Start as an Emergency Physician

"Heavy bleeding during the operation!"

He Jing raised his hand, and his gloves were covered with blood.

The scene was so familiar, it was exactly the same as that of a pregnant woman bleeding profusely that night.

It's just that last time the pregnant woman was bleeding from the yin tract, this time the uterus was opened, and the uterus was bleeding directly.

Zhou Yuan immediately walked up to check the situation.

"Immediately prepare absorbent absorbent gelatin sponge yarn, prepare thrombin-soaked gauze!"

The master thrombin hemostasis method immediately determines the best way to stop the bleeding.

Generally speaking, it is difficult to unify the dosage of thrombin, and can only be roughly divided into heavy bleeding and ordinary bleeding.

Ordinary bleeding is to dissolve thrombin into a 50~2000U/ml solution spray, spray directly on the bleeding site, and soon play a coagulation mechanism to complete hemostasis.

At present, He Lili is bleeding profusely, so Zhou Yuan gave up spraying to stop bleeding and directly chose to use gauze or sea surface to deal with the wound.

"Prepare the extracorporeal drain and proceed with the infusion immediately!"

The previously opened venous access worked.

Zhou Yuan took the gelatin sponge handed by the instrument nurse and began to stop the bleeding.

Under the action of thrombin, the soluble fibrin in the plasma undergoes chemical changes and is transformed into insoluble fibrin, which directly blocks the bleeding port and completes the rapid hemostasis.

In addition, thrombin also promotes mitosis of epithelial cells at the wound site, and wound healing becomes faster.

"Give thrombin every twenty minutes. Zhou Yuan said to He Jing.

He Jing nodded dumbly.

I've already encountered such a thing, why can't I solve it...

Is it just because there is a tumor next to it? Just because of a tumor, I see a massive hemorrhage and suddenly my brain goes blank?

He Jing lowered her head, very self-blaming.

Zhou Yuan could see that He Jing was a little depressed, and said, "Quickly peel off the placenta, your uterine tamponade and compression are very good, otherwise the fetus will not be taken out so easily." "

He Jing was stunned, but he didn't expect Zhou Yuan to praise himself.

"Good!"

He Jing became energetic again, and soon completed the removal of the placenta.

Wei Lili and He Jing retreated to the side, and Dean Fang and Lu Shao came up.

Right now...... The main event begins!

"After the cesarean section is completed, the myomectomy will begin!" Zhou Yuandao.

"Scalpel. "

The first step is to remove the tumor from the intermural muscle.

Because the tumor is too large, it attaches to various parts of the uterine cavity, and the adhesion sites of the tumor and the uterus must be separated sequentially before the tumor can be removed.

He Jianyi is a good assistant, with his help, Zhou Yuan's surgical field is particularly good, he can directly observe several important blood vessels of the tumor, and it is very convenient to choose an incision.

"This is it. Zhou Yuan's eyes lit up.

The scalpel fell and cut right on the surface of the tumor where there were the fewest blood vessels.

This will have the least impact on He Lili and the least risk of surgery.

According to the vascular direction of the tumor, an arc-shaped incision is circumferred, which extends to the capsule of the tumor, and then blunt separation is carried out along the surface of the capsule.

The reason why sharp separation is not chosen is because of the fear of damaging blood vessels.

Bleeding from a blood vessel during surgery is not a thing, especially if it is a tumor with tumor cells.

The tumor in the intermural muscle area has more blood vessels, and Zhou Yuan cannot be directly incised.

"Vascular clamps. "

After blocking the blood flow, Zhou Yuan carefully cut and separated along the contact surface between the tumor and the intermural muscle.

Onlookers included instrument nurses, oncologists, obstetrics and gynecology oncologists, Dean Fang, Lu Shao, and two female doctors from the Department of Obstetrics and Gynecology.

Looking at Zhou Yuan's separation operation, several people held their breath and their eyes widened, not wanting to miss any detail.

"Fuck, what a dick..."

"Awesome. "

"It's amazing. "

"It's not human. "

"What a man of God!"

Words of appreciation rose from everyone's heart.

It wasn't until Zhou Yuan's scalpel came out of the other end that the tumor separated from the intermural muscles that everyone came back to their senses.

"That's it?"

"How is it the same as cutting a watermelon?"

“......"

"So fast. "

Zhou Yuan's attention was focused on the operation.

"Needle forceps. "

Zhou Yuan stitched the excised stump.

If you don't stitch it, blood will spurt out of it when the blood circulation is restored, and like a fountain, internal bleeding will occur.

"Absorbable thread. "

After completing the sutures, Zhou Yuan began to perform the suturing of the muscle layer.

Continuous suture method, suturing two layers, can ensure that the uterine intermural muscles can withstand the pressure of uterine contraction, otherwise it is easy to break.

The serous muscle layer was sutured intermittently with a No. 0 absorbable thread. Dead spaces are prone here, so Zhou Yuan's speed is relatively slow.

"Alright. "

Slowly, Zhou Yuan completed the stitching.

"It's only been eight minutes?!" the director of the oncology department was not calm.

Lu Shao was silent, looking at Zhou Yuan who was in the position of the main knife.

He felt that he had seen a man of God descend to earth, and this man of God had come to save the medical community...

Zhou Yuanmu did not squint and continued: "Perform subserous tumor resection. "

Because of the morphological characteristics of the subseous layer, the tumors attached here often have pedicles, and once the pedicles are damaged, they will also cause He Lili to become infected.

"Vascular clamps. "

Zhou Yuan clamped the tumor pedicle close to the uterine wall.

"Scalpel. "

The knife fell, and a fusiform incision appeared at the base of the subserosal of the uterus.

Because this part is not suitable for scalpels, Zhou Yuan changed the tissue forceps and stretched out the tissues on both sides, and then cut and separated the tumor.

"It's done. "

The tumor has one less attachment point to the uterus.

"Submucosal tumor resection. "

He Jian came back to his senses and looked at the tumor that had been cut with two attachment points, a little blinded.

It's too fast.

Zhou Yuan is the fastest man He Jianyi has ever seen.

"Tissue forceps. Zhou Yuandao.

The tumor is too large, and the tumor obviously protrudes into the uterine cavity, so it is necessary to enter the uterine cavity to clear the tumor.

This step requires the previous uterine incision to be made larger.

Without a good surgical vision, it is simply impossible to perform a fine separation of the tumor from the uterine mucosa.

Zhou Yuan suddenly thought that since the perfect-level compression hemostasis method could make the fingers feel the movement of blood vessels, and then stop the bleeding.

So, is it possible to have a perfect-grade myomectomy to let your fingers find the fibroids and remove them by yourself without the need for a surgical field?!

Zhou Yuan silently cut the muscle layer, completed the removal of the tumor, and then sutured it.

Care should be taken in this step to avoid the mucosal layer, so as not to implant the endometrium and artificially cause endometriosis.

When Zhou Yuanzai was carefully suturing the muscle layer, He Jing suddenly walked over and stood at the end of the patient's operating table.

Dean Fang turned his head to take a look, just in time to see He Jing squatting down and directly reaching into He Lili's voice channel...

"What are you doing!!" Dean Fang was stunned. _

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