Auto chess in the operating room

Chapter 77
In the next week, Tang Lou basically changed the dressing every day. As usual, the last suture was done at noon, and the last suture was done in the afternoon.

By the sixth day, almost all the patients in the ward knew that there was a young and handsome doctor with first-class dressing-changing skills, fast speed and gentle technique, and there were few infections and blood infiltration.

In the ward, the patients who were injured in the chemical plant explosion were also secretly stunned, and their eyes lit up every time they saw Xu Lanlan.

"Nurse Xiao Xu, take a look and arrange for me to ask Dr. Tang to change the medicine."

The patient in bed 11 licked his face and called Xu Lanlan to stop. These days Xu Lanlan is like the spokesperson of Tanglou, taking away a few lucky people from the ward every day.

"Doctor Xiao Tang has enough dressing changes today, and Doctor Leng will change them for you later."

Xu Lanlan is firmly in control of Tanglou's daily frequency, otherwise that guy is not restrained at all, and he really comes as much as he wants.

Therefore, now Xu Lanlan calculates the time every day, and sets aside a certain amount of rest time between each patient.

"It's Doctor Leng again, alas."

Not selected by Xu Lanlan, the patient was obviously disappointed.

It's not that Leng Yunze's technique is bad, it's just that Tang Lou has the fetter bonus of a master surgeon. For a day or two, everyone just thought that changing Tang Lou's dressing would reduce the pain, but after four or five days, they could obviously feel that Tang Lou Patients who changed dressings were better than other interns in terms of healing speed and infection rate.

After a while, the 11th bed was brought into the dressing room with some reluctance.

Bed 11 looked at Leng Yunze, and Leng Yunze looked at bed 11.

Bed 11 turned his head, lay down, took out a small wooden stick and bit it on the spare, it was stiff: "Come on, hurry up~"

It doesn't matter whether Leng Yunze does it or not, does it hurt so much for him to change the medicine?
The atmosphere was slightly awkward.

Leng Yunze felt aggrieved by eating the leftovers from a tenement building. If you don't like it, I won't like it anymore.

The patient was angry that he hadn't been turned over to the brand, and fell down in pain, but that's all.

When Bai Fumei followed Gao Fushuai, there was only Xiao Xiaozi and Clown who hated each other...

When Bed 11 and Leng Yunze disliked each other, Bed 20 happily walked out of the dressing room: "Doctor Xiao Tang's dressing change is good, it doesn't hurt at all."

"... "

Soon the first week was over, and the batch of patients Tang Lou handled were basically healed.

Tang Lou looked at the harvest of the week:

Level 4: Upgrade 20
Operation column (4/4): Suture (three-star, 9), diagnosis (one-star, 3), incision (one-star, 1), dressing change (three-star, 9)

Gold: 5
Bond (1/1): Master Surgeon (Level 3, 5/[-])

天赋（3/3）：1.缝合流水线（已激活）：2.聆听（主动技能，冷却时间一天）3.韧性：宿主在手术中，体力耐力增加50%
Storage column (4/9): Debridement (two stars, 6), hemostasis (one star, 1), exposure (one star, 1), emergency general (three stars, 9)

The content of the second week of training is incision.

This week is naturally more demanding than changing the dressing, and the screening of patients is also stricter.

Moreover, the incision is only the prelude to the operation, and the whole operation still needs to be performed by the attending physician.

Under the agreement of Huo Tong and Liu Tong, a total of five patients were screened and arranged this week, with Liu Tong as the chief surgeon and Tang Lou as the first assistant.

The first case was an acute appendectomy.

Liu Tong leads, Tang Lou is the first assistant, and Leng Yunze is the second assistant. Under normal circumstances, one assistant is enough for minor operations such as appendicitis. Considering Tang Lou's physical strength, he is only responsible for incision, and Leng Yunze is the second assistant. It's just a simple pull hook.

Acute appendix is ​​a very common disease in surgery, and appendectomy is one of the most common and frequently performed operations.

The patient was a 34-year-old male with suppurative appendicitis.

After rehydrating the patient and correcting disturbances in water and electrolyte balance, the anesthetist administers spinal anesthesia to the patient.

For appendicitis, Liu Tong is naturally familiar with it, and adjusted the patient to the supine position.

Liu Tong took a pen and began to draw incision lines on the patient's abdomen, and said to Tang Lou and Leng Yunze at the same time:

"Appendicitis surgery is generally performed through McBurney's incision. Of course, for those whose diagnosis is not very clear, a midline abdominal incision can be taken. Appendicitis surgery is generally easy to operate, but sometimes it is very difficult, such as ectopic appendix."

"Because the position of ectopic appendix often varies, the tender point can be used as the suitable incision for exposing the appendix."

After Liu Tong finished speaking, Tang Lou nodded at the side. Leng Yunze wanted to take a step closer to see the incision, but as the second assistant, he couldn't come close.

"Oh, so angry."

Leng Yunze felt so wronged in his heart, he was the one who helped Liu Tong's minor surgery before, but when Tang Lou came, he fell out of favor.

"I used to call him Xiao Leng Leng, but now I call him Na Er Zhu."

After Liu Tong drew the location of the incision, he explained to Tang Lou:

"The principle of surgical incision is to fully expose the surgical site and facilitate surgical operations. An ideal incision should:

First of all, it is the closest to the surgical site, and it is best to go directly to the surgical area
Second, parallel to important structures, the direction of the incision should be consistent with the course of important blood vessels to avoid damage
Third, try to be as beautiful as possible without leaving unsightly scars. For example, in addition to conventional appendectomy, there is now domestic umbilicus endoscopic appendectomy, which has the characteristics of less trauma and faster recovery.

Of course, there is also the most famous endoscopic retrograde appendicitis treatment, also known as ERAT, initiated by Professor Liu Bingrong of the Second Hospital of Harbin Medical University in China.

After ERAT, the patient's abdominal pain was relieved immediately, and he could go home or continue to work without hospitalization. "

Tang Lou and Leng Yunze are naturally yearning for it. ERAT technology is very famous. Of course, the most impressive thing is Professor Liu's PPT homepage of the proposal:
"ERAT——made in China"!
When the two young people were excited, Liu Tong directly poured cold water on him: "You don't have to think too much now. It would be good if you can do the most basic appendectomy well. As for the umbilical cavity technology, it is Even I have never done it. As for ERAT, there are less than three people in the province who can do it. Hecheng, even none."

"Oh~"

Leng Yunze's eyes dimmed quickly. What Liu Tong said was right. He would take over from Huo Tong's class in the future, and after a few decades, he would be able to get into his uncle's position and become the vice president.

Leng Yunze looked at Tang Lou again, if this guy got into the city's first hospital, he might not have the opportunity to participate in the lower umbilical foramen appendectomy, and of course he only participated.

As for, ERAT don't even think about it.

Liu Tong continued to give lessons to Tang Lou: "In addition to this, fourth, pay attention to the incision to avoid crossing the joints, and the function will not be affected after recovery."

"The last point, and the most important thing, is to fully expose the surgical site and make it easy to extend. Just follow the incision line I set and start."

Tang Lou nodded, then took the sharp scalpel from the equipment nurse, and used the most commonly used bow holding style.

The blade cut across the patient's skin, followed by the subcutaneous tissue, and then saw the white and traces of aponeurosis on the red external oblique muscle, and the incision was smooth.

"Second aid preparation, blunt dissection, retraction of the internal oblique and transversus abdominis."

Naturally, Leng Yunze quickly prepared the hook, pulled open the opening made by Tang Lou, fixed it, and fully exposed the surgical field.

Liu Tong looked at the incision made by Tang Lou, and was very satisfied. After all, it was already very good to be able to do this for the first time. Recalling the first time he went to the operating table to make an incision, the first knife was not strong enough, and the length of the cut was not enough. , and added a second way, barely exposed.

After completing the cut, Tang Lou stepped aside and continued to assist in the next steps.

As for Leng Yunze, he just needs to be a Lagou Xia obediently, with his hands tensed.

Liu Tong continued with the appendectomy, carefully fixing the peritoneum to the skin, and then ordered:
"Take peritoneal effusion for bacterial culture and drug sensitivity test."

After completing this step, the most critical thing is to find the appendix, which is commonly known as turning the intestines.

At this time, Liu Tong was also very serious. He carefully found the ascending colon and brought it to the ileocecal along the colon.

The movements are naturally extremely skillful, the place where the three colon bands converge is the root of the appendix.

Soon, a bloody, purulent fuzzy sticky object appeared in the field of vision.

(End of this chapter)