Chapter 406

The place where the skin has been prepared is like a naked chicken. It is lonely. After being contaminated with sterilized iodophor, it looks like Zhou Heiya's brine products.

"Little pull hook!" Zhang Fan said. The structure in the pelvic cavity is much less than that in the abdomen, especially in the male pelvic cavity. Zhang Fan made a conventional incision directly at the upper end of the pubis.

The scalpel crossed the skin as if it had drawn a straight line with a light yellow pen on white paper. Zhang Fan, one holding a knife and the other holding a rectangular gauze, gently pulled outward along the incision. Yellow fat slowly blooms bright red flowers.

Xue Fei holds an attractor in one hand and is always ready to suck blood to ensure the clarity of the operation field. In the other hand, he also holds a piece of gauze parallel to the gauze in Zhang Fan's hand and gently pulls it. This is to give the skin a tight state.

"Electric knife!" As the skin opens, there are bleeding spots. General micro capillary bleeding occurs in a state of exudation, while slightly larger capillaries slowly flow upward like spring water. Generally speaking, they are relatively mild.

The arteries are not good. They are very irritable regardless of their size. Their bleeding methods are the same. They are exposed. The pressure is not small. It often happens that they don't pay attention to the face of the operator.

After opening the skin, Zhang Fan began to enter with an electric knife. With the sound of the electric knife like an electric soldering iron, wisps of smoke began to float slowly.

At this time, the suction device should not only suck blood, but also smoke. A good doctor with an assistant will hardly let the smoke come out. Xue Fei's Kung Fu was average, so there was a lot of smoke.

"Brother, after the operation, I'll invite you to a barbecue. Xiao Yang, Xiao Li and Xiao Wang, let's go together. " He did it on purpose. Xiao Li is an operation nurse and Xiao Wang is a itinerant nurse.

Zhang Fan ignored him. Xiao Yang smiled and said, "director Xue, let's just have a barbecue. Please have a KFC." The two nurses smiled and said nothing.

"OK, I'll let Wang Zipeng buy it after the operation. I'll give you all the overtime pay for today's night shift twice. "

"Director Xue, you are very kind!" The itinerant nurse's smiling face blossomed. After she was called at home, she was a little unhappy. As a result, she was paid overtime twice.

The skin was opened in the middle of the pubic bone, the lower fascia was cut in turn, and the rectus abdominis muscle was separated and pulled to expose the anterior bladder space. The pubic bone is actually at the junction of the pelvis in the front of the human body, specifically above the genitals. People with thin fat layer can press it.

"My God! How did this happen? " When Zhang Fan entered the bladder, Xue Fei immediately exclaimed. No wonder he exclaimed that this kind of pressure-induced bladder injury is too rare.

If you hold your urine too much, your brain will be worried. As soon as it is worried, it will directly send a pain signal. Therefore, a person in a normal state will not hold it to this extent at all, that is, if he is drunk, otherwise he will not drink and explode his bladder.

The appearance of the bladder is very smooth. There is a thin film outside. You can vaguely see the vascular network crawling on the surface of the bladder, just like some particularly white faces.

When the fascia tissue is opened, you can see a broken paper shell cracked by firecrackers, a hole with a diameter of three or four centimeters. The hole is flowering. The bloody bladder meat is like a flower petal floating in the yellow urine, like a flower in the wind. And the internal structure of the bladder was turned out.

The outside of the bladder is smooth, which is to reduce friction with other tissues. There are many folds on the inner side of the bladder, forming gullies like a hill beam.

This structure is particularly similar to the stomach, which is why the bladder is called a small stomach in many stalls selling sheep offal. Moreover, when the bladder is cooked, it is actually similar to the taste of the stomach and has a chewy toughness.

"Attractor!" Zhang Fan immediately blocked the urine that was about to overflow with gauze.

With Zhang Fan's voice, Xue Fei immediately inserted the plastic head of the attractor into the cracked bladder. Because of the blood, the urine is obviously yellow. The suction device uses a transparent plastic tube to quickly suck urine.

Watching this scene, Xue Fei's mind didn't know how, so he flashed the scene of fashionable beauties on the street sucking orange juice with a straw with sunglasses, which couldn't be spilled. It's OK to think about it, but this shameless thing unconsciously chirped its mouth.

"What? Want to drink! " The main reason was that Xue Fei's voice was so loud that Zhang Fan was surprised.

"Well! How could it be? Don't talk nonsense. What now? Sew? " Xue Fei was a little embarrassed and hurried to change the topic, "what's the matter today!" The baby secretly scolded herself.

"I'll explore it first to see if there's any damage elsewhere." Generally, there is only one breakthrough in this situation, but as a doctor, if you don't see clearly, you will suffer from the operation and will be uneasy for a long time.

With Zhang Fan's examination, Zhang Fan said, "this man's prostate is also a little swollen. Ah! "

"It's strange not to be swollen. I'm a taxi driver and like to hold my urine. It's time to pay back in a few years. " Xue Fei said after taking a look.

What is the relationship between prostate and bladder? In fact, a very vivid metaphor is gourd. What kind of gourd is often used to hold wine in ancient costume TV dramas.

The as like as two peas are the bottom of the bottle, and the smaller one is the prostate. The gourd is the urethra. It is very vivid. If the above one is smaller, it will be exactly the same.

With the increase of age or bad habits, the prostate will slowly swell. This thing is not hollow, just like a fresh gourd, which is not hollowed out.

The larger and larger prostate will make the urethra narrower and narrower until it is too narrow to urinate. And because this place is very rich in nerves and muscles.

Therefore, after the current column gland swelling, when forced urination, various nerve reflexes will lead to muscle contraction and relaxation here, and the so-called urine ticking will appear!

Why are there so many nerves and various muscles in this place? It's also very simple, because the ejaculatory (a) seminiferous duct takes shape in this.

In other words, there are two channels in this place. The thicker one is the urethra and the thinner one is the ejaculatory (a) seminal tube, which is derived from the bladder.

"Sew it, there is no break elsewhere! This person must use antibiotics regularly after operation, otherwise the adhesion will not heal after infection and inflammation in this place, which will be troublesome. "

"Don't worry!" Xue Fei nodded.

Compared with other sutures, this suture is a little more layered, and some inactivated bladder tissue should be cut off.

Zhang Fan began to suture layer by layer with a needle, and sutured the bladder fissure in 2 or 3 layers with 3-0 or 4-0 intestinal suture. Catgut is actually the so-called absorbable thread. It's such a simple thing that China couldn't do in the early years.

Finally, the smooth bladder surface is like a chrysanthemum on the bladder, like a patch on the smooth volleyball.

The operation is like this. How to get in and how to get out. The layers must be stitched clearly, otherwise this place will be in a mess in the future.

"Fistula!" Zhang Fan said after stitching. After bladder suture, I'm afraid that urine will lead to bladder rupture or infection again. Fistula is to open a hole at the lower end of the front wall of the bladder with a knife and put it into a plastic tube to direct the urine away. I'm afraid that the infection will not heal as much urine comes out of the ureter and as much urine is led away.

Bladder surgery is very simple. It seems that opening the skin suture is over. In fact, the difficulty of this thing is exploration. There are several duct openings in the bladder.

The opening of both kidneys and ureters, like the vas deferens and urethral orifice buried in the wall, are very troublesome.

When the symptoms of ureteral injury show up, the corresponding kidneys become hydronephrosis. So don't look at the bladder, just like volleyball, it's actually very complicated.

At the end of the operation, Zhang Fan said to Xue Fei, "be sure to explain to your family and take good care of it, especially the fistula. You should pay more attention."

"OK! I see, brother, thank you! " When there was no one, Xue Fei said positively to Zhang Fan.

"It's all right. If you have an operation in the future, please call me! " Zhang Fan nodded. In fact, Zhang Fan felt a little disappointed. Xue Fei never called his brother before. He shouted Zhang Fan when he was happy and livestock when he was unhappy.

It seems that this brother doesn't sound natural! Self abuse?