(Thanks to the book friend of [Fei Yanren] for the reward of 20,000 yuan, thank you!)

The day of suffocation has finally passed.

Since most surgeons in the emergency department are at work today, Director Qian volunteered to take charge of the night shift tonight. After all, there are still too few people.

It is said that Vice President Lin is currently poaching some experts to their emergency department in other hospitals, but there is no good news yet.

An emergency doctor with rich experience and excellent skills is not so easy to find.

The next day, I went to work as usual. When I just finished checking the room with Jiang Yurong, Dr. Chen told me that the general surgery department would come to him for consultation!

"Let me consult?" Ruan Bin was slightly surprised. How could he ask him a resident doctor for consultation? Generally speaking, their emergency department usually seeks help from their general surgery department.

Even if you look for their emergency department, you should look for Director Qian Jiang Yurong at the same level.

"It is said that an elderly patient has obstructive jaundice and acute pancreatitis due to gallstones, and the situation is relatively complicated and difficult." Dr. Chen is not very familiar with the specific situation.

"Isn't this kind of disease just undergoing secondary and tertiary surgery, it shouldn't be very difficult." Ruan Bin frowned.

"I don't know exactly, it's probably because your laparoscopic surgery performed so well. Maybe they really encountered difficult problems?" Dr. Chen smiled.

"Okay, I'll go there." Ruan Bin walked towards the general surgery.

Speaking of which, the general surgery and emergency department are the closest relatives.

Surgeons in the emergency department are basically from general surgery.

Consulting room.

"Director, do you think this Ruan Bin can help us? I guess he has never encountered such a case, right?" Qiu Huahui asked. Both the other party and him are resident doctors. No matter how powerful the surgery is, he must have never seen such a case, right? What are some good suggestions?

"I think too." Hu Changmao agreed. He had been thinking hard for an hour, but still couldn't come up with any good idea.

"Okay, maybe he can understand something like this!" Dai Yaowen glanced at the two of them and said. Don't he know what these two guys are thinking, just think that Ruan Bin may not have the ability at all? Underestimate others? This mentality cannot be desired!

Soon, I arrived at the consultation room.

Ruan Bin saw three doctors in the consultation room waiting for his arrival.

They are Dai Yaowen, deputy director of the Department of General Surgery, one is the director of Hu Changmao, and the other is the hospitalized Qiu Huahui.

"Hello, Director Dai." Ruan Bin greeted him as soon as he came in.

He knew this director and had a few chats, but he didn't know the other two.

"Doctor Ruan, you are here. I know that your emergency department has always been the busiest, so I'm so embarrassed to let you take the time to come for consultation." Dai Yaowen said apologetically.

"It's nothing, it's all for the health of the patients." Ruan Bin said with a smile.

"Okay, then I won't talk much. This time we came to you, we met a difficult patient, a 78-year-old patient, transferred from a lower-level hospital."

"The patient's spine has been deformed due to many years of lumbar disc herniation, causing severe kyphosis and hunchback. He has been nearly 90 degrees. He can only walk with his back bent down and cannot lie flat when sleeping. Because of the deformation of the spine, the internal organs of the body are also squeezed to varying degrees, and the abdominal space is folded, compressed, and deeply concave into the body."

"Last week, he caused obstructive jaundice and acute pancreatitis due to gallstones, and he kept suffering from abdominal pain and vomiting. The situation was difficult. The troublesome thing is that the operation requires lying flat, but his abdomen is very different from that of ordinary people. It was a routine operation. Because his special physical condition has become more difficult, he went to several hospitals in his local city hospital, and all of them were politely refused treatment, so he was transferred to our hospital."

"Although we only performed second- and third-level surgery such as laparoscopic cholecystectomy and common bile duct excision and stone removal surgery, the difficulty is not as simple as ordinary second- and third-level surgery. I heard that Dr. Ruan, you have extraordinary achievements in laparoscopic surgery, especially after completing a 19-minute cholecystectomy, so I was thinking about asking you if there are any good solutions and suggestions." Dai Yaowen said.

Well, he was embarrassed to say that they did not have any good surgical plans yet. So he could only ask Ruan Bin to come and see if there were any suggestions and help.

"This kind of example is almost rare." After hearing this, Ruan Bin was relieved to ask him for consultation for the general surgery department. Such patients are indeed very rare.

This is not just that the patient cannot lie flat and cannot operate, but that there are many other factors involved.

"Can you take me to see the patient?" Ruan Bin asked.

This requires going to the on-site to see the patient's specific situation before he can make a judgment and find a solution.

"certainly!"

A crowd of people came to the ward in a hurry, and Ruan Bin saw this old man in his 70s.

His spine was severely deformed, his hunched back was nearly 90 degrees, and his abdomen seemed to disappear and he was deeply concave into his body. He could not lie flat, so he could only lie on his side.

"The entire abdomen of the patient is deeply concave into the body, and the groove can be stuffed into an adult's palm. From the front, there is only three horizontal finger space for adults and two horizontal finger spaces on the side. There is no need to consider opening surgery." Ruan Bin said.

"That's right, but although it's just an ordinary laparoscopic surgery, because the surgical position is difficult to tilt and the operation space of the surgical instrument is very small, it is more difficult than single-hole laparoscopic surgery. It's simply "survival in the cracks." Hu Changmao said with a headache.

"Well, first of all, it is difficult to intubate anesthetically. He has a difficult airway. Because of the deformation of the spine, his lungs must have been severely squeezed and the trachea is severely offset." Ruan Bin pointed out one of the difficulties incisively.

The trachea is severely offset, and the step of anesthesia and intubation will be difficult to operate.

Another thing is that normal surgery is when the patient lie down and the doctor stands and operates with laparoscopic opening from the front of the abdomen. As in the current situation, such routine surgery cannot be performed at all.

"Have you ever thought about letting patients sit and perform surgery?" Ruan Bin asked. He has world-class laparoscopic cholecystectomy. He has tens of thousands of surgical experiences and numbers in his mind.

What type of cholecystitis patients have never seen?

There were dozens of cases in his mind.

"Sitting? We have thought about it, but even if the patient is sitting, his abdomen cannot be seen at all, as if he has disappeared into his body. How can we do the surgery empty? It is difficult to get a single hole." Director Dai said with a headache.

This is also their only headache!

"I didn't say that we should take a different approach when doing laparoscopic operation holes from the abdomen! We should do it from the gap in the lower left abdomen to the upper right abdomen. At that time, the surgeon and the patient will "sit" for the operation!" Ruan Bin said lightly.

"This... looks feasible!" Dai Yaowen's eyes lit up after hearing this, and he was suddenly awakened by Ruan Bin's thoughts, feeling enlightened.
Chapter completed!