The Brilliant Village Doctor

In the corner of the operating room, yu'erbao, Zheng Yiyu, Zhou Menghan and other three stood on the other side, whispering, naturally discussing why their abnormal teacher was so abnormal!

Ren Junqi sits alone in a corner, ears up to listen to their comments or curse Lin Hao. From time to time, he secretly sends 1086 praises!

When it comes to pricking the heart, the four people can't help but look back at the operating table, but this one eye scared them all!

I don't know when, Lin Hao has already given Li chunrui anesthesia, ready to start her operation!

The three of them rush to the front and see Lin Hao opening Li chunrui's mouth with a fixator and adjusting the angle!

After fixing, he first used a standard gastroscope to slowly enter Li chunrui's mouth, through the throat, esophagus, and into the stomach cavity.

After seeing the stomach cavity on the monitor, Lin Hao made a careful distinction and determined where was the cardia, antrum, lesser curvature, body, greater curvature, angle notch, pyloric tube, pylorus, and duodenum. After that, he started the notes device, and the notes special catheter entered again along the gastroscope!

Lin Hao has no doubt complained about his three students. However, seeing that they are all concentrating on their own surgery, his heart can not be hardened again. He slowly explained to them: "at this stage, we can only say that we have done all the preparatory work before the operation. Now we can really start the operation. You can see that I will perforation the stomach wall and enter the abdomen Cavity

This operation is not a direct operation, but through the natural cavity into the patient's body for surgery, doctors and patients have no direct contact, naturally there is no bloody scene! Yu'erbao's courage also increased. Looking at the monitor, he asked, "isn't stomach perforation painful?"

Lin Hao was defeated by this idiot and said without love: "this gastric perforation is not that gastric perforation, and you don't see it? The patient has been anesthetized. How can it hurt? "

Yu'erbao nodded his head to show that he had been taught!

Zheng Yiyu then asked, "teacher, what is the premise of this operation?"

After Lin Hao thought about it for a moment, he summed it up seriously, "the premise is that we must understand the notes surgical equipment, not only to know all its functions, but also to know how to operate it, and master it skillfully, so as to learn and use it flexibly."

Ren Junqi also can't help but ask: "what should be paid special attention to?"

"Two o'clock!" Lin Hao raised two fingers: "one, this is not a direct operation, the naked eye can not directly see the surgical site, only through the display to see the situation inside! However, through the display, the image will be enlarged or reduced compared with the naked eye. At present, all endoscopes can not provide good three-dimensional vision! 2、 Surgical instruments are not hand-held, but controlled by electronic handle. They have no hand feeling at all. They must be cautious when operating! "

"Linda!" Yu'erbao felt bored when he heard it. Pointing to a button on the handle in Lin Hao's hand, he asked, "what is this key for?"

If he just pointed to the button to ask, it would not be a big deal, but he asked at the same time also cheap on the button to press!

"Ah Seeing this, Lin Hao dodged in a hurry and yelled, "Er Bao, what are you doing?"

However, caught off guard, Lin Hao is still a step slow, the button has been pressed.

As the button is pressed, a special endoscopic knife is also extended from the head of the catheter that goes deep into the gastric cavity. It cuts out vertically from the stomach wall from inside to outside, and penetrates the stomach!

Yu'erbao also saw the situation through the monitor and realized that he had made a mistake. In a hurry, he wanted to get the button up again.

Lin Hao, who dares to let him touch again, kicks him to the wall with one foot, and then carries out remedial operation in a hurry!

Fortunately, Lin Hao is not only a first-class reaction, familiar with the machine, and the operation is not generally superb, in his timely remedy, finally controlled the situation!

However, if Lin Hao's stomach was damaged slowly, it would be very slow!

If the viscera is only slightly damaged, Lin Hao can barely use the notes equipment to remedy again, but it is also limited, because the existing notes equipment is very simple and can not carry out too complex operation! So once there is a fatal injury that requires complex operations to be rescued, there is a big problem.

If it is an ordinary patient, there may be a remedy. General anesthesia and emergency laparotomy should be carried out immediately. However, Li chunrui's condition is very special. She can't bear to have an open stomach. So if she falls on her body, even if Lin Hao's supernatural powers are like Lin Hao, I'm afraid he can only watch her die on the operating table.

Thinking of these terrible results, Lin Hao's back was wet with cold sweat, and his anger poured out. He cursed yu'erbao, who was standing in the corner of the wall with his head pulled up: "you bastard, do you know that you almost killed her?"

Yu'erbao also knew that he had almost made a catastrophe. He didn't dare to answer and hang his head lower.

Seeing his appearance, Lin Hao hated iron but not steel. He really wanted to lay down his work and beat him hard first. But now the operation is the most important thing, so he just said in a deep voice: "the most important thing is to do this operation. If you are not familiar with notes equipment and don't know how to operate it, you should not move your hand. Otherwise, you will harm others and yourself!"Ren Junqi and other people looked at each other, but no one said anything, because just now, they also wanted to ask what functions those buttons have and how to use them!

When he didn't hear their response, Lin Hao said angrily, "do you hear me?"

Several people were scared and nodded in succession. Even Zhou Menghan, who was arrogant and spoiled, was no exception. Lin Hao at this moment is really terrible. He is not the most unpopular hero. He must be said to be the most terrible villain!!

Lin Hao took a few deep breaths. After calming down his emotions, he continued the operation.

The stomach, no doubt, is a thick walled organ with a strong contractility. Although the present situation is that it has been inadvertently cut through by Yu Er Bao, it has not hurt other organs, and the opening is not particularly large. So Lin Hao decided to follow this opening for surgery.

Through the incision, he expanded the channel with an expandable balloon and used it as an operating hole to insert the relevant instruments into the abdominal cavity!

After injecting CO2 into abdominal endoscopy to establish artificial pneumoperitoneum, we saw the huge bile duct cyst in Li chunrui's body!

He used endoscopic biliary guide wire, needle knife, sphincterotomy knife and metal clip, biopsy forceps, special knife and other instruments to cooperate to remove the cyst!

This is a seemingly very simple operation, but it is very difficult in practice, because the instruments are very limited and can only be operated in endoscopy. At present, soft endoscopes such as gastroscope can not provide the required torque in the operation process, which brings great difficulties to the operation. It has no hand feeling and is not intuitive enough. A little careless operation may cause irreversible damage Lin Hao, who is very experienced, did not dare to ask for a big one. He carefully removed the tumor bit by bit!

For half an hour, Lin Hao finally cut off the cyst. But if it was an open surgery, with hand-held instruments, with his technology, it would be just a few minutes at most!

The cyst is very large, obviously can't go out from the small operation mouth, Lin Hao can only cut it into sections, reach the size of the knife edge that can be expanded through the stomach, then cut the cyst through the abdominal cavity, to the stomach, to the esophagus, and then from the mouth piece by piece!

After the cyst was cleared out, the operation was not over. Lin Hao did the anastomosis of hilar bile duct and duodenum again!

In other people's opinion, the operation has been completed, but in fact it has not. The endoscope is still in Li chunrui's body, and there is a knife edge on the stomach wall when it is pulled out. It must be repaired.

Even if it is repaired, postoperative complications may occur, such as gastric fistula, intestinal fistula, abdominal infection and so on.

Lin Hao explained the possible complications to several of his students, including Ren Junqi, and asked, "how do you think you should repair the edge of the stomach wall so that there will be no leakage?"

Three students can not answer, rich theory of Ren Junqi thought for a moment: "titanium clip!"

"Yes, titanium clips used in endoscopy can solve simple small incisions to a certain extent, but they are not enough for complex closure!" Lin Hao said, pointing to something on the notes and saying, "this is called OTSC. It is a kind of metal closure device, which is similar to the mechanical principle of titanium clip. It can more firmly close more complicated incisions! But I don't think it's the most advanced yet! "

"Is there anything more advanced?" asked Ren Junqi

Lin Hao said, "there are two kinds."

Zheng Yiyu asked quickly, "which two?"

Lin Hao said: "one is laser welding, which uses the high energy of the laser to fuse the tissues to be connected together, and then achieve the effect of stitching. The maximum pressure of this method is almost twice as much as that of manual suture, and the acid environment has no effect on it. The histological examination of the suture site shows that the suture method is absolutely reliable. But at present, this method is still under research and experiment. "

It's not used in clinic. What do you say? Several students couldn't help but spurt a sentence in their heart.

Ren Junqi asked, "is there another one?"

"Bio adhesive!" Lin Hao said slowly: "the principle of this glue is just like glue bonding. The tissues on both sides of the incision are bonded together to meet the requirements of suture. Histological examination shows that the incision is normal mucosa without inflammatory cells. The bio glue has been absorbed, which shows that the bio glue technology is safe and effective. This method... "

Ren Junqi interface way: "still in the research experiment!"

"No!" Lin Hao held out a finger and shook it. "This method can be used immediately!"

The crowd opened their eyes. "Nani?"

Lin Hao pointed to a small bottle of medicine he had brought back from Guangxing pharmaceutical and said, "this is the bio adhesive I have developed."

People's eyes opened wider, and they looked at the transparent medicine without any label. Then they all stretched their necks to see Lin Hao's magical adhesive effect!

However, Lin Hao did not use it immediately. Instead, he asked slowly, "in addition to the problem of closing the incision, there is also a problem, that is, abdominal infection is a postoperative complication. What do you think can be used more effectively to avoid this problem?"

Zheng Yiyu said: "antibiotics!"Ren Junqi said: "normal saline!"

Zhou Menghan said, "iodophor!"

"None of you is right!" Lin Hao shook his head and slowly explained, "the effect of antibiotics is really good, but don't forget that she is allergic. She can't use antibiotics or anesthetics. Although normal saline is relatively safe, its effect is relatively small. Sufop can be used, but it is very harmful to the gastrointestinal tract! "

"What do you think should be used?" asked Ren Junqi

Lin Hao stretched out his finger and pointed to the other bottles of liquid medicine he had brought back from the hard bone star pharmaceutical industry. "My own Chinese patent medicine has the effect of antibacterial and anti-inflammatory, and it is mild in nature. It has no adverse reactions and no side effects."

Having said all these things, Lin Hao thinks that they should have an intuitive understanding of notes. As long as they know this, his purpose of taking them to the operation has been achieved, so he started to finish the operation!

He first washed the abdominal cavity with anti-bacterial and anti-inflammatory Chinese patent medicine, then closed the gastric wall incision with biological adhesive, and finally withdrew all the instruments from Li chunrui's body