After Tanglou incised the subcutaneous tissue, he began to ligate the branches of the superficial abdominal wall artery, vein, and Y external artery and vein, up to the external oblique aponeurosis, and exposed the superficial ring of the inguinal canal.

"Replace the blade, retract the thyroid hook to expose the surgical field..."

Yuan Hu and Lin Dong cooperated immediately. Even though they were already familiar with the surgical procedure, they were still a little stressed. Tanglou's movements were too fast.

"Tissue scissors..."

After Tang Lou completed the steps of the external oblique aponeurosis, he began to find and incise the hernia sac.

"Hemostatic forceps..."

Lin Dong watched Tanglou's operation and was amazed. He used two hemostats to clamp the upper and lower pieces of the external oblique aponeurosis and bluntly separated them below. The upper film exposed the joint tendon, and the lower film

Inguinal ligament.

The movements are very skillful and smooth.

"Is this nerve dissociation?"

Lin Dong trembled in his heart, this guy from Tanglou is really a very talented person and very bold.

When separating the external oblique aponeurosis, if you are not skilled, it is easy to damage the ilioinguinal nerve. Now Tanglou uses hemostatic forceps to bluntly separate the nerve from the internal oblique muscle.

Soon, Tanglou had used hemostatic forceps to pull the lower aponeurosis from under the nerve to the nerve, and then everted the aponeurosis so that the nerve was covered and protected by the aponeurosis.

"pretty."

Even though he had undergone so many hernia repairs, Lin Dong still praised him. I'm afraid this is what Dr. Qing did.

"Increase abdominal pressure..."

Under Tang Lou's precise control, the surgical process was extremely clear, and the bulging hernia mass was found on the anteromedial side of the spermatic cord.

"Scalpel..."

Tanglou continued to issue instructions and once again used the three-star incision to longitudinally incise the cremaster muscle and the internal spermatic fascia on the raised hernia mass.

The gray-white hernia sac was clearly exposed.

"Toothed tweezers..."

Yuan Hu immediately handed the instruments to Tang Lou. Looking at the serious Tang Lou, his heart trembled slightly. Doctor Tang became serious, he was so charming.

The next step is to cut open the hernia sac and examine the contents inside.

"The contents of the hernia sac were found during the operation: small intestine, omentum..."

Lin Dong cooperated and reported the results, which were consistent with the preoperative judgment.

After confirmation, proceed to the next step of freeing the hernia sac, which is to push the contents of the hernia sac back into the peritoneal cavity.

Let these escaped small intestines and omentum go back and forth wherever they go.

After the spermatic cord tissue around the hernia sac is bluntly separated in Tanglou, the next step is to ligate the hernia sac at a high position.

"Small hemostats...line 4..."

Lin Dong's eyes remained motionless, staring at the stitching of the tenement building. Even though he had seen it many times, he still couldn't get enough of it.

The suturing of the hernia sac is very particular, and purse-string suturing is used.

Sure enough, Tanglou's sutures are still pleasing to the eye. The stitch distance inside the hernia sac is controlled to be relatively small, while the stitch distance outside the hernia sac is controlled to be relatively large, so that the tightened purse will not leave any gaps.

Lin Dong is naturally aware of this suturing method. Many doctors who have studied hernia repair are aware of this method. However, he knows that if he wants to actually create a small inside and a large outside, and a uniform and orderly stitch spacing, it requires the precision of his hands.

The requirements for strength and stability are extremely high.

"This suture alone is enough to last a lifetime."

Lin Dong felt a little envious in his heart. He really didn't know how Tanglou was able to practice.

With Tanglou's precise suturing and ligation of the sutures, the hernia sac neck was quickly closed.

"Line 7..."

Tanglou's command sounded again.

Lin Dong frowned slightly, and soon understood that Tanglou was using No. 7 thread to prevent the knot from falling off, and tied it 0.5cm above the purse string suture.

"Fast but not chaotic, careful as silk but cautious and thoughtful."

Lin Dong didn't even know what to say. Tanglou's surgical habits were so good and his mind was very calm.

After completing this step, it is a very critical step, repairing the indirect hernia.

Compared with the traditional suturing through overlapping tissue, tension-free repair uses a patch made of artificial biological materials to strengthen the posterior wall of the inguinal canal without increasing the tension of the surrounding tissue, and there will be no unbearable pain after the operation.

, and there will be no pulling sensation or local bulging.

"Long tweezers...round needles...absorbable thread..."

Lin Dong assisted Tang Lou in fixing the patch on the pubic aponeurosis. Since Tang Lou’s previous exposure and separation were very clear, the patch was quickly placed.

Tanglou started suturing again, and made continuous sutures between the lower edge and the smooth surface of the inguinal ligament. At this point, most of the basic surgery was completed.

In hernia repair, there are many layers of incisions, so there are many places that need to be sutured, and different tissue structures, aponeurosis, etc. require different suturing methods.

Therefore, a large number of suturing consumes a lot of energy and time of the surgeon, which is one of the reasons why most surgeons take a very long time to perform this operation.

"Big round needle... No. 4 silk thread..."

After entering the continuous and uninterrupted fancy stitching, both Lin Dong and Yuan Jiu were surprised to find that Tanglou's speed was getting faster and faster, and it had been faster for more than an hour. Instead of being exhausted, their mental state was getting higher and higher.

.

"Sure enough, the more you fight, the braver you become."

Yuan Aldehyde's eyes lit up. Every nurse who had been in the operating room with Tang Lou would describe Dr. Tang in this way.

Other doctors become increasingly depressed in the middle of the operation, but Tanglou becomes more and more excited as the surgery progresses, and the intensity and frequency of his movements become faster and faster.

Yuan Aldehyde immediately handed over the instruments.

Tanglou then completed a textbook-style interrupted suture of the external oblique aponeurosis by dividing it by three and five.

"Short tweezers without teeth...small round needle...No. 1 silk thread..."

Only ten minutes passed before Tanglou completed the intermittent suturing of the subcutaneous tissue.

"Large-horned needle...No. 4 silk thread..."

After Tanglou issued the order, Yuan Aldehyde was ready. After Tanglou completed the interrupted sutures, he immediately disinfected the skin with ethanol gauze, covered the incision with gauze, and applied it to fix it.

...

...

At the same time, in operating room No. 6.

Wu Ye was also in the process of the operation, without any distractions, inserting the surgical instruments into the abdominal cavity through the small hole in the abdomen.

"Patch..."

Wu Ye shouted, and the nurse quickly handed it over.

Wu Ye was a little excited. This operation was smoother than before, and his operation was much smoother. He had a feeling of breaking through a bottleneck that he hadn't had in a long time.

"Perhaps it was the pressure that turned into motivation. This surgery has set a new time for all my previous surgeries."

When Wu Ye thought about going to the operating room in Tanglou later, and seeing him giving instructions with his hands behind his back during the operation that was only halfway through, the corners of his mouth curved up.

Wu Ye suppressed his smile and regained his composure, and continued to skillfully place the patch into the preperitoneal space.

"Nail gun..."

Since the surgery is performed under laparoscopy, the mesh is fixed with metal nails fired from a nail gun.

Soon Wu Ye completed the fixation of the patch, which meant that most of the operation was completed.

Wu Ye straightened his back and vaguely heard a creaking sound from his lumbar spine. After all, he had been undergoing surgery for so long, and he must have some occupational diseases.

However, this is also proof that he keeps accumulating. Doctors need a lot of surgeries. Why should a newbie step on his head?

Taking a slight breath, Wu Ye quickly threw himself into the operation. Although even if he rested for a while, he would definitely be faster than Tanglou, but one minute earlier, he could see Tanglou's still distressed face during the operation one minute earlier.

.

Wu Ye's spirit was lifted again.

"Dr. Wu, this operation went very quickly. It has made progress again."

Wu Ye's assistant gave a very timely lick.

Wu Ye laughed: "Today's operation is quite special. I can only complete the next operation by myself. I will give you a myofoneal suture for the next operation."

"Thank you, Doctor Wu."

The intern quickly thanked him and continued to hold the mirror.

In laparoscopic surgery, there are not many places for sutures. Wu Ye completed the operation in twenty minutes.

I checked the time and saw that it was less than 100 minutes and had already broken his personal record.

After leaving the follow-up care to the assistant, Wu Ye rushed to the operating room in the tenement building excitedly.
Chapter completed!