Auto chess in the operating room

Chapter 133 Magical Use of Orthopedic Traction Bow and Kirschner Wire (Second More)

After listening to Qingping's introduction, everyone was stunned.

"This was proposed by Tang Lou. This step of improvement will directly expand the application field of suspension gasless laparoscopic surgery. It is also the first attempt of our department, and it is also the first time Tang Lou has carried out."

Qingping continued to add a sentence, looking at Wen Dalong.

Wen Dalong looked through the previous patient information, and sure enough, the first four were routine laparoscopic surgery for a single elderly patient.

"Umbilical single-hole LA is very difficult. In addition to the technique of the main surgeon, there must also be a mirror assistant who cooperates very tacitly."

As a senior expert, Dr. Huang is naturally very familiar with umbilical single-port laparoscopy, because during single-port surgery, the internal and external operations of the operator and the spectroscopic operator are concentrated in a limited area.

In order to obtain a good surgical field of view, it is often necessary to change the position between the surgical instrument and the lens, or to obtain a better field of view by flipping the direction of the light source of the lens.It can be said that the requirements for the chief surgeon and the mirror assistant are very high.

"Yes, it is precisely because of the high difficulty that the experts made this trip worthwhile."

Qing Ping said calmly, looking forward to Tang Lou's performance in his heart. The difficulty of this operation is much higher than that of ordinary suspension airless laparoscopic surgery.

It is precisely because of the high difficulty that it is more suitable as the first operation.

Sure enough, after listening to Qingping's introduction, all the experts turned their attention to the screen. Since everyone is a senior expert in this field, they understand the promotion significance of this technique.

Professor Liu even clapped his hands and praised: "The upgraded version of Tang Lou's suspension-free pneumoperitoneum transumbilical single-hole LA can not only avoid the complications caused by pneumoperitoneum and pneumoperitoneum needle puncture, such as mediastinal gas Swelling, subcutaneous emphysema, air embolism, etc. Pneumoperitoneum is not used, and there is no need to worry about air leakage during the operation when instruments come in and out through the incision. The smoke generated during the operation can be directly discharged through the umbilical incision, which can maintain a good surgical field. Admire !"

Wen Dalong held back, pretending he didn't hear it at all, but he was very unconvinced in his heart: "I don't believe such a difficult operation, such a young doctor like you, can do it. Umbilical laparoscopy, hmph."

In the operating room, Tang Lou Ma En, the equipment and nurses are ready.

After more than 50 surgeries, Ma En and Tang Lou have developed a tacit understanding of cooperation. Coupled with the aura of the surgeon, Tang Lou naturally does not have to worry about coordination problems.

The anesthetist for this operation was naturally Chen Wenhao. Because of the new surgical method, Tang Lou asked Chen Wenhao to perform spinal anesthesia.

The patient naturally emptied the bladder before the operation without indwelling a catheter.

After the anesthesia was completed, according to Tang Lou's requirements, Chen Wenhao put the patient in a supine position with the head down and the feet high, and the left side was tilted about 20 degrees.After doing all this, Chen Wenhao stepped aside.

Tang Lou and Ma En stood on the left side of the patient, and the monitor was placed on the right side.

Since it is a single umbilical foramen, the marking of the incision is naturally different from the McBurney incision, and it is also different from the conventional three-hole method of laparoscopy.

Tang Lou made a 1.5cm mark on the patient's umbilical foramen.

In the observation room, the faces of all the experts naturally changed. Although theoretically speaking, the range of this kind of incision is 1.5CM-2.0CM, but in order to facilitate the operation, experienced surgeons will control the incision to 2.0CM.

Those who dare to use the 1.5CM incision are either rookies or those with high skills.

"interesting."

Among the expert group, a director appreciated Tang Lou's choice.

Naturally, Tang Lou didn't think so much, and he didn't show off his skills. His only idea was to minimize the incision as much as possible, make it more minimally invasive, and more beautiful.

After all, the patient is a very young professional woman.

After the marking was completed, Tang Lou naturally took the scalpel from the equipment nurse.

Under the three-star incision technique, Tang Lou's pen-style incision method is naturally extremely precise, opening the abdomen quickly one by one.

"cut protector"

Under the innate concentration, Tang Lou had no other distractions, completely immersed in the operation, and the airtight instructions came one after another.

Having followed more than 50 Tanglou units, Ma En and the equipment nurse have naturally practiced instinctive reflexes.

"Kirschner wires, draw bows"

Tang Lou's next command came out, and all the experts in the observation room were once again puzzled.

Even Cheng Jian, the pro-director, who was suspected to be his father-in-law, was a little at a loss.

"What the hell is this brat doing?"

Qingping watched everyone's reactions from the side, and slowly explained: "Presumably all experts know that conventional single-port laparoscopic channels (R-port, Triport, Uni-X) are very expensive, and can only Disposable use, and must be equipped with dedicated integrated 5. 0 mm laparoscopic equipment and special flexible single-hole laparoscopic operating instruments, expensive. General patients are unacceptable.”

Qingping spoke halfway, unscrewed his own teacup, took a big gulp, and then continued to add:
"Therefore, Tang Lou proposed a self-made abdominal wall suspension device using orthopedic traction bows and Kirschner wires."

During Qingping's explanation, in the operating room, Tang Lou inserted the Kirschner wire through the skin subcutaneously on the extension line of the McBurney incision in the right lower abdomen, and the subcutaneous penetration distance was about 15 cm.

After the two ends of the Kirschner wire are fixed with the traction bow, the suspension rod and cross bar are used to lift the traction bow, and the abdominal wall of the right lower abdomen is lifted to establish an operation space.

"A powerful and unconstrained style, really a genius."

Professor Liu's eyes lit up, looking at the self-made abdominal wall suspension device in the operating room.

Who would have thought that Kirschner wires could be used in this way. Kirschner wires are commonly used internal fixation materials in orthopedics. The original size of Kirschner wires is generally fixed at about 0.5 cm, and there are several different sizes with a diameter of 2-[-] mm.

It is often used to fix small fractures or avulsion fractures and other fractures with low stress. It is also often used to fix temporary fracture fragments in orthopedic surgeries.Very cheap.

As for the orthopedic traction bow, it can naturally be used repeatedly.

"Director Wen, how are you doing? Is it okay?"

Professor Liu moved the stool towards Wen Dalong, but Wen Dalong didn't talk to him, and moved the stool to the side.

"Laparoscopic Exploration"

Tang Lou gave the next order without stopping.

Naturally, Ma En quickly inserted the laparoscope and began to investigate.

"Ultrasonic knife, grasping forceps."

Only Tang Lou's calm voice remained in the operating room.

Tang Lou grasped the forceps in his left hand and the ultrasonic knife in his right, and skillfully removed the greater omentum in the right lower abdomen, and at the same time lifted the cecum.

At the same time, Ma En's camera is also along the colon, and the two cooperated very well, and soon saw the appendix.

"Intraoperative findings: suppurative acute appendicitis, root perforation and gangrene, severe adhesions"

Seeing the situation in the abdominal cavity, all experts breathed a sigh of relief. Tang Lou only made such a small incision. Now that he has encountered such a complicated situation, the biggest difficulty of single-port LA is at this moment. The operator's subtle operation requirements are very high.

"Ultrasonic Hemostasis Knife"

"Is that what he wants?"

Mentioning Tang Lou's instruction, all the experts were slightly taken aback, and then immediately reacted.

"This tenement building is too crazy!"

　That’s all for the evening, there will be more during the day tomorrow, please subscribe~ hehehe

　　
　
(End of this chapter)