Outside the operating room, Zheng Xiaoyu hurried over.

"What's wrong with Dr. Lee? How can we help? ”

After receiving a call from Li Xiyang, Zheng Xiaoyu rushed over as soon as he got out of surgery.

Li Xiyang nodded, "Wash your hands first, and talk while washing!" ”

"Good!"

After entering the disinfection room, Li Xiyang began to talk about the patient's situation, "The patient had appendicitis in the third trimester, and the color ultrasound showed that the appendix was suppurated, and it could be perforated at any time.

And once perforated, the patient will definitely die. ”

Zheng Xiaoyu was stunned for a moment, and said puzzledly, "No, although purulent appendicitis perforation is very tricky, it can also be said to be certain death!" ”

Li Xiyang explained, "This time the situation is more troublesome, because the patient refuses to have a blood transfusion during the operation, so once the appendix is perforated, the patient will definitely die due to excessive blood loss, and the fetus in the womb will definitely not be saved." ”

"What?"

Zheng Xiaoyu was stunned.

"How can a patient ask for such a request?"

Li Xiyang shook his head helplessly, "They are a sect, and they say that the faith of the church cannot be transfused, otherwise the soul will be polluted." ”

Zheng Xiaoyu frowned, "What kind of religious belief is this, it can't be a cult, right?" ”

Li Xiyang smiled, "Qian Min also asked the same question just now. ”

"But I don't know if it's a cult, I only know that the patient agrees to the operation, but can't have a blood transfusion, so I asked you to come and help!"

Zheng Xiaoyu suddenly realized that the problem was here.

But

Zheng Xiaoyu was a little embarrassed, "Doctor Li, this is the third trimester of pregnancy, once the operation is performed, it is impossible not to lose blood, and I can't help anything!" ”

Li Xiyang said with a smile, "Don't worry, as long as the operation is done quickly enough, you can find a way to control the amount of intraoperative bleeding, I already have a plan, but I need a doctor who cooperates tacitly!" ”

Hearing Li Xiyang say that he already had a plan, Zheng Xiaoyu breathed a sigh of relief.

Immediately afterwards, remembering that Li Xiyang said that the doctor who cooperated tacitly, Zheng Xiaoyu felt honored.

"Okay Doctor Li, I'll be your assistant and listen to your command!"

"Then thank you Dr. Zheng!"

In fact, the reason why Li Xiyang came to Zheng Xiaoyu was because the two of them had cooperated many times, and the other was because Zheng Xiaoyu was the best in the emergency department except for him in terms of appendicitis surgery.

The other party agreed to help, and Li Xiyang began to talk about his plan.

"In this operation, I will first cut off the blood flow of several blood vessels in a minimally invasive way, and I need you to perform intermittent hemostasis on the patient every 30 seconds during my operation.

If the patient's appendix is perforated during the procedure, you will need to aspirate immediately.

It is important to ensure that the patient completes the procedure before the blood loss reaches 1000 ml. ”

Zheng Xiaoyu's eyes lit up when he heard Li Xiyang's plan.

This scheme is simply fantastic.

However, if it is actually implemented, I am afraid that it is also dangerous.

But now I can only give it a go.

"Doctor Li, don't worry, leave the intermittent hemostasis to me, and you can operate wholeheartedly!"

"Good!"

Then the two walked into the operating room together.

Li Xiyang stood in the position of the chief surgeon and said to the anesthesiologist, "Use dural crest continuous tissue anesthesia. ”

The anesthesiologist nodded, then walked onto the operating table.

When is the surgery?

18:13。

Patient vital signs?

Everything works fine.

When the anesthesiologist stepped off the operating table, Li Xiyang nodded at Zheng Xiaoyu, who was standing opposite, "Let's start!" ”

No. 8 scalpel,

Hemostat!

Li Xiyang stretched out his hand to the instrument nurse.

After receiving the scalpel, Li Xiyang began to block several arteries and blood vessels according to the original plan.

This is done to reduce the patient's risk of major bleeding during surgery.

Because the patient is in the third trimester of pregnancy and has higher blood pressure than normal, if the appendicitis surgery is performed directly, a large amount of blood will immediately gush out of the blood vessel at the moment of cutting the blood vessel.

If this is the case, even with Li Xiyang's hemostasis rate, there is no guarantee that the operation will be completed before the blood loss of 1000 ml.

"Dr. Zheng, I'll leave it to you next."

"Good!"

Zheng Xiaoyu picked up two hemostats and took over Li Xiyang's work.

After observing for a moment and making sure that several important arteries had been successfully blocked, Li Xiyang took the scalpel again and prepared for appendicitis resection surgery.

The choice of incision for appendectomy usually depends on the location of appendiceal tenderness, the presence or absence of diffuse peritonitis, and the estimation of the difficulty of surgery.

Commonly used incisions are McCelis incision, rectus abdominis incision, and transverse incision.

In patients in the third trimester of pregnancy, an incision should be made where abdominal tenderness is most pronounced.

Because the patient's uterus enlarges and causes the appendix to shift, the most obvious place of tenderness is where the appendix is located.

This is usually done by moving 2 cm up the McCere's incision.

"Adjust the operating table so that the patient is tilted to the left side."

It is also possible to directly raise the patient's right buttocks by 45°, which is convenient for exposing the appendix and reducing the traction of the uterus during surgery.

After straightening the position, Li Xiyang said again,

"Little money, after rubbing the skin with an alcohol cotton ball, the skin is tightened."

This facilitates the incision of the skin and subcutaneous tissue.

"Good!"

Qian Min quickly stepped forward to cooperate.

Everything was ready, Li Xiyang picked up the scalpel.

"The incision is usually 5 to 6 centimeters, but this operation should not be too small to avoid affecting the abdominal operation and accidentally injuring the fetus."

"After the skin is cut, a sterile cloth is placed at both ends of the incision to protect it."

Because of the special situation of the patient, Li Xiyang had to be cautious.

All healthcare professionals are reminded of every detail.

After the skin is incised, underneath is the aponeurosis of the external oblique muscle,

"Little money, tissue scissors!"

Make a small incision in the direction of the muscle fibers, and use tissue scissors to expand the incision to both sides...

Place two thyroid retractors from the separated muscle space to the peritoneum, and blunt incision of the muscle layer to both sides, exposing the peritoneum...

"Small money, tooth tweezers and vascular forceps, repeatedly lift the peritoneum and relax it until the peritoneum is lifted accurately."

"Note that the peritoneum can be pushed by the handle of the knife during the process to separate the organs from the peritoneum and avoid accidentally injuring the intestinal wall."

"Yes!"

To prepare the peritoneum, put a gauze around it so that the exudate contaminates the incut when the peritoneum is cut...

Suction device...

A small incision is made in the peritoneum, and then the peritoneal incision is enlarged with tissue scissors...

Be careful not to injure the organs below!

"Because the peritoneum is elastic, the incision can be slightly smaller than the abdominal wall incision, so as to facilitate the protection of the incision and subsequent suture, and fix the peritoneal incision on gauze."

Note that when cutting the peritoneum, the tip of the scissors should be cocked, or the peritoneum can be cut open and fixed on a sterile cloth.

After the peritoneal incision, do not rush to touch it with your hands into the abdomen, which is one of the causes of infection caused by the incision.

If the appendix cannot be found under direct view, the cecum should be searched first, and the appendix should be found along the colonic pouch with instruments as much as possible.

The incision is filled as omentum, and the omentum is pushed away to the upper left.

If the omentum and appendix are tightly adherent, do not forcibly separate them to avoid breaking the appendix or inflammatory mass and causing pus to overflow and contaminate the abdominal cavity.

The omentum can be severed and ligated.

If the omentum is tightly adhered to the right lower quadrant, the omentum can be cut and ligated first, and then pushed away.

After exposing the cecum, the base of the appendix is searched through the colonic pouch.

When the appendix is difficult to expose, the cecum may also be lifted to look for the appendix.

Be careful not to forcibly pull the cecum, as this can cause lacerations to the base of the cecum. Once it occurs, it should be sutured immediately, otherwise complications such as peritonitis, intestinal fistula and adhesive intestinal obstruction may occur after surgery.

In order to reduce the discomfort of the upper abdomen caused by the stretching of the appendix, the mesoappendial closure should be carried out with 1%~2% precaine before the appendix is lifted into the abdominal cavity......

Li Xiyang explained while operating.

Everyone who was originally nervous because the patient was too special also slowly relaxed, and only needed to follow Li Xiyang's instructions step by step.

Zheng Xiaoyu, who was on the opposite side, relaxed his blood vessels from time to time, while quietly observing this scene.

She finally understood why Li Xiyang was always so convincing.

A good master knife must not only have exquisite skills, but also have the ability to guide and teach the people around him.

At the beginning, Qian Min and Lin Yue were both her students.

Even Qian Min is not as good as Lin Yue in other aspects except for his hard work.

But looking at it now, Qian Min's technical operation is far more solid than Lin Yue's, and there are even many small surprises.

And all this is obviously thanks to Li Xiyang.

Not only is he good at himself, but he also helps those around him grow.

Yes, the success of an operation does not depend on the surgeon alone.

It's the power of a team.

Zheng Xiaoyu began to reflect, maybe he should make some changes in the future.

To have the opportunity to participate in this operation and see this scene, Zheng Xiaoyu is grateful to Li Xiyang.

At the same time, the appendix was finally exposed to the field.

The diseased appendix has grown to 1.5 times the size of the abscess and is at risk of rupture at any time.

Once it ruptures, the fluid inside will flow out, and wherever it is contaminated, it will become infected, and if it touches the uterus, then it can only be performed immediately by cesarean section.

However, because the patient refuses to have a blood transfusion, it can almost be said that he will die.

Li Xiyang faced the appendix for the first time and was a little nervous.

Under the mask, Li Xiyang spat slightly.

Then start looking for the most suitable place to go down.

Because of the invasion of the abdominal cavity by the uterus, the operating space left for Li Xiyang was compressed only a little bit.

This is still a little space that Li Xiyang let the patient lie on his side slightly, so that the uterus was tilted to the side.

Finally, Li Xiyang found a suitable knife position.

Without a hint of hesitation, the blade was quickly slashed down, and the appendix was completely removed from the abdominal cavity.

There is no time to relax, because there is a knife wound, which means there is bleeding.

"3-0 absorbable line!"

Li Xiyang took the needle forceps and quickly sutured the wound.

The speed of the stitching was so fast that Zheng Xiaoyu, who was used to seeing it, couldn't help but admire, "Amazing!" ”

When the wounds were all sutured, Li Xiyang looked at the anesthesiologist and asked, "How much bleeding during the operation?" ”

The anesthesiologist looked at the eye device and said, "Less than 800 ml!" ”

Qian Min said excitedly, "Great, really successful!" ”

Surgery for appendicitis in the third trimester of pregnancy, with less than 800 ml of intraoperative bleeding, is incredible.

Zheng Xiaoyu smiled, "It's still Dr. Li's good skills!" ”

Everyone nodded again and again, "Yes, yes, Li Xiyang is really amazing!" ”

Li Xiyang waved his hand, "This is everyone's cooperation, but not my own credit!" ”

Everyone couldn't help but admire Li Xiyang's bearing even more.

"Okay, when the patient wakes up from anesthesia, first give a shot of pain, and then give a large amount of antibiotics, and keep giving until the white blood cells come down."

The patient has a special situation, and the postoperative care is also more attentive than normal.

"It is also necessary to give the patient tocolytic treatment, and it is best to give the patient tocolytic treatment tomorrow, and the patient's fetal condition must be closely observed."

Generally, three to four days after surgery is a high-risk time for miscarriage.

Everyone should cheer up and pay attention to the patient's vital data at all times.

……

Outside the operating room, the patient's husband is waiting anxiously.

The young volunteer hadn't left yet, because he felt that there might be something he needed help with later.

Looking at the man sitting next to him and praying to the sky, the volunteer couldn't understand why he was so worried now when he was so indifferent when he refused the operation.

Isn't faith greater than life?

I really don't understand these so-called religious and God-believing people.

Suddenly, the door of the operating room opened, and it was Li Xiyang who walked out.

The man who was still praying didn't notice it, and the volunteer hurriedly patted him.

Then the man ran towards Li Xiyang all of a sudden, and when he arrived, he kept gesturing with his hands.

Although he didn't understand what words those actions represented, Li Xiyang could imagine that he must be concerned about his wife's situation.

So he said to the volunteer behind him, "Tell him that the operation went smoothly and the patient has passed the danger." ”

"Really?"

The volunteers were also pleasantly surprised and immediately translated for the families.

Then I saw the man shed tears with excitement, and then another complicated gesture.

Obviously, the volunteer was also stunned for a moment.

Li Xiyang asked strangely, "What did he say?" ”

The volunteer came back to his senses and said, "He just thought about it carefully, faith is very important, but his wife's life is more important, if his wife needs a blood transfusion, give her a transfusion, God wants to punish, just punish yourself." ”

Hearing these words, Li Xiyang was also slightly stunned.

It's finally figured out!

Rare!

Yes, no matter what faith he believes, he can't erase his feelings as a husband and as a father to his children.

"Don't worry, the operation went smoothly and there is no need for blood transfusion."

"If there really is a God, He will not punish you, but only bless you!"

Li Xiyang was talking, and the volunteers were translating.

The patient's family kept bending down to thank them.

Li Xiyang waved his hand, "Your lover is still under anesthesia, and he will come out later, so you can wait here first." ”

After speaking, Li Xiyang seemed to think of something again, turned to the volunteer and said, "You tell him that in fact, their church does not let people transfuse blood, but only does not allow other people's blood to be transfused, and they can go to the hospital to store some blood when they are healthy.

When you get sick in the future, if you need it, you can directly transfuse your own blood, so it is not a violation of your faith! ”

The volunteers clapped their hands, yes.

hurriedly conveyed Li Xiyang's meaning to the other party.

Sure enough, I saw that the man nodded vigorously to Li Xiyang and bent over, still the same gesture.

Li Xiyang knew that the other party was expressing his gratitude.