I run a clinic in the United States

Chapter 126 Iceberg Little Hepburn

The holiday was short-lived, and the Iris Clinic resumed normal business again.

Many customers who came to the door expressed their appreciation for the new look of the Iris Clinic!

After inquiring about Zhou Qiao, Rachel transferred a patient to Murphy, a 25-year-old breastfeeding mother who was diagnosed with acute appendicitis.

If it is chronic, simple or mild suppuration, not too serious, and does not recur, she, as a physician, can prescribe some medicine and just give it a squeeze. But now it is acute, causing fever and nausea. Vomiting and severe pain in the lower abdomen, surgery is the fastest and most stable solution!
Rachel's admiration for Zhou Qiao is natural. She has never seen the 23-year-old visiting professor at the University of California in her life.

As for Murphy, after the last congenital diaphragmatic hernia operation, Rachel also sincerely appreciates it!

She often feels fortunate that she is an internist with relatively advanced qualifications. For many years, if she is a surgeon and competes with Murphy on the same stage, she will probably be under a lot of pressure, and she will worry about being crushed by her when she sleeps!

Murphy's hair was cut short, with natural maroon hair, without highlighting, like satin, with a fair face and exquisite facial features. Elena nicknamed her "Little Iceberg Hepburn".

"Iceberg" means that she has a cold temperament, and her lonely look of being outside the world always drives others away.

Needless to say, "Little Hepburn" is so beautiful that even Elena likes it and can't help but want to reach out and pinch it!

Even taking advantage of Murphy's inattention, Elena kissed her secretly, making the expressionless Murphy show a little bit of embarrassment very rarely!

Murphy rarely has this kind of intimacy with people.

Every time Elena molested Murphy, Zhou Qiao was envious!
The patient was given a painkiller injection, and then an order was issued to ask the patient to go for a preoperative examination, and at the same time, he told the patient to strictly fast from food and water.

The precious mother was accompanied by her husband, but the child was not brought and was sent to the grandmother to take care of it.

Because of the operation and the use of a lot of medicines, breast milk was also stopped, and my grandma was asked to feed milk powder.

Zhou Qiao also pays attention to the price of infant milk powder in the United States. It is indeed cheap. A can of more than ten dollars costs hundreds of dollars in China, and the ones bought in China are not necessarily genuine.

It's not that he wants to eat it himself, but it's been a long time now. Everyone knows that he is in the United States, and they always use various methods, including sending him messages directly, conveying them through his old father, and communicating with children in the same village. , ask him to mail milk powder!

Zhou Qiao was very helpless, because these things would take up a lot of his time, so he declined those who were not familiar with them directly, but for those who really couldn't be pushed back, he had to work hard by himself. How much money does the other party earn.

The profits of his current clinic are very generous, so he doesn't like the middleman's price difference on milk powder.Moreover, they are relatives, so the old father’s face will not look good if he has too many people.

After drawing up the operation plan, Murphy came to Zhou Qiao and asked him to help.

"Single-port transumbilical laparoscopic surgery...scar constitution..." Zhou Qiao read it carefully and nodded.

Just looking at the surgical plan, I can’t find any major faults.

As for the single-hole surgery, it was because the patient actively requested it. She has a scarred constitution. As soon as she heard that she was going to have surgery, she immediately lost her guard and begged Murphy if the incision could be smaller because she still had the scar from her last caesarean section. Extremely big and ugly!

She didn't want to have a few more hideous scars!The multi-hole laparoscope needs to make 3-5 holes, which is completely unacceptable to her!

Murphy told her that she only needed to make a small hole of about 1.5 cm in her belly button, because there were already wrinkles there, and if she used cosmetic sutures afterwards, it would basically be impossible to tell that a knife had been used!
Since Murphy had never performed an appendectomy before, Zhou Qiao took her and practiced it several times with the clay figurine while he had time. He did not give up until Murphy reached the expert level.

When it was time for the operation, a group of people came to the community hospital.

Single-port laparoscopy is also a tertiary operation and requires general anesthesia. The operating room conditions of the Iris Clinic are not enough, so it is still carried out by borrowing from the community hospital.

Compared with the University of California Medical Center, the rental cost of the operating room in the community hospital is much cheaper. For minor diseases such as appendicitis, the community hospital is naturally the first choice.

The anesthetist made an appointment with Andre, and the patient was placed in the supine position, and compound anesthesia was inhaled by intravenous inhalation.

After time out, the surgery officially begins.

The first song Ai Wa chose this time was "Rolling Waters of the Yangtze River East". It must be said that Ai Wa can surprise Zhou Qiao every time.

Andre gave a thumbs up, this song is beautiful!Although he can't understand!But he likes the majestic and tragic style of music!
Murphy turned a deaf ear, his green eyes turned lightly, the virtual 3D modeling was instantly activated, the holographic [-]D image was displayed, and the knife was moved!

The surgical instruments are laparoscopes and multifunctional laparoscopic puncture sheaths produced by Stryker Company of the United States, and single-hole laparoscopic instrument kits from Cambridge (including a series of disposable wrist-rotating instruments, which enter the puncture sheath and enter the body cavity in a straightened state. After that, according to the needs, rotate and bend into different angles or radians, and then lock, there are 7 degrees of freedom of operation that can be switched at will).

An arc-shaped incision of about 1.5 cm was made on the right side of the umbilicus, and a multifunctional puncture sheath was placed, and an insufflation tube was passed through the puncture sheath to establish an insufflation.

Pneumoperitoneum, simply understood is to inflate air, usually carbon dioxide, to blow up the stomach and make room for it.

Carbon dioxide is an inert gas. If oxygen is used, there may be sparks and explosion during surgery~
In addition, if carbon dioxide is used, the human body can absorb it, and it is easily discharged through the lungs, and hypercapnia is not easy to occur.

If oxygen or nitrogen is used, it is not easy to absorb and discharge. If the pressure is too high, the gas will enter the broken blood vessel and there is a risk of gas embolism!
Zhou Qiao can operate a five-port laparoscope with one hand with the help of a mirror support. Although Murphy is not as advanced as Zhou Qiao, it is no problem for one person to operate this single-port laparoscope with both hands.

Zhou Qiao is not so much an assistant as he is here to sit and guide and prevent accidents from happening.

Murphy moved lightly, adjusted the pneumoperitoneum pressure to about 12mmHg, maintained it, inserted the laparoscopic lens through a 10mm hole (this is not an incision, but a hole on the multi-functional puncture sheath), explored around, changed the head down, right Side elevation position.

The appendix is ​​a very special part. Some people have it big, some people have it small, some people have weird shapes, and some people have double appendix.

Murphy followed the colon, found the confluence of the three colon bands of the cecum, and then lifted the cecum up slightly!
"Eh~" Murphy couldn't help but chuckle.

Because, according to what she had learned and what Zhou Qiao taught, it was usually at this time that the appendix would appear!
Now, everything is ready, and with the ultrasonic knife in hand, we have reached the lair of the "Appendix Monster", but the "Appendix Monster" is not in the "lair"!
Murphy searched and searched again, but after searching several times, there was no appendix.

She couldn't help but wonder, had she been misdiagnosed?After all, this patient was referred to her by Rachel.

However, she had seen the patient's examination report, and it was undoubtedly acute appendicitis.

"Could it be that the other party has a previous medical history, and the appendix has been removed? But, if it was removed, how could it be diagnosed as appendicitis?"

"Or, could it be congenital absence of the appendix?"

Even a genius like Murphy couldn't help being a little confused.

Zhou Qiao patted his thigh slightly. This was his negligence, because this kind of situation is rare, and he didn't expect the patient to be in this situation, so he forgot to tell Murphy.

"Feifei, the appendix is ​​wrapped inside." Zhou Qiao pointed out softly.

Murphy was taken aback: "What the hell is Feifei? Is it my new nickname?"

For some reason, she felt a little sweet in her heart, and nodded, she manipulated the ultrasonic knife to gently stroke the serosa!
Suddenly, an inflamed and swollen appendix hidden inside popped out weakly and helplessly!
Not only Murphy breathed a sigh of relief, but Elena and Ava also breathed a sigh of relief.

The three little ones looked over with eyes full of admiration.

System: "Murphy's favorability +1, Murphy's current favorability is 89!"

Ava curled her lips and said to herself that although Murphy is powerful, he still needs Joe's guidance from time to time!Huh, without Qiao, she is nothing.

She has a lot of dissatisfaction with Murphy recently, because Murphy has cut her hair short, and after being dressed up by her sister, she has become more and more beautiful. But he didn't realize that he was so familiar with Murphy all day long.

In fact, even without Zhou Qiao, if there is a good platform and Murphy is given a few years to grow, her achievements will be amazing!It's just that she doesn't have a better platform now.It is also impossible to have a better platform than Zhou Qiao's!
With so many operations, he can still be the chief surgeon, and he has master-level or ceiling-level technical guidance!
Once you've found the "appendix monster", the next step is much easier!
The biggest advantage of this "appendix monster" is that it hides. If it is discovered, it will be nothing!
Murphy's professional level is more than enough to deal with it!

The appendix is ​​carefully peeled off, the adhesion with the surrounding tissue is completely separated, the avascular area at the root of the appendix is ​​penetrated, the root of the appendix is ​​clamped with the ligature pin, the appendix artery is separated, and the ligature pin is ligated.

After that, the knife is raised and lowered, the appendix is ​​cut and taken out, the hole is sutured, and the operation is completed.

Murphy felt that the ultrasonic knife was so easy to use!

In fact, in the previous traditional laparoscopic surgery, high-frequency electrosurgical scalpels were used for separation, cutting, hemostasis, etc., but ultrasonic scalpels obviously have more advantages, so they are now more and more widely used, and the surgical efficiency has also been greatly improved.

Although there was a delay in the whole operation process, the total length did not exceed 10 minutes.Call it fast.

Generally, novices do this for the first time after watching many times. Because they are not proficient, it takes at least four to 10 minutes, and some clumsy ones even need more than sixty minutes. Within 10 minutes, it can be regarded as a talent.

　Thanks to "Guizi Yizhu" for sending Luo Ya the chicken legs and blades.

　　
　
(End of this chapter)