The kidneys are important organs of the human body, and their basic function is to produce urine to remove metabolites and certain waste products and poisons from the body.

At the same time, water and other useful substances such as glucose, protein, amino acids, sodium ions, potassium ions, sodium bicarbonate ions, etc. are retained through the reabsorption function to regulate water and electrolyte balance and maintain acid-base balance.

At the same time, the kidneys also have endocrine functions, producing renin, ***, active vitamin D3, prostaglandins, kinins, etc.

It is also the degradation site of some endocrine hormones and the target organ of extrarenal hormones.

These functions of the kidneys ensure the stability of the body's internal environment and enable the normal metabolism

The kidneys are paired lentil-shaped organs located in superficial fossae on either side of the retroperitoneal ridge. about 10-12 cm long, 5-6 cm wide, 3-4 cm thick, weight 120-150 grams;

The left kidney is slightly larger than the right kidney, and the upper end of the longitudinal axis of the kidney is inward and the lower end is outward, so the upper pole of the two kidneys is close to each other and the lower pole is farther away, and the angle between the longitudinal axis of the kidney and the ridge column is about 30 degrees.

There is a depression on one side of the kidney, called the hilum, which is where the renal veins, renal arteries enter and exit the kidneys, and the ureters connect to the kidneys.

Each kidney is made up of more than 1 million nephrons.

Each nephron consists of three parts: glomeruli, renal sac, and renal tubule, and the glomerulus and renal sac form the renal corpuscle.

The kidneys are located on either side of the crest, immediately against the posterior abdominal wall, behind the peritoneum.

The upper end of the left kidney is flat at the lower border of the 11th thoracic vertebra, and the lower end is flat at the lower border of the 2nd lumbar vertebra.

The right kidney is half a vertebral body lower than the left kidney.

The 12th rib on the left side is oblique over the middle behind the left kidney, and the 12th rib on the right side is oblique over the upper part behind the right kidney.

In the longitudinal view of the kidney, it can be seen that the renal parenchyma is divided into two layers: the outer layer is cortical and the inner layer is the medulla.

Nephron is the basic unit of kidney structure and function.

Each nephron is made up of renal corpuscles and tubules.

Because the kidneys are vital to the body's circulation, special care must be taken with each nephrotomy procedure.

In nephrotomy surgery, fast is a big taboo.

However, at present, this patient is in a special situation, if the nephrotomy operation takes a long time, the ribs will inevitably break again, and even the flesh and blood organs may be punctured.

So that the surgery that has just been done is meaningless.

So the only way is to complete the surgery as quickly as possible.

But the rib pressure limit is 20 minutes, can you really do it?

Huang Youdao still can't believe it!

Seeing Li Xiyang's confident appearance, Huang Youdao still asked, "How sure are you?"

Li Xiyang thought for a while and said, "Ten percent don't dare to say it, but seven or eight percent still have it."

Seventy or eighty?

For surgeons, there is never a 100% operation, and the seven or eight achievements are already saying that they have absolute certainty.

Huang Youdao was silent.

"Dr. Lee, I believe in you, do it!"

"Yes, we all believe in you!"

Qian Min spoke, and the little nurses also echoed.

Even the anesthetic Lao Xu coaxed, "If anyone in our emergency department can complete such an operation, I think it is probably only Dr. Li."

Huang Youdao on the side was a little confused, what's wrong with these people?

Isn't it clear what you said earlier?

This operation is simply not possible.

Completing a nephrectomy in 20 minutes is impossible for even the top surgeons in the imperial capital.

….

Are these people all fools?

No common sense at all!

But no one cares about Huang Youdao's thoughts, Li Xiyang is the chief surgeon on the operating table.

Everyone only recognizes Li Xiyang.

Li Xiyang inserted a urinary catheter for the patient, and said to the medical staff, "It's the same as a normal nephrectomy, put the patient in place first."

"Hmm!"

The front directs the little nurse together

Help.

Together, we carefully shifted the patient's body to the right and pushed the patient's body to the right.

The fractured left arm is pulled by the anesthesiologist, who is responsible for protecting the patient's arm as everyone turns the patient's body.

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There is no thought of people in the accident world.

Incision of the dorsal periosteal and the soft tissue at the tip of the rib cage,

free ribs, detached periosteum,

Electrizer cuts,

The periosteal is separated from the dorsal periosteum, and the rib periosteum is separated from the ventral periosteum, so that the ribs are free.

Cut 12 ribs,

Hand thyroid pull hook open, revealed,

rib forceps cut ribs, olecranon rongeurs trimming,

Bone wax to stop bleeding.

The periosteum is incised, the pleura and diaphragm are pushed open, the lumbar dorsal fascia and part of the diaphragm are cut to expose the perirenal fascia

Hand the No. 15 knife and cut the curved mosquito forceps blunt separation,

Hands Mei's scissors are cut open, and the chest automatic retractor and S retractor can be revealed.

Soon, the scalpel separates the kidney adipose tissue and finally the fat sac, and the kidney is completely exposed to the surgical field.

This scene once again stunned everyone.

Kidney!

This is exposed?!

It's too fast!

From Li Xiyang's first cut, to now they see the patient's kidney, it only took less than two minutes before and after!

You must know that this step will take at least 10 minutes even if you change to Renhe's best general surgeon.

In less than two minutes, this guy is too strong!

At this moment, Huang Youdao completely saw how big the gap between himself and Li Xiyang was.

Don't look at the gap of just ten minutes, but these ten minutes are the chasm that he may not be able to cross in his entire life!

Diligence and hard work are really vulnerable in the face of talent!

At this moment, Huang Youdao thinks that Li Xiyang is a real surgical genius.

It's still the kind that is one in a million!

Now that the patient's kidney has been exposed to the surgical field, the next step is to remove the kidney and clean up the surrounding broken kidney tissue and dirty blood.

So Li Xiyang's operation still hasn't stopped,

Hand the No. 22 knife,

Free around the kidneys, remove the adhesions around the kidneys...

Separation of middle curved forceps, ligation of No. 4 silk thread to stop bleeding!

Sufficiently free kidney, excision of adhesion tissue around it,

Hand the chest cavity automatic retractor and S retractor to reveal the surgical field.

Separation of long curved pliers,

Tissue shear shear,

Line 4 ligation.

Expose and lift the ureter.

Right-angle forceps separation, middle curved forceps clamp the 8F red urethral catheter through and lift the ureter,

Straight mosquito forceps pull the end of the urethral catheter, free the ureter distal to it, and cut it

….

Blunt separation of medial forceps and Mei's scissors,

Hand 2 medium-curved forceps to clamp the end ureter, cut it with a 15-gauge knife, and tie the No. 7 silk thread.

Separate the tissues around the renal pedicle and cut off the renal pedicle blood vessels in a bundle,

Right-angle forceps, long curved forceps separation, clamping, Mei's shear shearing, No. 4 silk thread ligation.

3 plips clamped the renal pedicle blood vessels, 15-gauge knife incision, No. 10 and No. 7 silk sutures were double-ligated or sutured.

Clean the perirenal area, hand long forceps,

Mei's scissors trimmed, No. 4 silk suture ligated to stop bleeding.

At this point, the patient's kidney is finally removed.

"Bring the drain."

Li Xiyang spoke, and the little nurse hurriedly handed over the drain.

After Li Xiyang took it, he began to do the final cleaning for the patient.

After the drain was turned on, Li Xiyang used the drain to clean up around the patient's kidneys, and waited until all the dirty blood and kidney fragments in the patient's body were sucked out, and the patient's condition was completed.

At the moment, there is only one last step left, to suture the wound.

"Little money saline irrigates the incision, and the incision prevents drainage!"

"Kobayashi, start counting the items."

"Yes!"

Li Xiyang put

Under the scalpel, everyone went their separate ways.

When the patient's chest cavity was cleaned and the items were not missing, Li Xiyang began to suture.

Hand 9x24 angle needle 4 line fixation, suture renal fat capsule,

Interval suture with long forceps 9x24 round needle 4 lines, suture all layers of muscles,

Handed with toothed forceps 9x24 round needle 7 line intermittent suture; suturing the subcutaneous tissue,

Hand sponge clamp alcohol to hold small gauze blocks to disinfect the skin,

Hand toothed forceps 9x24 round needle 1 line intermittent suture,

Recount the number of items;

suture the skin with toothed forceps 9x24 round needle 1 line intermittent suture;

For the skin, hand 2 toothed tweezers, hand the sponge pliers to clamp the small pieces of alcohol yarn to disinfect the skin, and cover it with a cotton pad.

The whole suturing process was completed in less than 1 minute.

When everything was over, Li Xiyang glanced at the time and smiled, "9 minutes!"

It was supposed to be completed in 20 minutes, but it only took 9 minutes!

Are you sure this is nephrectomy, not appendicitis?!

Huang Youdao still muttered in disbelief, "Is it really done?"

"What do you think?"

"Could it be that the surgeries you just saw were fake?"

Li Xiyang asked with a smile on his face, and then Huang Youdao reacted, with a look of horror in his eyes.

Xindao, you're exaggerating!

The fastest nephrectomy in the world is probably not as fast as yours!

"Dr. Lee, how the hell did you do that?"

Li Xiyang said as he sorted out the instruments, "You can see that."

Huang Youdao was stunned, and then shook his head and smiled bitterly.

It's probably the gap between ordinary people and geniuses, even if you see it with your own eyes, you still feel incredible.

As for Qian Min and the others, they were also surprised, but not to the same extent as Huang Youdao.

After all, they have been on the same stage with Li Xiyang more than once, and they have long been accustomed to the latter's magic.

"After waking up, the patient should be sent to the ward, and after nephrectomy, he should lie flat for 2~3 days and observe that there are no complications before he can get out of bed.

Drainage was removed 48 hours after surgery.

If the amount of food eaten is small after surgery, intravenous fluids are required;

If abdominal distension is present, it can be treated with gastrointestinal decompression, anal exhaust or acupuncture; or oral Chinese medicine Tongguan decoction.

Also, pay attention to urination, if the urine output is less than 500 in 24 hours, you need to be alert to dehydration or kidney failure.

Nonprotein nitrogen elevations, acidosis, and fluid and electrolyte abnormalities should be prevented based on clinical and laboratory findings, and anti-infective therapy should be initiated.

Tell the patient not to take the medicine without authorization, and insist on taking the medicine under the guidance of the physician to avoid damage to the contralateral kidney function.

Instruct patients to observe urination and have regular kidney function checks."

After explaining the patient's postoperative care, Li Xiyang took off his sterile gown and walked out of the operating room.

Outside the operating room, the patient's parents are anxiously waiting.

Seeing Li Xiyang coming out, he immediately stepped forward tremblingly, "Doctor, how is my son?"

"Doctor, is my son okay?"

The husband and wife supported each other, tears in their eyes.

Li Xiyang smiled at the two of them and said, "Don't worry, the operation was successful!"

"Really?!"

"Great, great, doctor, thank you, thank you so much!"

Looking at the excited appearance of the husband and wife, Li Xiyang's mood was also extremely relaxed.

This is what every practitioner is looking for.

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