery. It's all about whether the surgery can go smoothly or not!

"I've checked everything, everything is normal, and no loopholes have been found! Ye An! Go and inform Lee! Take the stage in fifteen minutes! After answering Li Qi's question, Wei'er said to Ye An again.

According to the habit, the patient in Li Hospital entered the operating room, and the anesthesiologist made anesthetic before he came up. That is, the operation begins!

"Master Ye! Let's go up! Li Qi asked Dr. Ye to go up with the patient when he had already gone up to the fourth floor. The two also went up to the fourth floor.

There are two types of anesthesia, general anesthesia and local anesthesia. There are also two types of anesthetics, long-acting and short-acting. It depends on the situation of the surgery! The route of administration is also different, including intravenous administration, oral administration, nasal administration, intramuscular injection, spinal administration, etc.

Today, Dr. Ye is performing local anesthesia, called flax, in fact, this kind of real anesthesia is between general anesthesia and local anesthesia, so it is called sub! It is administered through the spinal canal.

The drug can be administered after the puncture is first punctured and the spinal canal is reached. Then leave a small catheter, which can be dosed at any time. Finally, it is glued with medical adhesive tape, and the outside is connected with a syringe.

It's a long story and complicated, but Dr. Ye can do it in just a few minutes.

While Dr. Ye was performing anesthesia, Li Qi began to perform some preoperative operations of the surgeon! Wash your hands, wash with soap, rinse with water, repeat several times, then test with a pawn, and then rinse with medical alcohol!

After washing, clench your hands into fists upwards. Wear a surgical gown, which must also be done with the help of a nurse behind you. Wear gloves and wear them without touching the outside! Every hospital operating room has an operating room system and a set of standard procedures!

It may be a little different, but the purpose is the same, to operate aseptically, to avoid or reduce indoor infections or reinfections! It's the original set, maybe a little simpler today, but it works even better!

Surgery is a team work, one link after another, and no one can be sloppy and wrong! Otherwise, it will affect the process of surgery, affect the effect and recovery of surgery, and endanger the patient's life! Surgeons always have to be cautious about walking on thin ice!

If you have a choice, no one is willing to be a surgeon, nervous tension, insomnia, nervousness, every time you have surgery, it is like going to the battlefield!

This is not afraid of 10,000, just in case, if the operation fails or there is an error, the patient and his family do not understand, the words are ugly or correct! At this time, it is even more devastating, and you will even want to never have surgery again! It's hard to experience this kind of sadness, remorse, entanglement, anger, and helplessness without being in this industry!

But every time the surgeon walks into the operating room and goes to the operating table, he forgets about it! At this time, there is only one thought, do this operation well, cure the disease and save people! This must be ridiculous and pathetic!

"Okay? Well! Today I am the main knife! Li Qi's surgical assistant, Wei'er operating table nurse, Ye An recorded, Dr. Ye observed the anesthesia, and Luo Bu responded and was responsible for observing the patient's vital signs! "Li Yuan came in when the anesthesia was completed, and assigned the task when it was ready!

This was originally arranged before the operation, but after taking the stage, I will emphasize it again, and it is also to let everyone clarify their responsibilities! "Do you want to add some renin? The anesthetic effect was produced! It's time to get started! Physician Ye said. Each anesthetic has a different anesthetic effect for a different time, which only the anesthesiologist knows!

When the anesthesiologist reaches a certain level, he wants to be numb, how long to numb, and how long to numb, and how long to numb! General anesthesia makes people feel like falling into a dream, and local anesthesia separates feeling from consciousness! It's already art, it's enjoyment!

"Add some points! It may be perforated, and the cleaning time will be longer, and it will prevent bleeding! Li Yuan answered while disinfecting the surgical field! Adding renin to anesthetics can enhance the anesthetic effect and reduce capillary and vascular bleeding!

As for disinfection, this one is simple but rigorous! The principle is to leave no dead ends on the outside and inside out! The disinfectant is canonized and alcohol, and alcohol can be removed in addition to disinfection! This is the disinfection of the place without infection, and if it is an infectious wound disinfection, then it is thoroughly operated from the outside in! This is from the outside in, and from the inside out, it is also to reduce the infection and avoid the spread of infection!

'Vier counts instruments and gauze! Ye An records! "Li Yuan ordered after the poison was eliminated! This is again a necessary procedure and a subsection. Count the records first, and then check them after the operation! Sometimes there is something left in the operation, and sometimes it has to be operated again!

When the records were counted, Li Qi laid out the hole towel. The operation has officially begun! The scalpel is composed of a handle and a blade, and the handle has a long validity period and can be used for sterilization. The blade is sharp, it is disposable, and it is medical waste when it is used up! As soon as the knife went down, a cut about three centimeters long appeared on the skin!

"It's the epidermis, the subcutaneous tissue, the fat layer!" Li Yuan talked while doing it! Maybe there are too many students, and it has become a habit to explain while operating! Including anatomical position, morphology, function and lesions!

If the operation is small and the person is relaxed, it will be combined with clinical practice, talking about symptoms, diagnosis, treatment, etc.! Li Qi has been like this for many years, and he has listened to as many surgeries as he has had with his eldest brother! And it's different every time! This is much better than a month in the classroom!

So everyone in the operating room didn't speak, only Li Yuan's voice was echoing! At this time, the charm value of Li Yuan should be the highest!

Li Qi has a vascular forceps in one hand and gauze in the other. After the incision in Li Hospital, the large blood vessels are lightly clamped with vascular clamps, and the small bleeding points are printed and pressed! You can't wipe it with gauze during surgery, that will damage the capillaries, this is also a detail!

When Li Qi began the operation, he knew that his previous worries were unnecessary! After this came to power, all the actions became an instinct! "Myometry! To the peritoneum! Prepare for a small retractor to pull gently! "Li Yuan is still talking and doing at the same time! When it reaches the peritoneum, the incision enters the membrane cavity and is to be pulled open with a retractor to expose the surgical field!

There are several types of retractors, large, medium and small, depending on the actual situation of the operation! If you have a caesarean section, use a large size! At this time, pulling the abdominal cavity will produce a traction reaction, and the patient will have the feeling of falling down, which is very uncomfortable! That's why Li Yuan said pull gently!

Pull open the abdominal wall, and when you enter the eye, the intestinal tube bulges out! Li Qi gently pressed it with gauze, and gently pinched it with tissue forceps to both sides of the abdomen!

"Why is it swelling out this time? Haven't been so turbulent before? Li Qi asked a little puzzled.

Exploratory laparotomy has been done a lot, and after entering the abdominal cavity, the intestinal tube will indeed emerge as a surgical incision! But it wasn't so turbulent, this time there was a pressure in the abdominal cavity! This will make the surgery more difficult and make it difficult for the surgeon to find the appendix! How can I remove my appendix if I can't find it?

"It's due to inflammation that causes intestinal flatulence! It is likely that the appendix is ruptured and perforated, and inflammatory discharge fills part of the abdominal cavity and pelvic intestines! will react so strongly! Li Yuan still explained easily and freely. It doesn't seem to be more than expected!

"Li Chuanchang! Out! Try not to hold your breath! Take it easy! After hearing this, Li Qi said to the patient Li Chuanchang.

Because it is flax, the patient is conscious, and he knows all the movements in the operating room! It's just that the surgical area is anesthetized! However, the pulling reaction mentioned earlier is not anesthetized! The range of reactions is too large! Allowing the patient to exhale can reduce the pressure in the abdominal cavity and facilitate the operation!

"Not bad! Protect the intestinal tube with gauze, and I'll probe! "Li Yuan is rare to praise! After saying that, he stretched out two fingers into the abdominal cavity, ready to go in and find out what was going on inside!

At this time, I saw Li Yuan close his eyes and probe his fingers in the abdominal cavity!

Li Qi held gauze in both hands, protecting the intestinal tube that overflowed outside the abdomen!

Li Qi still remembers that his eldest brother once said it when he was talking about anatomy. Anatomy is a basic discipline that must be learned well in both internal medicine, surgery and other disciplines. If you don't even understand the anatomical position, morphology and function, how can you see a doctor, let alone treat a disease and save people!

Surgeons, especially surgeons, should be well informed! Close your eyes and you'll have a three-dimensional dynamic anatomical picture in your mind!

It's like writing, if you practice to a certain extent, the paper will present the word in three dimensions, you just need to fill in the strokes! Whether the word is good or not depends on your level and realm!

It's like writing an article, whether it's a proposition or a free play! When you pick up the pen, you can write out what you feel into words, and then polish it to be a good article!

is like a martial arts master, when you practice to a certain extent, you no longer seek strange tricks, only the basic movements are left, maybe these actions are what we often do in our daily life! But it can be ever-changing, combine it as you like, and move it at will! It is also called no trick to win, there is a trick!

Li Yuan has reached such a realm at this time! Like an antelope hanging its horns, there is no trace! Like an incense elephant passing by, unpredictable!

'Huh! Ectopic appendix? It's also cracked and perforated! It's going to be there! Li Yuan opened his eyes, and his fingers withdrew from his abdominal cavity and said.

Li Yuan's fingers came out with a little purulent bloody discharge! This proves that the perforated and ruptured appendix has filled the pelvis!

I have just explored the normal anatomical position of the appendix in Li Yuan, but I have not felt the appendix in the ileocecal appendix! There were no signs of rupture and perforation!

"Ectopic appendix plus ruptured perforation, this is really rare! The key is bleeding! The bowel is so inflated again! It's a bit hard to find! Li Qi said with a little emotion.

Li Qi himself hasn't been on stage for seven or eight years, so he will come to power like this! It's speechless! Don't listen to Li Qi's understatement, it's actually really troublesome! The exponential exponential increase in the difficulty of the operation!

Let's explain it briefly!

If the current surgery is for simple acute appendicitis, the appendix has been removed and the appendix is embedded and sutured! After that, close the abdominal cavity!

If it is ruptured and perforated, you should also complete the suture step and turn to the abdominal cavity for cleaning! And now it is an ectopic appendix, and the intestinal tube is violently inflated due to rupture and perforation!

The surgical incision is small, and the surgical field of view is also small! It is difficult to find the location of the appendix, and it is more difficult to find it! It's really hard to start!

Can Li Qi not sigh? But without attracting the attention of the patient and worrying, scared and nervous! Surgery is more difficult! I have to understate! The most important thing at the moment is to find the ectopic appendix there!

'I'll find it again!' After Li Yuan finished speaking, he closed his eyes and started a new round of exploration!

Li Qi was thinking at this time, but unfortunately minimally invasive surgery is not yet mature. Otherwise, it could be simpler!

When Li Qigang interned, he witnessed an intestinal obstruction operation! When the abdominal cavity is opened, the intestinal tube is tense and inflated, and the obstruction site cannot be found, and finally all the patient's intestinal tubes are pulled out of the abdominal cavity to find it! Remember to do it for 12 hours to finish!

It's horrifying and infiltrating when you think about it now! If you really can't find it, it's really troublesome to get there!

First of all, can the anesthesia effect and time keep up?

Thirdly, whether the patient can bear it, whether it is a traction reaction or a problem with intestinal inflation can be life-threatening!

Secondly, the size of the surgical incision must be extended and the incision must be extended! Finally, how do you explain it to the patient and their family? Reasonable people are okay!

What if not?