Start with the emergency physician

After the skin tissue is exposed, the underlying external oblique aponeurosis also appears in the surgical field,

Zhu Gaoyang was a little surprised: “You can still see that I am fighting wild?” ”

Zhou Yuan did not reply.

“Tissue scissors.”

Zhou Yuan took the tissue scissors, let the ocean lift the aponeurosis on both sides, slowly sneaked along the bottom of the aponeurosis with scissors, and then cut the aponeurosis upwards and the outer ring downwards.

“This step can easily damage the ilioinguinal nerve of the nearby inferior iliac nerve.” Zhou Yuan reminded.

Zhu Gaoyang: “Be careful!” It’s all my treasure below! ”

He shook his head, wanting to see what Zhou Yuan was doing, but there was a cloth on the shelf in front of him, blocking his view.

At this time, his oxygen mask suddenly fell.

Zhu Gaoyang turned pale with fright: “Doctor! Doctor! My oxygen mask has come off! ”

Zhou Yuan frowned and glanced at it: “It’s okay.” ”

“What’s the matter! I want oxygen! ”

Haiyang said helplessly: “Then do you feel any different now than just now?” ”

Zhu Gaoyang was stunned for a moment, calmed down, and sniffed: “No…”

Zhou Yuan calmly freed the iliac inferior abdominal nerve and the ilioinguinal nerve, and said, “Originally, it was just to pretend, add an oxygen mask to you, you would not be so nervous, and as a result, you threw it off.” ”

Zhu Gaoyang: ???

The anesthesiologist came over, silently picked up the oxygen mask, and put it back on Zhu Gaoyang, “Now comfortable?” ”

Zhu Gaoyang: …

“I feel a little stuffy…”

“You all found that this oxygen mask is useless or not stuffy?” The anesthesiologist sighed.

Zhu Gaoyang sighed and glanced again, Zhou Yuan, Haiyang and the others were all burying their heads in hard work.

“Why do I get this disease? It suddenly bulged up, and I was scared to death. Zhu Gaoyang asked curiously.

“Life is bad.” Zhou Yuan said succinctly.

After saying this, he quieted down.

“Scalpel.”

“Vascular forceps.”

Zhou Yuan again separated the cremaster, the levator muscle of the pill, and the transverse fascia fibers of the abdomen, revealing the hernia sac.

It’s a gray-white thing, not very easy to identify.

Zhou Yuan glanced at Zhu Gaoyang, who was in a daze, and said, “Cough.” ”

“Okay, brewing… Ahem! ”

With the cough, one area protrudes with the spermatic cord, which is the hernia sac.

“The next step is to cut the wall of the hernia sac.” Zhou Yuandao.

Haiyang rubbed his hands next to him, “Junior Brother Zhou Yuan, give me a cut?” ”

Zhou Yuan nodded.

This surgery can be done by residents, and it is not a key link now, and there is no problem in letting the ocean practice.

Ocean happily picked up the scalpel.

Zhou Yuan paused and said, “Don’t cut the hernia sac wall directly, you don’t control it well, first make a small incision in the hernia sac wall, and then slowly expand the incision with scissors.” ”

This is a trick to avoid damaging the hernia contents.

Ocean nodded excitedly.

Zhou Yuanyi frowned: “Your hands are a little shaky…”

Ocean smiled: “The first time… A little excited. ”

The instrument nurse glanced at it, “It’s like a lucky cat.” ”

Zhou Yuan shook his head: “The lucky cat only has one hand shaking, this is the canteen aunt.” ”

Zhu Gaoyang, who heard the conversation, was stunned.

“Anesthesiologist, can you give me general anesthesia?”

The anesthesiologist nodded, took a finger-thick needle and walked over: “Are you sure?” ”

“Forget it.” Zhu Gaoyang closed his eyes and looked at Zhou Yuan and the others who were struggling under him in fear.

Except for the fact that the ocean shook for a while when he held the knife at the beginning, after the actual operation, the ocean’s hand was still very stable.

Soon, the walls of the hernia sac were cut open by the ocean.

“Put your index finger into your abdominal cavity, feel the position of the inferior artery of the abdominal wall to avoid damage, and carefully check for a second hernia.” Zhou Yuandao.

Ocean happily put his hand in, touched it, closed his eyes intoxicated, and said after a while: “No.” ”

With that, he was ready to push the contents of the hernia back into the abdominal cavity.

Zhou Yuan stopped him: “Not yet, check whether the contents of the intestine tube that fell in the hernia are necrotic.” ”

The ocean was stunned.

Zhou Yuan explained: “Once intestinal necrosis occurs, you push it back to cause inflammatory disease, which will be more serious. ”

“Okay, okay.”

The ocean carefully checked the color of the intestinal tube and the blood vessel pulsation, which were quite normal, and then pushed it back.

“Junior Brother, come on!” The ocean receded.

His hands were too addicted, and he was not sure of the next surgical steps.

Zhou Yuan nodded.

Zhu Gaoyang was also relieved.

“Scalpel.”

Zhou Yuan sharply cut off the hernia sac in the middle, “Hemostatic forceps.” ”

After completing hemostasis, Zhou Yuan left the distal hernia sac in the scrotum.

“Don’t you close the hernia sac?” Ocean asked.

“Nope. This can cause fluid or blood to build up in the hernial sac. ”

Zhou Yuan continued the operation at hand.

“Did you cut my vas deferens?” Zhu Gaoyang seemed to have some expectations.

Zhou Yuan: …

“Lift the proximal herniation sac with hemostats.” Zhou Yuan said.

After waiting for the ocean to lift, Zhou Yuan put his left index finger in, slowly dragged the inner surface of the proximal hernia sac, and the right index finger was wrapped in gauze, turned around, and peeled the proximal hernia sac to the position of the neck of the sac.

“See the spermatic vessels and vas deferens here?” Zhou Yuan’s eyes signaled.

Ocean nodded: “Do you want to cut it?” ”

“……”

Zhou Yuan: “I’m asking you to pay attention, don’t hurt.” It’s all over when it’s broken. ”

Zhu Gaoyang was stunned: “You didn’t say that before you went to the operating table!” ”

Zhou Yuan smiled and continued to operate.

“You can put it down, and then pull the lower edge of the internal oblique and transverse abdominis arch outward and upward.”

The ocean did so.

Zhou Yuan found a good position for the sac, ready to stitch the neck of the mountain sac.

After suturing, Zhou Yuan cut off the excess hernia sac wall, and then used needle and thread to pass through the transverse abdominis muscle and internal oblique muscle from front to back, where ligation was made to fix the neck of the hernia sac.

Next, as long as the hernia is repaired again, the organs in the abdominal cavity and the small intestine and large intestine will not flow down from this opening.

Zhou Yuan lifted the spermatic cord, passed a gauze strip for traction underneath, and then separated the levator testis muscle and transverse abdominal fascia around the spermatic cord.

“The defect here in the inner ring is large, and the transverse fascia of the abdomen here in the inner ring must be sutured before repair.” Zhou Yuandao.

Soon, the stitching of this step was also completed.

Ocean swallowed: “It’s so fast.” It’s so dazzling. ”

Zhu Gaoyang, who yawned a little, glanced helplessly at Zhou Yuan and Haiyang.

“Doctor, I want to give you a suggestion.” Zhu Gaoyang said suddenly.

“What?”

“Don’t you think the operating room is boring?” Zhu Gaoyang said.

Zhou Yuan looked up: “Then what do you want?” Give you a live stream of cutting the sperm cable? ”