Come on, Dr. Wu

Chapter 28 Appendiceal Surgery (please vote)
  Thinking of this, Wu Xiaofu was also a little sad. They all said that it was the fault of a father who failed to raise him, but how should he deal with this situation?
  "Teacher Liu!"

"There is a patient with appendicitis during the day. He will need an operation soon. I will go over right away. You can come on stage with me. You can rush to the hospital as soon as possible."

"Okay teacher, I'll wait for you at the hospital."

Appendicitis patient during the day? Wu Xiaofu couldn't help but think of that old bookworm, couldn't it be that one?

After taking a look at the medical records, it seems to be true.

The person on duty in the observation room at night was a teacher from the emergency medicine team. Wu Xiaofu took a look at the patient.

During the day, the patient was very willing to do the surgery and remove the appendix as soon as possible. But when his wife came, when her husband said that the appendix had been removed, in order not to affect his drinking, she pretended that he was angry and said directly. Give conservative treatment first and see what the effect is. If possible, it is best not to perform incision.

The doctor had no choice but to wait, but this time, the appendix was actually perforated.

At this time, there were two brothers of the patient in front of the patient's bed.

They were originally here to stay with you. After all, they are real friends. Even if you are sick, they are willing to stay with you. The patient took medicine in the afternoon and his symptoms have been relieved. At least there is no pain, so the patient feels that he is okay again. So I called two brothers and got some wine. These two brothers were also drunkards. The patient said he wanted to drink, so they dared to accompany him.

No, the patient who was supposed to be fasting instead drank two ounces of wine.

It's not that the patient didn't want to drink more, but that the appendix didn't allow it and the pain was excruciating. He screamed anxiously, and upon examination, it was found that it was perforated.

I heard that the wife was so angry that she also lay down at this time. The two brothers looked at each other with blurred eyes and felt scared at this time.

Wu Xiaofu was also speechless.

It is said that you should guard against fire, guard against theft, and guard against best friends. Today, there is another saying to guard against alcohol, meat, and brothers.

Liu Wenyin came very quickly. It seemed that she had set up her home next to the hospital. When the patient was sent to the operating room, the two brothers were still there. The patient was still talking to the two brothers, "Wait for me, in an hour." , I am a good man again, let’s continue drinking.”

If it weren't for the doctors and nurses holding him back, he might have had to be slapped by his wife before entering the operating room.

Today's appendicitis surgery is basically performed laparoscopically. The cost is definitely higher, but the scars left are relatively small.

Although this patient had a perforated appendix, he could still undergo laparoscopy.

However, the patient was unwilling to use it, not because of the high cost, but because he heard that laparoscopy was inserted through the navel, and he refused a little. In addition, he actually always thought that men need to leave some scars, but he really wanted to get rid of it. He can't do that cruel thing if he tries it on his own, but it's better this time. The scar will be increased under anesthesia. When he drinks in the future, he will leak out his stomach to show that he has also been involved in the crime.

Among the people at the stall, who could tell whether it was a surgical scar or a scar from a fight?

Liu Wenyin doesn't care about this. Patients can choose whatever they want. For appendix surgery, it is not always clear whether it is better to do incision or laparoscopy.

Even if the appendix surgery is performed through incision, the incision is very small. In fact, it is not much larger than the three eyes of laparoscopy, or even smaller. Moreover, when performed through incision, you can choose local anesthesia, usually with hard spine. Extramembranous anesthesia is different from laparoscopy, which basically requires general anesthesia.

These two types of anesthesia are also issues that many patients have to consider. They always feel that general anesthesia will make people stupid.

Of course, this is nonsense, but if you can't stand spreading rumors, patients believe a lot.

Therefore, patients prefer this kind of local anesthesia to general anesthesia.

Both Qu Ying and Wu Xiaofu entered the operating room together. Qu Ying was also very grateful for this. After all, Liu Wenyin had not planned to bring her in. It was Wu Xiaofu who suggested that she be brought in together. Although she worked overtime, she was able to participate. With the opportunity for surgery, Qu Ying no longer complained as before and was in a much better mood.

However, Qu Ying had never had surgery before, so she began to feel nervous at this time.

The anesthesiologist was not the Liu Wengui I met during the day. She was a female anesthesiologist, and her movements were also very agile.

The first step in the surgery is to choose the incision.

"Qu Ying, how to choose the incision for appendicitis?"

This was naturally difficult for Qu Ying. After all, it was the basic knowledge in the textbook, "Mai's point." "Come on, let's draw."

Hearing Liu Wenyin's words, Qu Ying was immediately stunned. It was her first time to have an operation, and she could answer questions just fine, but it was a bit awkward to do it.

However, Qu Ying was not a shy person and took over the drawing pen.

McBurney's point is actually the middle and outer third of the line connecting the navel and the right iliac ridge. The iliac ridge is the highest point on the pelvis. It is easy to find. You can find it by touching it from left to right, and it is symmetrical.

Qu Ying quickly found this point based on the knowledge in the textbook.

It's just that it's easy to find the dots, but it's difficult to draw the lines. After all, Liu Wenyin didn't ask her to find the dots, she asked him to draw the incisions.

"What kinds of appendiceal incisions are there?"

"Oblique incision in the right lower quadrant and transverse oblique incision in the right lower quadrant."

"Then which one should we choose?"

"MC it!"

These two questions were answered by Wu Xiaofu. Liu Wenyin rolled her eyes at Wu Xiaofu. She had not been working for long, and she was like an old doctor. She was mc!
  In fact, it is a McBurney incision, an oblique incision in the right lower abdomen.

Wu Xiaofu took the liner pen from Qu Ying's hand and drew it lightly.

Liu Wenyin didn't say anything and went to wash her hands directly, but Qu Ying breathed a sigh of relief and was somewhat grateful to Wu Xiaofu for rescuing her.

When Qu Ying washed her hands, she washed them very carefully, following the surgical procedures. However, looking at Wu Xiaofu's neatness, she was a little dumbfounded. The teacher was watching. Can you stop acting so casually?

However, the teacher didn't scold him yet. It wasn't fair. She had been scolded for a whole day, so at least he scolded Wu Xiaofu to make her balance.

Wu Xiaofu took the initiative to take over the task of disinfecting and laying out the sheets.

Of course, when Wu Xiaofu was about to seize the prize, Liu Wenyin couldn't help it anymore. Wu Xiaofu reacted quickly, changed the situation to a gift, and presented it to Liu Wenyin. Damn it, I had done too many surgeries in my dream. These were all subconscious actions. I forgot. Today I am an assistant.

Liu Wenyin gave Wu Xiaofu a look that made people beside her laugh.

Appendices and cholecystectomy are probably the two smallest operations in general surgery, and they are also the operations that emergency doctors are best at.

Although Liu Wenyin was only thirty-two, she had done this kind of surgery a lot. The gauze pad pushed the small intestine inward. After finding the cecum, she followed the three colon strips to the top of the cecum, and soon found the appendix. .

Um! Surgeons vividly call this method the intestinal palpation method.

It's like following the clues, and there are no mistakes. This is one of the reasons why appendectomy is simple.

The appendix is ​​clamped by the appendix forceps, and the mesoappendix is ​​clamped by the hemostatic forceps. Once the position is fixed, most of the operation is actually completed.

Pull the appendix out of the incision.

Um! So ugly!

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  (End of this chapter)