"Just ignore it?" Tian Guifen said worriedly, "What if there is a case?"

"Aunt Tian, there is no 100% safe thing in this world. Let's give you an analogy, let's say we have to go out every day, but as long as we go out, we risk being hit by a car. So are we just choking on food, so we don't go out?" Ren Jiangchi said, "Obviously not. Because the risk of being hit by a car is very small, and it is completely within the range we can bear!"

"Then you mean that the probability of Lei Lei's accidents during surgery is about the same as the probability of a car accident when he goes out?" Tian Guifen asked.

"I can't quite say that. Ren Jiangchi pondered for a moment, "Lei Lei's situation should be like this, there is no food at home, if you don't go out to buy some food, there is no risk of being hit by a car and dying, but you will definitely starve to death." Now he goes out to buy food, although there is a certain risk of car accidents, but he will definitely not starve to death!"

"Oh, Xiao Ren, as soon as you say that, I understand. Tian Guifen nodded and said, "This operation still has to be done!"

"Actually, Aunt Tian, what you need to pay attention to is the above one," Ren Jiangchi pointed to the fifth article on the informed consent form for surgery, and said to Tian Guifen: "If the lesion is found to be unresectable during the operation, or it is prone to life-threatening after resection, then palliative surgery or only exploration will be performed." This is the thing that Dr. Huang talked to us about before, if Lei Lei's small intestine lesion is more than 50 centimeters, then he will perform the next step of surgery and sew the incision as it is. As long as you can accept it, just sign it. ”

"Accept, what can you do if you don't accept?" Tian Guifen sighed, "Anyway, I pin my hopes on your diagnosis, I hope your diagnosis is correct, and the necrotic part of my family's Lei Lei's small intestine will not exceed two centimeters!"

"Aunt Tian, you just have to believe me, that's right! All you have to do now is to sign it quickly, and we will hand it over to Dr. Huang and let the operation begin, the time really can't be delayed!"

At 10:45 a.m., nearly an hour after being taken to the hospital, Fan Leilei was finally pushed into the operating room.

Even if Tian Guifen was reluctant, she could only sit on the chair in the waiting room outside and wait. Fortunately, Liu Nana, Fang Shengxue and Ren Jiangchi have been by her side to cheer her up and comfort her, so she feels a little better in her heart.

Zhang Xiangyang was worried in his heart, so he naturally refused to wait outside the operating room, he greeted Huang Guohui in advance, and then changed into a one-time visiting clothes and walked into the operating room.

In the operating room, Huang Guohui has already put on a surgical gown and is standing in front of the light box to review Fan Leilei's X-ray abdominal x-ray. He turned his head and saw Zhang Xiangyang coming in, and he just nodded briefly, which was regarded as a greeting.

Fan Leilei was lying on the operating table in a supine position at this time, under general anesthesia. At the midline of his right rectus abdominis muscle, Huang Guohui had previously marked the surgical area with a marker, which was about 6 centimeters long.

At this time, Huang Guohui's second assistant, a young doctor about 267 years old, was disinfecting the operating area.

He first disinfected the skin on the surface of the operation area three times with a 3% concentration of complexed iodine solution, and then entered the procedure of laying out the towel sheet. Fan Leilei's abdominal exploration surgery today, according to the regulations, requires a total of five sterile towels, two sterile ones, and one sterile laparotomy. The second assistant took the sterile towel sheet handed over by the nurse in turn and spread it out according to the regulations. Finally, the 75% alcohol solution handed by the nurse was used to disinfect the incision site. After everything is taken care of, the preparation for the operation is completed.

Huang Guohui listened to the report of the second assistant, and then stepped onto the operating table. He looked up again at the abdominal plain film on the viewing light box directly opposite the operating table, and then looked down at the incision site on Fan Leilei's abdomen, and then stretched out his right hand and shouted "knife".

The instrument nurse, who had been waiting next to him, quickly put the scalpel into his palm. Huang Guohui picked up the scalpel and drew decisively along the marked part, that is, the midline of Fan Leilei's right rectus abdominis muscle.

Zhang Xiangyang recognized Huang Guohui at a glance that he was holding a bow and holding a knife. This method of holding the knife has a wide range of movements, involving the entire upper limb, and the force is mainly on the wrist, which is undoubtedly the most suitable for making long skin incisions and incisions in the anterior sheath of the rectus abdominis muscle.

Huang Guohui's movements were extremely skillful, first cutting the skin covering the midline of the rectus abdominis muscle, then cutting the subcutaneous tissue, and then cutting the anterior sheath of the rectus abdominis muscle, by this time, Fan Leilei's right rectus abdominis muscle had been completely exposed to Huang Guohui's field of vision, and the knife in his hand finally stopped.

"Tray!" he shouted.

The instrument nurse hurriedly stretched out the tray, Huang Guohui threw the scalpel in the tray, and then inserted the thumbs of both hands into Fan Leilei's right rectus abdominis muscle, sorted it out according to the texture of the muscle, and then pulled the thumb to both sides, and Fan Leilei's rectus abdominis was pulled away from the middle.

If a layman sees this scene, he must think that Huang Guohui is too savage. But Zhang Xiangyang knew that Huang Guohui's move was called blunt separation. Blunt dissociation refers to a surgical method in which the doctor uses his hand, scalpel handle, or other non-sharp instruments to separate the original soft tissue. It can effectively prevent the damage of muscles, nerves and blood vessels in patients, and can also avoid excessive opening of muscle tissue, which is a commonly used surgical method. It's just that some doctors like to use scalpel handles, some doctors like to use other blunt tools, and Huang Guohui likes to use his hands directly, and the effect looks like tearing with brute force.

"Change the knife!" After separating the rectus abdominis muscle, Huang Guohui shouted again. The instrument nurse hurriedly handed him the new scalpel.

Huang Guohui still adopted the arch holding method to cut the posterior sheath of the rectus abdominis muscle, and at this time, Fan Leilei's peritoneum was exposed to Huang Guohui's field of vision. Huang Guohui took a deep breath and stopped again.

At this time, Zhang Xiangyang also ignored his identity as an observer, took two steps in the direction of the operating table, and found a field of vision that could see Fan Leilei's peritoneum clearly. Because by this time, many problems can already be observed through the peritoneum. For example, if there is bleeding in the abdominal cavity, the peritoneum will appear blue, and if the peritoneum itself shows signs of hyperemia and edema, it will indicate diffuse peritonitis.

And now, the reason why Huang Guohui stopped must be to observe whether Fan Leilei's peritoneum has signs of congestion and edema.

In general, the presence of diffuse peritonitis does not necessarily mean widespread necrosis of the small intestine, but extensive necrosis of the small intestine does certainly lead to diffuse peritonitis.

If Fan Leilei's small intestine is extensively necrotic according to the previous X-ray abdominal radiograph, then he should have typical signs of diffuse peritonitis, with severe edema and hyperemia in the peritoneum.

However, at this time, the peritoneum exposed to Huang Guohui and Zhang Xiangyang's field of vision basically maintained the normal shape of the peritoneum, and there was no edema and congestion at all, only slightly inflated outward.

At this time, Huang Guohui and Zhang Xiangyang still don't understand, that is, they were told by Ren Jiangchi's kid that the conclusion of the X-ray abdominal film reading is wrong. Even if there is a necrotic area in Fan Leilei's small intestine, the length of this area is limited, and it is far from the point of extensive necrosis.

How is this possible!

Fan Leilei's X-ray abdominal x-ray showed the characteristics, but the typical symptoms of extensive necrosis, why after opening and cutting the rectus abdominis muscle to expose the peritoneum, he came to the opposite conclusion?

Is Fan Leilei's performance an extremely special case, or is there some reason behind it that has not yet been discovered?

Huang Guohui turned his head and glanced at Zhang Xiangyang, and saw that this old-timer in the field of ordinary people in Tianyang City was exactly the same as him, and his face was full of shock and confusion. Obviously, Zhang Xiangyang, an old expert who has worked in the field of general surgery all his life, has not figured out the reason.

It seems that the only way to do this is to move on to the next operation, to cut the peritoneum, and to find the answer!

Thinking in his heart, Huang Guohui's knife-holding style has changed, from a bow-holding style to a pen-holding style......