[Ding, new task: Complete the first laparoscopic appendicectomy performed by the surgeon within 60 minutes, reward 4 gold coins, and refresh the card library once]

"Routine laparoscopic appendectomy usually takes 90-150 minutes. Isn't this too demanding?"

[Host’s three-star appendectomy can be performed nationwide within one hand. Host, you can do it.]

"It's too showy, isn't it?"

Tanglou really didn’t want to be too high-profile. After all, it was his first laparoscopic appendectomy.

[Isn’t it normal for the first time to go quickly?]

Tanglou:╭(╯ε╰)╮

...

...

After pre-operative communication with the patient, the family members signed and the surgery was quickly arranged.

It's just that this time there was more movement in the operating room. Besides Qing Ping, Song Yang also became very interested in Tanglou and also chose to watch.

When he heard that Tang Lou was going to perform his first laparoscopic appendectomy, Cheng Jian took time out and rushed to the operating room.

In front of the operating table, Tang Lou naturally stood in the position of the surgeon, Ma En was in the position of assistant holding the mirror, and the instrument nurse was on the other side.

Chen Wenhao has seen many surgeries at Tanglou, but this time he was still extremely surprised.

First, of course, this guy was an assistant last time, so he immediately started to perform the surgery.

Secondly, when he saw the big bosses in the operating room, he was a little suspicious of life. This time he thought he was smart and prepared three stools.

Then, they were all requisitioned again...

Standing in front of the operating table, watching his bench being divided up by several big guys, Qing Ping still looked like a young man who was quite sensible.

Chen Wenhao's face turned dark.

This feeling is like playing basketball on a basketball court, watching your mineral water bottle being picked up by the old aunt who picked it up and shaking the little bit of water. The wrinkles on your face are written like "Young man, you are always embarrassed to make me wait."

Come on, don’t you want this little water? Then I’ll take it!

And you originally wanted to wait until the ball was dead, when your throat was driest, and drink it all in one gulp.

Then, before you could make a decision, the old aunt said thank you, flattened it with her foot, stuffed it into the bag, and walked away quickly.

Chen Wenhao suddenly felt that the rest of the anesthesia process was boring, and he numbly completed the routine tracheal intubation anesthesia.

After that, it was handed over to Tanglou.

"Doctor Ma, please follow my instructions in a moment. We will try to complete the operation within an hour."

Tanglou didn't want to do it either, but the system bosses had issued tasks, and for four gold coins, they could only force Ma En.

"Within an hour?"

Ma En looked at Tanglou with an exaggerated expression: "This is impossible, even Doctor Qing can't do it so fast."

"Prepare for three-hole piercing!"

Tang Lou had no time to explain, so he raced against time and gave the order directly. Since the patient had an ectopic appendix, Tang Lou slightly changed the lower puncture position based on the traditional three holes.

"..The cannula is routinely established 10mm above the umbilicus, and the pressure is maintained at 9~13mm Hg.."

"... Make 5mm and 10mm incisions at the midpoint of the line connecting the umbilicus and pubic symphysis, and insert 5mm and 10mm trocars to insert endoscopic instruments to treat the appendix."

Tanglou accurately and calmly directed the first assistant and equipment nurse.

"Is there something wrong with the location of the opening?"

Since he had not participated in the consultation before, Cheng Jian was a little confused.

"Director Cheng, this patient's appendix is ​​ectopic, so the puncture location is a little different. We have demonstrated Tanglou's surgical plan."

Qingping quickly explained.

Cheng Jian nodded. After all, the surgeon in charge of this operation was Tang Lou, but it was still nominally registered to Qing Ping and supervised by him, so Cheng Jian was still relieved.

After Tanglou marked the spot, Ma En assisted in the puncture.

Ma En was also very surprised and didn't know why. Every time he cooperated with Tang Lou, his mentality was particularly stable, and his hand movements were much smoother and more proficient.

The piercing was completed perfectly, but before Ma En could appreciate his masterpiece, the next order came from Tanglou.

"Laparoscopy."

For appendiceal ectopia, it is easy to have difficulty finding the appendix when performing a conventional McLaren incision, but laparoscopy is different. The field of view under laparoscopy is wide and clear, and subsequent flushing is more accurate.

This is also the reason why Tanglou recommended laparoscopic surgery before.

Sure enough, under laparoscopy, although Ma En's technique of holding the mirror was not as perfect as Tang Lou's, it was still solid enough. Under Tang Lou's precise command, the cecum under the liver was quickly found.

"Intraoperative exploration revealed that the ileocecal part was tightly adherent to the liver, and the appendix was wrapped in a mass by the omentum."

Ma En fully adapted to the role of Isuke and began to report the investigation results.

"Zoom the camera away and prepare to dissociate the appendix."

Tang Lou gave the order in a leisurely manner, and Ma En responded quickly. Under Tang Lou's aura as the chief surgeon, he felt very at ease, and there was only Tang Lou's voice in his mind.

"The free appendix during the operation showed: 1cmX1cm fecal stone at the root of the appendix, the distal end of the appendix was highly dilated, dark in color, smelly, and surrounded by a little dark gray turbid exudate."

"Intraoperative confirmation: The patient has gangrenous appendicitis and fecal stones at the root of the appendix."

After Ma En told the results, Qingping and Song Yang on the side were somewhat mentally prepared, but they were still shocked by the aftermath.

"It's exactly as Tanglou guessed. This guy is really talented in diagnosis."

Qingping praised him without hesitation.

Song Yang didn't say anything, but he was a little convinced in his heart.

Being able to put aside the interference of such classic appendicitis symptoms, peel off the cocoon, and even connect it to the right ovary removal twenty years ago and the history of recurrent gastric cancer in the past two years, to systematically reason about the disease, this ability can only be said to be a gift.

.

It really has nothing to do with experience and qualifications.

"Tang Lou is not only talented in diagnosis, but the operating room is where he really shows off his talent."

Cheng Jian said softly from the side.

Only then did Qingping and Song Yang realize that, indeed, on the operating table, Tang Lou had shown a maturity that was beyond his age, and they could even feel the aura of a senior surgeon.

That is a calm temperament that can only come from having gone through hundreds of surgeries.

"Aspirate the abdominal pus, separate forceps, and prepare electrocoagulation hooks..."

"Mesoappendiceal 1-0 silk suture ligation..."

The only voice left in the operating room was the commanding voice from Tang Lou, and the busy figures of Ma En and the instrument nurse were already overwhelmed and struggling to cooperate.

"Do you feel that there is basically no time for adjustment and preparation between the steps of the Tanglou?"

"When you put it this way, it really feels like I'm in a hurry."

Qing Ping frowned slightly. Some surgeons in the operating room are used to operating quickly, but most of them are veterans who have performed more than a hundred operations, so they can form muscle memory-like operations.

Could it be that the Tanglou deliberately wanted to show off because they were watching.

"Tanglou, consider every step carefully and don't move too quickly."

Qing Ping still reminded him that if he goes too fast and leaves behind troubles, then the gains outweigh the losses.

When Ma En and the equipment nurse heard this, they couldn't agree more and waited for Tanglou to let them rest for a while.

Especially the equipment nurses frowned. Dr. Tang didn't know how to show mercy.

"Prepare a small piece of saline gauze"

However, what answered her was Tanglou's impersonal order. With his talent, concentration and resilience, Tanglou was actually very restrained. If Ma En's level was not limited, he would even want to speed up the steps.

"Ma En, when separating adhesions and treating the mesentery and appendix root, intestinal injury may sometimes occur. You can insert a small piece of normal saline gauze for appropriate compression. In the future, you must know how to observe and prepare the normal saline gauze before the operation."

Tang Lou taught it carefully, and then added: "You are still not skilled enough in laparoscopic appendicitis surgery. You must do it faster next time."

Ma En felt that the first half of the sentence was quite rewarding. When he heard the second half of the sentence, his whole face fell. Do you think everyone is a monster like you?

The first laparoscopic surgery, the surgeon looked as if he had been an experienced surgeon for decades.

I am a resident doctor who helps you as an intern, but you are still criticized for being slow?

Ma En really felt that it was too difficult for him.

As soon as Ma En completed this step, the separation of Tanglou had already been completed.

"Endo-GIA Cutting Closer Ready!"

Tanglou issued the next instruction.

“Endo-GIA Cutting Closer???”
Chapter completed!