Chapter 422

Zhang Fan and the surgeons began to change gloves. In the general operation, it is rare to change the operation, but this kind of pollution operation must change the gloves.

This kind of operation is not as complicated as tumor resection. It's simple. It's fried into a flower like intestines, which can save life. It's already very powerful by the surgeon. It's a little slower, and it's estimated that there's no life.

Now that the hemostasis is completed, the residual intestines and anus have been removed. The rest is self-evident. We have to find a way out for the digestive system.

As the saying goes, fire and water are ruthless, as are urine and urine. It's hard to die if you hold it for a while. So this reconstructed channel is also very important.

Life saving is done now. The rest is about the patient's quality of life. More than three hours have passed since the operation. Zhang Fan has been exercising. He doesn't stand long for less than six hours.

Anxiety, the anxiety before the operation has gradually subsided, and the rest is suffering, "no news is good news." Ms. Jiang leaned on the plastic bench outside the operating room with a blue face and said to herself.

The assistant and Secretary stood far away and dared to surround. They know that at this time, they must not touch the mold without looking for trouble. But several people make eye contact with each other, which is not a kind of heart disaster, but also a kind of helplessness that is difficult to tell.

The parents of the silly child have set out from their hometown in Jiangsu and Zhejiang. Concerned, or because of politeness and interest related people, the phone came in one after another. Ms. Jiang really wanted to smash the phone. I'm tired enough and have to perfunctory some people.

Several transferred doctors in the emergency department looked at the exemption book as thick as a book and quietly stretched out their tongue, "director Xue is really powerful. Almost all of them have been brought out. How timid! "

"You know what a fart. Is that cowardice? He didn't do the operation and the hospital wasn't his home. What's he afraid of? It's called a sense of responsibility. Do you understand? No learning, no skill! " The transferred female doctor got angry with another male transferred doctor who always harassed him.

Whether timid or responsible, Ouyang is satisfied anyway.

"I don't see. The boy is so clever. I'm afraid he didn't understand it. That's good! " Ouyang looked at the signed disclaimer. Although he didn't say anything, he was satisfied with Xue Fei. It is estimated that he has entered her little book.

I changed my gloves and washed the talc powder off my gloves. Zhang Fan and his colleagues continued the operation. They had received the operation patient when they were about to get off work at noon. By this time, it was already past the meal point, and the anesthesiologist and itinerant nurse had changed their meals.

The surgeon and instrument nurse can only bear it. At this time, the operation is not so urgent. Zhao Pingquan, director of general foreign studies, also has the mind to speak.

"Lao Chen, what's in the canteen today. Why did I ask, "it tastes like tofu." After a long operation, coupled with Zhang Fan's strange surgical habits, Lao Zhao endured too hard. Even if you don't let me eat, you won't let me talk!

"Braised meat and boiled tofu without hair loss, alas! I could bear to eat meat before. Today I have no appetite at all. Your surgeon is better. After the operation, you can eat outside. We're beaten to death. It's terrible. "

"That's all you want!" Lao Zhao mocked that he was hungry, nausea and nausea during the operation, and then stimulated the gastric mucosa to secrete a lot of gastric acid. At this time, his old stomach disease occurred again.

Most surgeons have stomach problems. They don't eat on time all year round. They are hungry and full, resulting in gastric ulcer. They begin to ache when they don't eat after dinner.

"Gauze, director Zhao endure, and the operation is almost over." Zhang Fan knew that Lao Zhao had gastric ulcer and accelerated his speed under his hand.

"It's all right. You can't die if you eat later. This is the child. I don't know if he can accept it after surgery. " Lao Zhao saved his life with a black face before the operation, but after he really saved his life, he felt a little cruel.

"Generally, this kind of reconstruction operation must give psychological counseling to patients before operation, so that patients can accept it in advance, but there is no way for emergency operation. Although the quality of life has declined a lot in the future, people are still alive! " Zhang Fan in turn began to persuade Lao Zhao.

From this point, we can see the difference between Lao Zhao and Zhang Fan's character. Zhang Fan hesitated before doing it, and Lao Zhao hesitated after doing it. It's kind to say it, and it's kind to say it's not good to say it's women's benevolence. There are flames of war in the Department, which has something to do with his character.

The abdomen should be rinsed and ligated, and the lower abdomen should be cleaned up. The operation has really entered the last step, fistula and abdominal closure.

There is a very troublesome thing about intestinal fistula. Although the intestines seem to be more than ten meters when they are spread out, there are ligaments around them. The vascular plexus around them is like a spider's web. On the contrary, the intestines are fixed. In other words, the intestines are not very mobile.

If you can move a little, Zhang Fan really wants to make an artificial anus for the silly child. Now it can only be reconstructed near the fracture. The remaining upper opening of the sigmoid colon.

This place is projected on the abdomen, which is actually the opening at the midpoint of the line between the navel and the left anterior superior iliac spine.

Fistula is simple, very simple, and experienced doctors can do it, but this permanent fistula is not what ordinary doctors can do.

First of all, we should consider the stability and application of the external anal bag. This is not a small thing. Hanging a bag on the patient for two days a day doesn't matter, but once the design of this permanent thing is unreasonable, it will bring endless trouble to the patient.

Because the cecum and anus have strong contractile ability, the mucous membrane inside is smooth and has a certain self-cleaning ability. Except for those who do not pay attention to hygiene, the general human body will not have peculiar smell.

But this permanent anal bag won't work. First of all, the tightness of this thing can not be compared with that of the anus, and there is less closure of orbicularis muscle. Therefore, the permanent odor will accompany it.

"Foreign patients like this will be intervened by psychologists during their stay in the hospital, and the rehabilitation doctors will give him some training in his future life. We still lack doctors! " The anesthesiologist looked at Zhang Fan and began to prepare for drilling, as if he thought of something, and began to burp.

"That's their clinician. No, we clinicians did all the work." Lao Zhao didn't want to listen to this. The old man and Ouyang are a generation. Their generation is also the strangest generation. He often said that he couldn't do it, but when he heard others say it, he was not happy immediately.

For fistula, Zhang Fan prepares for fistula at the lower side of the outside of the navel“ Sharp knife! " The nurse handed Zhang Fan a sharp knife. Zhang Fan placed one hand in the abdominal cavity and opened a two finger wide incision on the patient's belly with a sharp knife in the other hand, which directly penetrated into the abdomen.

Then clamp the colon with Babcock pliers and pull it out slowly. The intestinal tract is most afraid of ischemia. Although the toughness and flexibility of the intestinal tract are good, this thing can not be folded, even if it is distorted. If it is not done well, it is intestinal ischemia.

After pulling out the colon, Zhang Fan began to suture. This suture is very exquisite. The colon should be sutured at the opening of the abdominal wall without puncturing the intestinal tract.

This suture is not to mend clothes. Although the needle is very small, as long as it penetrates the intestine, with the extension of time, the proud and expensive thing of the intestine will become larger and larger with the small mouth, and finally necrosis.

You can only use a small needle and fine thread to slowly hang on the opening on the film outside the intestine. Suture is actually an auxiliary function, that is, let the two tissues contact and then fuse.

After a circle, Zhang Fan carefully stitched a circle and took a long breath. It's really a long breath. If you don't pay attention to this thing a little, there will be problems, and it's not a small problem. After all, the intestines are so little. It's not leek. If you cut it, it won't grow any longer.

After suturing the intestinal tract and interface, Zhang Fan began to trim the skin opening. Opening two fingers is for better suture, but if you leave a hole, the opening is a little too large.

The reconstruction is the anus, so it is best to choose all sizes according to the original device size. For example, a finger is inserted into the anus of a normal adult. Note that this is a normal person.

Therefore, when trimming the skin, you can also insert the size of a finger, because there is no orbicularis muscle, the suture should be a little smaller, and when you have to insert a finger, it should be a little tighter.

"Well! Director, is your finger a little thick? " Lao Zhao did manual work in his early years. His fingers can be as thick as Zhang Fan's.

"Rough? No, rough handle! Without the levator and sphincter, it's better to be thicker. "

"Ha ha!" Zhang Fan thought about it and smiled helplessly. It was a bitter smile. Although it was a reconstruction, it was just a look of goods, missing a lot of things.

Finally, Zhang Fan still didn't use the director's finger. He put his own finger in. Then close the suture from both ends of the incision. A little recycling. When it feels a little tight, it is the end of reconstruction.

This suture is no simpler than that of Zhang Fan. Feces, especially the feces of omnivorous animals, contain a large number of bacteria and viruses. As long as there is a gap for it to remain, it will be a very terrible thing.

Infection and death are possible. Even if there is no infection, as long as there is a gap, this thing will corrode and slowly form a fistula. Therefore, when Zhang Fan sutures, he is very careful. He can't suture too tightly, leading to ischemic necrosis, and there can't be a gap. The operation is not fast at all.

Press the anal bag, Zhang Fan looked, "good! There should be no big problem. Ready to close your stomach! "

Like cattle and sheep returning home, after Zhang Fan closed his abdomen, nurses and anesthesiologists began to be busy. With the cutting of the last needle, the operation was over!

The operation, which took more than four hours, was finally over.