"Skin incision, blunt dissection." The fat white man who performed the surgery seemed to be a surgeon with a teaching background. His technique was extremely skillful, but because he didn't have a mask, he had to turn his head sideways every time he explained the situation. "Incision inside the abdomen obliquely
Myofascia, the incision will be larger.”
Sun Lien stood in the distance. After being shocked by this scene, he came back to his senses and performed his duties seriously. He stared closely at Li Fengmin's status bar, fearing that the long list of statuses would suddenly change to "Dead".
words.
"Cut the internal oblique muscles and pay attention to the separation." The other veteran experts who assisted in the operation tacitly agreed to use alcohol to disinfect the muscles and fascia tissue that had been separated by deliberately bending the head of the meat fork.
"If you are satisfied with the incision, cut open the transversus abdominis muscle." Fatty Bai's technique was very sophisticated. He used the counter-lifting knife method to incise the transversus abdominis muscle. The blade cut open the transversus abdominis muscle tissue from the inside out to prevent injury.
Deep organ tissue.
"Continue to separate." The old man tilted his head and demanded in a low voice, "Wipe the sweat."
The wizened old man who was acting as the second assistant took out a cut white bath towel from the bag and wiped the sweat from the fat man's head. "Loose some weight, Old Chen, look at this bath towel, it's all oily."
The flowers are here."
Dr. Chen ignored the second assistant and continued the incision. After separating the transversus abdominis muscle tissue, what was exposed was the peritoneum and the veins and arteries of the thoracoabdominal wall attached to it. The incision Dr. Chen chose was quite good, just avoiding the c4 subcostal area.
The spinal nerve and the abdominal branch of the t4 spinal nerve. After separating the carotid arteries of the thoracoabdominal wall with a scalpel handle, Dr. Chen again used a counter-lift to incise Li Fengmin's peritoneum.
A large amount of blood quickly poured out of the bulging abdominal cavity.
"There was a lot of blood in the abdominal cavity, estimated to be at least about 1,500 ml." There was no suction device for surgery, and the large amount of blood immediately blocked all the surgical fields for Dr. Chen to continue the operation. In desperation, he could only use sterilized
The curved plate came out directly from the wound to catch the blood. He poured plate after plate of blood into the trash can next to him.
"To prepare the patch, use Takeda's tachosil." While pouring out the blood, Dr. Chen instructed Hu Jia, "Just prepare the patch. We'll talk about trimming the size later...Tighten the tourniquet a little tighter!
"
The two security guards who were originally preparing to hold Li Fengmin down to prevent him from struggling in pain during the operation looked at each other, endured the discomfort, and pulled the two ties tied around Li Fengmin's thighs a little tighter.
"The amount of bleeding has decreased, it should be the femoral vein or the external iliac vein." Dr. Chen, who was observing the intra-abdominal bleeding, continued to talk, then he put down the scalpel and directly put his hand into Li Fengmin's stomach to feel around.
The other doctors on the operating table all looked calm. Even Hu Jia showed no special behavior. On the contrary, Sun Lien in the audience was even more shocked.
The "internal bleeding" on Li Fengmin's head has faded.
Based on Sun Lien's experience, when a certain state fades, it means that the state has been controlled. Dr. Chen's seemingly rough actions actually have an effect.
"The left external iliac vein was torn longitudinally, and the tear was about one centimeter." Dr. Chen inserted half of his arm into Li Fengmin's stomach, but he was still mumbling, "Cut me a patch, one-by-three size."
of."
Hu Jia lowered his head and started to cut the patch. During surgery, some consumables often need to be trimmed, and there will certainly not be a ruler for the medical staff to compare and cut during the surgery. This all depends on the doctor's estimate. But every emergency room
Doctors and the instruments and nurses in each operating room are all experts at bringing their own measuring tools. Three centimeters is three centimeters, and it can be cut into 3.2 centimeters at most. The deviation will never be too big. To put it bluntly, I still work a lot and exercise.
The ability to come out.
The skinny second assistant opened his mouth again, "Old Chen, please hold down his iliac artery first. It will be dangerous if he bleeds again."
"Should I teach you?" Dr. Chen shot back unceremoniously, "The last time you, Wu Qihua, had an operation must have been ten years ago, right?" He paused and continued, "I have already blocked the tear.
I hope Lao Li's blood vessel was broken in this place. If there are other places broken... it will be troublesome."
Sun Lien watched the performance on the stage and fell into deep thought. Li Fengmin's longitudinal tear of the external iliac vein is actually a very rare condition. You must know that most patients with this symptom have suffered severe trauma.
Penetrating abdominal injuries, or simply open injuries, can lead to injuries to the external iliac veins hidden deep behind the sigmoid colon and inguinal ligament. But there is no way that Li Fengmin soaking in the swimming pool would be hit by such a strong external force and there is no nuclear submarine in the swimming pool!
After eliminating all factors, no matter how absurd the remaining explanation was, it was the answer. Sun Lien opened his eyes, but this speculation was indeed a bit absurd, and he still didn't dare to confirm that he needed some medical technical support.
"Hello, Doctor Yuan?" Sun Lien took out the phone from the waterproof bag tied to his arm and called Yuan Pingan directly in Ningyuan. "I have an emergency case here. Have you ever heard of spontaneous external iliac vein spontaneity?"
Sexual rupture?"
Yuan Pingan on the other end of the phone was eating a completely cold dinner. As soon as he heard Sun Lien's words, he realized that the leader of his treatment team had encountered a very difficult matter.
"I have read relevant reports, but this situation is very rare. There are probably no more than 50 cases reported. The last domestic record was in 2009." Yuan Pingan was very impressed by the information he had read, and he was even able to report it immediately
Recorded time. "The Army General Hospital of Jincheng Military Region recorded a case of spontaneous rupture of the left external iliac vein to form a hematoma. However, it was probably misdiagnosed as deep vein thrombosis first."
"How many ruptures are there?"
"It is very rare to have a spontaneous rupture. There is no record of multiple ruptures in one go."
"That's enough." Sun Lien gained confidence and did not continue talking to Yuan Pingan. He shouted directly to Dr. Chen who was talking on the stage, "Dr. Chen, the patient should have spontaneous rupture of the external iliac vein. In the past,
The patient in the case report had only one venous rupture!”
Doctor Chen asked his second assistant to wipe the oily sweat from his head again, "Spontaneous rupture? Never heard of it?" He shouted to Sun Lien, "How many statistics are there?"
"No more than 50 cases. The last time there was a report in China was in 2009!" Sun Lien replied.
Dr. Chen tilted his mouth, "There are too few statistics, and the confidence level is too low." He sighed, stood up straight, and slightly rotated the arm that had been inserted into Li Fengmin's stomach, exposing as much of his body as possible.
There was a lot of room. Then he inserted his other hand into his stomach.
After several minutes, he withdrew his hand that had been inserted later and said, "At least there is only one breach in the iliac vein."
Of course, the surgeon's method of discovering and solving problems is so direct, or it can be said to be simple and crude.
As long as it can save lives, no matter how rough the method is, it is a good method.