Published: 2015-5-5 Read: 390 times “Looking for a 5 mm ‘hole’ in the appendix is like looking for a needle in a haystack!” Late on the night of April 21, Rugao guy Xiao Li was urgently transferred from an outside hospital due to severe abdominal pain caused by intestinal perforation, and the general surgeon overcame the surgical field full of ooze and thick moss to patiently implement minimally invasive surgery to repair the “hole”. A week later, Xiao Li recovered and was discharged from the hospital. The local hospital diagnosed him with intestinal perforation, a large amount of free gas in the abdominal cavity and peritonitis, and recommended that he be transferred to a higher level hospital for treatment. On the way to our hospital by ambulance, Xiao Li was suffering from abdominal pain, his teeth were clenched and beads of sweat kept falling down. Chang Renan, Department of Hepatobiliary Surgery, Nantong University Hospital The patient had intestinal perforation and abdominal infection, and was in urgent need of surgery! After arriving at the hospital, the general surgery doctors on duty, Chang Ren’an, Chen Zhou Yang and Tao Ran, carefully analyzed the condition and quickly organized the perfect preoperative preparation. Considering that the patient is a young guy, if we risk performing a caesarean operation and looking for perforation, the conservative estimate is that the incision must be at least 20 cm long, which will inevitably have a great impact on the guy’s future ability to work, and the possibility of large intestine perforation, large intestine bacteria, once the incision infection, the consequences are unimaginable. After much consideration, the surgical team decided to use laparoscopy for Xiao Li’s surgery. The lumpectomy instruments are all on the scene, the doctor opened a small hole of one centimeter next to the belly button, external gas injection into the abdominal cavity, the lens is slowly placed, the whole abdominal situation in the high-definition screen at a glance. Then, “special tools” from the other two small holes into the stomach, remove the exudate pus moss, flushing and attraction, change the position, eliminate interference, looking for …… onstage and offstage, we keep our eyes open, carefully looking for the perforated part of the intestinal tube, as a needle in a haystack. Finally, following the trail of inflammation, a “hole” of only 5 mm in diameter in the appendix was exposed, and the operating room burst into cheers. Then, the surgical team overcame the difficulty of moving the arms of the instruments and sutured the perforation in the large intestine tightly under the lumpectomy, and then performed the abdominal water injection test, just like testing the success of the tire patch, the intestinal tube no longer leaked. Four days later, Xiao Li resumed venting and defecating. At present, in addition to the conventional gastrointestinal tumor, abdominal wall hernia, thyroid surgery has been carried out under lumpectomy, the general surgery department is also leading in the province to carry out the difficult hepatopancreatic and splenectomy surgery, and integrate to carry out 3D lumpectomy technology, single-hole lumpectomy technology, multi-scope combined technology. At the same time, in response to the medical needs of the masses, using the advantage of laparoscopy with better comprehensive exploration, the general surgery department began to carry out minimally invasive treatment in emergency surgery, such as laparoscopic appendectomy, gastrointestinal perforation repair, abdominal foreign body removal, abdominal exploration to stop bleeding, etc., and all have achieved more satisfactory results. Ya Zhou