Chapter 90: 0088 Unfortunately, can't muster a burst of positive energy

"Burn my calories!" Zheng Ren had changed his clothes, and before he even entered the operating room, he heard a chuuni voice shouting.

This must be Chu Yan zhi; now she can only burn calories too, after all she didn't sleep all night.

Entering the operating room, Xie Yiren had already put on her clothes and was standing at the instrument table counting the instruments.

Zheng Ren went to wash his hands, and when he came back to disinfect, he asked: "How much did they drink?"

"Each person eleven crates, and in the end they drank all the big green sticks from the crayfish shop." Chu Yan zhi exaggeratedly spread her arms, trying to indicate the height of the crates, but ultimately failed.

"Really asking for death." Zheng Ren cursed harshly while disinfecting.

"It's about Su Yun." Chu Yan zhi is one of the few who don't feel Su Yun's charm; she immediately shoved the pot at Su Yun, saying, "I've advised him many times, but he insisted on drinking."

"Sigh." Zheng Ren let out a breath.

I hope Su Yun learns a lesson; don't think girls can't drink, if this continues, someday he'll end up with urinary and fecal incontinence from being made to drink by Chang Yue.

Disinfect, lay down sterile drapes, put on surgical gown, add another layer of sterile drapes; Zheng Ren stood under the shadowless lamp, preparing for surgery.

The scalpel in his hand was somewhat shiny.

The incision was not made according to the standard appendectomy incision, nor was a small incision made as on the night of the appendicitis.

Zheng Ren took a nearly 10 cm incision beside the right rectus abdominis.

Because the patient was thin, after cutting open, simply separating the subcutaneous tissue and muscle reached the peritoneal layer.

Zheng Ren frowned; visible to the naked eye, the patient's peritoneum had turned black. That meant the infection had been long-standing, at least over three days.

This person's vitality is truly robust, able to endure appendicitis until perforation, and then until acute peritonitis. Know that the severe pain of a perforated appendix is not something everyone can tolerate.

Zheng Ren reached out, and the sheathed suction device slapped into his hand.

In the Xinglin Yuan live-stream room, the broadcast was underway.

Because it was early morning, the number of viewers was relatively low, only a few hundred.

Yes, the number is low. Normally, when this anonymous account goes live, there are at least a thousand people watching.

【The peritoneum is actually black; can this infection still be treated?】

【Even the expert deals with feces; I thought the expert was in hepatobiliary pancreatic surgery.】

【Young man, have you just arrived? Did the expert perform the miracle of 49 appendectomies in one night and receive worship?】

Without a doubt, the first moment after opening the peritoneum requires inserting the suction device to draw out pus, digestive fluids, and food residue from the abdominal cavity, to prevent leakage and secondary contamination.

【How strange, why isn't there any food residue?】

【Indeed, a few days ago I did a gastric perforation case, and there were even chunks of meat.】

【The expert is just too Ou; clearly intending to deal with feces, but upon opening it was spotless.】

The suction device drew out pus and exudate, but no food residue or feces.

Zheng Ren felt uneasy; although the surgery's difficulty had decreased, it meant the person lying on the operating table had not eaten for three to five days.

No wonder he has a large frame, yet he is skin and bones.

After sucking clean the pus and exudate from the abdominal cavity, Zheng Ren performed peritoneal protection and cautiously opened the cavity.

A large, blackish appendix appeared in the operating field.

The appendix's base had a perforation, and the area around it was already gangrenous and carbonized.

Zheng Ren carefully dissected the tissue around the appendix, his movements needing to be more than twice as slow as any previous surgery.

The carbonized tissue is especially brittle, and having been adhered to surrounding tissue for many days, a slight mistake while detaching the necrotic gangrenous tissue would cause irreversible damage to the surrounding tissue.

Although the surrounding tissue looks pallid and miserable, at least there is no gangrene, so recovery is still possible.

【Watching is so tense… Is this the appendicular artery? After gangrene, won't the appendicular artery bleed?】

【Are you a doctor? After gangrene, the appendicular artery contracts and locally seals. As long as the ligation is secure, there will be no bleeding. The difficulty lies in how to tie it firmly; the edema at the site on the appendicular artery without gangrene is truly severe. If one is not careful, once the edema subsides, the ligation knot will come loose.】

【Suturing two stitches would also work, but the force is hard to control; a little inattention would cause tearing.】

Soon, the doctors in the live-stream room began to discuss the condition attentively. By exchanging views, they could indeed break through individual limitations. Before Zheng Ren had even ligated the appendicular artery, they had already discussed where the surgical difficulty lay.

Although this is only basic knowledge, appendices with gangrene to this extent are rarely seen by anyone.

With societal progress, medical and sanitary conditions improve significantly each year. Hospitals are spread nationwide; even without tertiary hospitals, community hospitals and barefoot doctors are always available.

Even in the most remote villages, there are barefoot doctors who can perform appendectomies on a kang bed.

Enduring the excruciating pain of appendicitis, they held on until perforation, and then continued until septic shock from infection……

Whether it was Zheng Ren performing the surgery or the many doctors in the live-stream room, none had ever encountered this before.

What kind of person is this!

Zheng Ren meticulously used a fine tweezer to gradually separate the adhesions between necrotic and normal tissue, each step done with great care.

"Wipe sweat." Zheng Ren said.

Chu Yan zhi obediently took a piece of gauze and came to Zheng Ren's side.

Zheng Ren turned his head, leaving the operating field; Chu Yan zhi wiped the sweat that had seeped out from under his sterile cap on his forehead.

"Do you need an assistant? I've performed surgery at Huaxi." Chu Yanran suddenly said.

"No need." Zheng Ren directly refused.

Pah! A single dog unable to find a girlfriend.

So straightforward, where to go find a girlfriend?

Chu Yanran's suggestion never even crossed Zheng Ren's mind; his current tension lies in making the movements gentle, otherwise it would cause extensive tissue tearing, greatly affecting postoperative recovery. It's not that the operating field is insufficient, preventing him from seeing inside.

Under the current circumstances, even if Chu Yanran went on stage, there wouldn't be much she could help with.

It's just that his manner of speaking is too direct; alas, poor single dog.

【Ligated! Start ligating!】

【Stop jabbering, your danmaku is blocking my view.】

【Using a large round needle? My guess was indeed correct; a large round needle, deep suturing, is needed to avoid tearing.】

【Stop talking nonsense, it's your turn to go up, now in the Operating Field there is oozing blood from torn tissues, you can handle the patient's rescue.】

【Alright, then cut open the diaphragm and directly perform heart compression under direct vision.】

Zheng Ren deftly moved the needle holder, deeply piercing into the tissue beneath the appendix artery.

Relying on his feel, Zheng Ren kept advancing the needle until below the edematous area, then he lightly flicked his wrist, and the large round needle emerged from the other side.

He handed the needle holder to Xie Yiren, and Zheng Ren tied a very intricate surgical knot with both hands.

【My heart is about to jump out.】

【One careless move and it will tear; be careful, expert.】

【I do not Worry; could the expert still make such a mistake?】

【666~~~ The force is just right; how did he develop his feel?】

【Damn it, Xinglin Yuan doesn't allow tips; otherwise I'd send a burst of positive energy to the expert.】

After ligating the appendix artery, Zheng Ren rested for a dozen seconds, then began again to separate the gangrenous appendix adhered to the peritoneum, omentum, and nearby intestines.

The joke about eleven boxes of big green sticks is something… not a friend, but an acquaintance's younger sister said. She said that when she graduated from the Central Academy of Drama, she drank with the male classmate who could drink the most from morning to night, downing eleven boxes, and made the guy wet his pants. Just treat it as a joke; I don't know if it's true or false. Anyway, that day at the meal, I saw her casually drink a bottle of whiskey as if it were water.