Chapter 1418: 1374 Not Knowing Laparoscopic Surgery

He looked around twice, it was the system space, without Xie Yiren, without Su Yun, without Fang Lin, without Professor Liu, and without Quan Xiaocao.

The patient lay on the operating table, the gastroscope had not been removed yet.

Zheng Ren reached for a knife and directly began dissection.

This method, Zheng Ren normally would not dare try. He is very cautious, afraid that if he does too much, outside he would seem simple-minded and crude, directly dissecting.

This situation is relatively special; the glass shards will move around with intestinal peristalsis. If we don't mark the bleeding point while it's present and hurry to find them, we might not be able to find them later.

Zheng Ren directly made a large incision; just after opening the peritoneum, a jet of blood came straight at him. He slightly turned his body to let the jet pass, then reached out and pinched the ruptured point of the mesenteric artery.

After a slight hesitation, Zheng Ren still first ligated and sutured the mesenteric artery.

Otherwise this bleed is very fierce; the whole peritoneal cavity could be filled in just a few minutes, basically there would be no operating field.

Trying to find glass shards in a pool of blood would be even more difficult.

After dealing with the mesenteric artery, Zheng Ren used the suction device to suck the blood clean, then began to look for the glass shards.

……

……

Feng Jianguo was very worried, told the nurse to bring another one, let Quan Xiaocao push the laparoscopic equipment, while he himself began to scrub up.

"Feng Ge, want to lend a hand?" Zheng Ren suddenly asked.

Professor Feng found it strange; Zheng Lao Ban had just been preparing to leave, why would he now want to lend a hand to himself?

His tone was a bit anxious; everyone in the operating room sensed something was off.

Together with the change in attitude before and after, everyone felt somewhat surprised.

"Zheng Lao Ban? What's wrong?" Feng Jianguo asked cautiously.

"Arterial pressure has changed; I think the intestinal peristalsis moved the glass shard, tearing the blood vessel supplying the intestine." Zheng Ren glanced at the ECG monitor; the measured arterial pressure had dropped by 5 mmHg compared to before.

Feng Jianguo and Fang Lin also looked at the ECG monitor, both feeling quite surprised.

Such a small fluctuation probably isn't a problem, is Zheng Lao Ban just trying to scrub in on the surgery?

"Hehe, come, lend a hand, I haven't seen you do laparoscopic surgery before." Feng Jianguo laughed: "We do single-port, or……"

"Three ports, the faster the better!" Zheng Ren said.

Originally Feng Jianguo wanted to show off his laparoscopic skill; single-port laparoscope enters at the umbilicus, sutures removed post-op, no scar on the abdomen.

Saying how advanced it is is nonsense. Zheng Ren felt there was no breakthrough in technique, just a gimmick.

Now, when saving a life, who has time to show off? Following Zheng Ren's opinion, we should just do an open abdomen.

But after looking at the position just now, laparoscopy would also work.

Feng Jianguo laughed; Zheng Lao Ban's skill at stealing the camera is a weakness!

Also, he is a general surgeon turned interventionalist, capable of doing hepatic hydatid disease surgery, capable of doing abdominal encapsulating peritoneal sclerosis surgery, very proficient in anatomy.

Laparoscopy is a bit weak, but that's understandable.

Perhaps Zheng Lao Ban just wanted to practice laparoscopy.

"Su Yun, go help Xiao Cao." Zheng Ren said, then immediately pulled Feng Jianguo to go scrub up.

So urgent? Fang Lin stood on the platform, looking somewhat puzzled.

Su Yun, however, felt something abnormal; he glanced at the ECG monitor. The arterial pressure dropped another 3 mmHg while they were speaking.

Seeing the subtle signs, one could guess something had happened. But this judgment is too presumptuous; how could that guy see it? Su Yun doubted in his heart, yet he still ran over, helping Quan Xiaocao push the laparoscopic equipment over.

Right lateral decubitus, waist elevated, disinfected, standard disinfectant drapes.

Make an arc-shaped incision about 1 cm long at 1 cm below the umbilicus, insert a Veress needle into the peritoneal cavity, insufflate CO2 to achieve 15 mmHg pneumoperitoneum; place a Trocar.

Feng Jianguo basically didn't do anything; this whole series of actions were done by Zheng Ren.

Smooth as flowing clouds and water, not at all like someone who can't do laparoscopic surgery; Feng Jianguo remarked, Zheng Lao Ban is so skilled he could almost do the surgery with his eyes closed.

The laparoscope lens was inserted, exploring the peritoneal cavity; the field of view was a solid red, nothing visible.

Feng Jianguo was dumbfounded.

In his imagination, even if there was bleeding, it wouldn't be much.

So much blood, first suction. If after three minutes of suction there's still no operating field, convert the laparoscopy to open laparotomy, using two suction devices together.

"Feng Ge, hold the scope." Zheng Ren spoke without courtesy, his tone carrying the commanding air of a senior doctor.

Feng Jianguo blinked slightly.

Zheng Lao Ban normally wouldn't speak like this; today he's truly urgent!

Without worrying about who the operator is, Zheng Ren had Feng Jianguo hold the scope steady and began blind manipulation.

Normally speaking, here one should first suction the blood clean, then operate under direct vision.

Doing it this way would as much as possible avoid secondary injury.

But seeing the red field inside the abdomen, Zheng Ren directly performed blind manipulation. Feng Jianguo hesitated a moment, wondering whether to advise Zheng Lao Ban not to be so aggressive, but the operation on that side was already finished.

At the intersection of the left clavicular midline and the umbilical horizontal line, place a 12 mm trocar as the main working port; about 3 cm above the umbilicus along the linea semilunaris, place a 10 mm trocar as the auxiliary port.

At the main port, the grasper and suction device go in together. Then, after the suction device briefly clears the view, the grasper proceeds inside without hesitation.

Holy crap! Feng Jianguo has done over 2000 laparoscopic cases, mostly appendectomies and cholecystectomies, but he's never seen this kind of maneuver; it's too daring.

Laparoscopic surgery is called minimally invasive, but really it's only small external wounds; speaking of internal wounds, it's no different from open surgery.

Besides operative habit, like getting used to mirroring left and right hands, the operating field is also very important.

Before his eyes, nothing visible; Zheng Lao Ban is using the grasper as a hand, intending to go in and dissect?

But in just an instant, Feng Jianguo understood why Zheng Lao Ban wanted to use laparoscopy for the surgery.

There are glass shards in the peritoneal cavity, position unknown!

If one were to manually operate, one would have to worry about being cut by the glass shards, so movements would have to be much more conservative.

Now, with a non-toothed grasper acting as a hand wandering in the peritoneal cavity, there's completely no scruple.

MD, did I also get water in my brain?

Feng Jianguo, while looking at the laparoscope's screen, cursed himself in his heart.

Zheng Lao Ban, with a microscope, could perform the anastomosis Shou Bing of the tiny hepatic ducts, yet I actually thought they couldn't do Laparoscope Shou Bing.

This isn't just getting water in the brain—what else could it be?!

Truly foolish!

However, the field of view was all blood—where had this gotten to? Feng Jianguo narrowed his eyes; on the laparoscope TV screen, clusters of red passed by, the intestines writhing. The blood that had just been sucked clean was immediately sprayed out by strong pressure, filling the field of view.

Zheng Ren, taking advantage of the brief field of view, held the toothless forceps and advanced rapidly, making a sudden thrust.

Su Yun only frowned while watching.

"Yun Ge'er," Fang Lin called softly.

Su Yun glanced at him; seeing Fang Lin's inquiring gaze, he said nothing, just shrugged, indicating that he also didn't know what the boss's fierceness meant.